. Medical and surgical therapy. ed side (182). We may add that mechanical hyperexcitability ofthe nerve trunks may be occasionally observed. Per-cussion of the ulnar nerve in the space between theolecranon and internal condyle causes a characteristicmovement of adduction of the thumb with flexion ofthe first phalanx (adductor pollicis), combined with amovement of flexion of the fourth and fifth fingers 554 REFLEX NERVOUS DISORDERS at the first phalanx (interossei). Percussion of theposterior tibial nerve causes a movement of flexion ofthe toes. Mechanical hyperexcitability of the nerves appear
. Medical and surgical therapy. ed side (182). We may add that mechanical hyperexcitability ofthe nerve trunks may be occasionally observed. Per-cussion of the ulnar nerve in the space between theolecranon and internal condyle causes a characteristicmovement of adduction of the thumb with flexion ofthe first phalanx (adductor pollicis), combined with amovement of flexion of the fourth and fifth fingers 554 REFLEX NERVOUS DISORDERS at the first phalanx (interossei). Percussion of theposterior tibial nerve causes a movement of flexion ofthe toes. Mechanical hyperexcitability of the nerves appearslike muscular hyperexcitability to be closely associatedwith vaso-motor disorders and hypothermia; theapplication of heat may temporarily reduce orabolish it. Muscular Hypotonus Hypotonus is sometimes very pronounced and maybe as great as in the most serious nervous lesions, butits area is usually restricted. It may be very markedin certain muscular groups of the affected limb, andbe completely absent in others. Thus it may be. Fig. 8.—Hypotonus of the flexors of the fingers in a case ofcontracture of the flexors of the hand with hyperextension ofthe fingers {v. PI, VII, p 572). possible to obtain by passive movements in variouscases a hyperflexion of the hand formmg a very acuteangle with the forearm {v. Figs. 4 and 10), hyperexten-sion of the fingers in an arc of a circle {v. Figs. 8 and 9),hyperflexion of the thigh (leg extended) far beyonda right angle {v. Fig. 12), and hyperflexion of the legcombined with hyperflexion of the thigh, a complexmovement in which the thigh is brought close to theabdominal wall and the heel to the gluteal region SYMPTOMATOLOGY 555 {v. Figs. 13 and 15). Owing, however, to individualvariations in tonicity, no attention should be paid tohypotonus unless it is definitely asymmetrical. When it is very well developed, it may even be
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