Organic and functional nervous diseases; a text-book of neurology . natus are also aifected, producing a marked atrophy about theshoulder-blade, and later the teres and subscapularis become this condition the patient is completely paralyzed in the arms,which hang like flails at the side, and are of very little use, flexion atthe elbow being impossible by voluntary effort. As the disease progresses beyond this point the atrophy attacks themuscles of the body about the shoulders. The serratus magnus isparalyzed, and then the shoulder-blade sticks out from the side of thebody like a w
Organic and functional nervous diseases; a text-book of neurology . natus are also aifected, producing a marked atrophy about theshoulder-blade, and later the teres and subscapularis become this condition the patient is completely paralyzed in the arms,which hang like flails at the side, and are of very little use, flexion atthe elbow being impossible by voluntary effort. As the disease progresses beyond this point the atrophy attacks themuscles of the body about the shoulders. The serratus magnus isparalyzed, and then the shoulder-blade sticks out from the side of thebody like a wing. The rhomboids, the levator anguli scapulae, andthe lower half of the trapezius become paralyzed, the shoulder-bladecannot be moved, and the muscles of the back become so atrophiedthat all the bones are visible. Even in the extreme cases, however,certain muscles escape for some unknown reason—namely, the upperpart of the trapezius between the occipital bone and the clavicle, thetriceps, latissimus dorsi, and the lower half of the pectoralis major. Fig. Atrophy and paralysis with main en griffe in chronic anterior poliomyelitis. As these muscles stand out in contrast to the atrophied muscles aboutthem and contract because of the lack of opposition, deformity of theshoulders and of the neck is quite evident. As the disease extends the muscles of the neck are next invaded,and, as these hold the head in an erect posture, gravitation leads to afalling forward of the head, so that the chin rests upon the falling forward of the head is usually intensified by the contrac-tion of the sterno-cleido-mastoid muscles, which are not affected bythe disease. In the last stage of the case the paralysis and atrophy extend to theintercostal muscles and to the muscles of respiration, so that all respi-ration becomes diaphragmatic. As a rule, patients die from some in-tercurrent disease when the atrophy and paralysis have reached thisstage ; but in case they live the paralysi
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectnervoussystem, bookye
