. Medical and surgical therapy. the operation the upper end of the nerve was found to be adherent tothe internal popliteal, which was quite unaffected. GREAT SCIATIC AND POPLITEAL NERVES 185 base of the toes, and extends inwards to the innerborder of the foot, and outwards to the fifth meta-tarsal. On the external surface of the leg this disturbanceof sensation rises to differentheights, but it does not gener-ally extend further than themiddle third, and does notreach the shin. Round the zone of anaes-thesia we generally find aband of hypaesthesia of greateror less extent. Pressure onthe trunk
. Medical and surgical therapy. the operation the upper end of the nerve was found to be adherent tothe internal popliteal, which was quite unaffected. GREAT SCIATIC AND POPLITEAL NERVES 185 base of the toes, and extends inwards to the innerborder of the foot, and outwards to the fifth meta-tarsal. On the external surface of the leg this disturbanceof sensation rises to differentheights, but it does not gener-ally extend further than themiddle third, and does notreach the shin. Round the zone of anaes-thesia we generally find aband of hypaesthesia of greateror less extent. Pressure onthe trunk of the nerve at theneck of the fibula does notcause pain, unless there arelocal lesions of the bone. Reflexes. — The knee- andankle-jerks are present. Wehave seen cases in whichthe latter was absent. Theplantar cutaneous reflex isalways flexor. Idioinuscular contraction isexaggerated in the earUerstages in the large musclesof the antero-external regionand in the peronei. It diminishes in intensity,and gets rather slower when. Fig. 76. — Zone of sensorychanges of the dorsum of thefoot in a case of lesion ofthe external popliteal nerve. the paral>i}ic lesion is several ^iq. 77.—Distribution ofmonths old. This slow mus-cular contraction is best seenin the extensor brevis digi-torum in the earlier weeks(Sicard) ; it is not long indisappearing completely as the muscular atrophyprogresses. Vasomotor Disturbances —These are not rare cases there is a purple discolouration of the foot, sen-sory disturbance in lesionsof the external poplitealnerve. The black area re-presents anaesthesia, thedotted area hypaesthesia. 186 CLINICAL FORMS OF NERVE LESIONS which, is colder than the one on the opposite side.(Edema can never be detected. The skin is normal, and there is no important changein the nails or in the pilous system. Desquamationof the epidermis with diminution or disappearance ofsweating may sometimes be observed in the first twodorsal interosseous spaces. The
Size: 1059px × 2360px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1910, bookpub, booksubjecttherapeutics
