. Internal medicine; a work for the practicing physician on diagnosis and treatment, with a complete Desk index. ralysisof one spinal accessory, the head can-not be turned to the other side, thesternomastoid and the upper border ofthe trapezius are relaxed and in timewasted, and all movements about theshoulder, as raising the arm, are em-barrassed. When this paralysis isbilateral the head falls backward or foi-^vard, according as the sternomastoidor the trapezius is more affected. Bilateral paralysis of the spinal accessory is conspicuous in meningitis,especially the tuberculous form of childh
. Internal medicine; a work for the practicing physician on diagnosis and treatment, with a complete Desk index. ralysisof one spinal accessory, the head can-not be turned to the other side, thesternomastoid and the upper border ofthe trapezius are relaxed and in timewasted, and all movements about theshoulder, as raising the arm, are em-barrassed. When this paralysis isbilateral the head falls backward or foi-^vard, according as the sternomastoidor the trapezius is more affected. Bilateral paralysis of the spinal accessory is conspicuous in meningitis,especially the tuberculous form of childhood, and in progressive muscularatrophy. Lesion of the nerve at the base of the brain, including the acces-sory part (laryngeal fibres), paralyzes the vocal cords, and is likely at thesame time to implicate the hypoglossal or the glossopharyngeal and paralyzethe tongue or the palate. Torticollis or Wry=neck—Accessory Spasm.—True torticollis is a devia-tion of the head due to abnormal action of the muscles supplied by this may be a fixed deformity—congenital wry-neck—or. due to spasm—spas-. FiG. 390.—Torticollis (Jochimsthal) .—Young. DISEASES OF THE CRAMAL .\I:R\ES. 745 modic wry-nock. Jii coiiLriiiital torticollis tin re is ati-ophy of ntck niuscles,priiifipally the stcnioiiiastoid, in eonsctiueiice of prenatal poliomyelitis orof injury to the muscles during; labor. Contraction of the sternoniastoidtilts the head toward the affected side and at the same time rotates the facetoward the opposite side. The muscle stands out ri;,Md. Spasmodic torticollis is of the jiatuie of facial tic, and like it uiay beeither tonic or clonic. The position of the liead ordinarily is governed by thesternomastoid, but in some cases there is backward tilting in consecpienceof contraction of the trapezius. When the alfection is bilateral the Irape/iidraw the head backward,—retroeollic spasm,—aided by both stcrnomastoids,and the froiitales nniscles in association raise the
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectmedicine, bookyear192
