A treatise on orthopaedic surgery / by Royal Whitman.

  • Royal Whitman
Date:
1904
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on orthopaedic surgery / by Royal Whitman. Source: Wellcome Collection.

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    standing are constrained, and in the other the neck is stiff, or the head is turned, or drawn from the normal line. In the thoracic region early diagnosis is less often made, because in this section motion is so unimportant that its restraint may escape the atten- tion of the patient or parent. In considering diagnosis, therefore, and, in fact, treatment and prognosis, one should divide the spine into three sections to correspond with function : 1. The neck part, that allows free motion of the head, ending at the third dorsal vertebra. 2. The rigid thoracic part, which includes the third and the tenth dorsal vertebree. 3. The lower part, made up of the two lower dorsal and the lumbar vertebree, in which the principal movements of the trunk are carried out (Fig. 8). One must bear in mind the distribution of the nerves, because the characteristic pain is referred to their terminations, also the parts in relation to the spine at different levels that may be impli- cated in the disease. Thus, remembering that the symptoms of Pott’s disease are in general, stiffness, weakness, pain and deformity, one will always apply these symptoms to a_ particular region of the spine, and will picture to himself the effect of such stiffness, weakness, and deformity at this or that vertebra; the effect of an abscess in this or that situation, and the area of paral- ysis that might be caused by pressure on the cord at one or another level. | Landmarks. ‘The atlas is on a line with the hard palate. The axis is on a line with the free edge of the upper teeth. The transverse process of the atlas is just below and in front of the tip of the mastoid process. The hyoid bone is opposite the fourth cervical vertebra. The cricoid cartilage is on a line with the sixth cervical vertebra. The upper margin of the sternum is opposite the disk between the second and third dorsal vertebre. The junction of the first and second sections of the sternum is opposite the fourth dorsal vertebra. The tip of the ensiform cartilage 1s opposite the lower part of the body of the tenth dorsal vertebra. The anterior extremity of the first rib is on a line with the fourth rib at the spine, the second with the sixth, the fifth with the ninth, the seventh with the eleventh. The scapula overlaps the second and the seventh ribs, its lower angle being opposite the centre of the eighth dorsal vertebra.
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