File:Diseases of the nervous system (1908) (14593083128).jpg

Identifier: diseasesofnervo00chur (find matches)
Title: Diseases of the nervous system ..
Year: 1908 (1900s)
Authors: Church, Archibald, b. 1861, ed Salinger, Julius L. (Julius Lincoln), tr
Subjects: Nervous system
Publisher: New York and London : D. Appleton and company
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

View Book Page: Book Viewer
About This Book: Catalog Entry
View All Images: All Images From Book
Click here to view book online to see this illustration in context in a browseable online version of this book.

Text Appearing Before Image:
-ment. At the same timeit becomes evident, as Ed-inger explains, that theotherwise obscure distribu-tion of cutaneous innerva-tion in the extremitiesdoes not actually repre-sent the case, because thediagram is based on em-bryology (Figs. 150 and151). However, we mayalso utilize the diagramsof other authors. For thesake of the findings Ihave included those ofSeiffer, as well as thoseof Head; the diagram ofthe latter author has en-abled me exactly to localizemany spinal cord tumors—at least their upper boun-daries (Figs. 152, 153, 154,155, and 156). By the aid of thesediagrams we can usuallyascertain exactly the upperboundaries of a tumor.It is only necessary tobear in mind the relationof the individual spinalcord segments to the ver-tebral bodies and thespinous processes belong-ing thereto. For this pur-pose Gowers table is valu-able; for it shows that theCauda equina begins op-posite the first lumbarvertebral bodies and their Fig. 155.—Diagram. (After Head.) Spinous processes, and
Text Appearing After Image:
THE SEAT, EXTENSION AND COMPOSITION 359 that the greater portion of the lumbar vertebral column does not lie oppositethe lumbar portion of the spinal cord (Fig. 158). After determining by the aid of these diagrams the upper boundar)^ of atumor, we must ascertainits longitudinal extent andits lower boundary. Thisis often impossible, becausethe local phenomena due toabsence of function whichappear at the upper limitgenerally overshadow thoseproduced by pressure ofthe tumor upon the totaltransverse section of thespinal cord. It is easierto ascertain the longitu-dinal extension of the tu-mor within the cervicalenlargement, for when themuscles of the lower cer-vical segments remain un-involved there is no strongpressure upon these. Whenthe tumor is located op-posite the lower portion ofthe dorsal cord, and whenthe muscles belonging toit continue to show nodegenerative atrophy norDeR, we may concludethat it does not press uponthe upper portion of thelumbar enlargement. Howmany segments are

Note About Images