Elements of Surgical Diagnosis

Cover Elements of Surgical Diagnosis
Elements of Surgical Diagnosis
Alfred Pearce Gould
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, and noticing whether these actions are performed easily, readily, and without restraint, or whether the patient tries to avoid all jars, keeps the spine rigid, and endeavours to trans- mit the weight of the body through the arms, by seizing surrounding objects, by supporting the head with the hands, or by sitting with the hands resting on the seat or the knees. The several parts of the spine can be examined by placing the hand flat on the back, and getting the patient to bend and extend the r...egion, and noticing whether the vertebrae move one upon another, or are immovably fixed. In the cervi- cal spine the movements of nodding the head or rotation of the head and of flexion of the spine, 398 SURGICAL DIAGNOSIS. [Chap. Xxvi.
should be separately investigated, as they occur at separate joints. Thus, if nodding the head be free and painless, it shows that the occipito-atloid joint is unaffected ; if the face can be turned without diffi- culty from side to side, it shows that the atlo-axoid joint is free ; and if flexion of the spine be quite free and painless, it shows that the lower cervical spine is unaffected ; any one of these movements may be impos- sible, or very limited and painful, and this will point to disease of one or other of these regions.


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