A system of practical medicine. By American authors. Vol. 5 : $b Diseases of the nervous system
Science
A system of practical medicine. By American authors. Vol. 5 : $b Diseases of the nervous system
Medicine -- Practice
From this line (1-1) a vertical line, or one exactly perpendicular to
the first, is drawn through the external auditory meatus. At the top
of head this line—the auriculo-bregmatic line (A A)—indicates the
bregma or true vertex, which important landmark is to be marked with
carmine or aniline upon the scalp. Upon the top of the head an
imaginary horizontal line (4-4), parallel with the alveolo-condyloid
plane, is projected, and upon it we measure backward a distance of
50 mm. (2 inches), and then draw a second vertical line (B B). At the
point where this line reaches the convexity of the head is the
Rolandic point (R), under which, {94} in average heads, lie the upper
or posterior extremity of the fissure of Rolando, the upper ends of
the pre- and postcentral gyri, and within the longitudinal fissure the
paracentral lobe, which together constitute the cortical centre for
the leg of the opposite side. The Rolandic point, thus determined,
should be distinctly marked upon the shaven scalp.
A third horizontal line is next to be drawn from the external angular
process of the frontal bone backward, parallel with Broca's plane.
This line (2-2), which may be termed the fronto-lambdoid because its
posterior extremity usually passes at or near the upper angle of the
lambdoidal suture, serves for the determination of several important
parts. In the first place, the line (2-2) passes at about 5 mm. above
the upper border of the squamous suture, or through it, and under this
line, mostly {95} parallel to it, are the anterior two-thirds of the
fissure of Sylvius. Secondly, at about 5 mm. above and behind the
intersection of lines (A A) and (2-2) is the inferior extremity of the
fissure of Rolando, bounded by the pre- and postcentral gyri. In the
third place, upon this line (2-2), at a distance of 18 or 25 mm.
behind the external angular process, is the folded part of the base of
the third frontal gyrus or Broca's speech-centre (F 3).
[Illustration: FIG. 13. Topographical Lines applied to Henle's Figure
of the Skull. Location of the Rolandic point. Rolandic line,
motor-centres, and the branches of the middle meningeal artery.]
Having exactly determined and marked the situation of the Rolandic
point and of the inferior termination of the fissure of Rolando above
the ear, these two points are to be connected by a line, which is
represented on the diagram by a black bar. This, the Rolandic line, is
the guide for nearly all operations for the relief of spasm or
paralysis of traumatic origin, or of such as may be caused by tumors,
abscesses, etc. It is surrounded by the so-called motor centres for
the face, arm, and leg (?) as demonstrated by experiments upon animals
and by now numerous autopsies in human cases of injury and disease.
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