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
Other relations of interest are the apex of the temporal lobe, a
little beneath the line (2-2) and at about 10 to 15 mm. posterior to
the external angular process of the frontal bone; the situation of the
occipito-parietal fissure, almost immediately under the posterior end
of the line (2-2) at its junction with the lines (E E), which indicate
the posterior extremity of the cerebrum; the anterior end of the brain
being marked off by the line (D D).
{96} Furthermore, for certain purposes the limits of the basal or
central ganglia may be estimated as follows: Their superior limit is
indicated by a horizontal line (3-3) drawn at 45 mm. below the vertex,
their anterior limit corresponding to the head of the nucleus caudatus
by the vertical line (C C), and their posterior limit, the hinder end
of the thalamus, by the vertical line (B B).
Upon the median line at the top of the head an allowance of full
15 mm. should be made for the width of the superior longitudinal sinus
separating the hemisphere.
[Illustration: FIG. 14. The same Topographical Lines applied to the
Left Cerebral Hemisphere in Henle's Skull. The motor centres are
approximately indicated by dotted lines. (The leg centre should be
reduced in size as it lies near to and in the longitudinal fissure.)
The Rolandic line is placed a little behind the fissure for the sake
of clearness.]
The location of the middle meningeal artery, which so often furnishes
the blood that compresses the brain after various injuries to the
head, is surgically of great importance. The course of its two
principal branches is approximately indicated upon Fig. 13 by the
branching lines drawn on the anterior inferior angle of the parietal
and the upper part of the squamous portion of the temporal bone. In
the living subject the main trunk of the artery would be found under
the horizontal line (2-2) a little posterior to the speech-centre,
about 30 mm. behind the external angular process, and in front of the
beginning of the fissure of Sylvius.
Upon the shaven head of a patient seated in a chair or lying in bed
the principal landmarks and relations above defined can be mapped out
with sufficient approximation to accuracy by the use of a ruler to
mark {97} the alveolo-condyloid plane, and a cardboard cut so as to
stand astride the head in the auriculo-bregmatic vertical. A light
wooden apparatus can easily be made to indicate these two lines, while
the remaining measurements can be made with a steel tape-measure, and
the points marked with carmine ink or an aniline pencil.
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