Human anatomy; Medicine -- Study and teaching; Palpation
The movement of torsion or rotation round its own axis may be proved by
the following experiment:--Seated upright, with the back and shoulders
well applied against the back of a chair, we can turn the head and neck
as far as 70°. Leaning forwards so as to let the dorsal and lumbar
vertebræ come into play, we can turn 30° more.
58. =Position and motions of scapula.=--There are a few points worthy
of observation about the scapula. It covers the ribs from the second to
the seventh inclusive. We can feel its superior angle covered by the
trapezius. The inferior angle is covered by the latissimus dorsi, which
keeps it well applied against the ribs in the strong and athletic; but
in weak and consumptive persons the lower angles of the scapulæ project
like wings--hence the term ‘scapulæ alatæ.’
A line drawn horizontally from the spine of the sixth dorsal vertebra
over the inferior angle of the scapula gives the upper border of the
latissimus dorsi. Another line drawn from the root of the spine of the
scapula to the spine of the last dorsal vertebra gives the lower border
of the trapezius, which stands a little in relief.
59. The sliding movement of the scapula on the chest can be properly
understood only on the living subject. It can move not only upwards
and downwards as in shrugging the shoulders--backwards and forwards
as in throwing back the shoulders--but it has a rotatory movement
round a movable centre. This rotation is seen while the arm is being
raised from the horizontal to the vertical position, and is effected
by the co-operation of the trapezius with the serratus magnus. The
glenoid cavity is thus made to look upwards, the inferior angle slides
forwards, and is well held under the latissimus dorsi.
60. For the medical examination of the back, the patient should sit
with the arms hanging between his thighs, to lower the scapulæ as much
as possible. In this position the spine of the scapula corresponds
(nearly) with the fissure between the upper and lower lobes of the
lung; the apex of the lower lobe being about the level of the third rib.
_THE ABDOMEN._
The student is assumed to be familiar with the conventional lines
dividing the abdomen into regions.
61. =Abdominal lines.=--The linea alba, or central line of the abdomen,
marks the union of the aponeuroses of the abdominal muscles. It runs
from the apex of the ensiform cartilage to the symphysis pubis. As this
line is the thinnest and least vascular part of the abdominal wall, we
make our incision along it in ovariotomy, and in the high operation
of lithotomy; in it, we tap the abdomen in ascites, and the distended
bladder in retention of urine.
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