Greater trochanter

“ The trochanter, femur and tibia are all granulate and sparsely covered with short, simple hairs. Claw large, hand broad, smoothly convex on both sides; finger as long as the hand and slightly curved. It is also provided with long, tactile hairs. ”

“ Inspection discovers a depression where the great trochanter should be. On applying the open hand over the hip joint, whilst an assistant who grasps the pastern moves the limb in different directions, one can feel and hear, in spite of the mass of muscle covering the part, a modified crepitation due to sero-sanguinolent effusion in and around the joint. ”

“ Two strong muscles are inserted into the small trochanter by a common tendon, the iliacus internus and psoas magnus. This insertion should remain untouched if the fracture should not extend below the little trochanter. [92] It is not always necessary to injure them, and they will be of great use afterward, if the operation should prove successful. If the neck of the bone be broken through, rotating the thigh as directed may not assist much in dislocating its head. ”

“ Fractures of the great trochanter are the effect either of falls on that protuberance, or of the action of bodies striking against it. Oblique or transverse, situated sometimes at its summit, and sometimes at its base, these fractures may be either simple or complicated. They are rendered complicated sometimes by splinters and a swelling, as happens when a ball produces the division, and at other times by a fracture of the neck of the bone, an example of which we find in the Journal of Surgery, in the case of a man seventy years of age, who had been long subject to the itch. ”

“ According to Cruzel, fixation of the biceps femoris may occur, in very thin animals, without rupture of the musculo-aponeurotic layer, the process being then simply confined to stretching of the aponeurotic layer over the summit of the trochanter. Under such circumstances the musculo-aponeurotic layer presents a cup-like depression, into which the summit of the trochanter fits, and thus effectually prevents movement of the muscle.
Whether the accident is due to an actual fissure, or only to stretching of the aponeurosis, the symptoms are the same. ”

“ If we compare the femur of certain animals with that of man, we see that the corresponding details of form are readily recognisable, but they are slightly modified. Thus, on examining the superior extremity, we find there a head, a neck, a great trochanter, and a lesser; but the neck is usually short and thick, and the great trochanter does not occupy the same level with regard to the articular head of the bone. ”

“ In this injury there is apparent lengthening of the limb, and flattening of the hip; the patient is able to use the member, though not freely. Before swelling has taken place, crepitation can be perceived on laying hold of the trochanter whilst the limb is in motion; and the trochanter itself is found to be in a slight degree moveable.
Fracture of the upper part of the shaft is attended with immediate and great shortening; the limb is much misshapen, and lies on its outer side, with the knee partially bent. The upper fragment of the bone projects ”

“ In some Orthoptera, especially in Blattidae, and in Termitidae, there is a transverse chitinised fold interposed between the sternum and the coxa, and this has the appearance of being the same piece as the trochantin of the anterior legs of Coleoptera.
Fig. 58.—Hind leg of Panorpa: a, episternum; a′, epimeron; b, coxa; b′, coxal fold of epimeron; c, trochanter; d, femur; e, tibia; f, tarsus.
Beyond the coxa comes the trochanter; this in many Hymenoptera is a double piece, though in other Insects it is single; usually it is the most insignificant part of the leg. ”

“ The femoral glands lie chiefly over the saphenous opening and along the outer side of the saphena vein: they receive the absorbents of the lower extremity; they receive some also from the scrotum—of which we have practical evidence in cases of chimney-sweepers’ cancer.
98. Trochanter major.—The trochanter major is a most valuable landmark, to which we are continually appealing in injuries and diseases of the lower extremity. ”

“ We discover, in general, that the cure is complete, from a disappearance of the signs of the fracture, more particularly from the motions of the great trochanter, in which circumduction28 succeeds to rotation on its own axis, when the limb is made to move on itself, that is, to rotate outwards or inwards. ”

“ In the hind-wings—on account of their reduced size—the nervures are even more reduced than in the fore-wings.
The legs of Hymenoptera are of the typical insectan form, and the foot is usually composed of five segments. In many families the trochanter appears to be represented by two small segments, there being thus an extra joint in the leg. ”

“ The inner trochlea differs from that of the Scelidothere in having a greater relative antero-posterior extent, and in forming, in place of an uniform convex surface, a trochlea similar in structure to that on the outer side. The extent of rough surface on the upper part of the astragalus intervening between the articular surface for the bones of the leg, and that for the scaphoides is extremely small in the Megathere and Mylodon (?) ; it is relatively greater in the Scelidothere ”

“ Trochilus, trok′i-lus, n. a genus of humming-birds. [Gr. trochilos.]
Trochite, trō′kīt, n. one of the wheel-like joints of the stem of an encrinite.—adj. Trochit′ic.
Trochiter, trok′i-tėr, n. the greater tuberosity of the humerus, admitting several of the muscles of the shoulders.—adj. Trochitē′rian.
Trochlea, trok′lē-a, n. a pulley-like cartilage through which the superior oblique muscle of the eye-ball passes: in the elbow-joint, the articular surface of the lower extremity of the humerus, grasped by the greater sigmoid cavity of the ulna.—adjs. Troch′lēar, shaped like a pulley ”

“ Treatment.—In the first stages of an acute affection absolute quiet must be enforced; local antiphlogistic applications are beneficial. Later, vesication of a liberal area surrounding the trochanter major is indicated. Where the condition has become chronic in horses that are to be kept at heavy draft work there is little chance for complete recovery. And, naturally, one is not to expect resolution in cases where there exist erosion and ossification of cartilage—where crepitation is discernible. ”

“ Its least diameter is 3′′·3, and its antero-posterior and transverse diameters, at the same point as in the other bones, 1 × 1·25, or pretty nearly in the usual proportions. Nevertheless the bone, throughout its whole remaining extent, is less rounded on the inner side of the shaft than is usual. The trochanter minor is of gigantic size; and the shaft of the bone, about and below the middle, exhibits a subtriangular aspect (Fig. 58) , though scarcely to be called carinate. The cortical substance is of the normal thickness. ”

“ Origin by a flat tendon from the transverse processes of the second and third caudal vertebræ. The muscle forms a flat band which passes distad along the middle of the lateral side of the thigh over the pelvis and caudad of the great trochanter. At the middle of the thigh it ends in a very thin tendon. ”

“ Speaking generally, it may be said that downward movements of the arms are less good than upward ones, and that their synchronous and symmetrical action is accomplished with greater ease than is the operation of one only.
The debut of mental torticollis is usually insidious. Whether head or shoulder be implicated first, the incipient motor reaction is infrequent, inconsiderable, and transitory. Little by little its frequency increases and its duration lengthens, till the end of a few months sees the torticollis established. ”

“ Length of the two joints = 4 : 9, breadth = 5 : 12. Thorax with three large triangular holes (twice as broad as the cephalis) between the three pyramidal, divergent feet, which at the distal end are connected by a narrow band of network, composed of two or three rows of polygonal pores. The entire pyramidal shell is enveloped by a very delicate web of irregular, polygonal {1241}meshes, closing also the basal mouth. (In fig. 5 the greater part of the web is taken off to demonstrate the large holes of the thorax) . Only two feet are visible. ”

“ They are developed in the alimentary canal, and then perforate its tissues and enter the muscles. Twelve trichinæ have been found in a section of human muscle only one-twelfth of an inch square and one-fifth of an inch in thickness.
The early symptoms of trichinæ are very uncertain, being the same as those of some other disease. The patient complains of severe pain in the abdomen and is troubled with diarrhea. When the trichinæ pass into the muscles, they occasion great suffering. There are sharp pains in the muscles, the perspiration is profuse, and the patient becomes exhausted. ”

“ Whenever it is desirable for any reason to avoid leaving any external mark of the puncture, it should be made at the navel, first drawing the loose fold of skin at one side and puncturing through the navel; then, when the trocar is withdrawn the loose skin around the navel returns to its natural position. The trocar can be pointed downwards and to each side, injecting some of the Preservative in each place, thus accomplishing the thorough injection of the abdominal cavity from only one point of insertion. ”

“ Fürbringer differs from Hoffmann in that he considers that the nerve was originally a motor nerve, and was not transformed from sensory to motor, yet thinks Hoffmann's suggestion is in the right direction.
He points out that the crossing of the trochlearis is not a crossing of fibres between two centres in the central nervous system, but may be explained by the shifting of the peripheral organ, i.e. the muscle, from one side to the other, and the nerve following this shift. ”

“ It consists of four complete trochaic dipodies or eight trochaic feet. The tribrach, irrational spondee, irrational anapaest and cyclic dactyl may stand in any foot save the last. The last foot is regularly a trochee or a tribrach, though (the last syllable being syllaba anceps, 2533) an apparent spondee or anapaest, but not a dactyl, may arise. The principal break in the line is regularly a diaeresis after the fourth foot (which in that case must not be a dactyl) . Occasionally, however, there is instead a caesura in the fourth or fifth foot. The scheme is:—
477 Example ”

“ A larger opening than is produced by means of an exploratory trochar may be made into a joint cavity, causing escape of synovia as it is secreted for days and even for weeks and no serious or permanent trouble is experienced in some cases. ”