Upper arm

“ Besides these peculiarities of the hands and feet, which, moreover, are supplied in every joint with tendons and muscles of great motive power, the fore-arm is capable of turning the wrist forwards or backwards, or, as it [Pg 213] is called, rotating, and also of bending. Again, the upper arm is loosely but firmly attached to the shoulders and neck, so as to admit of great range of motion, so what with the bending and rotation of the fore-arm, and the mobility and cushioned state of the fingers, these creatures possess a wonderful apparatus, suited for extreme action and safe holding on. ”

“ Your arm must be raised until high overhead, the hand hanging from the wrist and dropped into your lap or down at the side, letting the elbow "give," so that the upper arm drops first, and then the fore arm and hand,—like three heavy sand-bags sewed together. The arm can be brought up to the level of the shoulder, and then round in front and dropped. ”

“ In this upper-arm type the muscles affected are supplied by three different nerve-stems—the axillary, musculo-cutaneous, and the radial. In the forearm type the most common variety consists in paralysis of the extensors of the wrist, thus exactly imitating lead palsy.44 The supinator remains intact, the intrinsic muscles of the hand are sometimes intact, sometimes paralyzed. ”

“ The flesh in front of the elbow will not be pinched if, the [92] forearm being fitted very accurately, the muscles of the upper arm are allowed free play, by cutting away the front of the armlet to half its height, but in this case an indirect attachment to the shoulder is essential. ”

“ In both cases, the lower arm stretches itself out quickly, at the same time that the feet are striking; and the upper arm strikes at the same time that the feet are impelling, the hand of the latter arm beginning its stroke on a level with the head. ”

“ The upper part of the body is to be kept straight, the vertebral column neither twisted to the right nor to the left; the shoulder-blades both of the same height, are, together with the upper arm, freely suspended on the ribs, and in no way supporting the body ”

“ The upper part of the trunk is known as the thorax, or chest, and the lower part as the abdomen. The portions of the trunk to which the arms are attached are the shoulders, and those to which the legs are joined are the hips, while the central rear portion between the neck and the hips is the back. The fingers, the hand, the wrist, the forearm, the elbow, and the upper arm are the main divisions of each of the upper extremities. ”

“ While the right hand strokes upward over the left side and upper chest, and the body is raised and bent to the right, the left outstretched arm is carried or swung around to the back and upward over the head to the front and down on the outer side of the right thigh, so that it reaches there when the right arm is released at the right armpit. The right arm then performs a similar movement, while the left hand is stroking upward over the right side. ”

“ As far as the upper extremities are concerned, the only muscles called into activity are the flexors of the fingers; those of the arm and shoulder are simply put on the stretch, an operation which, without corresponding contraction, weakens rather than strengthens muscular fibre. ”

“ Those at the knee, for example, contribute more to the length of limb than do those at the hip or ankle, and they are also the last to unite. In the upper limb the more active epiphyses are at the shoulder and wrist, and these also are the last to unite. ”

“ Several of the muscles in the forearm run into tendons in the wrist because if the muscle part were to extend along the wrist, this part of the arm would be large and clumsy instead of graceful and slender. ”

“ For instance, if there is a DISLOCATION OF THE ELBOW, the patient being settled, let one man take hold of his arm near the shoulder, to make counter extension while another makes extension at the wrist. You yourself being seated grasp the elbow with your two hands by applying your fingers to the anterior part and your thumbs to the posterior, press on the projecting point of bone downwards and forwards. ”

“ You know the wonder of a woman's arm--the fore arm, I mean; the sweet fading away from rounded biceps and hint of muscle, down through small elbow and firm soft swell to the wrist, small, unthinkably small and round and strong. ”

“ The elbow is more or less removed from the axis of the body, by the action of the deltoid, the long portion of the biceps, and the supra-spinatus muscles, which, being unnaturally stretched, contract themselves and tend to carry the bone outward. The pains which result from this position, force the patient, in order to relieve them, to lean towards the affected side, to keep the fore-arm half-bent, the elbow resting on the hip, so that the arm, finding a place of support, may be freed from the painful movements, and from the disagreeable sensation produced by its own weight. ”

“ A young man taller than the patient, or standing on some elevated object, by his affected side, (the patient also being in a standing posture) is to apply his shoulder below the patient’s armpit, while he stretches and pulls the patient’s hand towards his own belly, so that the rest of the patient’s body is suspended at the back of the person who supports him. But if the patient be light, another light child is to be suspended from him. For while the arm and the rest of the body are pulled downwards oppositely, the shoulder put under the armpit, readily replaces the dislocated limb. ”

“ I should also add that nearly every person who has lost an arm above the elbow feels as though the lost member were bent at the elbow, and at times is vividly impressed with the notion that his fingers are strongly flexed. ”

“ Then, by moving the hand down on the inside of the arm toward the elbow, the lessening muscle may be readily traced until it terminates in a tendon, of much less size than the muscle, but of great strength, which is inserted into the bone just below the elbow. As the fore-arm is drawn up, and especially if there be a weight in the hand, the tendon may be felt just within the elbow-joint, running toward the point of insertion. ”

“ For the back stroke therefore, and that the arm may not only bend at the elbow, but also extend and straighten itself with force, other muscles, the longus, and brevis brachiæus externus, and the aconæus, placed on the hinder part of the arms, by their contractile twitch, fetch back the fore-arm into a straight line with the cubit, with no less force than that with which it was bent out. The same thing obtains in all the limbs, and in every moveable part of the body. ”

“ As for the arms, it is noticeable that they still retain the ordinary mammalian habit in being hairier on the back than on the front; and this also is quite in accordance with our present suggestion, because the same differentiating causes have not worked upon the arm as they work upon the back and legs. The peculiar position of the anterior extremities in man, together with the erect posture, makes the arms come much more frequently into frictional contact with the body or clothing on their inner than on their outer surface. ”

“ The muscle, directly that “something” comes to it along its nerves, contracts, shortens, and grows thick; it rises up in the arm; its lower tendon pulls at the radius; the radius with the ulna moves on the fulcrum of the humerus at the elbow-joint, and the arm is bent. ”

“ He lifts us to a sitting posture, places himself behind us, and folds his arms around our body, alternately tightening and relaxing his clasp, as if to test the elasticity of the ribs. Then seizing one arm, he draws it across the opposite shoulder, until the joint cracks like a percussion-cap. ”

“ The ideal arm, however, should gradually decrease in size from the shoulder to the wrist, the outlines being marked by those inward curves which are also noticeable in well-formed shoulders. The wrist should be slender without being thin, the bone at the outer side being well covered and indicated rather by dimples than otherwise. ”

“ And see, under the big deltoid, which fits round the shoulder like an epaulette and pulls the arm up, is the scapular group, things like tidily sorted skeins, thick on the shoulder-blades, diminished to a tendon string at their insertion in the arm; their business is to pull the arm back, in opposition to the big pectoral muscle which pulls it forwards. ”

“ The arm is either allowed to rest upon the table, upon the flexor mass of muscles of the forearm near the elbow as a kind of movable fulcrum, or is held with the forearm parallel to the table and a short distance above it. ”

“ The arm from the shoulder to the elbow in bending increases in length, that is in the length from the shoulder to the elbow, and this increase is equal to the thickness of the arm at the wrist when seen in profile. ”

“ Let A place her left arm under the patient's head and shoulders as before, her right arm under the small of his back; let B place her right arm also under the small of his back and her left arm under his thighs, and at a signal let them lift together. In this way the weight is so evenly distributed that a heavy person can be lifted without great difficulty. ”

“ The bones of the arm were strong, with strong projections for the attachment of muscles; those of the wrist were few in number and closely united. The rudimentary first finger, or thumb, consisting of a single slender bone, was turned backward toward the shoulder for the support of the membrane in front of the elbow. ”

“ Clasp the fore-arm about three inches below the elbow, then open and shut the fingers rapidly, and the swelling and relaxation of the muscles on the opposite sides of the arms, alternating with each other, will be felt, corresponding with the movement of the fingers. While the fingers are bending, the inside muscles swell, and the outside ones become flaccid; and, while the fingers are extending, the inside muscles relax, and the outside ones swell. The alternate swelling and relaxation of antagonist muscles may be felt in the different movements of the limbs. ”

“ The outer fragment follows more freely than the inner piece the action of the muscles; but, most of all, the weight of the unsupported shoulder and arm causes the displacement to which the outer fragment is liable. ”