Full resolution (JPEG) - On this page / på denna sida - Passive Movements - Nerve Vibrations - Nerves of the Trunk - Dorsal Sensory Nerves - Nerves of the Lower Extremity - Nervus Ischiadicus Major
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72 PASSIVE MOVEMENTS:
We should not forget, in general nerve treatment of the back,
to follow the crest of the os ilium, and to give frictions where
the topographical anatomy teaches us that the sensory branches
of the last dorsal nerve, ilio-hypogastric nerve, and upper lumbar
nerves pass downwards. When the frictions are correctly made,
i.e. a little obliquely, these nerves respond readily.
NERVES OF THE LOWER EXTREMITY.
Nervus Ischiadicus Major.
This is far the most important nerve in the lower extremity.
It emerges, as we know, through the great sacro-sciatic foramen
beneath the gluteus maximus, and lying nearly midway between
the great trochanter of the femur and the tuberosity of the
ischium, it passes straight down the back of the thigh to the
popliteal space.
The patient is placed in the prone position, as shown in fig. 5,
and the foot of the leg to be treated is crossed over the other.
We have here a position in which we can manipulate all the
nerves on the back of the limb most readhy, because all
the muscles from those of the gluteal region down to the calf
are more or less relaxed.
If we wish only to stimulate the nerve in a general treatment,
and when there is no particular pain, then a few quick frictions
should be made over the nerve, while we follow its course
upwards and downwards. I must repeat here, what I have said
before, that care must be taken not to make the friction before
one is well down upon the nerve, or feels it, as in the popliteal
space. On the other hand, if we have to do with a patient
who suffers from such a complaint as sciatica, it is better to
put the last phalanx of the thumb over the nerve where it
emerges from the pelvis, and to make vibrations there. In
recent cases of sciatica I have treated, I proceeded in this way,
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