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All the muscles of the arm, forearm, and hand are paralysed, and, as a rule, also the pectorals and spinati, but the rhomboids and serratus anterior escape. There is paralysis of the sympathetic fibres to the eye and orbit, with narrowing of the palpebral fissure, recession of the globe, and the pupil is slow to dilate when shaded from the light.
This rotation is seen while the arm is being raised from the horizontal to the vertical position, and is effected by the cooperation of the trapezius with the serratus magnus muscles. The patella, or knee-pan, the two condyles of the tibia, the tubercle on the tibia for the attachment of the ligament of the patella, and the head of the fibula are the chief bony landmarks of the knee.
In cases of long standing it is not so simple, because other muscles, the spinati, the clavicular fibres of the pectoral and the serratus, take its place and elevate the arm; there is always loss of sensation on the lateral aspect of the shoulder. There is rarely any call for operative treatment, as the paralysis is usually compensated for by other muscles.
In those whose occupation entails carrying weights upon the shoulder it may be contused, and the resulting paralysis of the serratus is usually combined with paralysis of the lower part of the trapezius, the branches from the third and fourth cervical nerves which supply this muscle also being exposed to pressure as they pass across the root of the neck.
When he "strings," as he called it, the sartorius, that ribbon muscle shows itself as a tight cord, extending from the front of the iliac spine to the inner side of the knee. Another trick was to leave flaccid that part of the serratus magnus which is attached to the inferior angle of the scapula whilst he roused energetic contraction in the rhomboids.
Montserrat is famous throughout Spain on account of its statue of the Virgin, which is supposed to have been made by S. Luke, and brought to Barcelona in the year 50 by S. Peter, which, of course, is nonsense. S. Luke never painted, and S. Peter never visited Spain. This extraordinary mountain derives its name from its saw-like appearance, Mons serratus.