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Advanced Graphics Programming Using OpenGL 1st
Edition Tom Mcreynolds Digital Instant Download
Author(s): Tom McReynolds, David Blythe
ISBN(s): 9781558606593, 1558606599
Edition: 1
File Details: PDF, 4.27 MB
Year: 2005
Language: english
Advanced Graphics
Programming
Using OpenGL

TOM McREYNOLDS
DAVID BLYTHE

MORGAN KAUFMANN
ELSEVIER
Advanced Graphics Programming Using OpenGL
The Morgan Kaufmann Series in Computer Graphics and Geometric Modeling
Series Editor: Brian A. Barsky University of California, Berkeley

This series publishes the finest works for the accomplished and aspiring graphics professional. The series includes intermediate
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Advanced Graphics Programming Using OpenGL The Computer Animator’s Technical Handbook
Tom McReynolds and David Blythe Lynn Pocock and Judson Rosebush
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Advanced Graphics
Programming
Using OpenGL

TOM McREYNOLDS

DAVID BLYTHE

AMSTERDAM • BOSTON • HEIDELBERG • LONDON

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To my friends and colleagues from Silicon Graphics; it was a fabulous time and place to
learn about 3D graphics. – DB

To Ede Forney and Harry McGinnis; you were there when it counted. – TM
Contents

Preface xxiii

Acknowledgments xxvii

Biographies xxviii

PART I

Concepts 1

CHAPTER 1

Geometry Representation and Modeling 3

1.1 Polygonal Representation 3

1.2 Decomposition and Tessellation 4

1.3 Shading Normals 8

1.3.1 Smooth Shading 9
1.3.2 Vertex Winding Order 11
1.4 Triangle Stripping 12
1.4.1 Greedy Tri-stripping 13

1.5 Vertices and Vertex Arrays 14

1.5.1 Vertex Buffer Objects 15
1.5.2 Triangle Lists 16
1.6 Modeling vs. Rendering Revisited 17

vi
 Contents vii

CHAPTER 2

3D Transformations 19

2.1 Data Representation 19

2.2 Overview of the Transformation Pipeline 20

2.2.1 Object Space and the Modelview Transform 20
2.2.2 Eye Space and Projection Transform 21
2.2.3 Clip Space and Perspective Divide 22
2.2.4 NDC Space and the Viewport Transform 22
2.2.5 Window Space 23

2.3 Normal Transformation 23

2.4 Texture Coordinate Generation and Transformation 25

2.4.1 Texture Matrix 25
2.4.2 Texture Coordinate Generation 25

2.5 Modeling Transforms 27

2.6 Visualizing Transform Sequences 28

2.7 Projection Transform 30

2.8 The Z Coordinate and Perspective Projection 30

2.8.1 Z Coordinates and Fog 32

2.9 Vertex Programs 32

2.10 Summary 34

CHAPTER 3

Color, Shading, and Lighting 35

3.1 Representing Color 35

3.1.1 Resolution and Dynamic Range 36
3.1.2 Gamma 37
3.1.3 Alpha 39
3.1.4 Color Index 39

3.2 Shading 40

3.3 Lighting 43
3.3.1 Intensities, Colors, and Materials 46
3.3.2 Light Source Properties 47
viii Contents

3.3.3 Material Properties 49

3.3.4 Vertex and Fragment Lighting 50

3.4 Fixed-Point and Floating-Point Arithmetic 53

3.4.1 Biased Arithmetic 54

3.5 Summary 56

CHAPTER 4

Digital Images and Image Manipulation 57

4.1 Image Representation 57

4.2 Digital Filtering 60

4.3 Convolution 62

4.4 Images in OpenGL 63

4.5 Positioning Images 65

4.6 Pixel Store Operations 65

4.7 Pixel Transfer Operations 67

4.7.1 Scale and Bias 67
4.7.2 Pixel Mapping Operations 67

4.8 ARB Imaging Subset 68

4.8.1 Convolution 68
4.8.2 Color Matrix Transform 68
4.8.3 Histogram 69
4.8.4 MinMax 70
4.8.5 Color Tables 70
4.8.6 Blend Equation and Constant Color Blending 71

4.9 Off-Screen Processing 72

4.10 Summary 72

CHAPTER 5

Texture Mapping 73

5.1 Loading Texture Images 73

5.1.1 Texture Borders 74
5.1.2 Internal Texture Formats 75
 Contents ix

5.1.3 Compressed Textures 76

5.1.4 Proxy Textures 77

5.2 Texture Coordinates 77

5.2.1 Texture Coordinate Generation and Transformation 79

5.3 Loading Texture Images from the Frame Buffer 79

5.4 Environment Mapping 80

5.4.1 Generating Environment Map Texture Coordinates 81
5.4.2 Texture Maps Used in Environment Mapping 82
5.4.3 Cube Mapping 83
5.4.4 Sphere Mapping 85

5.5 3D Texture 88
5.5.1 Using 3D Textures to Render Solid Materials 89

5.6 Filtering 90

5.7 Additional Control of Texture Level of Detail 91

5.8 Texture Objects 93

5.9 Multitexture 95
5.9.1 Multitexture Model 96
5.9.2 Multitexture Texture Environments 97

5.10 Texture Environment 98

5.10.1 Advanced Texture Environment Functionality 99
5.10.2 Fragment Programs 100

5.11 Summary 102

CHAPTER 6

Rasterization and Fragment Processing 103

6.1 Rasterization 104

6.1.1 Rasterization Consistency 105
6.1.2 Z-Fighting 105
6.1.3 Bitmaps and Pixel Rectangles 107
6.1.4 Texture, Color, and Depth Interpolation 108
6.1.5 w Buffering 109

6.2 Fragment Operations 110

6.2.1 Multisample Operations 111
6.2.2 Alpha Test 111
6.2.3 Stencil Test 111
x Contents

6.2.4 Blending 112

6.2.5 Logic Op 114

6.3 Framebuffer Operations 115

6.3.1 Accumulation Buffer 116

6.4 Summary 117

CHAPTER 7

Window System and Platform Integration 119

7.1 Renderer and Window State 120

7.2 Address Space and Threads 121

7.3 Anatomy of a Window 122

7.3.1 Overlay and Underlay Windows 122
7.3.2 Multiple Displays 123

7.4 Off-Screen Rendering 124

7.4.1 GLX Pbuffers 125
7.4.2 WGL Pbuffers 126

7.5 Rendering to Texture Maps 126

7.6 Direct and Indirect Rendering 127

CHAPTER 8

OpenGL Implementations 129

8.1 OpenGL Versions 129

8.2 OpenGL Extensions 131

8.3 OpenGL ES for Embedded Systems 131

8.3.1 Embedded Profiles 132
8.3.2 Common and Common-Lite Profiles 133
8.3.3 Safety Critical Profile 136
8.3.4 OpenGL ES Revisions 136

8.4 OpenGL Pipeline Evolution 137

8.5 Hardware Implementations of the Pipeline 138

8.5.1 Rasterization Acceleration 138
8.5.2 Primitive Setup Acceleration 141
8.5.3 Transform and Lighting Acceleration 141
8.5.4 Pipeline Balance 142
 Contents xi

8.5.5 Parallelism Opportunities 142

8.5.6 Reordering the Pipeline 149
8.5.7 Mixed Software and Hardware Implementations 150

8.6 The Future 151

P A R T II

Basic Techniques 153

CHAPTER 9

Multiple Rendering Passes 155

9.1 Invariance 155

9.2 Multipass Overview 156

9.3 The Multipass Toolbox 159

9.3.1 Arithmetic Operations 159
9.3.2 Arbitrary Functions 160
9.3.3 Conditionals 161
9.3.4 Variables 162
9.3.5 Parameters 163

9.4 Multipass Limitations 165

9.5 Multipass vs. Micropass 165

9.5.1 Multitexture 166

9.6 Deferred Shading 167

9.7 Summary 167

CHAPTER 10

Antialiasing 169

10.1 Full-Scene Antialiasing 170

10.2 Supersampling 171

10.2.1 Supersampling by Overdrawing 172
10.2.2 Supersampling with the Accumulation Buffer 173
10.2.3 Multisample Antialiasing 175
10.2.4 Drawbacks 176
xii Contents

10.3 Area Sampling 177

10.4 Line and Point Antialiasing 178

10.5 Antialiasing with Textures 180

10.6 Polygon Antialiasing 181

10.7 Temporal Antialiasing 182

10.7.1 Motion Blur 183

10.8 Summary 184

CHAPTER 11

Compositing, Blending, and Transparency 185

11.1 Combining Two Images 185

11.1.1 Compositing 186
11.1.2 Compositing Multiple Images 187
11.1.3 Alpha Division 190

11.2 Other Compositing Operators 190

11.3 Keying and Matting 192

11.4 Blending Artifacts 192

11.4.1 Arithmetic Errors 192
11.4.2 Blending with the Accumulation Buffer 193
11.4.3 Approximation Errors 193
11.4.4 Gamma Correction Errors 193

11.5 Compositing Images with Depth 194

11.6 Other Blending Operations 195

11.7 Dissolves 196

11.8 Transparency 199

11.9 Alpha-Blended Transparency 200

11.9.1 Dynamic Object Transparency 202
11.9.2 Transparency Mapping 203
11.9.3 Transparency Sorting 204
11.9.4 Depth Peeling 205

11.10 Screen-Door Transparency 205

11.10.1 Multisample Transparency 207

11.11 Summary 208

 Contents xiii

CHAPTER 12

Image Processing Techniques 211

12.1 OpenGL Imaging Support 211

12.2 Image Storage 212

12.3 Point Operations 213

12.3.1 Color Adjustment 213
12.3.2 Interpolation and Extrapolation 213
12.3.3 Scale and Bias 215
12.3.4 Thresholding 215
12.3.5 Conversion to Luminance 216
12.3.6 Manipulating Saturation 216
12.3.7 Rotating Hue 218
12.3.8 Color Space Conversion 219

12.4 Region-based Operations 223

12.4.1 Contrast Stretching 224
12.4.2 Histogram Equalization 224

12.5 Reduction Operations 225

12.6 Convolution 227

12.6.1 Separable Filters 227
12.6.2 Convolutions Using the Accumulation Buffer 228
12.6.3 Convolution Using Extensions 230
12.6.4 Useful Convolution Filters 230
12.6.5 Correlation and Feature Detection 233

12.7 Geometric Operations 235

12.7.1 Pixel Zoom 235
12.7.2 Scaling Using Texture Mapping 236
12.7.3 Rotation Using Texture Mapping 237
12.7.4 Distortion Correction 237

12.8 Image-Based Depth of Field 238

12.9 High Dynamic Range Imaging 241

12.9.1 Dynamic Range 241
12.9.2 Tone Mapping 242
12.9.3 Modeling Adaptation 245

12.10 Summary 245

xiv Contents

CHAPTER 13

Basic Transform Techniques 247

13.1 Computing Inverse Transforms Efficiently 247

13.2 Stereo Viewing 249

13.3 Depth of Field 252

13.4 Image Tiling 254

13.5 Billboarding Geometry 257

13.6 Texture Coordinate vs. Geometric Transformations 261

13.6.1 Direct Vertex to Texture Coordinate Mapping 263
13.6.2 Overlaying an Entire Scene with a Texture 263
13.6.3 Overlaying a Scene with an Independent Texture
Projection 264

13.7 Interpolating Vertex Components through a Perspective

Transformation 265
13.7.1 Transforming Vertices in the Application 265
13.7.2 Interpolating Vertex Components 266
13.7.3 Computing LOD 267

13.8 Summary 268

CHAPTER 14

Texture Mapping Techniques 269

14.1 Loading Texture Images into a Framebuffer 270

14.2 Optimizing Texture Coordinate Assignment 270

14.3 3D Textures 271

14.4 Texture Mosaics 274

14.5 Texture Tiling 277

14.6 Texture Paging 279

14.6.1 Texture Subimage Loading 282
14.6.2 Paging Images in System Memory 285
14.6.3 Hardware Support for Texture Paging 286
14.7 Prefiltered Textures 287
14.7.1 Computing Texel Aspect Ratios 288
 Contents xv

14.8 Dual-Paraboloid Environment Mapping 291

14.8.1 The Mathematics of Dual-Paraboloid Maps 291
14.8.2 Using Dual-Paraboloid Maps 294
14.8.3 OpenGL Dual-Paraboloid Support 296
14.9 Texture Projection 296
14.10 Texture Color Coding and Contouring 298
14.11 2D Image Warping 300
14.12 Texture Animation 302
14.13 Detail Textures 306
14.13.1 Signed Intensity Detail Textures 309
14.13.2 Creating Detail Textures 311
14.14 Texture Sharpening 312
14.15 Mipmap Generation 313
14.16 Texture Map Limits 315
14.17 Summary 316

CHAPTER 15

Lighting Techniques 317

15.1 Limitations in Vertex Lighting 317

15.1.1 Static and Adaptive Tessellation 319
15.1.2 Local Light and Spotlight Attenuation 320

15.2 Fragment Lighting Using Texture Mapping 321

15.3 Spotlight Effects Using Projective Textures 322

15.4 Specular Lighting Using Environment Maps 325

15.4.1 Multitexture 326

15.5 Light Maps 327

15.5.1 2D Texture Light Maps 327
15.5.2 3D Texture Light Maps 330

15.6 BRDF-based Lighting 332

15.7 Reflectance Maps 332

15.7.1 Gloss Maps 332
15.7.2 Emission Maps 334
xvi Contents

15.8 Per-fragment Lighting Computations 334

15.9 Other Lighting Models 335

15.9.1 Fresnel Reflection 335
15.9.2 Gaussian Reflection 336
15.9.3 Anisotropic Lighting 337
15.9.4 Oren-Nayar Model 340
15.9.5 Cook-Torrance Model 342

15.10 Bump Mapping with Textures 343

15.10.1 Approximating Bump Mapping Using Texture 345
15.10.2 Tangent Space 346
15.10.3 Forward Differencing 347
15.10.4 Limitations 351

15.11 Normal Maps 352

15.11.1 Vector Normalization 352

15.12 Bump-mapped Reflections 353

15.13 High Dynamic Range Lighting 354

15.13.1 Bloom and Glare Effects 354

15.14 Global Illumination 355

15.14.1 Virtual Light Technique 355
15.14.2 Combining OpenGL Lighting with Radiosity 356
15.14.3 Ambient Occlusion 357

15.15 Summary 359

P A R T III

Advanced Techniques 361

CHAPTER 16

CAD and Modeling Techniques 363

16.1 Picking and Highlighting 363

16.1.1 OpenGL Selection 364
16.1.2 Object Tagging in the Color Buffer 365
16.1.3 Proxy Geometry 366
16.1.4 Mapping from Window to Object Coordinates 367
16.1.5 Other Picking Methods 367
16.1.6 Highlighting 367
 Contents xvii

16.1.7 XOR Highlighting 368

16.1.8 Foreground Object Manipulation 369

16.2 Culling Techniques 369

16.3 Occlusion Culling 370

16.3.1 Choosing Occluders 371
16.3.2 Building the Occlusion Map 371
16.3.3 Building the Depth Estimation Buffer 372
16.3.4 Occlusion Testing 372
16.3.5 Other Occlusion Testing Methods 373

16.4 Geometric Level of Detail 373

16.4.1 Changing Detail 374
16.4.2 Transition Techniques 375

16.5 Visualizing Surface Orientation 377

16.6 Visualizing Surface Curvature 379

16.7 Line Rendering Techniques 380

16.7.1 Wireframe Models 381
16.7.2 Hidden Lines 382
16.7.3 Polygon Offset 384
16.7.4 Depth Range 384
16.7.5 Haloed Lines 385
16.7.6 Silhouette Edges 386
16.7.7 Preventing Antialiasing Artifacts 389
16.7.8 End Caps on Wide Lines 390

16.8 Coplanar Polygons and Decaling 390

16.9 Capping Clipped Solids 392

16.10 Constructive Solid Geometry 393

CHAPTER 17

Scene Realism 403

17.1 Reflections 404

17.1.1 Object vs. Image Techniques 404
17.1.2 Planar Reflectors 407
17.1.3 Curved Reflectors 411
17.1.4 Interreflections 419
17.1.5 Imperfect Reflectors 422
xviii Contents

17.2 Refraction 424

17.2.1 Refraction Equation 424
17.2.2 Planar Refraction 426
17.2.3 Texture Mapped Refraction 428
17.2.4 Environment Mapped Refraction 429
17.2.5 Modeling Multiple Refraction Boundaries 430
17.2.6 Clipping Refracted Objects 431

17.3 Creating Environment Maps 432

17.3.1 Creating Environment Maps with Ray Casting 433
17.3.2 Creating Environment Maps with Texture Warping 434
17.3.3 Cube Map Textures 437
17.3.4 Sphere Map Textures 440
17.3.5 Dual-paraboloid Maps 443
17.3.6 Updating Environment Maps Dynamically 448

17.4 Shadows 449

17.4.1 Projective Shadows 450
17.4.2 Shadow Volumes 452
17.4.3 Shadow Maps 459
17.4.4 Creating Soft Shadows 463

17.5 Summary 465

CHAPTER 18

Natural Detail 467

18.1 Particle Systems 467

18.1.1 Representing Particles 469
18.1.2 Number of Particles 473
18.1.3 Modeling Particle Interactions 473
18.1.4 Updating and Rendering Particles 475
18.1.5 Applications 478

18.2 Dynamic Meshes 484

18.3 Procedural Texture Generation 487

18.3.1 Filtered Noise Functions 487
18.3.2 Generating Noise Functions 489
18.3.3 Filtering Using Texture Convolution 490
18.3.4 Optimizing the Convolution Process 492
18.3.5 Spectral Synthesis 495
18.3.6 Turbulence 496
 Contents xix

18.3.7 Random Image Warping 498

18.3.8 Generating 3D Noise 498

18.4 Summary 500

CHAPTER 19

Illustration and Artistic Techniques 501

19.1 Projections for Illustration 501

19.1.1 Axonometric Projection 502
19.1.2 Oblique Projection 503
19.2 Nonphotorealistic Lighting Models 505
19.2.1 Matte Surfaces 505
19.2.2 Metallic Surfaces 506
19.3 Edge Lines 507
19.4 Cutaway Views 508
19.4.1 Surface Texture 510
19.5 Depth Cuing 511
19.6 Patterns and Hatching 512
19.6.1 Cross Hatching and 3D Halftones 513
19.6.2 Halftoning 515
19.7 2D Drawing Techniques 516
19.7.1 Accuracy in 2D Drawing 516
19.7.2 Line Joins 517
19.7.3 2D Trim Curves 518
19.8 Text Rendering 520
19.8.1 Image-based Text 520
19.8.2 Geometry-based Text 523
19.9 Drawing and Painting 525
19.9.1 Undo and Resolution Independence 527
19.9.2 Painting in 3D 527
19.9.3 Painting on Images 529
19.10 Summary 530

CHAPTER 20

Scientific Visualization 531

20.1 Mapping Numbers to Pictures 531

Discovering Diverse Content Through
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 It was a great service, in which perhaps Gluck figured most
conspicuously, to show that when tendon ends could not be neatly
coapted an animal material could be interposed in such a way as to
serve as a trellis along which cells could group, or around which they
might organize, and thus gradually and finally become a part of the
complete tendinous cord. Silk and catgut have best served this
purpose, and new tendons have gradually formed around these
artificial substitutes, to the length of 10 Cm. In every fresh case
where there has been such loss of original structure as to justify a
measure of this kind, or in certain old cases where tendons have
long since sloughed away, it may be possible to resort to these
expedients.
It has been possible to transplant fresh tendons from the smaller
animals and to see them serve the same purpose in a satisfactory
manner.
Among these methods of tendoplasty is tendon grafting, by which
a part or all of the tendon of an active muscle is inserted into the
terminal portion of a paralyzed muscle and thus made to assume to
a greater or less extent the purpose and function of the latter; in
other words it assists in ingeniously diverting the activity and
direction of a given muscle to a purpose different from its original
intent. By this diversion a more equal or equable distribution of
muscle force is afforded the parts into which the affected muscles
are inserted. For its successful performance only those muscles
which are still active can be utilized. Among the simplest of cases
where this expedient can be used are those produced by traumatic
and peripheral paralyses, or traumatic loss of a given tendon or a set
of tendons. It is rarely to be practised as an emergency measure, but
as an expedient to be availed of later. It finds its greatest usefulness
in cases of long standing. It is equally applicable where muscles and
tendons have been divided by injury, or paralyzed by injury to their
nerve supply, as well as where deformities are produced by chronic
neurotic disturbance, by scars, by excessive callus, etc. It proves
equally serviceable in paralyses of spinal origin, particularly those
due to anterior poliomyelitis.
Tendon grafting will serve both as a substitute in cases of lost
function and as a provision against future deformity. In cases of the
ordinary paralyses of children, tendoplasty should be deferred for
several months after the occurrence of the paralysis. In the case of
growing children it is desirable not to wait too long, as other
objectionable features may present themselves. In the congenital
and hereditary paralyses and in conditions like athetosis or the
dystrophies of syringomyelia, meningocele, etc., also in such
conditions as habitual dislocations of the patella, much can be
accomplished by a carefully planned tendoplasty. It will be easily
seen then how wide a field of usefulness lies before one who
familiarizes himself with the recent technique of tendon surgery.

Fig. 124

Fig. 125

Two methods of tendon implantation and fixation. (After Vulpius.)

 Fig. 126 Fig. 127 Fig. 128

Transplantation of a portion of the anterior tibial tendon, into the bone or into the
opposed group of muscles. (After Vulpius.)

So far as technical considerations are concerned these operations

should be performed only with the minutest attention to asepsis.
When this has been secured a permanent dressing may be applied,
the limb being left in the position most desired, and maintained there
for several weeks. For this plaster of Paris makes the best support.
The use of the rubber bandage will permit the operation to be
bloodlessly made, by which it is greatly facilitated. If careful suturing
be practised, there will be but little tendency to subsequent oozing or
interference with repair. Fine discrimination is always needed in the
matter of adjusting the length of tendon ends and the point of their
fixation. A useless tendon which has been long stretched over a
curved joint will have become elongated, and the tendon to be
applied to it should be affixed farther down than would be otherwise
necessary. The disposition of the upper portion of the useless tendon
and muscle may also call for serious attention. It is rarely necessary
to extirpate them. They are already atrophied, and to remove them
would be to still further reduce the dimensions of the part. The
excluded portions can thus be simply discarded. When there has
been deformity with more or less pseudo-ankylosis the malposition
should be forcibly redressed and the tendon grafting deferred until a
subsequent time; the latter, to be successful, should be performed
alone.
 Incisions are usually made along and over the course of the
tendons to be exposed, but not so close that the cutaneous scar can
interfere with the tendon sheath. The lower end of a paralyzed
muscle will appear very differently from that of one which is healthy;
in the former instance the tissue will have lost its muscular character,
and will be yellowish white and fatty. A fascia which has been
stretched out of shape may be sutured in folds and will serve of itself
to give support and shape to the part which is renewed.
The methods of uniting tendons are so numerous that they can be
better estimated by a glance at the accompanying diagrams after
Vulpius than by description (Figs. 124 to 128). It is not necessary to
utilize all of the tendon of a healthy muscle, as it can be split and a
portion diverted to its new function. It is not to be expected that
tendons thus arranged will perfectly serve their purpose the first time
they are used. There must elapse a period of education of the
nerves and muscles whose relations are thus altered, and
improvement in the use of the parts thus operated will accrue for
months and even years. It is desirable that tendon surfaces thus
applied to each other be made broad and extensive in order that
their adhesion may be more firm.
A modification of tendon grafting consists in implanting the tendon
end into the periosteum instead of into some other tendon. There are
various ways of making this implantation, either by simple suture or
by boring into the bone or canalizing under a periosteal bridge. Fig.
129 illustrates how the tendon of the tibialis anticus can be utilized in
both ways. It will thus be seen that a tendon can be given either
tendinous, periosteal, or osteal implantation. Tendons thus utilized
rarely undergo necrosis or degeneration. So long as the possibility of
infection be excluded almost anything can be done with these
structures, in spite of their apparent lack of vascularity and vitality.
There are times when it is necessary to lengthen a tendon as well
as to shorten it. Fig. 129 illustrates methods by which both of these
measures can be performed. Analogous methods have been
practised with muscles themselves, although here the circumstances
are different and nothing similar can be accomplished. Portions of
the pectoralis major have been grafted into the biceps for paralysis
of the latter.
 Fig. 129 Liberating the ring
finger in musicians,
by dividing the
accessory tendons of
the extensor
communis digitorum,
is an expedient
suggested some
years ago by Brinton.
It is made by an
incision less than a
quarter of an inch
long, through the skin
and fascia, just below
the carpal articulation
of the metacarpal
bone of the ring
Showing methods of lengthening tendons. (Burrell.)
finger, and above the
radial accessory slip,
parallel with and on the radial aspect of the extensor tendon of that
finger. The point of a narrow blunt-pointed bistoury is then inserted
flatwise beneath the accessory slip down to a point just in front of the
knuckles of the ring and middle fingers, where the blunt point should
be felt beneath the skin. The bistoury is now turned upward, the
middle finger strongly flexed, and the ring finger extended so as to
make the slip tense when it is divided. The accessory slip on the
other side of the extensor tendon is similarly divided through a
distinct incision. Snug compression is made with a bandage over the
wounds, with the thumb free, and after two days the patient is
permitted to use the fingers in piano-playing in order to prevent
reunion of cut surfaces.

MYOTOMY AND TENOTOMY.

Myotomy is a measure seldom practised. It is performed either
subcutaneously or by open incision. Tenotomy is indicated whenever
contracted tendons need simply to be divided, either in chronic
orthopedic cases or after injuries or operations when it is desired to
put muscles temporarily at rest. The tendo Achillis has thus been
divided to prevent the consequences of muscle spasm when dealing
with certain fractures, especially compound fractures of the leg.
There are obvious advantages obtaining in subcutaneous tenotomy
when properly performed; the freedom from hemorrhage, the
minuteness of the opening, the rapidity of healing, are all in its favor.
It is performed with a small-bladed knife, known as the tenotome,
with either sharp or blunt point, the cutting portion being from 1 to 2
Cm. in length. The sharp-pointed tenotome suffices for its own
insertion, the blunt one being used after an opening has been made
with a sharp one. The puncture is made obliquely through the skin,
which should be drawn a little aside from the site of the deeper
opening in order that it may be hermetically closed as it slips back
into place. Whether the cutting blade should be turned outward or
inward will depend largely on the preference of the operator and the
location of the tendon. In some locations, as about the hamstring
tendons, the puncture should be made with the sharp instrument and
the deeper tenotomy with the blunt one. If the tendons alone have
been divided there will be trifling hemorrhage and the puncture can
be occluded without entrance of air. Similarly an aponeurotomy may
be performed. Not only may the tendons be divided by the open
method, but everything else which resists. This is practised more in
contracted knee-joint and in club-foot, when operated on by Phelps’
method, than anywhere else. Special indications for the operation
will be given in other parts of this work.

GANGLION.
This term is applied to a cyst of new-formation, which occurs in
connection with the sheath of a tendon, having a lining membrane
continuous with the sheath and containing thick, gelatinous, mucoid
fluid. It is termed “weeping sinew.” It is often seen on the back of the
wrist in connection with the extensor tendons, but may occur in
various parts of the body. It probably begins as a hernia of the
synovial membrane through a weak spot in the tendon sheath, which
tends to increase in size, weakening surrounding structures by
pressure, and interfering more or less with the function of the tendon
whose sheath is involved. These cysts sometimes connect with joint
cavities, especially those occurring behind the knee-joint; as a rule,
however, they do not. At first they constitute merely a disfigurement;
later they produce natural impairment of function. In the majority of
cases the sac becomes finally shut off from the tube with which it
originally connected.
When these lesions are new they may be successfully dealt with
by forcible rupture, such as can be made by firm pressure. When
old, or when rupture has failed, they should be treated by incision,
practised the same as a tenotomy, by moving the skin to one side,
pricking the sac, turning the blade of the tenotome so as to permit
the fluid to be emptied by pressure, and then, by manipulating the
point, irritate and do some damage to the sac lining. Such
provocation as this will be followed by a hemorrhage, and the
resulting clot may obliterate the sac by organization and cicatricial
contraction. This failing, excision is the only expedient which
promises success. The slightest operation upon a ganglion should
be done under aseptic precautions.

FELON, OR WHITLOW.
Felon, or whitlow, was discussed in the previous chapter,
especially the form which has its origin around the root of the nail. It
often originates in tendon sheaths and even in bone or close to it. It
is so often accompanied by a suppurative thecitis, i. e.,
tendosynovitis of destructive form, especially when not primarily
incised, that the necessity for early treatment needs to be
emphasized. It gives rise to excessive pain, with throbbing, and to
swelling of livid hue and intense degree. The parts involved are too
essentially fibrous and resisting to yield, hence the intensity of the
pain. Deep incision at the earliest moment, for the purpose of
relieving tension, is the only proper treatment. To temporize with hot
poultices, etc., is to invite necrosis and sepsis. This incision may be
made with local anesthesia. Even though little pus be obtained the
relief of tension will afford the greatest comfort (Figs. 130, 131 and
132).
 Fig. 130

Felon of thumb. (Burrell.)

 Fig. 131 Fig. 132

Neglected suppurating thecitis resulting Same, dorsal aspect. (Burrell.)

in palmar abscess. (Burrell.)

A more striking example of similar trouble is that which gives rise

to palmar abscess, the suppurative process extending up the wrist
beneath the annular ligament, and down into the little finger and
thumb. This is not infrequently the result of infection of callosities in
the palm of the hand. Infection may travel rapidly, and when confined
beneath resisting structures will prove exceedingly destructive; the
muscles of the forearm may melt down and great permanent
damage be done.
 Here, as when the finger alone is involved, early, free, and deep
incision will prove the salvation of the part. These incisions should be
made as indicated in Figs. 133 and 134, i. e., parallel with the
nerves, tendons, and vessels, all of which should be spared, as well
as the palmar arch. Should the latter be divided, the vessel ends
may be ligated or the wound packed. If cavities be left by the
destructive process they should be opened and the part treated by
continuous immersion in warm water, or the openings may be
packed with gauze saturated in brewers’ yeast. A few days of this
treatment will clean up all sloughs.

Fig. 133

Diagram of palmar incisions.

Fig. 134

Diagram of dorsal incisions. (Burrell.)

SURGICAL DISEASES OF THE MUSCLES.

 CONTUSIONS OF THE MUSCLES.
Muscles react like other tissues under the influence of contusions.
Hemorrhages not too copious are gradually absorbed, and muscle
tissue repairs itself, as indicated in the chapter on Wounds and their
Repair. Much outpour of blood into a muscle will temporarily
seriously impair its function, while pigmentation or ecchymosis may
result after a few hours or days, according to the depth of the injury.
There is the same liability to suppuration after infection of muscles
as elsewhere. A large hematoma can scarcely form within a muscle,
save in consequence of a rupture of a considerable portion of its
substance. Strains and sprains of lesser degree of violence provoke
impairment of function proportionate to their severity. In nearly every
instance there is a certain amount of rupture of muscle fiber and
outpour of blood.

RUPTURE OF THE MUSCLES.

Complete rupture across a muscle is unusual. It may occur in the
belly of the muscle or near one of its terminations. A tendon may be
torn out of a muscle or may itself snap. These accidents are almost
invariably accompanied by symptoms that indicate both the nature
and location of the injury. A severe strain followed by intense pain,
with a sensation of yielding, leaves little doubt as to what has
happened. Unless the muscle lie deeply its parting may be
appreciated by palpation, though the depression or interval may be
obliterated by the outpour of blood. The large tendons of the arm and
shoulder have been ruptured by a violent effort, the abdominal
muscles by contusions and by such efforts as wrestling, the
sternomastoid by excessive traction during forceps delivery, and the
tendons of the legs and ankles by jumps during such games as lawn
tennis, etc.; while the frequency with which the muscles of the
perineum and even the sphincter ani are torn during parturition is
well known. It is also well known that muscles are weakened by the
exanthemas and the infectious diseases.
Treatment.—An injury of this kind and of moderate degree seen
early may be treated by physiological rest and position.
(See chapter on Treatment of Wounds.) When, however, there is
marked impairment of function, such as will follow the yielding of one
or more tendons or muscle insertions, then suturing offers the
greatest promise of a cure. When the quadriceps tendon is torn
away from the patella or the tendo Achillis from the heel, prompt
suture under aseptic precautions will save a long period spent in
partial recovery of function.
Occasionally one or more tendons will be completely avulsed, as
when a finger is torn out of the hand and brings with it one or more of
the tendons belonging to it. In accidents of this kind six to twelve
inches of tendon and muscles may be lost. In such a case nothing
can be done except to care for the wound resulting from the injury.

DISLOCATION OF TENDONS AND MUSCLES.

Tendons and muscles are occasionally dislocated, that is, forced
from their normal positions. Accidents of this kind usually occur with
the long tendon of the biceps, which is torn from its bicipital groove;
the peronei and the posterior tibial in the leg, the extensor muscles
of the thigh, and those of the back of the wrist. The lower angle of
the scapula is normally held down by a small portion of the
latissimus dorsi; should this be displaced the scapula rises
somewhat in wing form. These injuries lead to more or less loss of
function, and, when they become disabling, may justify operation,
which would include incision, exposure of the tendon in its abnormal
position, and its restoration to its proper place where it should be
held by sutures. Such operation should be followed by enforced
physiological rest of the part.

HERNIA OF MUSCLES.
Hernia of muscle is the name applied to the escape of muscle
through a ruptured fascial or aponeurotic covering. Such a protrusion
will be recognized only during the contraction of the muscle and will
disappear at other times. When the diagnosis is made the edges of
the rent in the fascia should be united by sutures and the part put at
rest.
 WOUNDS OF MUSCLES.
Wounds of muscles in no way differ from other wounds which have
been considered in the chapter on Wounds and their Treatment. If
circumstances permit there is every indication for the suture of a
divided muscle in order that its function may be less impaired after
the wound is healed. These sutures, when inserted, should be made
to separately include the divided fascia or aponeurosis with which
the injured muscle is in relation.

MYALGIA.
There are numerous painful affections of muscles known as
myalgia. It is questionable whether a rheumatism of muscle fiber
ever occurs. That which patients describe as muscular rheumatism
is not that which it is termed. Sometimes it is the result of previous
exudate between muscle fibers, sometimes the result of hemorrhage
of interstitial type. Muscles thus affected are more or less tender and
give pain when used. It will usually be found that there is some
marked toxic condition, such as uric acid, syphilis, or lead poisoning,
behind it.
Treatment.—Many of the muscle pains of which patients complain
after operation, which are also toxic, are relieved by
the administration of aspirin in 0.5 Gm. doses. The injection of a
small amount of atropine into the body of the muscle will often give
relief. Those remedies which hasten elimination, including hot baths
and massage, are often of great value.

MYOSITIS.
This may be non-inflammatory and be due to prolonged use of a
member, as in writers’ cramp; or toxic, as in lead palsy; or traumatic,
caused by minute lacerations and hemorrhage. The more acute
forms may be due to extension from neighboring foci or to direct
infection. A form of infection involving both muscles and tendon
sheaths, and lately recognized, is the postgonorrheal. It has been
shown that gonorrhea may produce an active disturbance in synovial
sheaths and in muscle structures and a gonococcus myositis, as well
as a gonococcus tendovaginitis, are now well recognized. These do
not always proceed to suppuration, but may provoke loss of function
for some time.
The suppurative form of myositis is seen more often after typhoid
and gonorrhea than after the other internal infections, but may occur
after any of them. In these cases abscess results in the belly of the
muscle involved, while the pus evacuated will show the appropriate
organism. It is met with less often in endocarditis and erysipelas.
Any or all the active and destructive infections may occur primarily
in muscle structure. They are usually the result of an extension,
although they maybe even in this way very disastrous. The amount
of muscle destruction that may be seen in a limb after an infected
and neglected compound fracture is astonishing.
Myositis Calcificans.—Calcification and ossification of muscles
are alike due to deposition of calcium salts,
but under different circumstances. Myositis calcificans may be the
result of tuberculous disease following caseation, as it does in lymph
nodes and in other parts of the body, or occurring as a general
deposit throughout the muscles, essentially an infiltration, as is seen
in the muscles of the legs. Myositis ossificans implies a formation of
true bone in muscle substance. A peculiar form arising in the
adductor longus results from the pressure of the limb against the
saddle; this has been known as rider’s or cavalryman’s bone.
Something similar in the deltoid has been called drill bone, because
usually seen in soldiers who carry their weapons upon the shoulders;
while a form which occurs in the brachialis anticus has been referred
to as fencer’s bone, and one in the calf muscles as dancer’s bone. It
occurs in two types, one of which is characterized by ossification in
succession of the various muscles, this occurring first in the trapezii,
latissimi, and rhomboidei. In explanation of these lesions, it has been
suggested that all of these connective mesoblastic tissues may
manifest certain atavistic tendencies and thus revert to bone. The
question is certainly not one of periosteal origin. Binnie has shown,
in a remarkable case reported by himself, that ossification is both of
the fibrous and cartilaginous type. Only in the localized forms can the
periosteum be suspected. In these it may be that there has been
detachment of some of its tissue or escape of some of its cells into
the muscle area. The ossifying lesions of surrounding muscles will
sometimes interfere with the motions of joints after they have been
injured. Any localized calcareous or ossific deposit which can be
recognized may be removed.
Myositis Syphilitica.—This occurs in gummatous form, no
muscles being exempt; those of the tongue
are most frequently involved. It is seen also in the sternomastoid.
Not infrequently these gummas have been mistaken for malignant
tumors. Sometimes they degenerate and sometimes suppurate. A
lesion of this kind will usually be multiple, but it may have enough
infiltration around it to be difficult of recognition. Lesions of this kind
are also seen in hereditary cases. A more distinctively interstitial
affection of muscles leads sometimes to their contracture, as seen
about the arms, beginning with malaise and incoördination, and
extending to disabling lesions. These will yield to properly directed
antisyphilitic treatment.
Myositis Tuberculosa.—This affection is usually the result of
extension from adjoining foci. As in the
case of syphilis it may assume the infiltrating or the gummatous type.
It is more frequently encountered than the muscular expressions of
syphilis; it does not yield nearly as readily to treatment, and calls for
excision of the affected area and for cauterization or other protection
as against re-infection.

PARALYTIC AFFECTIONS OF MUSCLES.

More or less permanent paralysis is sometimes the result of
contusion or direct injury of a nerve trunk. Thus the paralysis of the
deltoid which follows injury to the circumflex nerve in connection with
dislocations of the shoulder is a frequent accident. It does not require
continued pressure upon the nerve to produce this. It may follow a
dislocation reduced within a few moments. Again, paralysis of the
arm muscles is occasionally the result of pressure made by crutches.
It has been known to occur from similar pressure while the patient
was upon the operating table with his arm hanging over the table’s
edge. This is an accident which should be carefully avoided.
Moreover, it follows sometimes from mere violent muscle effort. The
condition, while simple in its etiology, is difficult and sometimes
impossible to cure.
Treatment.—The treatment should consist mainly of massage and
electricity, with the elimination of all possibility of
toxemia. The resources of tendoplasty (see above) should also be
considered, as well as those of neuroplasty.

ATROPHIES AND CONTRACTURES OF MUSCLES.

Muscular paralysis is always followed by atrophy, which will lead to
marked diminution in size of the part; when the atrophy concerns a
single muscle or muscle group it will frequently be followed by
deformity due to action of the opposing muscles. Tonic spasm of
muscles unopposed may lead to contractures, often with ankylosis.
The degree of deformity which is produced may eventually require
amputation of a limb.
Other forms of contractures are produced either as the result of
central or spinal scleroses or as expressions of irritative spasm
provoked by a neighboring bone or joint trouble. The two types may
cause similar deformities, which vary widely in their etiology. The
former are seen in certain cases of brain and spinal-cord diseases,
the latter especially in connection with tuberculous arthritis.
Inasmuch as the flexors are stronger than the extensors these
deformities consist largely of hyperflexion. Ultimately the shape and
growth of bones and the nutrition, appearance, and function of the
part are influenced.
Muscle atrophy which is the result of confinement in one position,
as after the treatment of fractures, is of minor importance and tends
to disappear spontaneously as soon as function is resumed.
Treatment.—In most of these instances patience may be easily
overtaxed while waiting the tardy results of massage
and such correction as apparatus may afford. Very frequently the
additional help of an anesthetic, with forced movements, often with
tenotomies and sometimes with tendon grafting, will be required.
When contractures can be foreseen, as they may be in connection
with many lesions which produce them, such as burns and others
not specifically mentioned, they should be guarded against by
splints, apparatus, or whatever may best serve the purpose.

PARASITIC AFFECTIONS OF THE MUSCLES.

The parasitic affections of muscles are rare. Trichinosis rarely
produces tumors which come under the surgeon’s hands. Still there
may result from it a form of myositis with formation of cysts which
may so far interfere with muscle function as to demand removal.
Hydatid cysts and cysticercus are extremely rare, especially in this
country.

DISEASES OF THE BURSÆ.

There are two types of bursæ in the body: first, the subcutaneous,
or mucous, which are loose sacs containing a clear mucoid fluid.
They develop regularly when bony prominences are exposed to
friction and develop adventitiously wherever undue irritation is
produced. Thus beneath every bunion there will be found a good-
sized and thickened bursa.
Synovial bursæ, the second type, are met with in close proximity
to joints, and between tendons which play upon each other. They
frequently communicate with the joint which they overlie, and
infection may easily spread from one to the other. They are liable to
traumatism, either extrinsic or intrinsic, the former from chafing or
more direct injury, the latter by excessive muscle exertion. When
infected they suppurate, forming abscesses of conventional type. As
the result of contusions they are frequently filled with blood, in which
case there is a bursal hematoma. Acute bursitis usually merges into
localized abscess.
PLATE XXX
 Foreign Body (Broken Needle) in Foot. Buffalo
Clinic. (Skiagram by Dr. Plummer.) Illustrating
the Value of this Method of Exactly Locating a
Foreign Body and involving the Tissues
Considered in Chapter XXVIII.

Chronic bursitis constitutes a circumscribed collection of fluid,

often with thickening of the bursal sac, and frequent deposition of
products of exudation. Here, too, pus may form as the result of
infection, while calcification sometimes takes place in old cases. A
chronic bursitis is likely to be either of syphilitic or tuberculous origin.
It is usually seen beneath old bunions, and in the prepatellar bursa,
which is equally exposed to irritation, and which also gives rise to
housemaid’s knee. This lesion used to be considered as always of
syphilitic character, but this is far from correct.
Hygroma, or hydrops, is a term frequently applied to these
localized collections of fluid. The former is more likely to be of
tuberculous origin, and the retained fluid may contain rice-grain
bodies. A chronic bursitis, originally of traumatic origin, may become
infected and present a tuberculous lesion, or it may be influenced if
not caused by a syphilitic diathesis, especially about the knee, where
these conditions generally occur. Other bursæ which produce
disturbances that eventually take the patient to a surgeon are met
with in the following locations: beneath the ligamentum patellæ,
which will give a prominence on each side of the ligament,
particularly when the knee is flexed; over the tubercle of the tibia;
beneath the quadriceps extensor tendon, which will cause a swelling
two or three inches above the upper border of the patella; between
the tendon of the semimembranosus and inner head of the
gastrocnemius, which will present in the popliteal space as a
somewhat globular swelling; beneath the deltoid; beneath the
gluteus muscles, where the tendons pass over the great trochanter;
between the tendo Achillis and the calcis; over the outer malleolus,
occurring in tailors by virtue of the position in which they work. Large
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