|VIEW THE MOBILE VERSION of www.homemedicine.ca|| Informational|
Medical ArticlesNature's Teaching
NATURE is not only our one guide in the matter of phy...
Direct Laryngoscopy Adult Patient
Before starting, every detail in regard to instrumental equi...
Rash Or Hives
Infants are often troubled with large red, angry-looking spots...
The Freedom Of Life
I AM so tired I must give up work," said a young woma...
When a limb becomes swelled and white, pouring hot water very ...
If the case be recent, take the B D current; if old, take A D...
Bronchoscopy In Diseases Of The Trachea And Bronchi
The indications for bronchoscopy in disease are becoming inc...
The presence of a well marked case of exophthalmic goiter is ...
The Surgical Dissection Of The Superficial Bloodvessels Etc Of The Inguino-femoral Region
Hernial protrusions are very liable to occur at the inguino-f...
How Nuts should be Used. Another form of fat is the meat of ...
Scarlet-fever Or Scarlatina
is an eruptive fever, produced by a peculiar contagious poiso...
I see a lot of spiritually-induced physical illness in my pra...
Inspection of the hypopharynx and upper esophagus is readily...
Nerve Centres Failing
Many diseases flow from this cause, but at present we only con...
Stage 3 Passing Through The Thoracic Esophagus
The thoracic esophagus will be seen to expand during inspira...
The Sitz-bath May Be Taken In A Small Wash-tub If There Is No
proper sitz-bath-tub at hand. It should be large enough to allo...
Balance Loss Of
Cases where loss of balance in walking and standing are due to...
Alice was a middle-aged woman who couldn't understand why she...
How To Sleep Restfully
IT would seem that at least one might be perfectly fr...
This distressing symptom, which accompanies various illnesses,...
Difficulties Of Direct Laryngoscopy
Category: DIRECT LARYNGOSCOPY
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery
The larynx can be
directly exposed in any patient whose mouth can be opened, although
the ease varies greatly with the type of patient. Failure to expose
the epiglottis is usually due to too great haste to enter the speculum
all the way down. The spatula should glide slowly along the posterior
third of the tongue until it reaches the glossoepiglottic fossa, while
at the same time the tongue is lifted; when this is done the
epiglottis will stand out in strong relief. The beginner is apt to
insert the speculum too far and expose the hypopharynx rather than the
larynx. The elusiveness of the epiglottis and its tendency to retreat
downward are very much accentuated in patients who have worn a
tracheotomic cannula; and if still wearing it, the patient can wait
indefinitely before opening his glottis. Over extension of the
patient's head is a frequent cause of difficulty. If the head is held
high enough extension is not necessary, and the less the extension the
less muscular tension there is in the anterior cervical muscles. Only
one arytenoid eminence may be seen. The right and the left look
different. Practice will facilitate identification, so that the
endoscopist will at once know which way to look for the glottis.
Of the difficulties that pertain to the operator himself the greatest
is lack of practice. He must learn to recognize the landmarks even
though a high degree of spasm be present. The epiglottis and the two
rounded eminences corresponding to the arytenoids must be in the
mind's eye, for it is only on deep, relaxed inspiration that anything
like a typical picture of the larynx will be seen. He must know also
the right from the left arytenoid when only one is seen in order to
know whether to move the lip of the laryngoscope to the right or the
left for exposure of the interior of the larynx.
Next: Instruments For Direct Laryngoscopy
Previous: Rules For Direct Laryngoscopy