The legend of Parson Rudall and the Botathen Ghost will be recognised by many Cornish people as a local remembrance of their boyhood. It appears from the diary of this learned master of the grammar-school--for such was his office, as ... Read more of The Botathen Ghost at Scary Stories.caInformational Site Network Informational
Privacy


Home


Medical Articles


Mother's Remedies


Household Tips


Medicine History


Forgotten Remedies


Search

Medical Articles

Is Physical Culture Good For Girls?

A NUMBER of women were watching a game of basket-ball...

Foreign Bodies In The Bronchi For Prolonged Periods

The sojourn of an inorganic foreign body in the bronchus for ...

Rupture

The abdomen is formed of a series of rings containing the bowe...

Bran Poultice

Get a sufficient quantity of good bran in an ordinary washhand...

Length Of Pack

Usually it is time for the patient to come out from his pack,...

Biscuits And Water

The biscuits referred to are manufactured in Saltcoats.[A] The...

Bronchial Aspiration

As mentioned above, bronchial aspiration is often necessary....

Cancer In Foot

We have noted one case in which "Cancerous Gangrene" in the fo...

Anesthesia In Heart Disease

While no physician likes to give an anesthetic to a patient w...

Our Spirit-levels

The Sixth Sense. Though we usually speak of having five sens...

Foreign Bodies In The Larynx And Tracheobronchial Tree

The protective reflexes preventing the entrance of foreign bo...

Weariness

Where persistent weariness is felt, and the least exertion bri...

Emergency Tracheotomy

Stabbing of the cricothyroid membrane, or an attempted stabb...

The Coal Foods

Kinds of Coal Foods. There are many different kinds of Coal...

Decompensation

To understand the physiology, pathology and the best treatmen...

Symptoms

The symptoms are increased tension, which means, sooner or la...

Hands Dry And Hard

Pack the hands in SOAP LATHER (see) mixed with a little fine o...

Shingles

Though not often fatal, this illness gives serious trouble. It...

Torpid Liver

Take A D or B D current, full medium force. Treat with N. P. ...

The Care Of The Heart-pump

The Effect of Work upon the Heart. Whatever else in this body...



Entering The Bronchi





Category: INTRODUCTION OF THE ESOPHAGOSCOPE
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery

The lip of the bronchoscope should be turned
in the direction of the bronchus to be explored, and the axis of the
bronchoscope should be made to correspond as nearly as possible to the
axis of this bronchus. The position of the lip is designated by the
direction taken by the handle. Upon entering the right bronchus, the
handle of the bronchoscope is turned horizontally to the right, and at
the same time the assistant deflects the head to the left.

The right upper-lobe bronchus is recognized by its vertical spur;
the orifice is exposed by displacing the right lateral wall of the
right main bronchus at the level of the carina. Usually this orifice
will be thus brought into view. If not the bronchoscope may be
advanced downward 1 or 2 cm., carefully to avoid overriding. This
branch is sometimes found coming off the trachea itself, and even if
it does not, the overriding of the orifice is certain if the right
bronchus is entered before search is made for the upper-lobe-bronchial
orifice. The head must be moved strongly to the left in order to view
the orifice. A lumen image of the right upper-lobe bronchus is not
obtainable because of the sharp angles at which it is given off. The
left upper-lobe bronchus is entered by keeping the handle of the
bronchoscope (and consequently the lip) to the left, and, by keeping
the head of the patient strongly to the right as the bronchoscopist
goes down the left main bronchus. This causes the lip of the
bronchoscope to bear strongly on the left wall of the left main
bronchus, consequently the left upper-lobe-bronchial orifice will not
be overridden. The spur separating the upper-lobe-bronchial orifice
from the stem bronchus is at an angle approximately from two to eight
o'clock, as usually seen in the recumbent patient. A lumen image of a
descending branch of the upper-lobe bronchus is often obtained, if the
patient's head be borne strongly enough to the right.

[FIG. 65.--Schema illustrating the entering of the anteriorly
branching middle lobe bronchus. T, Trachea; B, orifice of left main
bronchus at bifurcation of trachea. The bronchoscope, S, is in the
right main bronchus, pointing in the direction of the right inferior
lobe bronchus, I. In order to cause the lip to enter the middle lobe
bronchus, M, it is necessary to drop the head so that the bronchoscope
in the trachea TT, will point properly to enable the lip of the tube
mouth to enter the middle lobe bronchus, as it is seen to have done at
ML.]

Branches of the stem bronchus in either lung are exposed, or their
respective lumina presented, by manipulation of the lip of the
bronchoscope, with movement of the head in the required direction.
Posterior branches require the head quite high. A large one in the
left stem just below the left upper-lobe bronchus is often invaded by
foreign bodies. Anterior branches require lowering the head. The
middle-lobe bronchus is the largest of all anterior branches. Its
almost horizontal spur is brought into view by directing the lip of
the bronchoscope upward, and dropping the head of the patient until
the lip bears strongly on the anterior wall of the right bronchus (see
Fig. 65).





Next: Introduction Of The Esophagoscope

Previous: The Fulcrum Of The Bronchoscopic Lever Is At The Upper Thoracic Aperture



Add to del.icio.us Add to Reddit Add to Digg Add to Del.icio.us Add to Google Add to Twitter Add to Stumble Upon
Add to Informational Site Network
Report
Privacy
SHAREADD TO EBOOK


Viewed 853