If the disease be general in the system, moving from place to...
Compression Stenosis Of The Esophagus
The esophagus may be narrowed by the pressure of any periesop...
Of Fungous Ulcer Of The Navel In Infants
It sometimes occurs that a little fungous sore exists upon th...
Amenorrhea Suppressed Menstruation
Treat as for chlorosis. But if the case be recent--the effect...
See Bowels, Locking of, above. ...
Acute Dilatation Of The Heart In Acute Disease
It has for a long time been recognized that in all acute prol...
The Light Reflex On The Forceps
It is often difficult for the beginner to judge to what dept...
The Surgical Dissection Of The Popliteal Space And The Posterior Crural Region
On comparing the bend of the knee with the bend of the elbow,...
Burns Case Xxxv
The following case will present a specimen of my trials of th...
Extraction Of Tacks Nails And Large Headed Foreign Bodies From The Tracheobronchial Tree
In cases of this sort the point presents the same difficulty...
Early Symptoms Of Irritating Foreign Body Such As A Peanut Kernel In The Bronchus
1. Initial laryngeal spasm is almost invariably present wit...
THE mere idea of a brain clear from false impressions gives a...
Many of the troubles which come in this process arise simply f...
The delusion that health can be restored by swallowing drugs i...
Towels Cold Wet
A towel of the ordinary kind, and full size, is soaked in a ba...
Circulation Of The Blood
Nothing is more important for the health or healing of any org...
Generally the tongue will tell whether the stomach is ulcerate...
For use in our treatment we recommend Coutts' Acetic Acid. It ...
Diet And Corpulence
A tendency to obesity should always be carefully checked by at...
Varix And Angioma Of The Esophagus
These lesions are sometimes the cause of esophageal hemorrhag...
Examination Of The Trachea And Bronchi
Category: INTRODUCTION OF THE BRONCHOSCOPE
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery
All bronchial orifices must
be identified seriatim; because this is the only way by which the
bronchoscopist can know what part of the tree he is examining.
Appearances alone are not enough. It is the order in which they are
exposed that enables the inexperienced operator to know the orifices.
After the removal of the laryngoscope, the bronchoscope is to be held
by the left hand like a billiard cue, the terminal phalanges of the
left middle and ring fingers hooking over the upper teeth, while the
thumb and index finger hold the bronchoscope, clamping it to the teeth
tightly or loosely as required (Fig. 63). Thus the tube may be
anchored in any position, or at any depth, and the right hand which
was directing the tube may be used for the manipulation of
instruments. The grasp of the bronchoscope in the right hand should be
similar to that of holding a pen, that is, the thumb, first, and
second fingers, encircle the shaft of the tube. The bronchoscope
should never be held by the handle (Fig. 64) for this grasp does not
allow of tactile sense transmission, is rigid, awkward, and renders
rotation of the tube a wrist motion instead of but a gentle finger
action. Any secretion in the trachea is to be removed by sponge
pumping before the bronchoscope is advanced. The inspection of the
walls of the trachea is accomplished by weaving from side to side and,
if necessary, up and down; the head being deflected as required during
the search of the passages, so that the larynx be not made the fulcrum
in the lever-like action.
[FIG. 64.--At A is shown an incorrect manner of holding the
bronchoscope. The grasp is too rigid and the position of the hand is
awkward. B, Correct manner, the collar being held lightly between the
finger and the thumb The thumb must not occlude the tube mouth.]
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Previous: Difficulties In The Introduction Of The Bronchoscope