VIEW THE MOBILE VERSION of www.homemedicine.ca Informational Site Network Informational
Privacy


Home


Medical Articles


Mother's Remedies


Household Tips


Medicine History


Forgotten Remedies


Search

Medical Articles

Aphonia Loss Of Voice

This affection requires treatment variously, as it depends on...

Catarrh Chronic

If in the head, first give face-bath, as in common colds, exc...

Wounds Bleeding Of

After sending for a surgeon the first thing to be looked at in...

Dropsy

Use the A D current, moderate force. Give general tonic treat...

Styptic Charms

Fancy can save or kill; it hath closed up wounds, when t...

Glands Swollen

This is a very common trouble, especially in the young. To res...

To Prevent Small-pox

Use _Macrotin_ 1st night and morning, and if nursing or expos...

Weaning

Many of the troubles which come in this process arise simply f...

Nervous Prostration

Persons suffering from nervous prostration have probably allow...

Gastroscopes

The gastroscope is of the same construction as the esophagos...

Trauma

The chief traumatic factors in chronic laryngeal stenosis ar...

Barley

If this grain is well grown and thoroughly well cooked, it wil...

Alkalies

Anything which tends to increase the acidity of the tissues a...

Sea-sickness

The cause of this is a nervous derangement of the internal org...

Diet And Corpulence

A tendency to obesity should always be carefully checked by at...

Paralysis

Take the B D current, medium force. If the paralysis be in a ...

Paroxysmal Tachycardia Management

There is no specific treatment for paroxysmal tachycardia. Wh...

Polypus

See Nostrils. ...

Wounds And Bruises

On this subject, I must necessarily be very brief. When a wou...

Additional Rules For The Treatment Of Eruptive Diseases

In all these eruptive diseases, especially small-pox, all I h...



Second Stage





Category: DIRECT LARYNGOSCOPY
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery

The spatular end of the laryngoscope should now be
tipped back toward the posterior wall of the pharynx, passed posterior
to the epiglottis, and advanced about 1 cm. The larynx is now exposed
by a motion that is best described as a suspension of the head and all
the structures attached to the hyoid bone on the tip of the spatular
end of the laryngoscope (Fig. 55). Particular care must be taken at
this stage not to pry on the upper teeth; but rather to impart a
lifting motion with the tip of the speculum without depressing the
proximal tubular orifice. It is to be emphasized that while some
pressure is necessary in the lifting motion, great force should never
be used; the art is a gentle one. The first view is apt to find the
larynx in state of spasm, and affords an excellent demonstration of
the fact that the larynx can he completely closed without the aid of
the epiglottis. Usually little more is seen than the two rounded
arytenoid masses, and, anterior to them, the ventricular bands in more
or less close apposition hiding the cords (Fig. 56). With deep
general anesthesia or thorough local anesthesia the spasm may not be
present. By asking the patient to take a deep breath and maintain
steady breathing, or perhaps by requesting a phonatory effort, the
larynx will open widely and the cords be revealed. If the anterior
commissure of the larynx is not readily seen, the lifting motion and
elevation of the head should be increased, and if there is still
difficulty in exposing the anterior commissure the assistant holding
the head should with the index finger externally on the neck depress
the thyroid cartilage. If by this technic the larynx fails to be

revealed the endoscopist should ask himself which of the following
rules he has violated.

[FIG. 55.--Schema illustrating the technic of direct laryngoscopy on
the recumbent patient. The motion is imparted to the tip of the
laryngoscope as if to lift the patient by his hyoid hone. The portion
of the table indicated by the dotted line may be dropped or not, but
the back of the head must never go lower than here shown, for direct
laryngoscopy; and it is better to have it at least 10 cm. above the
level of the table. The table may be used as a rest for the operator's
left elbow to take the weight of the head. (Note that in bronchoscopy
and esophagoscopy the head section of the table must be dropped, so as
to leave the head and neck of the patient out in the air, supported by
the second assistant.)]

[FIG. 56.--Endoscopic view at the end of the second stage of direct
laryngoscopy. Recumbent patient. Larynx exposed waiting for larynx to
relax its spasmodic contraction.]





Next: Rules For Direct Laryngoscopy

Previous: First Stage



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 1108