InformationalPrivacy
| VIEW THE MOBILE VERSION of www.homemedicine.ca | Informational Privacy |
 |
Home |
Medical Articles |
Mother's Remedies |
Household Tips |
Medicine History |
Forgotten Remedies |
Search |
Medical ArticlesErysipelasThis troublesome disease is also known as St. Anthony's Fire, ... Demonstrations Of The Nature Of Congenital And Infantile Inguinal Herniae And Of Hydrocele PLATE 39. Fig. 1--The descent of the testicle from the loins ... To Prevent Itch A dose of _Sulphur_, or rubbing a little flour of sulphur on ... The Dissection Of The Oblique Or External And The Direct Or Internal Inguinal Herniae The order in which the herniary bowel takes its investments f... The Religion Of It THE religion of it is the whole of it. "All religion ... Colic Of Whatever Kind Use A D current, pretty strong force. In severe cases, introd... Piles This very common trouble is caused by one or more of the veins ... Nature's Teaching NATURE is not only our one guide in the matter of phy... Period Of Eruption Or Appearing Of The Rash Commonly, on the second day, towards evening, sometimes on th... Headache This symptom or affection, (if it can be classed as a disease... Flushings Hot These are often a really serious trouble, especially to women,... Hives See Rash. ... The Resort Treatment Of Chronic Heart Disease In line with the continued growing popularity of special reso... Paroxysmal Tachycardia This condition is generally termed by the patient a "palpitat... Contraindications To Direct Laryngoscopy There are no absolute contraindications to direct laryngosco... Rebellion! _This is preaching rebellion!_ I know it is, and it is wit... Chloride Of Lime About the same opinion may be given on _Chloride of Lime_. As... The Unrelenting Boredom Of Fasting Then there's the unrelenting boredom of fasting. Most people ... The Blood-mesh Of The Skin The Blood Vessels under the Skin. Not merely the nails and th... Eyes Spots On These spots are of two different kinds, and yet they are very ... |
Second StageCategory: 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
Viewed 1074 |
||||||||||||||||||||
