|VIEW THE MOBILE VERSION of www.homemedicine.ca|| Informational|
Medical ArticlesTo Prevent Yellow Fever
Take _Aconite_, _Belladonna_ and _Macrotin_, 1st in rotation ...
Bowels Glands Of
Symptoms of glandular trouble in the bowels are--weariness and...
Janeway [Footnote: Janeway, T. C.: A Clinical Study of Hypert...
Probably most acute infections cause more or less myocarditis...
That medicines act locally, that is, manifest their symptoms ...
Inflammation Of The Bowels - Enteritis
This consists in inflammation of the muscular and peritoneal ...
applied, with water at the strength of thirty drops of the _t...
Throat Sore (clergyman's)
Those who are in the habit of using their voice much should be...
The author wishes to caution the reader not to rely merely on...
This symptom or affection, (if it can be classed as a disease...
Direct Laryngoscopy In Children
The epiglottis in children is usually strongly curled, often...
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...
Cicatricial Stenosis Of The Esophagus
Etiology.--The accidental swallowing of caustic alkali in sol...
Aphonia Loss Of Voice
This affection requires treatment variously, as it depends on...
To Prevent Itch
A dose of _Sulphur_, or rubbing a little flour of sulphur on ...
The use of these to give temporary relief, often degenerating ...
The regular bronchoscope is a hollow brass tube slanted at i...
A very useful and comparatively safe method is illustrated i...
Diets To Heal The Critically Ill
A critically ill person is someone who could expire at any mo...
It is difficult to determine the cause of toothache, and more...
Category: INTRODUCTION OF THE ESOPHAGOSCOPE
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery
Passing the cricopharyngeus is the most difficult part of
esophagoscopy, especially if the patient is unanesthetized. Local
anesthesia helps little, if at all. The handle of the esophagoscope is
still pointing upward and consequently we are sure that the lip of the
esophagoscope is directed anteriorly. Force must not be used, but
steady firm pressure against the tonically contracted cricopharyngeus
is made, while at the same time the distal end of the esophagoscope is
lifted by the left thumb. At the first inspiration a lumen will
usually appear in the upper portion of the endoscopic field. The tip
of the esophagoscope enters this lumen and the slanted end slides over
the fold of the cricopharyngeus into the cervical esophagus. There is
usually from 1 to 3 cm. of this constricted lumen at the level of the
cricopharyngeus and the subjacent orbicular esophageal fibers.
 [FIG. 67.--Schematic illustration of the author's high-low
method of esophagoscopy. In the first and second stages the patient's
head fully extended is held high so as to bring it in line with the
thoracic esophagus, as shown above. The Rose position is shown by way
[FIG. 68.--Schematic illustration of the anatomic basis for difficulty
in introduction of the esophagoscope. The cricoid cartilage is pulled
backward against the cervical spine, by the cricopharyngeus, so
strongly that it is difficult to realize that the cricopharyngeus is
not inserted into the vertebral periosteum instead of into the median
[FIG. 69.--The upper illustration shows movements necessary for
passing the cricopharyngeus.
The lower illustration shows schematically the method of finding the
pyriform sinus in the author's method of esophagoscopy. The large
circle represents the cricoid cartilage. G, Glottic chink,
spasmodically closed; VB, ventricular band; A, right arytenoid
eminence; P, right pyriform sinus, through which the tube is passed in
the recumbent posture. The pyriform sinuses are the normal food
Next: Stage 3 Passing Through The Thoracic Esophagus
Previous: Stage I Entering The Right Pyriform Sinus