WHEN first I saw our banner wave Above the nation's council-hall, I heard beneath its marble wall The clanking fetters of the slave! In the foul market-place I stood, And saw the Christian mother sold, And childhood with its locks of gold,... Read more of Abolition Of Slavery In The District Of Columbia, 1862 at Martin Luther King.caInformational Site Network Informational
Privacy


Home


Medical Articles


Mother's Remedies


Household Tips


Medicine History


Forgotten Remedies


Search

Medical Articles

Drinks Refreshing

This is a matter of great importance to the sick. Nor is anyth...

Heel Sprained

Often in sprains all attention is given to the bruised and tor...

Asiatic Cholera

I was practicing in Cincinnati during the prevalence of Chole...

Pulse Counting The

Most valuable information as to the nature and progress of dis...

Cardiovascular Renal Disease Arrhythmia

While this terns really signifies irregularity and intermit...

Chloride Of Lime

About the same opinion may be given on _Chloride of Lime_. As...

Paroxysmal Tachycardia Management

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

Disorders Of Muscles And Bones

The Muscles and Bones Have Few Diseases. Considering how comp...

The Cause Of Disease

Ever since natural medicine arose in opposition to the violen...

Treatment Of Broken Compensation

The consideration of this subject will include the following ...

Greatrakes

VALENTINE GREATRAKES was born at Affane, County of Waterford,...

Acute Mild Endocarditis

This inflammation of the endocardium is generally confined to...

Lancing Swellings

See Abscess. ...

Ringworm

This distressing and most infectious trouble is due to a small...

Entering The Bronchi

The lip of the bronchoscope should be turned in the directio...

Whooping Cough

The cough is a spasmodic action of nerves which are otherwise ...

Extent Of Electric Agency

When we have settled upon the position that the electricity o...

Contrariness

I KNOW a woman who says that if she wants to get her ...

Talismans

A talisman may be described as an emblematical object or im...

To Prevent Colds

Keep the _arms_, _hands_ and _chest_ well clothed and warm. ...



Stage 2





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.

[109] [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
of accentuation.]

[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
raphe.]

[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
passages.]





Next: Stage 3 Passing Through The Thoracic Esophagus

Previous: Stage I Entering The Right Pyriform Sinus



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 1060