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The Fulcrum Of The Bronchoscopic Lever Is At The Upper Thoracic Aperture
Category: INTRODUCTION OF THE BRONCHOSCOPE
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery
Disregard of this rule will cause
subglottic edema and will limit the lateral motion of the tip of the
bronchoscope. It is the function of the assistant to make the head and
neck follow the direction of the proximal end of the bronchoscope and
thus avoid any pressure on the larynx (see Peroral Endoscopy, Fig.
135, p. 164).
In passing down the trachea the following two rules must be kept in
1. Before attempting to enter either main bronchus the carina must
2. Before entering either main bronchus the orifices of both should
be identified and inspected.
The carina is identified as a sharp vertical spur (recumbent
patient) at the distal end of the trachea, on either side of which are
the openings of the main bronchi. As the carina is situated to the
left of the midline of the trachea, the lip of the bronchoscope should
be turned toward the left, and slight lateral pressure should be made
on the left tracheal wall while the head of the patient is held
slightly to the right. This will expose the left bronchial orifice and
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