Site Of Lodgement
Categories: FOREIGN BODIES IN THE ESOPHAGUSSources: A Manual Of Peroral Endoscopy And Laryngeal Surgery
Almost all foreign bodies are arrested in the
cervical esophagus at the level of the superior aperture of the
thorax. A physiologic narrowing is present at this level, produced in
part by muscular contraction, and mainly by the crowding of the
adjacent viscera into the fixed and narrow upper thoracic aperture. If
dislodged from this position the foreign body usually passes downward
to be arrested at the next narrowing or to pass into the stomach. The
esophagoscopist who encounters the difficulty of introduction at the
cricopharyngeal fold expects to find the foreign body above the fold.
Such, however, is almost never the case. The cricopharyngeus muscle
functionates in starting the foreign body downward as if it were food;
but the narrowing at the upper thoracic aperture arrests it because
the esophageal peristaltic musculature is feeble as compared to the
powerful inferior constrictor.
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Rupture And Trauma Of The Esophagus
These may be spontaneous or may ensue from the passage of an instrument, or foreign body, or of both combined, as exemplified in the blind attempts to remove a foreign body or to push it downwards. Digestion of the esophagus and perforation may resu... Safety-pin Closer
There are a number of methods for the endoscopic removal of open safety-pins when the point is up, one of which is by closing the pin with the instrument shown in Fig. 37 in the following manner. The oval ring is passed through the endoscope until i... Scald Head
of children, where there is a discharge of yellow and watery pus from the sores, and the eruption extends to the ears or face, like the disease called the _crusta lactea_ (milk crust), the same washes as for itch, are the most effectual, while at th... Scarlatina Anginosa Or Sore-throat Scarlet-fever
Wherever the _throat_ is affected, which is almost always the case, the disease is called _scarlatina anginosa_, or _sore-throat scarlet-fever_. This is the form described at the commencement of this article. There are several varieties, however, of... Scarlatina Miliaris
Sometimes the red patches of the rash are covered with small vesicles of the size of mustard-seed, which either dry up or discharge a watery liquid, leaving thin white scurfs, that come away with the cuticle during desquamation. Although this form, ... Scarlatina Simplex Or Simple Scarlet-fever
In the _mildest form_ of the disease, called _scarlatina simplex_, or _simple scarlet-fever_, there is no inflammation of the throat, the fever is moderate, and the patient suffers very little. Unfortunately this form is so rare, that many experienc... Scarlatina Sine Exanthemate
There are also mild cases of scarlet-fever, when little or no rash appears, and the throat is very little affected. These are the result of a particularly mild character of the epidemy, together with a peculiar condition of the skin, the desquamatio... Scarlet Fever
This fever assumes two principal forms: Simple or mild, and Malignant. In the _Simple form_, there is great heat of the surface, extremely quick and frequent pulse, headache, and some sense of pain and soreness in the throat. After a day or two, the... Scarlet-fever Or Scarlatina
is an eruptive fever, produced by a peculiar contagious poison, and distinguished by extreme heat, a rapid pulse, a severe affection of the mucous membranes, especially those of the mouth and throat, and by a burning scarlet eruption on the skin. ... Sciatica
This is neuralgia in an ischiatic nerve, commonly the great ischiatic. Use the B D current, strong as the patient can well bear. Place the foot in warm water with N. P., or place the sponge-roll N. P. at the sole of the foot, (the former is the be... Sea-sickness
_Nux Vomica_ should be used once in about four hours, for twelve hours before sailing, as a preventive to sea-sickness. If, however, symptoms, such as dizziness or blur before the eyes, and headache, begin to come on, a dose of _Nux_ should be tak... Second Stage
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... Secondary Eliminations Are Disease
However the exact form the chain from irritation or malnutrition to enervation progresses, the ultimate result is an increased level of toxemia, placing an eliminatory burden on the liver and kidneys in excess of their ability. Eventually these orga... Self-consciousness
SELF-CONSCIOUSNESS may be truly defined as a person's inability to get out of his own way. There are, however, some people who are so entirely and absolutely self-conscious that everything they do, even though it may appear spontaneous and i... Self-control
TO most people self-control means the control of appearances and not the control of realities. This is a radical mistake, and must be corrected, if we are to get a clear idea of self-control, and if we are to make a fair start in acquiring i... Sentiment _versus_ Sentimentality
FREEDOM from sentimentality opens the way for true sentiment. An immense amount of time, thought, and nervous force is wasted in sentimentalizing about "being good." With many, the amount of talk about their evils and their desire to overcome them... Shock
The treatment of shock will probably always be unsatisfactory as the cause is so varied, and, although circulatory prostration and vasomotor paresis always constitute the acute condition, the physiologic health of the heart and blood vessels is so v... Signs Of Heart Weakness
It should be remembered that a normal heart may slow to about 60 during sleep, and all nervous acceleration of the pulse may be differentiated during sleep by the fact that if the heart does not markedly slow, there is cardiac weakness or some gener... Simple Dilatation
The term "simple dilatation" may be applied to the dilatation of one or both ventricles when there is no valvular lesion and when the condition may not be called broken compensation. The compensation has been sufficiently discussed. Dilatation of th... Simple Hypertrophy
Like any other muscular tissue, the heart hypertrophies when it has more work to do, provided this work is gradually increased and the heart is not strained by sudden exertion. To hypertrophy properly the heart must go into training. This training... Site Of Lodgement
Almost all foreign bodies are arrested in the cervical esophagus at the level of the superior aperture of the thorax. A physiologic narrowing is present at this level, produced in part by muscular contraction, and mainly by the crowding of the adja... Site Of Lodgment
The majority of foreign bodies in the air passages occur in children. The right bronchus is more frequently invaded than the left because of the following factors: I. Its greater diameter. 2. Its lesser angle of deviation from the tracheal axis. 3. ... Sitz-bath Anchor Of Safety
If there be much delirium, the sitz-bath may be required longer, and the pack shorter, as indicated above (81). In all such cases the packs and sitz-baths, alternately, ought to be continued, till the nervous symptoms disappear altogether, and shoul... Sleep And Rest
Why We Need Rest. A most important element in a life of healthful exercise, study, and play is rest. Even when we are hard at work, we need frequent breathing spells and changes of occupation and amusement to keep one part of our muscles, or our bra... Small Pox - Variola
This disease begins with pain in the head and back, chilly sensations, followed by a high fever, so similar in all respects to a severe attack of Bilious or "winter" fever, that it is difficult or impossible to distinguish it with certainty, as Smal... Small-pox
_Small-pox_, by far the most dangerous of them, has found a barrier in its destructive progress in Dr. Jenner's discovery. Vaccination is an almost sure prophylactic against it; but, notwithstanding, many, with whom the preservative was neglected or... Social/cultural/psychological Obstacles To Fasting
Numerous attitudes make it difficult to fast or to provide moral support to friends or loved ones that are fasting. Many people harbor fears of losing weight because they think that if times were really tough, if there was a famine or they became il... Sore Nipples
This affection of nursing women frequently comes on before the birth of the child, but generally does not make its appearance until after the suckling has continued for a week or more. It seems in some cases to be connected with the aphthae (sore mo... Spasmodic Stenosis Of The Esophagus
Etiology - The functional activity of the esophagus is dependent upon reflex action. The food is propulsed in a peristaltic wave by the same mechanism as, and through an innervation (Auerbach and Meissner plexus) similar to that which controls intes... Spatula-protected Method
Safety-pins in children, point upward, when lodged high in the cervical esophagus may be readily removed with the aid of the laryngoscope, or esophageal speculum. The keeper end is grasped with the alligator forceps, while the spatular tip of the l... Spectacles
If the operator has no refractive error he will need two pairs of plane protective spectacles with very large eyes. If ametropic, corrective lenses are necessary, and duplicate spectacles must be in charge of a nurse. For presbyopia two pairs of spe... Specular Esophagoscopy
Inspection of the hypopharynx and upper esophagus is readily made with the esophageal speculum shown in Fig. 4. High lesions and foreign bodies lodged behind the larynx are thus discovered with ease, and such a condition as a retropharyngeal absces... Spermatorrhea
The points to be gained are, to reduce the action of the amatorial organs of the brain and the secretion of the testes, and to contract and strengthen the tissue of the seminal vesicles and the prostrate gland. Take the B D current. First, treat ... Sponge-pumping
While the usually thin, watery esophageal and gastric secretions, if free from food, are readily aspirated through a drainage canal, the secretions of the bronchi are often thick and mucilaginous and aspirated with difficulty. Further-more, bronchia... Stage 2
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 tha... Stage 3 Passing Through The Thoracic Esophagus
The thoracic esophagus will be seen to expand during inspiration and contract during expiration, due to the change in thoracic pressure. The esophagoscope usually glides easily through the thoracic esophagus if the patient's position is correct. Af... Stage 4 Passing Through The Hiatus Esophageus
When the head is dropped, it must at the same time be moved horizontally to the right in order that the axis of the tube shall correspond to the axis of the lower third of the esophagus, which deviates to the left and turns anteriorly. The head and... Stage I Entering The Right Pyriform Sinus
The operator standing (as in Fig. 66), inserts the esophagoscope along the right side of the tongue as far as and down the posterior pharyngeal wall. A lifting motion imparted to the tip of the esophagoscope by the left thumb will bring the rounded... Starches
Sources of Starch. The starches are valuable and wholesome foods. They form the largest part, both in bulk and in fuel value, of our diet, and have done so ever since man learned how to cultivate the soil and grow crops of grain. The reason is clear... Starvation
It is true that ethical medical doctors use the least-risky procedure they are allowed to use. But this does not mean there are no risks to allopathic treatment. The medical doctor justifies taking the risks by saying that the risk/reward ratio is t...