Peroral endoscopy and laryngeal surgery . constantly changing, the variety of forms in the eiuloscoiiic pictureis almost cntUess. The respiratory, bechic, pulsatory, reflex and trans-mitted muscular movements and compressions so modify the normalimage that nothing but study of the image, as seen in the living, will 176 INTRODUCTION OF THE BRONCHOSCOPE. educate the eye, as elsewhere meiilioned. When the axes of the bronchialand the bronchoscopic lumhia exactly correspond, the lumen of thebronchus seems to diminish more or less concentrically owing to per-spective, and the orifices of the branch
Peroral endoscopy and laryngeal surgery . constantly changing, the variety of forms in the eiuloscoiiic pictureis almost cntUess. The respiratory, bechic, pulsatory, reflex and trans-mitted muscular movements and compressions so modify the normalimage that nothing but study of the image, as seen in the living, will 176 INTRODUCTION OF THE BRONCHOSCOPE. educate the eye, as elsewhere meiilioned. When the axes of the bronchialand the bronchoscopic lumhia exactly correspond, the lumen of thebronchus seems to diminish more or less concentrically owing to per-spective, and the orifices of the branch bronchi with the white shiningridge between are seen beyond (Fig. 143). These views represent com-plete images which are momentarily obtained. Movements of the vari-ous kinds mentioned are constantly hiding the orifices and ridges thatare a centimeter or more beyond the tube-mouth. These are accuratelypresented images. When the axis of the bronchoscope deviates fromcoincidence with the luminal axis, more or less of the wall toward which. Fig. 143.—Normal endoscopic images. Semiscliematic. i. Left main , left upper lobe bronchus. I, left inferior lobe bronchus (or stem bronchus),showing dorsal and ventral branches. 2. Right main bronchus. SL, superior lobebronchus. M, middle lobe. I, lower lobe bronchus showing orifices of dorsal andventral branches. The main bronchus (right or left) below the upper lobebronchus is usually referred to as stem bronchus because there is no true bifurca-tion, only a giving off of lesser branches from the stem. the tube-mouth de\iates, is seen. the form and position of the ringsseen in perspective in the bronchial wall it is possible to estimate howfar the luminal axis deviates from the bronchoscopic axis, and thus thedirection of the particular branch bronchus may be estimated. By thesame means the proper direction in which to move the tube to obtain aview directl)- into the long axis of the lumen is known. C)n the posteriortrachea
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectrespira, bookyear1915
