. Local and regional anesthesia; with chapters on spinal, epidural, paravertebral, and parasacral analgesia, and other applications of local and regional anesthesia to the surgery of the eye, ear, nose and throat, and to dental practice. - Coronoid process Internal oblique lineExternal oblique line Internal obliqueline -Mental foramen Fig. 186.—Relationship of the ascending ramus to the body of the jaw. The arrowindicates the direction in which the syringe should be advanced to the inferior dentalforamen. (After Fischer.) The foramen itself, in adults, is always situated above the alveolarridg
. Local and regional anesthesia; with chapters on spinal, epidural, paravertebral, and parasacral analgesia, and other applications of local and regional anesthesia to the surgery of the eye, ear, nose and throat, and to dental practice. - Coronoid process Internal oblique lineExternal oblique line Internal obliqueline -Mental foramen Fig. 186.—Relationship of the ascending ramus to the body of the jaw. The arrowindicates the direction in which the syringe should be advanced to the inferior dentalforamen. (After Fischer.) The foramen itself, in adults, is always situated above the alveolarridge and in a horizontal plane, about cm. from the anterior ridgeof the jaw (the external obhque line) (Figs. 187-189). The two halves of the mandible, when viewed from in front,gradually diverge toward the angle, so that the inner surface of theangle with the mandibular foramen is inclined posteriorly andpharyngeally, and appears to be entirely covered by the internaloblique line. (See Figs. 186, 187, 190, loi). ^6o LOCAL ANESTHESIA ^Position of Syringe.—The line of the body of the mandible is nothorizontally continuous in a straight line to the ascending ramus, Coronoid ——Condyloid process. ZlAngle Mylohyoid ridge Mylohyoidgroove Fig. 187.—Variations of the inferior dental foramen at (iilTcrcnt ages: A, Mandibleof a child, aged seven years (the needle should be inclined slightly downward); H. man-dible of a youth, aged eighteen years; C, mandible of a male adult, aged thirty arrows indicate the direction of the needle. (.After Fischer.) but presents a lateral bulging at the angle, so that the internal surfaceof the ascending ramus is not parallel with the lingual surface of thebody of the jaw. (See Figs. 18C, 190, 191.) The ramus opens pos- THE HEAD, SCALP, CRANIUM, BRAIK, AND FACE 561 teriorly. (See Figs. 188, 189, 190, 191.) If, therefore, the obliqueforamen is to be reached, we must never advance posteriorly parallelwith the teeth (Figs. 192, 193), but
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