. Local and regional anesthesia : with chapters on spinal, epidural, paravertebral, and parasacral analgesia, and on other applications of local and regional anesthesia to the surgery of the eye, ear, nose and throat, and to dental practice. Fig. 210.—Nerves of the head (from Arnold) seen from the side: a. Needle directedalong orbital route (Matas) into foramen rotundum; b, Hartel route to gasserian ganglion.(Hartel.) THE HEAD, SCALP, CRANIUM, BRAIN, AND FACE 545 Whatever the real basis of this relation may be in the individualcase, in practice both amount to the same thing; namely, that we ma
. Local and regional anesthesia : with chapters on spinal, epidural, paravertebral, and parasacral analgesia, and on other applications of local and regional anesthesia to the surgery of the eye, ear, nose and throat, and to dental practice. Fig. 210.—Nerves of the head (from Arnold) seen from the side: a. Needle directedalong orbital route (Matas) into foramen rotundum; b, Hartel route to gasserian ganglion.(Hartel.) THE HEAD, SCALP, CRANIUM, BRAIN, AND FACE 545 Whatever the real basis of this relation may be in the individualcase, in practice both amount to the same thing; namely, that we maynot seek the puncture point in an exactly designated place, for ex-ample, at the height of a certain molar tooth, but that the puncturepoint varies within certain limits. We may not expect that we maypenetrate forthwith into the skull by any one puncture point selectedand reach our mark, but we must frequently make up our minds torepeated puncture. This changes the puncture point until it hasreached the right axis, and now without resistance attains the cranial. Fig. 211.—Right pterygopalatine fossa, foramen rotundum and superior orbital fissureseen from behind. Needle a is passed from the pterygopalatine fossa out of the foramenrotundum. Needle b is pushed in a steeper direction through the inferior orbital fissureand impinges within the superior fissure. (Hartel.) cavity, a situation that we have indicated above by the expressionconcentric puncture. We have now examined the relation of the axis of the trigeminusto the upper jaw in different skulls, and designate as the middle partan axis which strikes the upper alveolar margin at the height of themiddle molar tooth (Fig. 202, a). Steep means (c) cutting point ofthe axis with the posterior margin of the alveolar process, over steep(e) still farther back; level (b) means cutting point under the processof the malar bone at the height of the first molar tooth, over level(d) farther in front of it. The values found are entere
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectanesthe, bookyear1914
