Diseases of the nose and throat; a text-book for students and practitioners . above theanterior extremities of tlie vocal bands, is seen a roundishprominence, brighter red than the surrounding mucous lining,—the cushion of the epiglottis. When the white vocal ligaments are approximated, only ashadow-line is seen between them; but, w^hen separated, it isusual to see below the cricoid cartilage, and, on a still lowerlevel, the crico-tracheal membrane and some rings of thetrachea, with the intervening membranous tissue. In somecases the bifurcation of the trachea and two or three rino^s ofthe rig
Diseases of the nose and throat; a text-book for students and practitioners . above theanterior extremities of tlie vocal bands, is seen a roundishprominence, brighter red than the surrounding mucous lining,—the cushion of the epiglottis. When the white vocal ligaments are approximated, only ashadow-line is seen between them; but, w^hen separated, it isusual to see below the cricoid cartilage, and, on a still lowerlevel, the crico-tracheal membrane and some rings of thetrachea, with the intervening membranous tissue. In somecases the bifurcation of the trachea and two or three rino^s ofthe right bronchus are easily visible; the left bronchus is toomuch to the side and too small to be illuminated, although one THE LARYNGEAL IMAGE. 353 can sometimes see a short distance into it. The tracheal ringsare grayish, the intervening spaces presenting a color not unlikethat of the ventricular hands. In making a thorough examination of the larynx andtrachea, much care should he given to the position of thepatients liead and to the angle at wliicli the mirror is held; the. Fig. 101.—Auto-Laryngoscope. latter can only he acquired hy a fiiir amount of practice, whilethe former is to he regulated hy tlie dependence of the epiglottisand the desire to see the deeper parts. In examining thetrachea it is often necessary to have the patient sit very erect,the head not thrown hack, hut rather inclined forward, theexaminers eye helow the patients mouth, and the light thrownslightly from helow upward into tlie laryngeal mirror. The 23 354: DISEASES OF THE NOSE AXD THROAT. patient should breathe deeply m order to separate the vocalbands as much as possible. In the absence of a laryngoscopic mirror, Voltolini advisedthe following manipulation for examining the epiglottis and, inmany cases, the arytenoid region: The tongue is protruded andheld between the patients thumb and finger; the physician,with one hand, elevates the larynx from without, while withthe other he forces the tongue down
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Keywords: ., bookcentury1800, bookdecade1890, bookpublisherph, booksubjectnose
