. 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. s, the foramen opticum, the foramina ethmoidalia, pos-terior and anterior. In the lower horizontal plane lies the foramenrotundum. If we keep our needle in the horizontal planes, then weassuredly avoid the puncture of the broad inferior end of the fissurasuperioris, which contains the nerves of the muscles of the eye andlarge veins. On puncture in the uppe


. 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. s, the foramen opticum, the foramina ethmoidalia, pos-terior and anterior. In the lower horizontal plane lies the foramenrotundum. If we keep our needle in the horizontal planes, then weassuredly avoid the puncture of the broad inferior end of the fissurasuperioris, which contains the nerves of the muscles of the eye andlarge veins. On puncture in the upper plane we encounter laterally the 5°4 LOCAL ANESTHESIA place of entrance into the orbit of the nervi frontalis and lacrimalis,medially the place of entrance of the nasal nerve. In this connectionprecaution is to be observed only in so far as danger exists of injury ofthe nervus opticus by going too deep. In the lower horizontal planewe encounter the nervus maxillaris and its orbital branch, the temporo-malar. Fig. 172 shows the orbit with bulb, conjunctival sac, palpebralfissure (after Merkel), as well as the horizontals ab and cd specified byus, and the puncture-points for medial (1), lateral (2), and inferior (3)orbital Fig. 171.—Orbit from in front, same specimen as Fig. 170 with the horizontal planes out-lined. (Hartel.) If we ask ourselves how the palpebral fissure is related to ourpuncture points, then we must remember this, that only the innerangle of the palpebral fissure is a fixed point, while the external angle,when the eye is opened, moves upward several millimeters. Theinner angle of the palpebral fissure lies in the region of the lacrimalfossa, and the palpebral fissure occurs varying in its height, in anycase always in the region situated between the two horizontal planesof the orbit. With the eye moderately opened the superior and in-ferior palpebral margins should correspond to the two horizontal , the puncture point for the media


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Keywords: ., bookcentury1900, bookdecade1910, booksubjectanesthe, bookyear1914