Peroral endoscopy and laryngeal surgery . phagus, which is bewildering until sufiicient education oi theeye enables the operator to recognize the landmarks. The most important thing of all is the position of the patient, ,-uiclnext to that comes recognition of the epiglottis, and next the proper mo-tion of lifting the hyoid bone to expose the larynx. 70 ANESTHESIA FOR PKRORAI, ENDOSCOPY. The correct position will be understood by reference to the illus-trations. In Fig. GO, the patient is placed on a pillow in a natural posi-tion. The larynx can readilv be examined in this position, if it is d
Peroral endoscopy and laryngeal surgery . phagus, which is bewildering until sufiicient education oi theeye enables the operator to recognize the landmarks. The most important thing of all is the position of the patient, ,-uiclnext to that comes recognition of the epiglottis, and next the proper mo-tion of lifting the hyoid bone to expose the larynx. 70 ANESTHESIA FOR PKRORAI, ENDOSCOPY. The correct position will be understood by reference to the illus-trations. In Fig. GO, the patient is placed on a pillow in a natural posi-tion. The larynx can readilv be examined in this position, if it is de-sired merely to inspect it, and is useful for laryngeal diagnosis and someendolaryngeal oi<erations ; but for the insertion of an insufflation tube,bronchoscope, or other instrument, it is absolutely necessary for any butthe most expert to have the head in full extension. It has been customaryto draw the head over the table to gain the full extension in the Boyceposition, and for bronchoscopy this is needed for the purpose of moving. Fig. 60. Fig. 61. Fig. 62. Fig. 60. Photograph of patient with head upon a pillow, the hca<l Inthis position it is easy to examine the larynx with the laryngoscope for diagnosis,but the larynx will not be exposed in a line with the tracheal axis so that this posi-tion is not adapted to the passing of tubes through the laryngoscope. Fig. 61. The pillow is removed, the head is flat on the table and the anesthetistis to force the head into the extended position. The thumbs are on theforehead and the lingers are at the side of the head. The direction of motion isshown by the dart. Fig. 62. The anesthetist is lifting with the tip of the laryngoscope in the direc-tion of the dart. The laryngoscope is always held in the left hand. The right hand,of which the index has been protecting the upper lip, has now received the catheterfrom the nurse. The head must be in lull extension. the head and the bronchosco])e abotit so as to ent
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectrespira, bookyear1915
