. 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. l 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 medial puncture as well as thepuncture point for the lateral puncture lies above the palpebral fissure,as is evident from Fig. 172. THE HEAD, SCALP, CRANIUM, BRAIN, AND FACE 5
. 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. l 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 medial puncture as well as thepuncture point for the lateral puncture lies above the palpebral fissure,as is evident from Fig. 172. THE HEAD, SCALP, CRANIUM, BRAIN, AND FACE 505 Further, we must bear in mind that the central axes of the twoorbital cavities converge posteriorly; consequently, the lateral orbitalwall runs diagonally from in front backward toward the median lineat an angle that deviates about 450 from the sagittal. The projectionsof the straight lines drawn along the outer orbital walls meet in theregion of the dorsum sellae at right angles. The medial orbital walls,on the other hand, run approximately sagittally and diverge but littlefrom behind forward. If we observe the rules here mentioned, then on making the orbitalpunctures we can assuredly avoid an injury of the bulb and of the nervus. Fig. 172.—Orbit and eye, showing outlines or orbital margin. Heavy circle showslimits of the bulb; dotted circle, limits of conjunctival sac. a-b, Upper horizontal plane;c-d, lower horizontal plane; i, median point of puncture for injecting nasal nerve; *,point of puncture for injecting frontal and lacrimal nerves; 3, point of puncture for orbitalinjection of foramen rotundum. (After Merkel.) opticus. In practice we displace the bulb with the finger from thepoint of entrance, and carry the needle into the depth between theorbital wall and the finger-tip that protects the bulb. By this meanswe keep the needle in the region of the horizontal planes mentioned,and guard against the point of the needle entering the region boundedby both planes and fr
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectanesthe, bookyear1914
