. 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. actice are easily overcome;above all, it must be observed that the insertion of the needle is madenot directly at the edge of the bone in the internal oblique line, butsomewhat lingually from the bone. Behind this internal ridge thebony substance bulges still farther lingually, running over into thelingula after having first formed a second convex excresce
. 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. actice are easily overcome;above all, it must be observed that the insertion of the needle is madenot directly at the edge of the bone in the internal oblique line, butsomewhat lingually from the bone. Behind this internal ridge thebony substance bulges still farther lingually, running over into thelingula after having first formed a second convex excrescence (, 187, 188). After the correct point of insertion, about r cm. above the levelof the masticating surface of the last molar, has been found the obliqueforamen is reached, just above the lingula, with the needle (Figs. 184,187, 188). THE HEAD, SCALP, CRANIUM, BRAIN, AND FACE 523 The distance from the anterior margin of the internal oblique lineto the posterior margin of the lingual is about 15 mm. During the injection it is best, as has been correctly emphasizedby Williger, to rest the syringe barrel on the bicuspids or between Frenum labiisuperior isGingiva -Upper lip Upper dental arch_^ Hard palate s -- Soft palate %Umda. Anterior pillarPosterior pillar Tonsil Point of insertion ofneedle in rctromolarfossa Cut portion of cheek Points for injection in mental fossa Fig. 189.—Oral cavity, widely opened. The solid black line indicates the correctposition of the syringe for mandibular anesthesia. The arrows at the anterior portion ofthe mandible indicate the points of insertion of the needle in the reflection of mucous mem-brane for injection in canine fossa. (After Spalteholz.) the canine and first bicuspids of the opposite side, thus securing acertain support for the syringe and an indication for the correct levelfor the insertion of the needle. (See illustrations.) Management of the Needle.—After insertion the needle is advanced 524 LOCAL ANESTHESIA to the bone w
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectanesthe, bookyear1914
