Peroral endoscopy and laryngeal surgery . ked a longtime with the operator. To accomplish the making of the upper thoracic aperture (insteadof the larynx) the fulcrum of the bronchoscopic lever, the second assistantmust have a good general sense of direction and must have a mental pic-ture of the position and direction of the long axis of the part of thetube in the patient which he must gain from the uninserted portion ofthe tube. If the tube is deeply inserted he must mentally line up theposition of the bronchoscope in the patient from an imaginary line drawnfrom the proximal tube-mouth to th
Peroral endoscopy and laryngeal surgery . ked a longtime with the operator. To accomplish the making of the upper thoracic aperture (insteadof the larynx) the fulcrum of the bronchoscopic lever, the second assistantmust have a good general sense of direction and must have a mental pic-ture of the position and direction of the long axis of the part of thetube in the patient which he must gain from the uninserted portion ofthe tube. If the tube is deeply inserted he must mentally line up theposition of the bronchoscope in the patient from an imaginary line drawnfrom the proximal tube-mouth to the bronchoscopists right eye. This IXTKODLCTION Ol Till-: nKONCUOSCOPli. 165 line must necessarily be a prolongation of the long axis of the bron-choscope. The axial line of the tube and the upper thoracic apertureand their relations to each (jUkt must be constantly in the mind of thesecond assistant. In the descriptions before and hereafter given of various positionsof the head and neck it is to lie understood that these in no way inter-. FiG. 136.—Radiograph of bronchoscope in the right upper lobe bronchus of awoman of 25 years. The bronchoscope was inserted through the mouth and theangle is shown to be as advantageous as would be possible through a tracheotomicwound. The position of the patient is easy and natural in this instance, the radio-graph being made for verification of the overlay localization in a suspected case ofinterlobar al)scess. Had demonstration been the object, the upper part of the lubecould easily have been l)rought to the clavicle. The lesser shadow passing down-ward is from pus and shows the location of the middle and inferior lobe (stem)bronchi. This radiograph also shows that the limit of lateral movement is fixedby the upper thoracic aperture; not by the larynx, hence tracheotomy is of no ad-vantaf^e for bronchoscopy, so far as angle is concerned. fere with the endnscopist following lln lumen unr the second assistantfollowing the operator. Set it is
Size: 1523px × 1639px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1910, booksubjectrespira, bookyear1915
