. 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. o the plane of the teeth (Figs. 183, 187,188, 189). If the direction of the ascending ramus is projected ante-riorly, the line will meet with the other side in the canine region, be-tween the canine and the bicuspids (Figs. 183, 184, 187, 188, 189).Thus, in order to reach the inferior dental foramen the syringe mustbe rested behind the canine on the opposi
. 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. o the plane of the teeth (Figs. 183, 187,188, 189). If the direction of the ascending ramus is projected ante-riorly, the line will meet with the other side in the canine region, be-tween the canine and the bicuspids (Figs. 183, 184, 187, 188, 189).Thus, in order to reach the inferior dental foramen the syringe mustbe rested behind the canine on the opposite side. (See Figs. 183, 187, 520 LOCAL ANESTHESIA 188, 189.) The foramen in adults is situated at a higher level than inchildren. The horizontal direction of the needle must, therefore, bemodified in children by slightly lowering it posteriorly and pharyngeallyin order to reach the foramen directly. (See Fig. 182, A, B, C.) Character of the Tissues.—The character of the tissues encounteredis most favorable for injection in the oblique foramen. The temporal and external pterygoid muscles are inserted above,the internal pterygoid below, the foramen, leaving the close proximityof the foramen free from muscular fibers. (See Fig. 190.). Fig. 186.—Lingual points of injection for mucous anesthesia of mandible. Crossesindicate points of injection; arrows, direction of needle; black line of dashes, the angle ofthe ramus to the body of the jaw. (After Fischer.) Instead we find considerable accumulations of loose interstitialconnective and adipose tissue, which readily absorbs and retains theinjected solution. (See Fig. 191.) This cushion of tissue is situated about 1 or 2 cm. above the al-veolar process. Technic of Injection.—With the left index-finger the anteriorportion of the base of the ascending ramus is palpated, the patientsmouth being opened widely. Two very marked bony ridges are felthere, one anterior external, the external oblique line, and one pos-terior internal, the
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectanesthe, bookyear1914
