Autoscopy of the larynx and the trachea : (direct examination without mirror) . pressed upon the pos-terior part of the tongue the middle of thetongue is depressed more than the more fixed,lateral portions, so that a groove is formedbetween the palato-glossal arches; it follows,therefore, that the spatula, as used in auto-scopy, should have the shape of a groove. Thenarrower the groove, the less it infringes uponthe lateral, more fixed portions of the tongue,and the more deeply therefore can it be pressedinto the middle portion of the tongue. Thespatula may not be too narrow, however, be-cause
Autoscopy of the larynx and the trachea : (direct examination without mirror) . pressed upon the pos-terior part of the tongue the middle of thetongue is depressed more than the more fixed,lateral portions, so that a groove is formedbetween the palato-glossal arches; it follows,therefore, that the spatula, as used in auto-scopy, should have the shape of a groove. Thenarrower the groove, the less it infringes uponthe lateral, more fixed portions of the tongue,and the more deeply therefore can it be pressedinto the middle portion of the tongue. Thespatula may not be too narrow, however, be-cause the tongue would at times rise up on bothsides of it, and thus shut out the light. As notonly the tongue, but also the superior maxilla,must be kept out of the way of the straight lineof vision, the spatula for autoscopy must forma straight line from before backward; only at (15) 16 AUTOSCOPY. the end, where it has ah-eady passed the con-vexitj^ of the tongue, the ordinary (prelaryn-geal) spatula is given a downward curve, sothat it can elevate the epiglottis by exercising. Fig. 3.—Standard Spatula (S) attached to the Elec- ?tkoscope, and intka-lakyngeal spatula {s), bothWITH Hoods Omitted. the proper pressure upon the base of the tongue(and thus also upon the bodj of the hyoid bone,which can always be easily felt in the valleculse)and upon the median glosso-eiiiglottidean liga-ment. The tip {d, Fig. 3) of the spatula, which THE TECHNIQUE. 17 must be thickened and well rounded, in orderto avoid injury to the mucous membranes, mustalso be notched to receive this latter spatula for adults is 14 centimetres long; atthe tip it is about 2 centimetres wide, and it isabout IJ centimetres wide where it pagses theconvexity of the tongue. It is made of nickel-plated German silver, is exceedingly easy toclean, and can be readily sterilized in boilingwater. The tip of the ordinarily used standardspatula is bent downward so that its free borderis 1 centimetre below the level
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Keywords: ., bo, bookcentury1800, bookdecade1890, bookidautoscopyoflaryn00kirs
