Volume 1

A manual of diseases of the throat and nose : including the pharynx, larynx, trachea, oesophagus, nasal cavities and neck / by Morell Mackenzie.

Date:
1880-1884
Catalogue details

Licence: Public Domain Mark

Credit: A manual of diseases of the throat and nose : including the pharynx, larynx, trachea, oesophagus, nasal cavities and neck / by Morell Mackenzie. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

    23/640 (page 7)
    THE EXAMINATION OP THE PHARYNX. means of the pharyngeal vein. The lymphatics are aiTangod, as the veins in two plexuses, con-esponding with those of the nose and root of the tongue ; they pass into glands sitiiated at the bifur- cation of the common carotid, and in the region of the greater comu of the hyoid bone. , • . - v The motor nerves of the soft palate are : the motor portion ot the lower division of the fifth which suppUes the tensor palati through the Otic o-an?lion; the facial supplying the levator palati and azygos uvula3 through the connection of its trunk with the Vidian by the petrosal nerves, and the palatine brajiches of Meckel's ganglion which supply the palato-glossus and palato-pharyngeus The sen- sory nei-ves are derived from the second division of the Mth (its nasal ganglion), which supplies the anterior surface of the velum. 'The o-losso-pharyngeal, vagus, and spinal accessory fuimsh twigs to the lateral and posterior portions of the soft palate and the tonsil. 'The chorda tympani presides over the secretory functions. THE EXAMIisTATION OE THE PHAEYNX. The pharynx is not entirely accessible to direct vision, and the laryngoscope or phaxyngoscope (as the instrument h^s been cailed -when employed to examine the upper part of the throat) is requisite for the inspection of certain parts. Further, from the situation and conformation of the pharynx, some regions can only be investigated by means of probes or by digital exploration. In making an ordinary examination, it is best to use the large frontal mirror of the laryngoscope. The patient should be directed to open his mouth and take a deep inspiration. The tongue should then be gently pressed •down -with a spatula, or, better still, with the handle of a laryngeal mirror. Sometimes, however, this organ is so unruly, and the patient so sensitive, that the slightest pres- sure will produce retching. Under these circumstances a view can often be obtained, without touching the tongue, Avhen the patient inspires deeply; or the tongue may be protruded, and firmly but gently grasped between the thumb and index finger of the operator, enveloped in a towel or napkin. If the patient at the end of deep inspiration then utters the vowel a, the soft palate and uvula, as well as tlie pillars of the fauces, will come into view. The first object which attracts attention is the uvula, Avliich in health is about a quarter of an inch in length, and of a pale red colour, lilce the palpebral conjunctiva. Erom the margin of the uvula on either side at its base.