Landmarks, medical and surgical / by Luther Holden.

  • Luther Holden
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: Landmarks, medical and surgical / by Luther Holden. Source: Wellcome Collection.

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    freely out of the mouth in any attempt to remove carcinoma extending far back into its root. There is great difference in the shape of the hard palate ; this difference depends upon the depth of the alveolar pro- cesses. In some it forms a broad arch ; in others it is narrow, and rises almost to a point like a Gothic arch, and materially impairs the tone of the voice. Throat.—To examine the throat well, the nose should be held so as to compel breathing through the mouth. Thus the soft palate will be raised, the palatine arches widened, and the tonsils and the back of the pharynx fairly exposed. Pressing the tongue downwards, provided it be done very gently, is also of advantage. Rude treatment the tongue at once resists. The forefinger can be passed into the throat, beyond the epiglottis, as low as the bottom of the cricoid cartilage, and thus search the pharynx down to the top of the oesophagus, and the hyoid space (on each side) where foreign bodies are so apt to lodge. The greater cornu of the hyoid bone can be felt as a distinct projection on either side. In introducing a tube into the oesophagus, the finger should keep the instrument well against the back of the pharynx so as to prevent its slipping into the larynx. Pass the finger between the teeth and the cheek and feel the anterior border of the coronoid process of the jaw. On the inner side of this process, between it and the tuberosity of the upper jaw, is a recess, where a deeply-seated temporal abscess might burst, or might be opened, Behind the last molar on the inner side of the upper jaw, we can distinctly feel the hamular process of the sphenoid bone ; also the lower part of the pterygoid fossa, and the internal pterygoid plate. Behind, and on the outer side of the last molar, can be felt part of the back of the antrum and of the lower part of the external pterygoid plate. On the roof of the mouth we can feel the pulsation of the posterior palatine artery. Haemorrhage from this vessel can be arrested by plugging the orifice of the canal, which lies (not far from the surface) on the inner side of the last molar, about | of an inch in front of the hamular process,