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.

    30/116 (page 14)
    When the mouth is wide open, the pterygo-maxillary ligament forms a prominent fold readily seen and felt beneath the mucous membrane, behind the last molar teeth. A little below the attachment of this ligament to the lower jaw we can easily feel the gustatory nerve, as it runs close to the bone below the last molar tooth. The exact position of the nerve can be ascertained in one's own person by the acute pain on pressure. A division of the nerve, easily effected by a small incision, gives much temporary relief in cases of advanced carcinoma of the tongue. To feed a patient in spasmodic closure of the jaw, it is well to know that there is behind the last molar teeth a space sufficient for the passage of a small tube into the mouth. 30. Antrum.—Lift up the upper lip and examine the front v/all of the antrum. The proper place in which to tap it is above the second bicuspid tooth, about one inch above the margin of the gum. The fangs of the first and second molars project most of all into the antrum; and when carious are the most likely to set up suppuration in its cavity. 31. Posterior nares.—A surgeon's finger should be familiar with the feel of the posterior nares, and of all that is within the feel behind the soft palate. This is important in relation to the attachment of polypi, to plugging the nostrils, and to the proper size of the plug. In the examination of this part of the back of the throat it is necessary to throw the head well back, because, in this position, nearly all the pharynx in front of the basilar process comes down below the level of the hard palate, and can be seen as well as felt. But when the skull is horizontal, i.e. at a right angle with the spine, the hard palate is on a level with the margin of the foramen magnum, and the parts covering the basilar process are con- cealed from view. The head then being well back, introduce the fore-finger behind the soft palate, and turn it up towards the base of the skull. You feel the strong grip of the superior constrictor. Hooking the finger well forwards, you can feel the contour of the posterior nares, Their size depends__upon the anterior,