Human anatomy; Medicine -- Study and teaching; Palpation
There is great difference in the shape of the hard palate; this
difference depends upon the depth of the alveolar processes. 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 œsophagus, 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 œsophagus 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. Hæmorrhage 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 1/3 of an inch in
front of the hamular process.
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.
Public-domain text, read in full here on John Shaqi.
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