Human anatomy; Medicine -- Study and teaching; Palpation
The facility with which instruments can be introduced into the nasal
opening of the duct depends upon its position as well as its size. This
position varies in different instances. Sometimes it opens directly
into the roof of the inferior meatus, in which case the hole is large
and round, so that tears readily run into the nose. In other instances
the opening is situated on the outer wall of the meatus, and is then
always such a narrow fissure as to be hardly discernible. The practical
conclusion then is, that a probe can be easily introduced when the
opening is in the roof of the meatus, but not without difficulty
and laceration of the mucous membrane when on the outer wall. This
difficulty indeed may be increased by the narrowness of the meatus,
arising from an unusual curvature of the spongy bone.
18. =Nose and nasal cavities.=--The line where the cartilages of
the nose are attached to the nasal and superior maxillary bones can
be traced with precision. The close connection of the skin to the
cartilages admits of no stretching; hence the acute pain felt in
erysipelas and boils on the nose. The external aperture of the nose is
always placed a little lower than the floor of the nostril, so that the
nose must be pulled up before we can inspect its cavities.
Looking into the nostrils, we find that the left is, in the majority
of cases, narrower than the right, owing to an inclination of the
septum towards the left. A communication sometimes exists between
them, through a hole in the septum, as in the case of the celebrated
anatomist Hildebrandt. By stretching open the anterior nares we
can get a view of the end of the inferior spongy bone. The middle
spongy bone cannot be seen: its attachment to the ethmoid is high up,
nearly opposite the tendo oculi. The cavities are so much narrowed
transversely by the spongy bones, that in the extraction of polypi it
is better to dilate the blades of the forceps perpendicularly, and near
the septum.
19. =Mouth.=--What can be seen and felt through the mouth? The upper
surface of the tongue, ‘_speculum primarum viarum_,’ is a study in
itself. We notice, on its under surface, a median furrow, on each side
of which stands out the ranine vein, lying upon the prominent fibres
of the lingualis. In the middle line of the floor of the mouth is the
‘frenum linguæ,’ with the orifice of the duct of the submaxillary
gland on each side of it. The gland itself can be detected immediately
beneath the mucous membrane by feeling further back near the angle of
the jaw, at the same time pressing the gland upwards from below.
The long ridge of mucous membrane on each side of the floor contains
the sublingual glands.
We can feel the attachment of the ‘genio-hyo-glossi’ behind the
symphysis of the jaw. The division of this attachment would enable a
surgeon to draw the tongue more freely out of the mouth in any attempt
to remove carcinoma extending far back into its root.
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