The organs, having been removed, are placed on the board, œsophagus
upward, and the tip of tongue toward the prosector. The =tongue= is
then cut in the median line and the cut surfaces examined. Transverse
cuts may be made when indicated. The uvula is then lifted up and
examined; and the =tonsils= and =palate= next examined, the former
by means of longitudinal incisions. The intestinal shears are now
introduced through the fauces into the œsophagus and the left pillar
cut between the uvula and the tonsil. The posterior wall of the
=pharynx= and that of the =oesophagus= for its entire length is
then cut in the median line, and these structures examined. After
the examination of the larynx from above, the long blade of the
intestinal shears is introduced into the =larynx= and =trachea=, and
these are cut in the posterior median line into the right bronchus.
The œsophagus is pulled to the left (prosector’s right) out of the
way. The left bronchus is opened by a special incision to avoid
cutting aorta and œsophagus. The larynx is now lifted up and held in
both hands with the thumbs on the horns of the thyroid cartilage, and
the fingers outside, and the larynx opened by forcibly bending back
or breaking the cartilage, so that the entire interior of the larynx
can be examined without touching the mucosa.
The neck-organs are now turned over, with the aorta toward the
prosector and the tongue pointing away. The right and left lobes of
the thyroid are opened by oblique cuts running from above downward
and inward, and the isthmus is cut sagittally. The =parathyroids=
must be dissected out behind and below the thyroid, along the
course of the terminal branches of the inferior thyroid artery.
The =parotid=, =submaxillary= and =sublingual glands= and the
=cervical lymphnodes= are opened by longitudinal cuts. The =aorta=,
=carotids=, =jugulars= and their branches are opened with the curved
or probe-pointed scissors. The =vagus=, =superior= and =inferior
laryngeal nerves= and the =cervical sympathetic ganglia= are to
be examined when the case requires it. The examination of the
neck-organs then closes with the inspection of the =muscles= of the
neck and the =cervical vertebrae=.
If permission cannot be obtained for the complete removal of the
mouth-organs, the neck-organs may be removed by cutting them
transversely against the vertebræ between the hyoid bone and
thyroid cartilage and then stripping them from the vertebræ and
removing them as in the method given above. The skin-incision in
such cases need not be carried higher than the collar-line, the
skin of the neck being loosened by a subcutaneous dissection.
Public-domain text, read in full here on John Shaqi.
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