6. =Oesophagus.= Contents, size (dilatation, stenosis, diverticula),
color and character of mucosa (normally smooth, transparent, pale,
grayish-white, often hypostatic on posterior surface), inflammation,
swelling of mucosa, leukoplakia, œdema, erosions, ulcers, action of
corrosive poisons, perforation, foreign bodies, varices (cirrhosis,
splenic anæmia), hemorrhage, aneurismal erosion, infective
granulomata (tuberculosis, syphilis and actinomycosis are all rare),
neoplasms (benign are rare, sarcoma rare; carcinoma most common
usually at the lower or middle third), parasites (thrush the most
important infection). Postmortem softening of the œsophagus from the
regurgitation of stomach-contents must not be mistaken for pathologic
conditions. Oesophagomalacia is of the rarest occurrence during life.
7, 8. =Larynx and Trachea.= Nature of contents, character and
position of _epiglottis_ and _plicæ aryepiglotticæ_ (the latter
should be thin; greatly thickened in inflammation and œdema),
mucosa (normally gray-red and smooth); _vocal cords_ (position and
relations as viewed from above; should be thin and tendon-like;
mucosa thickened in inflammation and œdema; may be atrophic),
œdema, inflammation, diphtheritic membranes, ulcers, syphilis,
tuberculosis, leprosy, glanders, actinomycosis, rhinoscleroma,
neoplasm, foreign-bodies, etc. An extreme œdema of the glottis may
disappear after death, and its occurrence be shown only by the
wrinkled appearance of the mucous membrane. Anomalies are rare,
the most common being a laryngocele. In typhoid fever erosions and
ulcers are not rare in the larynx. In small-pox ulcers, diphtheritic
inflammations and hemorrhages may occur. The most common tumor is
the fibroma or fibro-epithelioma (papilloma), occurring particularly
in children and singers (“children’s nodule,” “singer’s nodule”).
Angioma, myoma, lipoma and chondroma are rare. Thyroid adenoma, the
so-called “amyloid-tumor” and adenoma of the mucous glands are rare.
Sarcoma is also rare. Lymphosarcoma and leukæmic infiltrations are
not common. Primary carcinoma is more frequent than sarcoma, but
is relatively rare. It occurs most frequently in men, arising on
the true vocal cords, and is squamous-celled. In trichinosis the
laryngeal muscles usually show an early and abundant invasion. The
most important pathologic conditions of the trachea are anomalies
(diverticula, fistula, tracheocele), inflammation (catarrhal,
membranous, pseudomembranous), tuberculosis, syphilis, secondary
erosions, ulcers and perforations (tumors of thyroid, cancer of
œsophagus, tuberculosis and suppurating lymphnodes, aneurisms),
stenosis, compression from enlarged thyroid, thymus or lymphnodes,
dilatation, tracheotomy, intubation, and neoplasms (relatively rare).
The cartilages of both trachea and larynx should be examined for
inflammation, pigmentation, etc.
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