The anatomy and physiology of the recurrent laryngeal nerves / by Franklin H. Hooper.

  • Hooper, F. H. (Franklin Henry), 1850-1892.
Date:
1887
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Licence: Public Domain Mark

Credit: The anatomy and physiology of the recurrent laryngeal nerves / by Franklin H. Hooper. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    the nerves of the par vagum and their recurrents become elongated, and hence the circuitous route the latter are found to take after- ward, forming loops in which the aorta and right subclavian artery are, as it were, suspended. . . . Had not the great blood-vessels been originally thus interposed between the brain and larynx, the inferior laryngeal nerves would not have been entangled by them, and we should find them in the adult taking the nearest route to their des- tination.” These early papers upon this subject are most interesting, and show that their authors were careful observers. They pointed out the right path, which, however, was not followed by all subsequent writers who expressed themselves on the question. Swan, for instance, entertained certain theories in regard to the influence which the blood-vessels had upon the nervous system, aud in “An Essay on the Connection between the Action of the Heart and Arteries and the Functions of the Nervous System,” London, 1829, p. 50, he applied his views in a very curious way to explain the recurrent course of the inferior laryngeal nerves. After speak- ing of their encompassing the subclavian artery on the right side and the arch of the aorta on the left, and remarking that it was very singular that neither of the carotids was included, he says : “ I con- ceive this disposition was intended for producing a more extensive sympathy between the arteries of those parts of the body which are subjected to be excited by exercise, and the glottis; for when the action and distension of the arteries are increased by exercise, the recurrent nerves become stimulated, and consequently the muscles of the glottis, the opening of which thus becomes widened, so as to admit a greater and more free supply of air into the lungs. It may be supposed that any other disposition would have sufficed, so long as the parts were properly supplied with nerves, and a case is related by I)r. Stedman where the recurrent was wanting on the right side, and its place was supplied by numerous branches of the par vagum ; but in this instance ‘ the right subclavian artery rose from the arch of. the aorta behind and a little to the left side of the left subclavian, and, forming an arch, pierced between the oesophagus and vertebral column in the region of the first vertebra of the back, and then passed over the first rib on the right side.’ It must be remarked that the right subclavian was already under the influence of the left recurrent, and therefore the usual distribution was not necessary on the right side. The same unusual distribution I have also observed in a rabbit, which was very healthy, but I never saw it in exercise,