Diseases of the larynx / by J. Gottstein ; translated and added to by P. M'Bride.

  • Gottstein, Jacob, 1832-1895.
Date:
[1885?]
Catalogue details

Licence: Public Domain Mark

Credit: Diseases of the larynx / by J. Gottstein ; translated and added to by P. M'Bride. 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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    a picture of the architecture of the interior of the larynx, for only in this way can laryngoscopic examination be made intelligible. The interior represents an elongated irregular cavity which, for con- venience of description, may be divided into an upper, a middle, and a lower, although the boundaries which are supposed to divide these separate parts are founded principally on external contour, and are not justified either by special anatomical conditions nor by the course of pathological processes. The superior laryngeal space (vestibula laryngis) extends from the entrance of the larynx to the ventricular bands. Its anterior surface is formed by the epiglottis, and is, in accordance with the shape of this cartilage, convex with a slight concavity in the centre, while the lower part shows a prominent rounded projection—the tubercle of the epiglottis. The posterior wall is formed by the upper portion of the arytenoids above the attachment of the ventricular bands, and by the cartilages of Santorini, which ai'e attached to their apices. This wall, called the interarj'tenoid commissure, is liable to considerable changes in shape through the movement of the cartilages, appearing during deep inspiration, when the cartilages are widely separated, as a flat depression, while, as the cartilages are approximated, it forms a perpendicular sulcus Avhich, during complete closure of the glottis, is changed into a hardly recognisable cleft. The latei'al walls, which are composed of the aryepiglottic folds, are attached to the epiglottis, which is wedge- shaped with the smaller end downwards, so that they approach each other below, and proportionately diminish th^ space between them. . ; The middle laryngeal space is bounded above by the ventricular bands, below by the vocal cords, and laterally by the ventricles. The space between the ventricles forms an oval which is wider behind than in front, and is inclined obliquely downwards and backwards. The space between the vocal cords is the glottis proper, and varies in shape and width according to the position of the cords. Each of the ven- tricles forms an oblong space between the ventricular band and vocal cord, which is about as long as the latter. The inferior laryngeal space is bounded above by the vocal cords, below by an imaginary plane through the lower edge of the cricoid cartilage in front, and at the sides by the conoid ligament and by the anterior and lateral portions of the cricoid cartilage; while posteriorly is situated the plate of the cricoid and the base of the arytenoids. The walls of the space diverge from the under surface of the vocal cords, until a circumference corresponding to that of the first rings of the ti'achea is attaiiaed.