A handbook of surface antomy and landmarks / by Bertram C.A. Windle.

  • Windle, Bertram C. A. (Bertram Coghill Alan), 1858-1929.
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: A handbook of surface antomy and landmarks / by Bertram C.A. Windle. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    will feel the so-called tarsal cartilage, to the inner end of which is attached the palpebral ligament or tendo oculi affixed at its other end to the margin of the orbit. To find this it is only necessary to close the eyelids and draw them outwards when the ligament will be made tense and appear under the skin as a transverse ridge. This ridge is an important surgical landmark, as it crosses the lachrymal sac at the junction of its upper and middle thirds, and thus serves as a guide to the surgeon in opening the latter for the evacuation of an abscess. The student should place his finger upon his own tendo, and open and close the eyelids several times, in order to note that each time the latter occurs the ligament is made tense. A sucking action on the part of the subjacent sac is thus produced, by means of which the tears are drawn into its interior through the canaliculi. Having studied this ligament the student may next practice eversion of the eyelid, one of those very minor operations on the deft performance of which so much of the comfort of a patient depends. Mr. Nettleship thus describes it:—The patient looks down, a probe is laid along the lid above the upper edge of the cartilage, the lashes, or edge of the lid, are then seized by a finger and thumb of the other hand, and turned up over the probe which is simultaneously pushed down. After a little practice the probe can be dispensed with, and the lid everted by the forefinger and thumb of one hand alone, one serving to fix and depress the lid, the other to turn it upwards.