Throat Examination
Objective
• To visualize the palatine tonsil and pillars, posterior pharyngeal wall, uvula and soft palate.
• To visualize vallecula, epiglottis, vocal cords, pyriform fossa and other parts of larynx.
Position
Sitting.
Anesthesia
Nil or local.
Procedure
1. The patient is asked to open his mouth and the anterior 2/3 of the tongue is depressed with this spatula.
2. At the same time the patient is asked to say aa-aa-ah so that the soft palate moves up allowing a good view of the oropharynx.
3. The projecting tongue is held with a piece of gauze between the thumb and middle finger of the left hand. The index finger of the doctor elevates the upper jaw.
4. The mirror is warmed gently to prevent fogging and is tested on the back of the hand for its temperature.
5. Holding the mirror like a pen it is passed by the side of the uvula into the laryngopharynx.
6. Avoid touching the posterior pharyngeal wall.
7. A beam of light is thrown on the mirror and reflected onto the larynx. The patient is asked to say Eeee. . . so that the epiglottis moves up and the phonetic movements of the vocal cords can then be appreciated better.
Instruments
• Lack’s spatula (Fig. 16.31)
• Laryngeal mirror
• Direct laryngoscope
• Chevalier Jackson laryngoscope with removable slide
• Fiberoptic laryngoscope.
Any questions be sent to drmmkapur@gmail.com
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