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Laryngoscope 1

Laryngoscope
A laryngoscope (larynx + scope) is a medical device that is used to
obtain a view of the vocal folds and the glottis, which is the space
between the cords. The first laryngoscope was invented in 1854 by
Manuel Patricio Rodrguez Garca.[1]

Rigid laryngoscope
There are many types of laryngoscopes. A rigid laryngoscope utilized
by anesthesia, pulmonary or critical care personnel for intubation
typically consists of a handle (incorporating two batteries) and an
interchangeable blade with a bulb light source. White light bulbs have
been traditional for years. Use of black light bulbs to enhance the
illumination of the phosphorus in the vocal cords are recent
innovations introduced. Laryngoscopes used by otolaryngologists are
found in many variations, used for various specialized tasks during
endoscopy or surgery of the upper aerodigestive tract.

The original anesthesiologists' laryngoscope used a straight "Magill


Blade", and this design is still the standard pattern veterinary
laryngoscopes are based upon; however the blade is difficult to control Laryngoscope in use intubating a dummy
in adults and can cause pressure on the vagus nerve, which can cause
unexpected cardiac arrhythmias to spontaneously occur in adults.
There are many types of laryngoscope blades used by anesthesia personnel. The two main types are the curved
Macintosh blade and the straight Miller (or Robertshaw) blade. The Macintosh blade sits anterior to the epiglottis
and raises it out of the visual pathway, while the Miller blade sits posterior to the epiglottis, trapping it while
exposing the glottis and vocal folds. Incorrect usage can cause trauma to the front Incisor teeth; the correct technique
is to lift the chin upwards and forward at the same time, not to use the blade as a lever with the teeth serving as the
fulcrum.

The Miller and Robertshaw blades are usually used for infants, this is due to the larger comparative size of the
epiglottis, which makes the Macintosh blade less effective.
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Direct laryngoscopyis carried out (usually) with the patient lying on


his or her back; the laryngoscope is inserted into the mouth on the right
side and flipped to the left to trap and move the tongue out of the line
of sight, and, depending on the type of blade used, inserted either
anterior or posterior to the epiglottis and then lifted with an upwards
and forward motion ("away from you and towards the roof "). This
move makes a view of the glottis possible. There are at least ten
different types of laryngoscope used for this procedure, each of which
has a specialized use for the otolaryngologist. This procedure is most
often employed in direct diagnostic laryngoscopy with biopsy. It is
extremely uncomfortable and is not performed on conscious patients,
or on patients with an intact gag reflex.

Laryngoscopy is performed to facilitate endotracheal intubation as part


of general anesthesia or CPR (cardiopulmonary resuscitation) during
cardiac arrest, or, more specifically, for procedures on the larynx or
other parts of the upper aerodigestive tract.
A Miller laryngoscope blade on an infant
Most sources claim that the Laryngoscope was invented by Manuel laryngoscope handle.
Patricio Rodrguez Garca, Professor of Music, and singing teacher for
Jenny Lind, the "Swedish Nightingale"; whilst other medical
authorities (Morell Mackenzie writing in 1865) claim that the inventor
was Benjamin Guy Babington, who called his device "glottiscope",[2]
while Peak Woo identifies Bozzini and Garignard de la Tour as the
first specialists to use mouth mirrors to check the larynx.[3]

Another type of procedure performed by many ENT specialists in


clinics is called an indirect laryngoscopy. It utilizes a straight
rod-mounted mirror (laryngeal mirror; vide Instruments used in
otolaryngology) that is inserted into the throat and used to look at the
laryngeal inlet. A Macintosh size 3-blade on an adult
laryngoscope handle

Transnasal Flexible Laryngoscope


A transnasal flexible laryngoscope can be used for office-based diagnostics. The patient remains wide awake during
the procedure, so that the vocal fold can be observed during speech or singing. Surgical instruments passed through
the scope can be used for performing procedures such as biopsies of suspicious masses.

Uses of Laryngoscopes
Helps in intubation during the administration of general anaesthesia or for mechanical ventilation.
Detects causes of voice problems, such as breathing voice, hoarse voice, weak voice, or no voice.
Detects causes of throat and ear pain.
Evaluates difficulty in swallowing : a persistent sensation of lump in the throat, or mucous with blood.
Detects strictures or injury to the throat, or obstructive masses in the airway.
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External links
Videos of direct laryngoscopy recorded with the Airway Cam (TM) imaging system, a head mounted camera
system that captures the perspective of the operator. [4]
Photos of Flexible Laryngoscopy and Its Variations [5]

References
Yahoo Health on Laryngoscopy [6]
Transnasal Flexible Laryngoscopy (TFL) [7]

References
[1] American Otological Society (1905). The Laryngoscope. Volume 15, pp. 402-403
[2] Hunting, Penelope (2002). The history of the Royal Society of Medicine, RSM Press, p.79. ISBN 1853154970
[3] Stark, James (2003). Bel canto: a history of vocal pedagogy. University of Toronto Press, p. 5. ISBN 0802086144
[4] http:/ / airwaycam. com/ video-library. html
[5] http:/ / homepage. mac. com/ changcy/ endo. htm
[6] http:/ / health. yahoo. com/ ency/ healthwise/ hw232056/ hw232059;_ylt=Amgb8b_Qd0FDsxd1rMIryuXogrMF
[7] http:/ / www. entcolumbia. org/ tfl. htm
Article Sources and Contributors 4

Article Sources and Contributors


Laryngoscope Source: http://en.wikipedia.org/w/index.php?oldid=358041971 Contributors: 25yearsERdoc, AURANGDON, AbinoamJr, Acdx, Anyeverybody, Azoreg, Bemoeial, Biorem,
CambridgeBayWeather, Chrisjw37, Commit charge, DagosNavy, Doctorbhanu, Dulciana, Erich gasboy, Finavon, GAndy, Gerhard51, Graham87, Greenrd, Hehkuviini, Hemanshu,
Henning.Schrder, Iversonali3, Jet731, Kaal, Kosebamse, Mild Bill Hiccup, Mmoneypenny, MrsSundberg, Naddy, Nealmcb, Nrswanson, Pimlottc, Plastikspork, Posible2006, RJFJR, Sarindam7,
Sietse Snel, Skysmith, Somatical, Spacevezon, Spra, Stevertigo, Tenbergen, Thanach, 28 anonymous edits

Image Sources, Licenses and Contributors


Image:Intubation.jpg Source: http://en.wikipedia.org/w/index.php?title=File:Intubation.jpg License: Public Domain Contributors: Original uploader was Hfastedge at en.wikipedia
Image:Infant laryngoscope.jpg Source: http://en.wikipedia.org/w/index.php?title=File:Infant_laryngoscope.jpg License: unknown Contributors: Erich Schulz,
Image:laryngoscope.jpg Source: http://en.wikipedia.org/w/index.php?title=File:Laryngoscope.jpg License: Public Domain Contributors: Erich gasboy, Ricky81682

License
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