LARGACTIL
L
L a rg a c til
A b r a n d n a m e f o r t h e a n t i p s y c h o t i c a n d
a n t i - e m
e t i c d r u g
c h l o r p r o m a z i n e .
la rg e in te s tin e
T h e l a s t s e c t i o n o f t h e
g a s t r o i n t e s t i n a l t r a c t .
I t b e g i n s a t a p o u c h c a l l e d t h e
c a e c u m
( f r o m
w h i c h t h e
a p p e n d i x
h a n g s ) . T h e
m a i n p a r t , t h e
c o l o n ,
h a s f o u r s e c t i o n s :
t h e a s c e n d i n g , t r a n s v e r s e , d e s c e n d i n g , a n d
s i g m o i d c o l o n . T h e i n t e s t i n e e n d s a t t h e
r e c t u m ,
w h i c h i s c o n n e c t e d t o t h e
a n u s .
T h e l a r g e i n t e s t i n e p r o c e s s e s t h e r e -
m a i n s o f f o o d a f t e r n u t r i e n t s h a v e b e e n
e x t r a c t e d . I t r e a b s o r b s w a t e r , v i t a m i n s ,
a n d m i n e r a l s a l t s i n t o t h e b l o o d s t r e a m ,
a n d e x p e l s t h e w a s t e m a t e r i a l a s
f a e c e s
.
L a riam
T h e
b r a n d
n a m e
f o r
t h e
a n t i m a l a r i a l
d r u g
m e f l o q u i n e .
la rv a m ig ra n s
I n f e c t i o n s t h a t a r e c h a r a c t e r i z e d b y t h e
p r e s e n c e o f t h e l a r v a l ( i m m a t u r e ) f o r m s
o f c e r t a i n p a r a s i t i c w o r m s i n t h e b o d y .
V i s c e r a l
l a r v a m i g r a n s
( t o x o c a r i a s i s )
i s
c a u s e d b y a t y p e o f w o r m t h a t n o r m a l l y
p a r a s i t i z e s d o g s . C u t a n e o u s l a r v a m i g r a n s
( c r e e p i n g e r u p t i o n ) i s c a u s e d b y a f o r m
o f
h o o k w o r m i n f e s t a t i o n ;
t h e l a r v a e p e n e -
t r a t e t h e s k i n a n d m o v e a r o u n d , l e a v i n g
i n t e n s e l y i t c h y r e d l i n e s t h a t a r e s o m
e -
t i m e s a c c o m p a n i e d b y b l i s t e r i n g . B o t h
t y p e s
o f l a r v a m i g r a n s
c a n b e t r e a t e d
w i t h
a n t h e l m i n t i c d r u g s .
LOCATION OF
LARYNGEAL NERVES
Both nerves leave the brain at the
base ofthe skull and pass down the
neck. One hooks around an artery
behind the right clavicle, the other
hooks around the aorta; both return
to the larynx.
R ig h t
l a r y n g e a l
L e ft
l a r y n g e a l
m
/7
1
i M
la ry n g e a l n e rv e
O n e
o f
a
p a i r
o f
n e r v e s
t h a t
c a r r y
i n s t r u c t i o n s f r o m t h e
b r a i n
t o t h e
l a r y n x
( v o i c e b o x )
a n d
s e n d
s e n s a t i o n s
f r o m
t h e l a r y n x t o t h e b r a i n .
la ry n g e a l n e rv e p a ls y
P a r a l y s i s o f o n e o r b o t h o f t h e
l a r y n g e a l
n e r v e s
.
L a r a n g e a l
n e r v e
p a l s y
m a y
b e
c a u s e d b y d i s o r d e r s t h a t c a u s e p r e s s u r e
o n t h e n e r v e , s u c h a s a n
a n e u r y s m
( l o c a l -
i z e d s w e l l i n g ) i n t h e a o r t a o r a t u m o u r
i n
t h e
t h y r o i d
g l a n d ,
o e s o p h a g u s ,
o r
l u n g . T h e c o n d i t i o n m a y a l s o r e s u l t f r o m
i n f e c t i o n s
o r
p o i s o n i n g
a f f e c t i n g
t h e
n e r v e s ,
o r
d a m a g e
d u r i n g
s u r g e r y
o n
t h e t h y r o i d g l a n d , l u n g , o r h e a r t . L a r y n -
g e a l
n e r v e
p a l s y
c a u s e s
c o m p l e t e
o r
p a r t i a l
v o c a l c o r d
p a r a l y s i s ,
r e s u l t i n g i n
v a r y i n g d e g r e e s o f v o i c e l o s s .
la ry n g e a l s t rid o r
A f o r m
o f
s t r i d o r
( a n a b n o r m a l , h i g h -
p i t c h e d
s o u n d
d u r i n g
b r e a t h i n g )
t h a t
e m a n a t e s f r o m t h e
l a r y n x
( v o i c e b o x ) . I t
m a y o c c u r i f t h e l a r y n x i s i n f l a m e d , o r
p a r t i a l l y b l o c k e d b y a n i n h a l e d o b j e c t .
T h e c o n d i t i o n m a y a l s o a p p e a r a t b i r t h ,
o r s o o n a f t e r , w h e n i t i s k n o w n a s c o n -
g e n i t a l s t r i d o r ; t h e c a u s e i s t h o u g h t t o
b e a b n o r m a l s o f t n e s s o f t h e c a r t i l a g e i n
t h e l a r y n x ( l a r y n g o m a l a c i a ) .
C o n g e n i t a l
l a r y n g e a l
s t r i d o r
r a r e l y
c a u s e s
s e r i o u s
p r o b l e m s
a n d
u s u a l l y
c o r r e c t s i t s e l f a s t h e b a b y g r o w s . H o w -
e v e r , m e d i c a l o r s u r g i c a l t r e a t m e n t m a y
b e
n e e d e d
i f t h e
c o n d i t i o n
i n t e r f e r e s
w i t h b r e a t h i n g .
la ry n g e c to m y
S u r g i c a l r e m o v a l o f a l l o r p a r t o f t h e
l a r -
y n x
( v o i c e b o x ) t o t r e a t a d v a n c e d c a n c e r
( s e e
l a r y n x , c a n c e r o f ) . I f
t h e e n t i r e l a r y n x
i s r e m o v e d , a s t o m a ( o p e n i n g ) i s t h e n
m a d e i n t h e t r a c h e a ( w i n d p i p e ) , t h r o u g h
w h i c h t h e p a t i e n t w i l l b r e a t h e . A f t e r t h e
o p e r a t i o n ( c a l l e d a t r a c h e o t o m y ) n o r m a l
s p e e c h i s n o l o n g e r p o s s i b l e , b u t m a n y
p a t i e n t s l e a r n t o s p e a k u s i n g
o e s o p h a g e a l
s p e e c h .
T h e r e a r e a l s o e l e c t r o n i c d e v i c e s
a v a i l a b l e t h a t h e l p t o g e n e r a t e s p e e c h .
la ry n g itis
I n f l a m m a t i o n
o f t h e
l a r y n x
( v o i c e b o x )
t h a t m a y b e a c u t e , l a s t i n g o n l y a f e w d a y s ,
o r c h r o n i c , p e r s i s t i n g f o r a l o n g p e r i o d .
PROCEDURE FOR LARYNGOSCOPY
There are two techniques for examination ofthe larynx. The patient’s throat is
examined with the use ofa mirror in indirect laryngoscopy. In direct laryngoscopy,
the patient’s throat isviewed with an instrument called a laryngoscope. Ifa flexible
laryngoscope is used, only local anaesthesia is needed; ifa rigid laryngoscope is
used, general anaesthesia is required.
INDIRECT LARYNGOSCOPY
the doctor rests an angled mirror on the soft
palate. A lamp or mirror on the doctor’s head
illuminates the larynx, which isvisible in
the angled mirror.
DIRECT LARYNGOSCOPY
F l e x ib le
l a r y n g o s c o p e
L a r y n x
Flexible laryngoscope
A flexible laryngoscope is passed down the
throatvia the nostril; a rigid laryngoscope is
passed via the mouth.
View of larynx
This view was
obtained with a
laryngoscope.
The vocal cords
are at the centre
and the epiglottis
forms the arc at
the top.
458
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