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The use the autoscope and the bronchoscope, from which great help may obtained in certain cases, especially in localizing and removing foreign bodies, necessarily confined operators especial skill. One should note the color the cords, becoming reddish in acute laryngitis, the presence tumors, nodules the free edge, and the mobility the cords in phonation and respiration. Tuberculous, syphilitic or malignant ulceration may noted the epiglottis.

Congestion and edema may present from circulatory disturbances, from acute infectious diseases, especially diphtheria, and from irritation steam, acid vapors or other traumatism.

The swelling in connection with angioneurotic edema may The recurrent laryngeal nerve supplies all the muscres the larynx except the cricothyroid, supplied the superior laryngeal.

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The spinal accessory nerve furnishes the motor filaments those branches the vagus.

Paralysis the larynx may thus originate Lesions affecting the nuclei in the medulla, as in bulbar Through pressure upon the vagus or spinal accessory nerves in their course, as in tumors the neck, or in those operative cases, especially involving the thyroid gland, custom college essays in which a ligature includes mistake the vagus nerve, or otherwise damaged. Through pressure upon the laryngeal branches, especially the inferior, because its long and exposed course, from aneurism, enlarged bronchial glands, goiter or tumor any kind, contracting pleural adhesions, large pericardial effusion, or great dilatation the left auricle. The left nerve, passing below the aortic arch, especially exposed in the intrathoracic conditions mentioned, while the right may involved in subclavian aneurism. The paralysis may toxemic as in diphtheria, alcoholism Hysterical aphonia and that due inflanmaation the structures the larynx should mentioned. Paralysis the recurrent nerve upon one side causes the corresponding cord remain motionless in the cadaveric position, as especially seen upon the left side in aneurism the aorta the doutle form oftener the result diphtheritic neuritis i need help with my research paper or central disease than local pressure.

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In the unilateral form the unparalyzed cord passes beyond the median line meet its fellow, and thus restores phonation in many cases, though not perfectly.

In the double form, aphonia complete, and the cords can neither brought together for effective cough, nor separated allow deeper breathing upon Paralysis the abductor or posterior crico-arytenoid muscle leaves the affected cord in the buy academic papers central position, and thus interferes with inspiration. This interference threatens suffocation if the paralysis bilateral.

Expiration, coughing, and phonation are not especially compromised. The unilateral form especially significant pressure upon one recurrent nerve, the left being most frequently involved.

The double form generally central, and may Paralysis the lateral crico-arytenoid and the associated muscles prevents the cords from attaining the central position in phonation adductor paralysis. This commonly bilateral, and the especial form seen phd research proposal writing service uk in hysteria. Phonation only affected, as may noted observation the normal movement the cords during paraphrasing a sentence respiration. This type can i buy research papers paralysis seen also in acute laryngitis and after abuse the voice. If the internal thyro-arytenoids alone involved, the approximated cords leave an elliptical opening at the center if the interior arytenoid thesis topics in education muscle paralyzed a triangular Gowers table gives an excellent summary the conditions discussed stridor only deep inspiration. One cord moderately abducted and motionless, the Both cords near together, and during inspiration not separated, but One cord near the middle line not moving during inspiration, the other Cords normal in position and moving normally Hoarseness arises when the function the larynx interfered with that dysphonia results, the cause being either local laryngeal disease or laryngeal paralysis. If the interference sufficient Laryngitis some type the most common cause both conditions. Either edema, congestion, inflammation, chronic thickening, ulceration, tumor, foreign body or cicatricial contraction may the active agent in damaging the vocal function. Paralysis the various laryngeal muscles produces different types dysphonia and aphonia.

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