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Full text of "Diseases Of The Nose Throat And Ear"

CHAPTER 2
CLINICAL EXAMINATION

Good illumination is essential for the examination of the nasal cavities as well
as for that of the pharynx, larynx and ear. The specialist has the benefit of a
bull's eye lamp whicFobncentraSes the rays of a frosted light bulb. The light is
reflected by a concave forehead mirror through the aperture in which the
examiner conducts his investigation with one eye while the other gives
binocular vision past the side of the mirror. During the examination the
patient sits upright with the lamp close to the left side of his head. Direct
sunlight should be excluded from the room. In other situations, the consulting
room of the general practitioner or the patient's home, these desirable aids
may be lacking. A forehead mirror may be used to reflect daylight or the light
from a bedside lamp, but the fact that the rays reflected from the mirror are
not concentrated means that the intensity of light is not sufficiently good to

Fig. 13. Anterior rhinoscopy, with the
aid of a nasal speculum.

give penetration or to give an accurate impression of mucosal colour. A
small lamp attached to a band around the head and powered by dry batteries
may be sufficient, or the electric auriscope may be used with the largest
speculum.

Anterior rhinoscopy is achieved by focusing the light into the nasal cavity to
be examined, and dilating the anterior naris by means of a nasal speculum.
This is not easy to manipulate by the beginner, and the correct method of
holding it is shown in Fig. 13. The blades are apposed and inserted into the
nostril and are allowed to open slowly thus exposing the nasal cavity. The

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