Epiglottis

“ In such scaly and feathered animals there is no epiglottis, but its office is supplied by the larynx, which closes and opens, just as in the other case the epiglottis falls down and rises up; rising up during the ingress or egress of breath, and falling down during the ingestion of food, so as to prevent any particle from slipping into the windpipe. ”

“ Inflammation, Erosion, and Ulceration of the Epiglottis.
Of the diseases of particular portions of the larynx, those of the epiglottis deserve especial attention in a work designed for general practitioners, on account of the comparative ease of recognizing and treating them if understood, and the promptness their management requires. They occur more frequently than is generally supposed, their symptoms are often erroneously ascribed to other affections, and they may lead to extensive disease in the respiratory apparatus, sometimes of a very serious character. ”

“ And this is probable, for the epiglottis lies over the windpipe, as a fence and strainer, that the drink may get in by little and little, lest descending in a large full stream, it stop the breath and endanger the life. And therefore birds have no epiglottis, because they do not sup or lap when they drink, but take up a little in their beak, and let it run gently down their windpipe. ”

“ One anatomical fact may be so invincible that a view of the glottis cannot be obtained at all: the epiglottis may so overhang the opening to the larynx that a good view of its interior is absolutely impossible, in other cases only occasionally and under very favorable circumstances. Such cases are, however, of the rarest occurrence, while there are not a few persons in whom one may even see down the windpipe as far as its division into the two main bronchial tubes, and inflammation may thus often be traced from the vocal bands far down the mucous membrane common to the larynx, windpipe, etc. ”

“ He discovered the lymph-vessels, and maintained, against Plato and others, that the epiglottis prevents the entrance of fluids into the lungs, but he supposed digestion to be produced by mechanical trituration in the stomach, and preferred gymnastics, exercise, diet, and baths to drugs or other therapeutic measures. ”

“ Pressing the tongue downwards, provided it be done very gently, is also of advantage. Rude treatment the tongue at once resists. The forefinger can be passed into the throat, beyond the epiglottis, as low as the bottom of the cricoid cartilage, and thus search the pharynx down to the top of the œsophagus, and the hyoid space (on each side) where foreign bodies are so apt to lodge. ”

“ This is closed, when necessary, by a little valve, or lid, called the epiglottis (epi means upon.)
E. And this faithful sentinel is none other than that perpendicular little body which we can see in our throats, and which we have dubbed palate.
I. You are right, Ellinora. Over this, food and drink pass on their way to the road to the stomach, the gullet. The pressure of solids or liquids tends to depress this lid on the glottis; and its muscular action in deglutition, or swallowing, tends to the same effect. ”

“ Although so admirably guarded against harm by the strong and elastic chest-walls, and against all inimical approach by that ever-vigilant sentinel, the epiglottis, they are, from the very nature of their functions, preeminently subject to danger from without as well as from within. The delicate mechanism of living lung-tissue can not be subjected to direct observation; the minute cells for containing air would be crushed by air admitted from without, and the heart arrested for a moment for inspection would never beat again ”

“ It is to be emphasized that while some pressure is necessary in the lifting motion, great force should never be used; the art is a gentle one. The first view is apt to find the larynx in state of spasm, and affords an excellent demonstration of the fact that the larynx can he completely closed without the aid of the epiglottis. ”

“ The tongue is often the seat of nodules, which in all respects correspond to those of the skin. The gums, the velum, and the uvula may be either infiltrated or dotted with nodules. The rest of the mucous membrane of the pharynx is more frequently infiltrated than beset with nodules, and the same is true of the epiglottis, which sometimes becomes quite stiff and almost immoveable. In the larynx, the true and false cords are more frequently the seat of infiltration than of nodules ”

“ Deglutition is difficult; and, from the inactive state of the muscles which naturally close the glottis during swallowing, and from the greater or less destruction of the epiglottis, a portion of the fluid taken by the mouth escapes into the windpipe, produces violent coughing, and is ejected by the mouth or nostrils. As the disease advances, the lungs become affected, the patient is incapacitated for ordinary exertion by the dyspnœa which ensues, he grows weak and languid, and seems, in fact, to labour under phthisis pulmonalis. ”

“ PATHOLOGY AND MORBID ANATOMY.—The seat of the morbid process being the connective tissue, those localities of the larynx in which this tissue is most abundantly interposed between the mucous membrane and the cartilage are most liable to infiltration. I must say from my own experience that the epiglottis—particularly the glosso-epiglottic region—is most frequently affected,3 next the ary-epiglottic folds, then the arytenoid region, and then the ventricular folds. The ventricles and the vocal bands are very rarely involved. ”

“ The patient, if he has fallen asleep, often starts up suddenly, and catches at the nearest object, having dreamed probably of drowning or strangulation. Deglutition is seriously impeded, the strength is exhausted, the body is emaciated, the features become contracted, and evince great anxiety. As already stated, the serous effusion is chiefly situated in the upper part of the larynx, particularly on the lips of the glottis, and on the inferior surface of the epiglottis; and on introducing the finger, a soft swelling can be felt beneath this cartilage. ”

“ To “tickle the palate” with delicious food, to make food “palatable,” are very common, though misleading, expressions. However, two very careful investigators have reported that the lining of the whole mouth cavity, including gums, the lining of the cheeks, the hard palate, and even the teeth, are sensitive to sour stimuli. Acetic acid of full strength was used as a stimulus in these experiments.
5. The epiglottis, parts of the larynx, and the vocal cords are sensitive to taste stimuli. ”

“ MICROBE. A very small animal that devotes all its energy to moving into the system of an entire stranger. Once in it begins to do light housekeeping on the aforementioned stranger's epiglottis. (For the meaning of epiglottis consult the first doctor you meet. If he doesn't tell you he's no gentleman.) ”

“ The beginner is apt to insert the speculum too far and expose the hypopharynx rather than the larynx. The elusiveness of the epiglottis and its tendency to retreat downward are very much accentuated in patients who have worn a tracheotomic cannula; and if still wearing it, the patient can wait indefinitely before opening his glottis. Over extension of the patient's head is a frequent cause of difficulty. If the head is held high enough extension is not necessary, and the less the extension the less muscular tension there is in the anterior cervical muscles. ”

“ The middle one of these lobes is the largest; it is free, and rests immediately over the triangular orifice of the larynx just described, which, when depressed, it is in size adapted to cover. In a line continuous with the floor of the upper larynx and penetrating beneath the epiglottis, is a cavity or sac lined with mucous membrane. ”

“ As the depressor muscles of the hyoid are divided, there is interference with deglutition and phonation, but respiration is not affected. In such cases the upper portion of the epiglottis is often cut off, and the base of the tongue, the tonsil or the soft palate may be injured. The lingual, external maxillary and superior thyreoid arteries, and the hypoglossal nerve are also liable to be divided at this level, but the main vessels of the neck usually escape. There is pain and difficulty in swallowing, and food and saliva tend to escape through the wound. ”

“ Our ears do not catch them exactly, or we unconsciously substitute for the foreign sound some sound from our own language. Our vocal organs, too, do not adapt themselves readily to the reproduction of the strange sounds in another tongue, as we know from the difficulty which we have in pronouncing the French nasal or the German guttural. Similarly English differs somewhat as it is spoken by a Frenchman, a German, and an Italian. The Frenchman has a tendency to import the nasal into it, and he is also inclined to pronounce it like his own language, while the German favors the guttural. ”

“ It is impossible to produce good tone with a high larynx. When the larynx rises, the throat closes and you must always have your throat open. Don’t forget, your throat must be open and you can get it open only by keeping the larynx low.” He tries again with the same result and awaits further instructions. I take another tack and say to him, “Your tongue rises every time you sing and impairs the form of the vocal cavity. Keep it down below the level of the teeth, otherwise your vowels will be imperfect. You should practice a half hour each day grooving your tongue.” ”

“ The eye which is closed by the pupillary membrane, and the nostrils, which are scarcely indicated, would not be capable of receiving impressions, even in the supposition that light and odour could act upon them. Applied against the palate, the tongue is in contact with nothing capable of producing savour. Were it in contact with the waters of the amnios, the effect would be the same, because as we have said, there is no sensation, where there is no variety of impression. The saliva of one person to another person possesses savour, to the individual himself it is insipid. ”

“ Where a spirant or fricative is immediately preceded by an explosive, a double sound or affricative is the result (e.g. German pf, Armenian t’š) ; where the spirant follows the explosive we have the aspirated letters, which will be spoken of hereafter. Among the continuous consonants must be ranked the nasals, produced by dropping the uvula and so allowing some of the breath to make its way to the nostrils through the pharynx, and the trills produced by the vibration of the uvula, the lips, or more commonly the tongue. ”

“ Mediæ are therefore accompanied by the tone of the voice, and this may even, where they begin a syllable, set in a moment before, and where they end a syllable, continue a moment after the opening of the mouth, because some air may be driven into the closed cavity of the mouth, and support the sound of the vocal chords of the larynx. Because of the narrowed glottis, the rush of the air is more moderate, the noise of the air less sharp than with the tenuis, so that a great mass of air may rush at once from the chest. ”

“ The soft palate, also, possesses the sense of taste; hence, an article that has an agreeable flavor may very properly be spoken of as palatable, as is often done. All parts of the tongue do not perceive equally well the same flavors. Thus, the front extremity and margin, which is the portion supplied by the "fifth pair" of nerves, perceives more acutely sweet and sour tastes; but the base of the tongue, supplied by the glosso-pharyngeal nerve, is especially sensitive to salt and bitter substances. ”

“ I also think pronunciation of a foreign tongue could be better taught than by demanding from the pupil those internal acrobatic feats that are generally impossible and always useless. This is the sort of instruction one receives:
“Press your tonsils against the underside of your larynx. Then with the convex part of the septum curved upwards so as almost—but not quite—to touch the uvula, try with the tip of your tongue to reach your thyroid. Take a deep breath, and compress your glottis. Now, without opening your lips, say ‘Garoo.’”
And when you have done it they are not satisfied. ”

“ Those already considered operate on the tongue en masse;—elevate, advance, depress or retract it, shift its volume to either side, and direct its extremity, by a kind of circumduction, over a wide range of surface. Thus, the stylo-glossus can elevate and retract, the hyo-glossus depress and lateralise; the anterior fibres of the genio-hyo-glossi, with the linguales, regulate the motions of the tip, while the genio-hyoid and adjunct fibres of the genio-hyo-glossi can cooperate in these movements by shifting the base of support in any direction. ”