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Updated: May 20, 2025
Whatever the procedure chosen for the operation, preliminary tracheotomy is a prerequisite. It should be made well below the isthmus of the thyroid gland, and from three to fifteen days before the laryngectomy. This affords time for the lungs to become accustomed to the new manner of breathing, and the trachea becomes fixed to the anterior wall of the neck.
A small tumor of the middle lobe of the gland, not larger that a hen's egg, will do more damage to the trachea than will a large tumor, such as that shown by Senn, after Bruns. When a tumor has attained this size, pressure-symptoms are often relieved by the weight of the tumor making traction away from the trachea.
The lungs are two in number, and occupy the pleural chamber of the thorax, one en each side of the median line, being separated from each other by the heart, the greater blood vessels and the larger air tubes. Each lung is free in all directions, except at the root, which consists chiefly of the bronchi, arteries and veins connecting the lungs with the trachea and heart.
With its consideration, we complete our view of the sources of supply to the blood, and begin our study of its purification. The Trachea, or Windpipe. If we look into the mouth of a friend, or into our own with a mirror, we see at the back part an arch which is the boundary line of the mouth proper. There is just behind this a similar limit for the back part of the nostrils.
The respiratory system may be likened in form to a well branched tree, with hollow trunk, limbs and leaves: The trachea is the trunk; the two bronchi, one going to the right side and the other to the left side, are the main branches; the bronchioles and their subdivisions are the smaller branches and twigs; the air cells are the leaves.
Braman describes the case of a man on whom several injuries were inflicted by a drunken companion. The first wound was slight; the second a deep flesh-wound over the trapezius muscle; the third extended from the right sterno-cleido-mastoid midway upward to the middle of the jaw and down to the rapine of the trachea. The external jugular, the external thyroid, and the facial arteries were severed.
Examine it in an anatomical view, or if you do not know anatomy consult anatomists, and you will learn that this general covering by various circumvolutions and finer and finer extensions from itself enters into the inmost parts of the lungs, even into the smallest bronchial branches and into the sacs themselves which are the beginnings of the lungs, not to mention its subsequent progress by the trachea into the larynx and toward the tongue.
They drain the various groups of glands which lie nearer the surface, also the interior of the skull, the larynx, trachea, thyreoid, and lower part of the pharynx, and pour their lymph into the main trunks at the root of the neck. It is commonly enlarged in affections of the tonsil and posterior part of the tongue.
Blyth believes, that the young of both sexes resemble the adult male. Mr. Blyth ascertained, by examining many specimens, that the trachea is not convoluted in either sex of R. bengalensis, which species resembles R. australis so closely, that it can hardly be distinguished except by its shorter toes.
If, as is sometimes the case, the difficulty proceeds from a relaxation of the diaphragm, with general sagging down of the thoracic and abdominal viscera, so as to draw upon the trachea, then treat the whole trunk tonically, using the B D current.
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