Image from page 82 of "Regional anesthesia : its technic and clinical application" (1922)
Identifier: regionalanesthes00laba
Title: Regional anesthesia : its technic and clinical application
Authors: Labat, Gaston Mayo, William J
Subjects: Anesthesia, Local Local anesthesia
Publisher: Philadelphia and London : W. B. Saunders company
Contributing Library: West Virginia University Libraries
Digitizing Sponsor: LYRASIS Members and Sloan Foundation
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Text Appearing Before Image:
Fig. 32.—Gasserian ganglion block: 1, Direction of needle toward the midpointof the zygoma: 2, direction of needle toward the articular tubercle of the zygoma. BLOCKING OF CRANIAL NERVES 6i directed toward his pupil (Fig. 31) and, when looking laterally; it isdirected toward the midpoint of the zygoma (Fig. 32). The forefinger,placed in the mouth, serves as a guide and prevents the point of theneedle from going through the mucosa of the cheek. In its progressionfrom the skin the needle passes beneath the mucous membrane medialto the buccinator muscle, between the ascending ramus of the lowerjaw and the tuberosity of the maxilla, and through the pterygoid muscles.
Text Appearing After Image:
Fig. 33.—Gasserian ganglion block. Directions of the needle shown in relation to theskull. At a depth of about 5 cm. the point of the needle strikes against thesmooth infratemporal plane, in front of the foramen ovale. Its direc-tion is upward, inward, and backward. The hub of the needle is thenraised so that its point aims at the articular tubercle of the zygoma,care being exercised to keep the needle in the plane passing throughthe pupil of the patient (Fig. 33). Contact of the infratemporal planeis soon lost and the needle, being introduced from 1 to 1.5 cm. 62 REGIONAL ANESTHESIA deeper, passes behind the infratemporal plane into the foramen ovale,after coming in contact with the third branch of the trigeminus.Paresthesias or radiating sensations in the lower jaw immediatelyfollow, thus indicating that the needle is in its correct place. Some-times the point of the needle is felt passing through a membranes tretched in front of the foramen before any paresthesias are obtainedIn
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