indirect laryngoscopy
Fig. 1. Indirect laryngoscopy

Laryngoscope method of examination of the larynx through the mouth. There are two types of laryngoscopy indirect, or mirror, and direct, or autoscopy. Indirect laryngoscopy make with the help of the round mirrors attached at an angle of 120 degrees to the metal rod. Laryngeal mirror have different diameter from 15 to 30 mm For convenience mirror is inserted into a special pen. When indirect laryngoscopy doctor and patient sitting against each other; the light source is placed to the right of the patient at the level of the ear, some backwards from him. The patient opens his mouth and his tongue out; doctor with gauze napkins keeps the language of the patient's left hand and right - enters into the mouth of laryngeal mirror, directing him a light beam reflected from the frontal reflector (Fig. 1). Directly to the use of laryngeal mirror warmed up slightly in the spirit lamp or in hot water, always checking the level of heating, touching the mirror to the rear of his palm. To determine the mobility of the larynx and closure of the vocal cords patient offer alternately to breathe and say a falsetto sound "e" or "and". The uvula and soft sky at laryngoscopy slightly pushed the mirror backward and upward.
You cannot, however, be touched by the mirror in the back of the throat and tongue, so as not to cause gagging.
Mirror picture larynx does not coincide with the actual location of its parts: that which is in the larynx is in front (the epiglottis, the front ends of the vocal cords), reflected in the upper part of the mirror, that is located in the larynx back (harpaloides cartilage, rear ends of the vocal cords), the mirror reflects the bottom.
In those cases, when the mirror examination of the larynx why is either impossible (for example, young children) or insufficient (removing foreign bodies, tumors), use direct laryngoscopy.
For direct inspection of the larynx need to straighten the angle formed by the horizontal axis of the oral cavity and a vertical axis of the larynx.
This is achieved through a special spatula or tubes.

direct laryngoscopy
Fig. 2. Direct laryngoscopy:
1-3 consistent stages with relevant endoscopic paintings.

Direct laryngoscopy is done under local anesthesia: the mucous membrane of the larynx grease 2% solution dikaina. The introduction of a spatula in the larynx consists of three points (Fig. 2): 1-bringing the spatula until the epiglottis; 2-diverting the end of a spatula edge of the epiglottis and holding it up to the entrance to the larynx; in the field of view appear harpaloides cartilage and rear sections of the vocal cords; 3 - Ottaviani the root of the tongue forward and translation trowel in a vertical position; this brings into view the back wall of the larynx and upper part of the trachea, the true and the false vocal chords.
Direct laryngoscopy can be produced only by a specialist with relevant experience.