96 .-. APPLIED ANATOMY. 



junction of the triangular cartilage with the perpendicular plate of the ethmoid and 

 the vomer. In treating these fractures, the most efficient method is to grasp the 

 septum with the flat blades of an Adams forceps (after cocainization) and lift 

 the bones up or to one side as needed. In cases where it is not desired to use 

 the forceps, the writer grasps the nose with a wet towel, makes traction to loosen 

 the fragments, and then pushes them over into place. The triangular cartilage is 

 frequently injured; with the displacement or loosening of the upper lateral cartilages 

 a great amount of displacement may be caused, so that the nose instead of forming a 

 straight line is bent to one side from the ends of the bones down to the tip. Injuries 

 to the septum in childhood are probably the cause of a large number of the cases of 

 deviation of the septum, spurs, etc. , seen later in life. 



In fractures the mucous membrane is often torn, thus allowing air to enter the 

 tissues at the site of fracture, producing emphysema. If such a patient blows the 

 nose violently, the air may be forced under the skin of the face, around the eyes and 

 up the forehead. 



Anterior Nares. The nostrils or anterior nares in the white race are an 

 elongated oval in shape and run in an anteroposterior direction, being separated from 

 each other by the columna. They lie in a direction- parallel with the floor of the nose, 



FIG. 114 Fracture of the nose showing depression of the nasal bone. 



so that to examine the nasal fossae with a speculum the instrument is first introduced 

 from below, then tilting the tip of the nose upward, the speculum is directed back- 

 ward. To see the floor of the nose, it is necessary to raise the outer end of the 

 speculum still higher, because the floor is below the bony edge. From the outer 

 edge of the nostril the nasal cavities go upward and backward for a distance of . 5 to 

 i cm. This part, called the vestibule, is covered by skin, not mucous membrane. 

 It bears stiff hairs vibrissae. Inflammation of these hair-follicles and associated 

 glands produces exceedingly painful pustules. It is here likewise that dried mucus 

 collects and forms scabs, which stick to the hairs and are hard to remove. The 

 attempt to remove them probably is the cause of infection and inflammation around 

 the roots of the hairs. The vestibule leads to the ridge of bone or crest, which is 

 directly posterior to the side of the nasal spine. This ridge of bone is on a higher 

 level than the floor of the nose, and in order to view the latter the nostrils must be 

 raised, by means of the speculum, above it (Fig. 115). 



View from the Anterior Nares. In looking into the nose from in front, if the 

 speculum is directed downward, the floor of the nose and the inferior meatus can 

 be seen. On the inner side is the septum, on the outer the anterior end of the 



