The larynx is positioned low in the neck and requires some special an abilities and devices for examination.

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Indirect Laryngoscopy

The simplest form of laryngeal check is called "indirect laryngoscopy". The examiner have the right to place a tiny mirror in the ago of the throat and also angle that down in the direction of the larynx. Light have the right to be reflect downward and also the larynx deserve to be checked out in the mirror. Indirect laryngoscopy is fast an easy, and gives a nice three dimensional view of the larynx in true color. However, some individuals have a strong gag reflex and cannot forgive the mirror exam. Also, the patient can not be examined throughout normal speech since the mirror need to remain in the ago of the throat.

Flexible and also Rigid Endoscopes

There room two special optical instruments that have the right to assist the physician in check of the larynx during an office visit. The instrument shown listed below on the left is a nasopharyngoscope. The curved component of the border is a functional fiberoptic cable that deserve to be passed through the nose and through the pharynx till it provides a check out of the vocal folds. The versatile scope reasons very tiny gagging and also is actually fairly comfortable. Utilizing this versatile endoscope, the larynx deserve to be examined during normal speech. However, the resolution with this limit is reduced due to the fact that the image must travel through a bundle of little optical fibers.

The instrument on the right is dubbed a 90 level telescope. The limit is inserted at the back of the mouth. In ~ the earlier there is a prism that shows light 90 degrees. This scope is a little more daunting for the patient, however it gives very clear and enhanced image the the vocal cords.

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A camera deserve to be enclosed to each of these scopes and the examination can becorded for documentation. The photo on the left reflects a picture taken through a 90 degree telescope of regular vocal folds. The wrinkle are partially opened and the opening right into the trachea deserve to be seen in between them.

Stroboscopic Examination

During speech, the vocal folds vibrate 100 times per second or more. This is too rapid to be checked out by our eyes. In bespeak to an ext carefully study the vocal folds in action, a special light source called a strobe irradiate is used. The strobe sends off a an extremely bright and very short flash of light. If the strobe flash is recurring at the precise same price that the vocal folds space vibrating, lock will show up "frozen" in time. (This is the exact same principle together a time light the is used to song up a car). If the firing rate is then adjusted so that it is a tiny faster or a small slower 보다 the vibration rate of the folds, the crease will show up to move in sluggish motion.

The strobe exam is very useful because it allows us come see exactly how the vocal folds space functioning. Some voice obstacle are led to by subtle changes in the tissue that renders up the folds. These alters may not be noticeable on a regular fiberoptic or winter exam the the larynx, however can it is in seen with a mindful strobe exam.

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To the left is a photo taken native a stroboscopic test of the typical vocal cords throughout speech. The movie was taken v a flexible examining scope favor the one shown above.(The record is in .MOV format and is around 1 Mb in size.

Direct Laryngoscopy

Another form of examination is referred to as "direct laryngoscopy", and this involves straight looking in ~ the larynx. Since of the gag reflex, straight laryngoscopy is most regularly done in the operating room under a basic anesthetic. During direct laryngoscopy, biopsies can additionally be taken of any kind of suspicious lesion in the larynx or other parts the the throat.

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The photo to the right shows how straight laryngoscopy is done. The examiner holds an instrument dubbed a laryngoscope in his or her hand, and also looks through this tool to study the larynx. A microscopic lense can additionally be supplied to look at the vocal folds and other components of the larynx under high magnification.