The entrance of a foreign body into the larynx is at once the signal for violent expulsive efforts, and in the majority of instances voluntary extrusion is accomplished. Should the object, however, pass the vocal cords, the route to the bifurcation of the trachea is free and unobstructed. At the bifurcation, as the right bronchus is larger and turns at a less abrupt angle to reach the root of the lung, the body is more likely to fall into its lumen, although this result is by no means positive.‡ If the object is of irregular shape it will not closely fit, and violent efforts at coughing may still loosen it. It may, however, be arrested in its reverse course at the vocal cords. The violence of the efforts, and the interference with the air supply, unfortunately make inspiratory suction as sudden and nearly as intense as expiration, and the offending
WILLARD DF. REMOVAL OF FOREIGN BODIES FROM THE AIR PASSAGES. JAMA. 1901;XXXVII(17):1077–1080. doi:10.1001/jama.1901.62470430001001
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