Abstract:
A system for determining a position of a medical device in a respiratory system of a patient is provided. The system includes a positioning apparatus, a flexible guide rod having a distal portion, the flexible guide rod configured to be inserted into a passage of the respiratory system of the patient through the positioning apparatus, and an emitter coupled to the distal portion of the flexible guide rod. The system also includes a flexible guide tube, covering the flexible guide rod, and configured to move together with the guide rod through the positioning apparatus and the respiratory system of the patient, wherein the guide rod can be removed through the guide tube and positioning apparatus, leaving a passage into the respiratory system of the patient through the guide tube, a magnet external to the patient, the magnet configured to create a magnetic field in the patient, and at least three sensors positioned external to the patient, the at least three sensors configured to interact with the emitter positioned on the distal portion of the guide rod and the magnetic field created in the patient by the magnet. The system also includes a display screen and a computer connected to the display screen and the at least three sensors external to the patient, wherein the position of the emitter at the distal portion of the guide rod, relative to the respiratory system of the patient, is configured to be detected by at least one of the at least three sensors external to the patient, output to the computer, and indicated on the display screen in a schematic representation of the respiratory system of the patient.

Description:
CROSS-REFERENCE TO RELATED APPLICATION 
       [0001]    This patent application is a continuation application of U.S. patent application Ser. No. 14/553,094, filed Nov. 25, 2014, which is a continuation application of U.S. patent application Ser. No. 14/256,629, filed Apr. 18, 2014, which is a continuation application of U.S. patent application Ser. No. 13/048,163, filed Mar. 15, 2011, application is a continuation of U.S. patent application Ser. No. 12/431,835, filed Apr. 29, 2009, which is a continuation of U.S. patent application Ser. No. 10/990,870, filed Nov. 17, 2004, which is a continuation of U.S. patent application Ser. No. 09/728,553, filed on Dec. 2, 2000, now U.S. Pat. No. 6,820,614, the entirety of each of which is incorporated by reference. 
     
    
     FIELD 
       [0002]    The present disclosure relates to medical devices. 
       BACKGROUND 
       [0003]    Tracheal intubination has previously been utilized to provide an unobstructed air passage to a patient&#39;s lungs. Tracheal intubination is frequently done under emergency circumstances which are not optimal. It has previously been recognized that is necessary to have a tracheal tube bend around the patient&#39;s epiglottis and move from the patient&#39;s pharynx into the larynx at the upper end of the patient&#39;s trachea rather than into the patient&#39;s esophagus. However, it is difficult for a person inserting the tracheal tube to know where the leading end portion of the tracheal tube is located relative to the patient&#39;s larynx. 
         [0004]    Various methods and devices for assisting in tracheal intubination are disclosed in U.S. Pat. Nos. 4,832,020; 4,865,586; 4,913,139; 5,353,787; 5,235,970; 5,560,351; and 5,694,929. 
       SUMMARY 
       [0005]    In one embodiment, a system for determining a position of a medical device in a respiratory system of a patient is provided. The system includes a positioning apparatus, a flexible guide rod having a distal portion, the flexible guide rod configured to be inserted into a passage of the respiratory system of the patient through the positioning apparatus, and an emitter coupled to the distal portion of the flexible guide rod. The system also includes a flexible guide tube, covering the flexible guide rod, and configured to move together with the guide rod through the positioning apparatus and the respiratory system of the patient, wherein the guide rod can be removed through the guide tube and positioning apparatus, leaving a passage into the respiratory system of the patient through the guide tube, a magnet external to the patient, the magnet configured to create a magnetic field in the patient, and at least three sensors positioned external to the patient, the at least three sensors configured to interact with the emitter positioned on the distal portion of the guide rod and the magnetic field created in the patient by the magnet. The system also includes a display screen and a computer connected to the display screen and the at least three sensors external to the patient, wherein the position of the emitter at the distal portion of the guide rod, relative to the respiratory system of the patient, is configured to be detected by at least one of the at least three sensors external to the patient, output to the computer, and indicated on the display screen in a schematic representation of the respiratory system of the patient. 
         [0006]    In another embodiment, a method of positioning a medical device in a respiratory system of a patient is provided. The method includes inserting a flexible guide rod covered with a flexible guide tube into a passage of a respiratory system of the patient through a positioning apparatus, wherein the flexible guide rod has an emitter coupled to the distal portion of the flexible guide rod and advancing the guide tube, together with the guide rod, through the positioning apparatus and into the respiratory system of the patient. The method also includes positioning at least three sensors external to the patient, wherein the at least three sensors are configured to interact with the emitter positioned on the distal portion of the guide rod and a magnetic field created in the patient by a magnet positioned external to the patient, wherein the at least three sensors are positioned to enable the at least three sensors to connect to a computer, and wherein the computer is coupled to a display screen configured to display a schematic representation of the patient&#39;s respiratory system, wherein the computer receives output from at least one of the at least three sensors external to the patient and detects the position of the emitter attached to the distal portion of the guide rod. The method also includes steering the distal portion of the guide rod relative to the respiratory system of the patient to the desired position and removing the guide rod from the guide tube and positioning apparatus, leaving a passage into the respiratory system of the patient through the guide tube. 
         [0007]    In yet another embodiment, a system for determining a position of a medical device in a passage in a patient is provided. The system includes a positioning apparatus, a flexible guide rod having a distal portion, the flexible guide rod configured to be inserted into the passage in the patient through the positioning apparatus, and an emitter coupled to the distal portion of the flexible guide rod. The system also includes a flexible guide tube, covering the flexible guide rod, and configured to move together with the guide rod through the positioning apparatus and the passage in the patient, wherein the guide rod can be removed through the guide tube and positioning apparatus, leaving a passage through the guide tube, a magnet external to the patient, the magnet configured to create a magnetic field in the patient, and at least three sensors positioned external to the patient, the at least three sensors configured to interact with the emitter positioned on the distal portion of the guide rod and the magnetic field created in the patient by the magnet. The system also includes a display screen and a computer connected to the display screen and the at least three sensors external to the patient, wherein the position of the emitter at the distal portion of the guide rod, relative to the passage in the patient, is configured to be detected by at least one of the at least three sensors external to the patient, output to the computer, and indicated on the display screen in a schematic representation of the passage in the patient. 
         [0008]    It should be understood that any one of the features of the present invention may be used separately or in combination with other features of the invention. It&#39;s believed that various combinations of the features, other than those disclosed herein, may advantageously be utilized and will be apparent to those skilled in the art from the description contained herein. In addition, it should be understood that features of the present invention may be used for purposes other than tracheal intubination. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0009]    The foregoing and other features of the present invention will become more apparent upon a consideration of the following description taken in connection with the accompanying drawings wherein: 
           [0010]      FIG. 1  is a fragmentary schematic illustration depicting the use of a positioning apparatus to position a guide rod relative to the mouth and trachea of a patient; 
           [0011]      FIG. 2  a fragmentary schematic illustration depicting the manner in which a tracheal tube is moved along the guide rod of  FIG. 1  into the trachea of the patient; 
           [0012]      FIG. 3  is a fragmentary schematic illustration, similar to  FIG. 1 , illustrating the manner in which a laryngoscope may be combined with the positioning apparatus; 
           [0013]      FIG. 4  is a fragmentary schematic illustration depicting the use of another embodiment of the positioning apparatus to position a guide rod relative to the mouth and trachea of a patient; 
           [0014]      FIG. 5  is an enlarged schematic fragmentary sectional view of a portion of the apparatus of  FIG. 4  and illustrating the relationship between a guide rod and a guide tube; 
           [0015]      FIG. 6  is an enlarged schematic fragmentary sectional view of a portion of the apparatus of  FIG. 4  and illustrating the relationship between the guide tube, guide rod, and a guide member in the positioning apparatus; 
           [0016]      FIG. 7  is a schematic fragmentary sectional view illustrating a manner in which the positioning apparatus engages a patient&#39;s Adam&#39;s apple and the manner in which a magnet is moved along the outside of the neck of the patient; 
           [0017]      FIG. 8  (on sheet  3  of the drawings) is an enlarged fragmentary schematic illustration of indicia on a portion of the guide rod of  FIG. 4 ; 
           [0018]      FIG. 9  is a fragmentary schematic illustration of the guide rod with the positioning apparatus and guide tube of  FIG. 4  removed after positioning of the guide rod relative to the patient&#39;s trachea; 
           [0019]      FIG. 10  is a fragmentary schematic illustration, generally similar to  FIG. 9 , illustrating the manner in which a tracheal tube is moved along the guide rod into the patient&#39;s trachea; 
           [0020]      FIG. 11  is a fragmentary schematic illustration, generally similar to  FIG. 4 , illustrating an embodiment of the apparatus in which the tracheal tube is used to guide movement of the guide rod; 
           [0021]      FIG. 12  is a fragmentary schematic illustration, similar to  FIG. 1 , illustrating an embodiment of the positioning apparatus which transmits an image of body tissue adjacent to a leading end portion of the guide rod; 
           [0022]      FIG. 13  is a fragmentary schematic illustration, generally similar to  FIGS. 1 and 12 , of an embodiment of the invention in which a detector on a leading end portion of a guide rod detects emitters disposed on the neck of the patient; 
           [0023]      FIG. 14  is a fragmentary schematic illustration, depicting the manner in which a plurality of emitters are arranged in an array around the Adams&#39;s apple of the patient of  FIG. 13 ; 
           [0024]      FIG. 15  is a fragmentary schematic illustration, generally similar to  FIG. 13 , of an embodiment of the invention in which detectors on the neck of the patient detect an emitter on a leading end portion of the guide rod; 
           [0025]      FIG. 16  is a fragmentary schematic illustration, generally similar to  FIG. 14 , illustrating a manner in which a plurality of detectors are positioned in an array around the Adam&#39;s apple on the neck of the patient of  FIG. 15 ; 
           [0026]      FIG. 17  is an enlarged schematic fragmentary sectional view of the leading end portion of a guide rod on which a detector and a plurality of expandable steering elements are disposed; 
           [0027]      FIG. 18  is a plan view, taken generally along the line  18 - 18  of  FIG. 17 , further illustrating the relationship of the expandable steering elements to the leading end portion of the guide rod; 
           [0028]      FIG. 19  is a schematic fragmentary sectional view of a leading end portion of a guide rod on which an emitter and a plurality of expandable steering elements are disposed; 
           [0029]      FIG. 20  is an enlarged schematic fragmentary sectional view of a leading end portion of a tracheal tube and illustrating the manner in which a light source and light conductor are disposed on the tracheal tube to facilitate visualization of tissue disposed adjacent to the leading end portion of the tracheal tube; 
           [0030]      FIG. 21  is an enlarged schematic fragmentary sectional view of a leading end portion of a tracheal tube and illustrating a plurality of detectors which are disposed on the leading end portion of tracheal tube; 
           [0031]      FIG. 22  is an enlarged schematic fragmentary sectional view of a leading end portion of a tracheal tube illustrating the manner in which a plurality of emitters and expandable steering elements are mounted on the leading end portion of the tracheal tube; 
           [0032]      FIG. 23  is a schematic illustration depicting the positioning apparatus of  FIGS. 1 and 2 ; 
           [0033]      FIG. 24  is a schematic illustration, generally similar to  FIG. 23 , illustrating another embodiment of the apparatus of  FIGS. 1 and 2 ; 
           [0034]      FIG. 25  is a fragmentary schematic illustration of a portion of a positioning apparatus having another embodiment of the positioning section; 
           [0035]      FIG. 26  is a fragmentary schematic illustration depicting the relationship between the positioning section of  FIG. 25  and a patient&#39;s Adam&#39;s apple during use of the positioning apparatus; 
           [0036]      FIG. 27  is a fragmentary schematic illustration of a portion of a positioning apparatus having another embodiment of the positioning section; and 
           [0037]      FIG. 28  is a fragmentary schematic illustration depicting the relationship between the positioning section of  FIG. 27  and a patient&#39;s Adam&#39;s apple during use of the positioning apparatus. 
       
    
    
     DETAILED DESCRIPTION 
     General Description 
       [0038]    The present invention relates to a new and improved method and apparatus for use in tracheal intubination or other medical procedures. A portion of a patient&#39;s head  10  and respiratory system  11  has been illustrated schematically in  FIG. 1 . The schematicized illustration of the patient&#39;s head  10  and respiratory system  11  includes a mouth  12  which is connected with a throat  14  in a neck  16  of the patient. 
         [0039]    A pharynx extends downward from a nasal cavity in the head  10  of the patient. The pharynx is connected with an esophagus  26  and a trachea  28  in the neck  16  of the patient. The esophagus  26  extends from the pharynx to the stomach of the patient. The trachea  28  extends from the pharynx to the bronchial tubes and lungs of the patient. 
         [0040]    The trachea  28  ( FIG. 1 ) has an upper end portion  30  which is referred to as the larynx. Vocal cords or folds  32  have been indicated schematically in  FIG. 1  and are disposed in the larynx  30 . The vocal cords  32  are adjacent to the Adam&#39;s apple  34  of the patient. The Adam&#39;s apple  34  is a laryngeal prominence formed by lamina of cartilage in the larynx. 
         [0041]    Opening of a passage for air from the patient&#39;s mouth to the patient&#39;s lungs may require insertion of a flexible tracheal tube  38  ( FIG. 2 ). Movement of the flexible tracheal tube  38  from the patient&#39;s mouth  12  into the pharynx of the patient is relatively easily accomplished. However, directing the tracheal tube  38  into the patient&#39;s trachea  28  may present difficulties. This is because the tracheal tube must extend past the epiglottis into the larynx  30  at the upper end of the trachea  28 . The tracheal tube  38  must not enter the esophagus  26  rather than the trachea  28 . During movement of the leading end of the tracheal tube  38  through the larynx  30 , it is desirable to have the tracheal tube near the central portion of the laryngeal cavity in order to minimize irritation of the vocal folds or cords  32  by the tracheal tube. 
         [0042]    In accordance with one of the features of the present invention, a flexible guide wire or rod  50  ( FIG. 1 ) is utilized to guide movement of the flexible tracheal tube  38  ( FIG. 2 ) into the trachea  28 . The flexible guide rod  50  has a soft generally spherical leading end portion  52 . The leading end portion  52  of the guide rod  50  is formed of a resiliently compressible material which is readily deflected by engagement with the vocal cords or folds  32  and by engagement with the surface of the trachea  28 . If desired, the leading end portion  52  of the guide rod  50  may be coated with a suitable lubricant to facilitate movement of the leading end portion between the vocal cords with minimum of irritation. 
         [0043]    In accordance with another of the features of the invention, the guide wire  50  is initially positioned relative to the patient&#39;s trachea  28  with a positioning apparatus  56  ( FIG. 1 ). The positioning apparatus  56  engages the patient&#39;s Adam&#39;s apple  34  to locate the positioning apparatus relative to the trachea  28  of the patient. In addition, the positioning apparatus  56  provides a measurement which is a function of the distance between the Adam&#39;s apple  34  and the mouth  12  of the patient. This measurement is utilized to determine the distance through which the guide rod  50  is to be moved relative to the positioning apparatus  56  as the guide rod is inserted into the trachea  28 . 
       Positioning Apparatus 
       [0044]    The positioning apparatus  56  has been and will be described herein in association with tracheal intubination. However, it is contemplated that the positioning apparatus  56  will be used in association with many other medical procedures where accurate positioning of an object relative to body tissue is desired. The positioning apparatus may be used in association with endoscopic, arthroscopic or fiber optic surgical procedures. It is believed that the positioning apparatus  56  will be used in conjunction with medical procedures where it is necessary to position an object at a location in a patient&#39;s body where there is only limited access. 
         [0045]    The positioning apparatus  56  positions the guide rod  50  relative to the patient&#39;s trachea  28  during insertion of the guide rod into the patient&#39;s trachea. In addition, the positioning apparatus  56  provides an indication of the distance which the guide rod is to be moved into the patient&#39;s trachea. By using the positioning apparatus  56 , a person moving the guide rod  50  into the patient&#39;s trachea  28  can know where the leading end portion  52  of the guide rod is located relative to the trachea. 
         [0046]    The flexible guide rod  50  may be formed of either polymeric material or metal. The illustrated polymeric guide rod  50  has a relatively small diameter and is readily deflected. The guide rod  50  has a circular cross sectional configuration. 
         [0047]    The guide rod  50  is axially movable relative to the positioning apparatus  56  under the influence of force manually applied to the portion of the guide rod disposed to the left (as viewed in  FIG. 1 ) of the positioning apparatus  56 . This force results in axial movement of the guide rod  50  relative to the positioning apparatus  56 . In addition, the leading end  52  of the guide rod  50  may deflect body tissue to clear a passage for the guide rod  50 . 
         [0048]    As the guide rod  50  is moved axially relative to the positioning apparatus  56 , the guide rod may be resiliently deflected by engagement with the body tissue of the patient. As the guide rod  50  is manually pushed toward the right (as viewed in  FIG. 1 ), the leading end  52  of the guide rod moves toward the larynx  30 . 
         [0049]    The positioning apparatus  56  is used to locate the leading end portion  52  of the guide rod  50  as the guide rod moves toward the larynx  30 . The positioning apparatus  56  includes a base section  78  and an arcuate upper section  80  ( FIG. 1 ). The base section  78  engages the patient&#39;s Adam&#39;s apple  34  to locate the positioning apparatus  56  relative to the patient&#39;s trachea  28 . The upper section  80  of the positioning apparatus  56  guides movement of the guide rod  50  during insertion of the guide rod into the patient&#39;s trachea  28 . 
         [0050]    The base section  78  and upper section  80  of the positioning apparatus  56  cooperate to provide a measurement of the distance between the patient&#39;s mouth  12  and the patient&#39;s Adam&#39;s apple  34 . This distance will vary from patient to patient depending upon the size of the patient, the specific configuration of the head  10  of the patient, and other factors. The distance which the guide rod  50  must be moved axially into the patient&#39;s larynx  30  will vary as a function of variations in the distance between the patient&#39;s mouth  12  and the patient&#39;s Adam&#39;s apple  34 . This is because the patient&#39;s Adam&#39;s apple  34  is located adjacent to the entrance to the trachea  28 . 
         [0051]    The positioning apparatus  56  can be used to position many different objects at desired locations in a patient&#39;s body. For example, the guide rod  50  or a similar member could be inserted into a patient&#39;s stomach or colon. The base section  78  of the positioning apparatus would be positioned in engagement with an exterior surface on the patient&#39;s body at a location where the leading end portion  52  of the guide rod  50  is to be moved. The upper section  80  of the positioning apparatus  56  would cooperate with the base section  78  and guide rod  50  to provide a clear indication of the location of the leading end portion  52  of the guide rod  50  relative to the patient&#39;s body tissue, for example, the patient&#39;s stomach or colon. 
         [0052]    The base section  78  ( FIG. 1 ) of the positioning apparatus  56  includes a tubular cylindrical body section  86 . The base section  78  also includes a positioning section  96  which engages the patient&#39;s Adam&#39;s apple  34  and is supported by the body section  86 . The positioning section  96  engages the patient&#39;s Adam&#39;s apple  34 . Although the illustrated positioning section  96  ( FIG. 1 ) engages only a single location on the patient&#39;s neck  16 , the positioning section could be constructed so as to engage a plurality of locations on the patient&#39;s neck. For example, it may be preferred to use a positioning section  96  having two positioning fingers disposed on laterally opposite sides of the Adam&#39;s apple  34 . 
         [0053]    It is contemplated that the positioning section  96  could have many different constructions. It is believed that it may be particularly advantageous to utilize a positioning section  96  having the construction illustrated in  FIGS. 25 and 26  herein. Alternatively, the positioning section  96  may have the construction illustrated in  FIGS. 27 and 28  or  FIGS. 4 and 7  herein if desired. 
         [0054]    Force may be manually applied against the positioning section  96  to straighten the trachea  28  of the patient. Thus, the patient&#39;s trachea  28  may have a slight anterior bend when the patient&#39;s head  10  is in the position illustrated in  FIG. 1 . This slight bend can be eliminated by the manual application of minimal force to the positioning section  96 . This force presses the positioning section  96  against the patient&#39;s neck. 
         [0055]    Although it is preferred to use the patient&#39;s Adam&#39;s apple  34  to locate the positioning apparatus  56  relative to the patient&#39;s trachea  28 , a different portion of the patient&#39;s body could be used to locate the positioning apparatus relative to the patient&#39;s trachea. For example, the patient&#39;s shoulders could be used. Alternatively, bones in the patient&#39;s neck  16  could be used to locate the positioning apparatus  56  relative to the patient&#39;s trachea  28 . However, it is believed that it will be preferred to use the patient&#39;s Adam&#39;s apple  34  to locate the positioning apparatus  56  due to the close proximity of the patient&#39;s Adam&#39;s apple to the upper end of the patient&#39;s trachea  28 . 
         [0056]    The arcuate upper section  80  of the positioning apparatus  56  includes an arcuate member  108  which is slidably connected with the body section  86  at a connection  110 . The connection  110  is movable axially along the cylindrical body section  86 . The body section  86  is movable transversely to the arcuate member  108 , in the manner indicated by the arrows  112  in  FIG. 1 . Suitable indicia, indicated by lines in  FIG. 1 , may be provided on the arcuate member  108  to indicate the position of the connection  110  relative to the arcuate member. 
         [0057]    The connection  110  may include a plurality of set screws (not shown) having manually engagable flanges or arms. One of the set screws may be tightened to prevent movement between the body section  86  and the connection  110 . Another set screw may be tightened to prevent movement between the arcuate member  108  and the connection  110 . 
         [0058]    When the connection  110  has been moved to a desired location along the body section  86 , a set screw in the connection is tightened to hold the arcuate member  108  against axial movement along to the cylindrical body section  86 . The arcuate member  108  is then moved transversely to the body section  86 , that is, in the direction of the arrows  112 , to position a guide section  114  in alignment with the patient&#39;s mouth  12  and trachea  28 . When the tubular guide section  114  has been aligned with the patient&#39;s trachea  28 , another set screw in the connection  110  is tightened to hold the arcuate member  108  against transverse movement relative to the body section  86 . 
         [0059]    The guide rod  50  extends through a cylindrical passage in the guide section  114 . Therefore, transverse movement of the arcuate member  108  relative to the body section  86 , that is, in the direction indicated by the arrows  112  positions the guide rod  50  in alignment with the patient&#39;s mouth  12 . The guide rod  50  is axially movable relative to the guide section  114  into the patient&#39;s mouth  12  and trachea  28 . 
         [0060]    In the illustrated embodiment of the invention, the distance between the patient&#39;s Adam&#39;s apple  34  and the arcuate member  108  is indicated by indicia  124  ( FIG. 1 ). The indicia  124  is disposed on the cylindrical body section  86  of the positioning apparatus  56 . The position of the connection  110  relative to the indicia  124  indicates the distance which the arcuate member is spaced from the positioning section  96 . The distance which the connection  110  is spaced from the positioning section  96  is a function of the distance between the patient&#39;s Adam&#39;s apple  34  and the entrance to the patient&#39;s mouth  12 . 
         [0061]    In the illustrated embodiment of the invention, the indicia  124  is formed by a plurality of colored bands  130 . Each of the bands  130  has a different color from the other bands. Each of the bands  130  has the same axial extent. However, the bands could have different axial extents if desired. Rather than using the colored bands  130  as the indicia  124 , numerical indicia could be provided. However, it is believed that it may be easier to read the different colored bands  130  than to read numerical indicia. 
         [0062]    Colored bands  142  are provided on the guide rod  50 . The colored bands  142  have different colors which correspond to the colors of the bands  130  on the cylindrical body section  86  of the positioning apparatus  56 . The colored bands  142  on the guide rod  50  are spaced from the end portion  52  of the guide rod by the same distance which correspondingly colored bands  130  on the body section  86  are spaced from the center of the Adam&#39;s apple  34 . 
         [0063]    The bands  142  on the guide rod  50  cooperate with an end portion  156  ( FIG. 1 ) of the guide section  114  to indicate when the leading end portion  52  of the guide rod is in a desired position relative to the patient&#39;s trachea  28 . Thus, assuming that a red colored band  130  on the cylindrical body section  86  of the positioning apparatus  56  is aligned with the connection  110 , the red band on the guide rod  50  will be moved to a position in which it is adjacent to the guide section  114 . When the guide rod  50  has been moved to a position in which the red band is adjacent to the guide section  114 , the leading end portion  52  of the guide rod will have moved through a desired distance into the patient&#39;s trachea  28  and will be aligned with the patient&#39;s Adam&#39;s apple  34 . 
         [0064]    When the positioning apparatus  56  is to be associated with a different portion of a patient&#39;s body, the indicia  124  would be revised to correspond to the distance which the guide rod  50  is to be moved relative to the arcuate member  108  to bring the leading end portion  52  of the guide rod into alignment with the positioning section  96  or to a position spaced a desired distance from the positioning section. It is contemplated that the positioning apparatus  56  maybe used during endoscopic, arthroscopic, or fiber optic surgery at many locations in a patient&#39;s body, for example during surgery on joints in the patient&#39;s body. 
         [0065]    The positioning apparatus  56  may be used in association with the delivery of medicants to relatively inaccessible locations in a patient&#39;s body. For example, a medicant could be connected with the leading end portion  52  of the guide rod  50  and released when the indicia  124  indicated that the medicant has been moved to a desired position relative to the positioning section  96 . The medicant may be released by activating a holder, disposed at the leading end portion  52  of the guide rod. A Bowden cable or other actuator may extend through the guide rod to the medicant holder to operate the medicant holder from a closed condition to an open condition to release the medicant. 
       Tracheal Intubination 
       [0066]    Once the guide rod  50  has been moved through a desired distance into the patient&#39;s trachea  28 , the positioning apparatus  56  is separated from the guide rod  50  while the guide rod remains stationary relative to the patient&#39;s trachea. Thus, once the indicia  142  on the guide rod  50  indicates that the leading end portion  52  of the guide rod has been moved through a desired distance into the patient&#39;s trachea  28 , axial movement of the guide rod  50  is interrupted. At this time, one of the colored bands  142  on the guide rod  50  corresponding to the one of the colored bands  130  aligned with the connection  110 , is aligned with the end surface  156  on the guide section  114 . 
         [0067]    The guide section  114  is then slid axially outward, that is toward the left as viewed in  FIG. 1 , along the guide rod  50 . During this sliding movement of the guide section  114  along the guide rod  50 , the guide rod is manually held against movement relative to the patient&#39;s mouth  12  and trachea  28 . The upper section  80  and base section  78  are separated from the patient during movement of the guide section  114  along the guide rod  50 . As this occurs, the guide rod  50  is stationary relative to the patient. 
         [0068]    Once the upper section  80  has been separated from the guide rod  50 , the tracheal tube  38  ( FIG. 2 ) is slid along the guide rod  50  into the patient&#39;s trachea  28 . Thus, the end of the guide rod  50  remote from the patient&#39;s mouth  12  and trachea  28  is inserted into the tracheal tube  38 . As this is done, the guide rod  50  is manually held against movement relative to the patient&#39;s mouth  12  and trachea  28 . The tracheal tube  38  is then moved axially along the guide rod  50  while the leading end portion  52  of the guide rod remains stationary in the patient&#39;s trachea. 
         [0069]    As the tracheal tube  38  is moved axially along the guide rod  50 , the guide rod directs the leading end portion of the tracheal tube into the patient&#39;s larynx  30  and past the vocal cords  32 . The leading end of the tracheal tube  38  is centered in the space between the vocal cords and the entrance to the patient&#39;s trachea by the guide rod  50 . This minimizes irritation of the patient&#39;s vocal cords  32 . The tracheal tube  38  is moved along the guide rod  50  at least until the leading end of the tracheal tube engages the leading end portion  52  of the guide rod  50 . 
         [0070]    It is contemplated that it may be desired to move the tracheal tube  38  further into the patient&#39;s trachea  28  than the distance which the guide rod  50  is moved into the patient&#39;s trachea. If this is the case, the tracheal tube  38  is pushed axially along the guide rod  50  past the leading end portion  52  of the guide rod. As this occurs, the leading end portion  52  of the guide rod  50  is compressed slightly and enters the tracheal tube  38 . 
         [0071]    Once the tracheal tube  38  has been moved to a desired depth into the patient&#39;s trachea  28 , the guide rod  50  is removed from the tracheal tube ( FIG. 7 ). The tracheal tube  38  then provides a passage for the conduction air, other gases, and/or medication to the patient&#39;s lungs. 
       Laryngoscope 
       [0072]    This contemplated that a laryngoscope  170  ( FIG. 3 ) maybe connected with the connection  110  which interconnects the body section  86  and arcuate upper section  80  of the positioning apparatus  56 . The laryngoscope  170  and body section  86  are moveable relative to each other to enable the laryngoscope to be positioned in the patient&#39;s mouth  12 . As the laryngoscope  170  is inserted into the patient&#39;s mouth  12 , the laryngoscope engages the patient&#39;s tongue. The laryngoscope then holds the patients tongue in a desired position in the mouth  12  of the patient. 
         [0073]    The laryngoscope  170  is then inserted further into the patient&#39;s mouth  12  to expose progressively deeper structures within the oropharynx. The laryngoscope  170  could be advanced to facilitate visualization of the glottic opening in a known manner. Although the laryngoscope may be provided as part of the positioning apparatus  56 , in the manner illustrated in  FIG. 3 , it is contemplated that the laryngoscope  170  could be separate from the positioning apparatus if desired. Regardless of whether the laryngoscope  170  is formed as part of the positioning apparatus  56  or separate from the positioning apparatus, the laryngoscope is utilized in a known manner in management of the patient&#39;s tongue and airway. 
       Second Embodiment 
       [0074]    A second embodiment of the invention is illustrated in  FIGS. 4 through 10 . Since the embodiment of the invention illustrated in  FIGS. 4-10  is generally similar to embodiment of the invention illustrated in  FIGS. 1-3 , similar terminology will be utilized to refer to similar components. 
         [0075]    A portion of a patient&#39;s head  210  has been illustrated schematically in  FIG. 4 . The patient&#39;s head includes a mouth  212  which is connected with a throat  214  and a neck  216  of the patient. Although the patient&#39;s head  210  has been schematically illustrated in an upright orientation in  FIG. 4 , it should be understood that the patient&#39;s head could be in a different orientation if desired. For example, the patient&#39;s head  210  could be in the orientation illustrated in  FIGS. 1 and 2  for the patient&#39;s head  10 . 
         [0076]    A pharynx  220  extends downward from a nasal cavity  222  in the head  210  of the patient. The pharynx  220  is connected with an esophagus  226  and a trachea  228  in the neck  216  of the patient. The esophagus  226  extends from the pharynx  220  to the stomach of the patient. The trachea  228  extends from the pharynx to the bronchial tubes and lungs of the patient. 
         [0077]    The trachea  228  ( FIG. 4 ) has an upper end portion  230  which is referred to as the larynx. Vocal cords or folds  232  have been indicated schematically in  FIG. 3  and are disposed in the larynx  230 . The vocal cords  232  are adjacent to the Adam&#39;s apple  234  of the patient. The Adam&#39;s apple  234  is a laryngeal prominence formed by lamina of cartilage in the larynx. 
         [0078]    Opening of a passage for air from the patient&#39;s mouth to the patient&#39;s lungs may require insertion of a flexible tracheal tube  238  ( FIG. 10 ). Movement of the flexible tracheal tube  238  from the patient&#39;s mouth  212  into the pharynx  220  of the patient is relatively easily accomplished. However, directing the tracheal tube  238  into the patient&#39;s trachea  228  may present difficulties. This is because an anterior bend  240  must be formed in the tracheal tube  238 . The anterior bend  240  extends around the epiglottis  242  into the larynx  230  at the upper end of the trachea  228 . The anterior bend  240  can be minimized by placing the patient in the orientation illustrated in  FIGS. 1 and 2 . 
         [0079]    During movement of the leading end of the tracheal tube  238  through the larynx  230 , it is desirable to have the tracheal tube near the central portion of the laryngeal cavity in order to minimize irritation of the vocal folds or cords  232  by the tracheal tube. In accordance with a feature of the present invention, a flexible guide wire or rod  250  ( FIGS. 4 and 9 ) is utilized to guide movement of the flexible tracheal tube  238  ( FIGS. 9 and 10 ) into the trachea  228 . The flexible guide rod  250  ( FIG. 9 ) has a soft generally spherical leading end portion  252 . The leading end portion  252  of the guide rod  250  is formed of a resiliently compressible material which is readily deflected by engagement with the vocal cords or folds  232  and by engagement with the surface of the trachea  228 . If desired, the leading end portion  252  of the guide rod  250  may be coated with a suitable lubricant to facilitate movement of the leading end portion between the vocal cords with minimum of irritation. 
         [0080]    In accordance with another feature of the invention, the guide wire  250  is initially positioned relative to the patient&#39;s trachea  228  with a positioning apparatus  256  ( FIG. 4 ). The positioning apparatus  256  engages the patient&#39;s Adam&#39;s apple  234  to locate the positioning apparatus relative to the trachea  228  of the patient. In addition, the positioning apparatus  256  provides a measurement which is a function of the distance between the Adam&#39;s apple  234  and the mouth  212  of the patient. This measurement is utilized to determine the distance through which the guide rod  250  is to be moved relative to the positioning apparatus  256  as the guide rod is inserted into the trachea  228 . 
         [0081]    In accordance with still another feature of the present invention, a magnet  260  ( FIG. 4 ) is utilized to attract the leading end portion  252  of the guide rod  250  and to steer the leading end portion of the guide rod into the patient&#39;s trachea  228 . The magnet  260  is a permanent magnet formed of a strongly magnetizable material such as cobalt and neodymium. Of course, other known magnetizable materials having high saturation magnetization values, such as cerium, praseodymium, and/or samarium with cobalt and/or other materials, could be used. Alternatively, the magnet  260  may be an electromagnet 
         [0082]    To enable the leading end portion  252  of the guide rod  250  to be attracted by a magnetic field emanating from the magnet  260 , the leading end portion  252  of the guide rod contains ferrite particles. The ferrite particles may or may not be magnetized. Or course, other known magnetizable or magnetic particles could be utilized. When a magnet is positioned on the leading end portion  252  of the guide rod  250 , the polarity of the leading end of the magnet on the guide rod is opposite from the polarity of the magnet  260 . 
         [0083]    As the guide rod  250  is moved downward (as viewed in  FIG. 4 ) along the patient&#39;s pharynx toward the larynx  230 , the leading end portion  252  of the guide rod enters the field of the magnet  260 . The field of the magnet  260  has sufficient strength to cause the guide rod  250  to deflect slightly toward the right (as viewed in  FIG. 4 ). As this occurs, the leading end portion  252  of the guide rod moves into the larynx  230  at a location adjacent to the center of the larynx. This enables the leading end portion  252  of the guide rod  250  to move between the vocal cords or folds  232  with a minimum of irritation to the vocal cords. Although the magnet  260  is described herein as steering the leading end portion  252  of the guide rod  250  into the trachea, it is contemplated that the magnet could be utilized to steer members at many different locations in a patient&#39;s body. 
         [0084]    The magnet  260  may be an electromagnet. If the magnet  260  is an electromagnet, the magnet may be turned on and off, that is, energized and de-energized during steering of the leading end portion  252  of the guide  250 . If desired, the leading end portion  252  of the guide rod  250  could also be formed by an electromagnet. If this was done, conductors for connecting the leading end portion  252  of the guide  250  would extend along the inside of the guide rod. By reversing the direction of current flow to either the electromagnet forming the magnet  260  or the electromagnet forming the leading end portion  252  of the guide rod  250 , the two electromagnets could be made to sequentially attract and repel each other. 
         [0085]    Steering of the leading end portion  252  of the guide rod  250  with the magnet  360  is facilitated by moving the magnet along the patient&#39;s neck  216 , in the manner indicated schematically in  FIG. 7 . The magnet  360  may be moved up and down along the patient&#39;s neck. The magnet  360  may also be moved sidewards relative to the patient&#39;s neck. By moving the magnet  360  relative to the patient&#39;s neck, a magnetic field emanating from the magnet is effective to pull the leading end portion  252  of the guide rod  250  in the desired direction. 
         [0086]    Although the use of the magnet  260  has been disclosed herein in association with the embodiment of the invention illustrated in  FIGS. 4-10 , it is contemplated that the magnet  260  could be used in association with other embodiments of the invention. For example, the magnet  260  could be used with the embodiment of the invention illustrated in  FIGS. 1 and 2 . 
         [0087]    The magnet  260  may be used to steer devices other than the guide rod  250 . When the positioning apparatus  56  ( FIG. 1 ) is to be associated with a portion of a patient&#39;s body other than the trachea, the magnet  260  ( FIG. 4 ) could be used to steer any one of many different devices to a desired location in the patient&#39;s body. A positioning apparatus, similar to the positioning apparatus  56  of  FIG. 1  or the positioning apparatus  256  of  FIG. 4 , and a magnet, similar to the magnet  260  may be used during endoscopic, arthroscopic, or fiber optic surgery at many different locations in a patient&#39;s body. Thus, the magnet  260  may be used to steer a guide rod being positioned relative to a joint by a positioning apparatus, similar to the positioning apparatus  56  of  FIG. 1  and the positioning apparatus  256  of  FIG. 4 , during surgery at the joint. The magnet  260  may also be used to position medicants at desired locations in the patient&#39;s body. Although it is believed that the magnet  260  will be advantageously used in association with a positioning apparatus similar to the positioning apparatus  56  of  FIG. 1  or the other positioning apparatus  256  of  FIG. 4 , the magnet may be used in situations where the positioning apparatus is not required. 
       Positioning Apparatus of FIGS.  4 - 10   
       [0088]    The positioning apparatus  256  ( FIG. 4 ) positions the guide rod  250  relative to the patient&#39;s trachea  228  during insertion of the guide rod into the patient&#39;s trachea. In addition, the positioning apparatus  256  provides an indication of the distance which the guide rod is to be moved into the patient&#39;s trachea. By using the positioning apparatus  256 , a person moving the guide rod  250  into the patient&#39;s trachea  228  can know where the leading end portion  252  of the guide rod is located relative to the trachea. 
         [0089]    During movement of the guide rod  250  into the patient&#39;s trachea, the guide rod is moved axially through a flexible, generally cylindrical, guide tube  264  ( FIG. 5 ). The guide tube  264  is formed of a resilient polymeric material. The guide tube  264  has a main section  266  and a leading end section  268 . The leading end section  268  has a side wall  270  which is thinner than a side wall  272  of the main section  266 . The side wall  270  is integrally molded as one piece with the thicker side wall  272 . A generally cylindrical passage  274  ( FIG. 5 ) extends axially through the guide tube  264 . 
         [0090]    The thin walled leading end section  268  of the guide tube  264  is molded so as to naturally assume the arcuate configuration illustrated in  FIGS. 4 and 5 . This enables the end section  268  of the guide tube  264  to be positioned in the patient&#39;s pharynx  220  ( FIG. 4 ) with the end section forming a bend which extends around the upper end portion of the patient&#39;s epiglottis  242 . Since the leading end section  268  has a relatively thin side wall ( FIG. 5 ), the end section can be easily deflected as it is moved into position in the patient&#39;s pharynx  220 . The thicker side wall  272  of the main section  266  of the guide tube  264  is effective to support the leading end section  268  in the patient&#39;s pharynx  220  and to depress a tongue  76  in the mouth  212  of the patient ( FIG. 1 ). 
         [0091]    The guide rod  250  may be formed of either polymeric material or metal. The illustrated polymeric guide rod  250  has a relatively small diameter and is readily deflected. The guide rod  250  has a circular cross sectional configuration. 
         [0092]    The guide rod  250  extends axially through the guide tube  264  ( FIG. 4 ). The guide rod  250  is axially movable relative to the guide tube  264  under the influence of force manually applied to the portion of the guide rod disposed to the right (as viewed in  FIG. 4 ) of the positioning apparatus  256 . This force results in axial movement of the guide rod  250  along the guide tube  264 . 
         [0093]    As the guide rod  250  is axially moved along the guide tube  264 , the arcuate leading end section  268  of the guide tube  264  resiliently deflects the guide rod  250  to form the arcuate bend illustrated in  FIG. 4 . As the guide rod  250  is manually pushed toward the left (as viewed in  FIG. 4 ), the leading end  52  of the guide rod moves downward (as viewed in  FIG. 4 ) toward the larynx  230 . As the leading end  252  of the guide rod  250  moves downward (as viewed in  FIG. 4 ), tissues which may tend to block movement of the guide rod are pushed aside by the leading end of the guide rod. This clears a passage for the guide rod  250   
         [0094]    The positioning apparatus  256  is used to locate the leading end portion  252  of the guide rod  250  as the guide rod moves along the guide tube  264 . The positioning apparatus  256  includes a base section  278  and an upper section  280  ( FIG. 4 ). The base section  278  engages the patient&#39;s Adam&#39;s apple  234  to locate the positioning apparatus  256  relative to the patient&#39;s trachea  228 . The upper section  280  of the positioning apparatus  256  holds the guide tube  264  which guides movement of the guide rod  250  during insertion of the guide rod into the patient&#39;s trachea  228 . 
         [0095]    The base section  278  and upper section  280  of the positioning apparatus  256  cooperate to provide a measurement of the distance between the patient&#39;s mouth  212  and the patient&#39;s Adam&#39;s apple  234 . This distance will vary from patient to patient depending upon the size of the patient, the specific configuration of the head  210  of the patient, and other factors. The distance which the guide rod  250  must be moved axially relative to the guide tube  264  to move the leading end portion  252  of the guide rod into the patient&#39;s larynx  230  will vary as a function of variations in the distance between the patient&#39;s mouth  212  and the patient&#39;s Adam&#39;s apple  234 . This is because the patient&#39;s Adam&#39;s apple  234  is located adjacent to the entrance to the trachea  228 . 
         [0096]    The base section  278  of the positioning apparatus  256  includes an upright tubular cylindrical body section  286 . The body section  286  has a cylindrical chamber  288 . The cylindrical upper section  280  of the positioning apparatus  256  is telescopically received in the chamber  288 . 
         [0097]    In addition, the base section  278  includes an end section  290 . The end section  290  extends perpendicular to the body section  286 . The end section  290  has a cylindrical central passage  292  which extends perpendicular to and intersects the central axis of the chamber  288 . The body section  286  and the end section  290  are integrally molded as one piece of polymeric material. 
         [0098]    The base section  278  also includes a positioning section  296  which engages the patient&#39;s Adam&#39;s apple  234  and is supported by the end section  290 . The positioning section  296  includes a cylindrical support rod  298  which extends through the passage  292  and is connected with a locating portion  302  which engages the patient&#39;s Adam&#39;s apple  234 . The locating portion  302  includes a generally hemispherical dome  304  and a resilient annular collar  306  which is connected to the rim of the dome  304 . The collar  306  extends around the Adam&#39;s apple  234  and engages upper and lower sides and left and right sides of the Adam&#39;s apple to center the dome  304  on the Adam&#39;s apple. 
         [0099]    If desired, the locating portion  302  could be constructed to engage only two sides of the Adam&#39;s apple  234 . For example, the left and right sides of the Adam&#39;s apple  234 . It is believed that it may be desired to form the locating portion  302  with the construction illustrated in  FIGS. 25 and 26  herein. Alternatively, the locating portion  302  could be constructed so as to engage only the central portion of the Adam&#39;s apple  234 . 
         [0100]    However, it is believed that it may be desired to form the locating portion  302  so that it extends around the Adam&#39;s apple  234  so as to locate the positioning section  296  relative to the Adam&#39;s apple. Force may be manually applied against the positioning section  296  to minimize the anterior bend  240  ( FIG. 10 ) which must be formed in the tracheal tube  238 . The end section  290  is axially slidable along the support rod  298  so that the body section  286  is disposed adjacent to the chin  310  of the patient. 
         [0101]    Although it is preferred to use the patient&#39;s Adam&#39;s apple  234  to locate the positioning apparatus  256  relative to the patient&#39;s trachea  228 , a different portion of the patient&#39;s body could be used to locate the positioning apparatus relative to the patient&#39;s trachea. For example, the patient&#39;s shoulders could be used. Alternatively, bones in the patient&#39;s neck  216  could be used to locate the positioning apparatus  256  relative to the patient&#39;s trachea  228 . However, it is believed that it will be preferred to use the patient&#39;s Adam&#39;s apple  234  to locate the positioning apparatus  256  due to the close proximity of the patient&#39;s Adam&#39;s apple to the upper end of the patient&#39;s trachea  228 . 
         [0102]    The upper section  280  of the positioning apparatus  256  includes a cylindrical rod portion  314  which is telescopically received in the body section  286  of the positioning apparatus. An upper end section  316  has a cylindrical passage  318  through which the guide tube  264  extends. The passage  318  has a longitudinal central axis which extends parallel to the longitudinal central axis of the passage  292  and to the longitudinal central axis of the support rod  298 . The guide tube  264  is slidable in the passage  318 . 
         [0103]    The guide tube  264  extends from the passage  318  into the patient&#39;s mouth  212 . Thus, the passage  318  in the upper section  280  of the positioning apparatus  256  is axially aligned with the patient&#39;s mouth  212 . Similarly, the passage  292  ( FIG. 4 ) in the end section  290  of the base section  278  of the positioning apparatus  256  is axially aligned with the patient&#39;s Adam&#39;s apple  234 . Therefore, the positioning apparatus  256  can be utilized to measure the distance between the Adam&#39;s apple  234  and the patient&#39;s mouth  212 . 
         [0104]    The entrance through which the guide rod  250  must pass into the patient&#39;s trachea  228  is adjacent to the Adam&#39;s apple  234 . Therefore, the distance through which the leading end portion  252  of the guide rod  250  must be moved relative to the guide tube  264  ( FIG. 4 ) to enter the patient&#39;s trachea  228 , is a function of the distance between the patient&#39;s Adam&#39;s apple  234  and the patient&#39;s mouth  212 . The positioning apparatus  256  measures the distance between the patient&#39;s Adam&#39;s apple  234  and the patient&#39;s mouth by determining the position of the base section  278  and upper section  280  of the positioning apparatus relative to each other. 
         [0105]    In the illustrated embodiment of the invention, the distance between the patient&#39;s Adam&#39;s apple  234  and the patient&#39;s mouth  212  is indicated by indicia  324  ( FIG. 6 ). The indicia  324  is disposed on the cylindrical rod portion  314  of the upper section  280  of the positioning apparatus  256 . The rod portion  314  is telescopically received in the cylindrical chamber  288  in the body section  286  of the positioning apparatus  256 . 
         [0106]    The position of an annular upper end surface  328  on ( FIG. 6 ) the body section  286  relative to the indicia  324  indicates the distance which the rod portion  314  is extended from the body section  286 . The distance which the rod portion  314  is extended from the body section  286  is a function of the distance between the patient&#39;s Adam&#39;s apple  234  and the entrance to the patient&#39;s mouth  212 . 
         [0107]    In the illustrated embodiment of the invention, the indicia  324  is formed by a plurality of colored bands  330 ,  332 ,  334 ,  336 ,  338  and  340  ( FIG. 6 ). Each of the bands  330 - 340  has a different color from the other bands. It should be understood that a lesser or greater number of colored bands  330 - 340  could be provided if desired. It should also be understood that although the bands  330 - 340  have the same axial extent, the bands could have different axial extents if desired. Rather than using the colored bands  330 - 340  as the indicia  324 , numerical indicia could be provided. However, it is believed that it may be easier to read the different colored bands  330 - 340  than to read numerical indicia. 
         [0108]    Bands  342 ,  344 ,  346 ,  348 , and  350  ( FIG. 8 ) are provided on the guide rod  250 . The colored bands  342 - 350  have different colors which correspond to the colors of the bands  132 - 140  on the rod portion  314  ( FIG. 6 ) of the positioning apparatus  256 . It should be understood that although only the bands  342 - 350  having colors corresponding to the colors of the bands  132 - 140  are illustrated, an additional band having a color corresponding to the color of the band  330  in  FIG. 6  is provided on the guide rod  250 . 
         [0109]    The bands  342 - 350  ( FIG. 8 ) on the guide rod  250  cooperate with an annular end surface  356  ( FIG. 4 ) on the guide tube  264  to indicate when the leading end portion  252  of the guide rod is in a desired position relative to the patient&#39;s trachea  228 . Thus, assuming that the colored band  334  on the rod portion  314  of the positioning apparatus  256  is aligned with the end surface  328  on the body section  286  (as illustrated in  FIG. 6 ), the band  344  ( FIG. 8 ) on the guide rod  250  will be moved to a position in which it is partially covered by the guide tube  264  and projects outward from the end surface  356  ( FIG. 4 ) for a distance corresponding to the distance which the band  334  projects outward from the end surface  328  on the body section  286  ( FIG. 5 ). The band  344  has a color which is the same as the color of the band  334 . When the guide rod  250  has been moved to a position in which the band  344  is partially enclosed by the guide tube  264 , the leading end portion  252  of the guide rod will have moved through a desired distance into the patient&#39;s trachea  228 , for example, a distance of approximately ten centimeters. 
         [0110]    The bands  342 - 350  ( FIG. 8 ) on the guide rod  250  are spaced a predetermined distance from the end surface  356  ( FIG. 4 ) on the guide tube  264  when the leading end portion  252  of the guide rod is disposed in abutting engagement with the leading end section  268  of the guide tube  264 . During movement of the indicia on the guide rod  250  from a position spaced from the end surface  356  of the guide tube  264  to a position in which the leading band on the guide rod  150  is adjacent to the end surface  356 , the leading end portion  252  of the guide rod  250  will have moved from the pharynx  220  of the patient and into the larynx  230  past the vocal cords  232 . 
         [0111]    As the guide rod  250  continues to be manually pushed into the guide tube  264 , the leading end portion  252  of the guide rod advances downward (as viewed in  FIG. 4 ) in the trachea  228  of the patient. Movement of the guide rod  250  into the trachea  228  of the patient is interrupted when the band  344  having a color corresponding to the color of the band  334  ( FIG. 6 ) has been partially covered by the guide tube  264 . 
         [0112]    The magnet  260  is utilized to steer the guide rod  250  during movement of the leading end portion  252  of the guide rod from the patient&#39;s mouth  212  into the patient&#39;s trachea  228 . As the leading end portion  252  of the guide rod  250  is moved downward along the inside of the patient&#39;s neck, the magnet  360  is moved downward along the outside of the patient&#39;s neck. The magnetic field provided by the magnet  360  is effective to pull the leading end portion  252  downward as the magnet moves downward. Eventually, the leading end portion  252  of the guide rod  250  and magnet  260  will move downward from the entrance to the trachea  228  through a desired distance, for example a distance of approximately ten centimeters. Of course, the leading end portion  252  of the guide rod  250  could be moved through a different distance into the trachea  228  if desired. 
         [0113]    It is contemplated that the distance between the patient&#39;s Adam&#39;s apple  234  and the entrance to the patient&#39;s mouth  212  will vary from patient to patient. However, the distance which the leading end portion  252  of the guide rod  250  is moved into the patient&#39;s trachea  228  will remain constant at a desired distance, for example, ten centimeters. This is because as the distance measured by the positioning apparatus  256  increases, the distance which the guide rod  250  is moved relative to the guide tube  264  increases. Conversely, as the distance which is measured by the positioning apparatus  256  decreases, the distance which the guide rod  250  is moved relative to the guide tube  264  decreases. The distance which is measured by the positioning apparatus  256  varies as a function of the distance between the mouth  212  and larynx  230  of the patient. 
       Tracheal Intubination 
       [0114]    Once the guide rod  250  has been moved through a desired distance into the patient&#39;s trachea  228 , the guide tube  264  and positioning apparatus  256  are separated from the guide rod  250  while the guide rod remains stationary relative to the patient&#39;s trachea. Thus, once the indicia on the guide rod  250  indicates that the leading end portion  252  of the guide rod has been moved through a desired distance into the patient&#39;s trachea  228 , axial movement of the guide rod  250  is interrupted. At this time, one of the colored bands  342 - 350  on the guide rod  250  corresponding to the one of the colored bands  330 - 340  aligned with the end surface  328  ( FIG. 4 ) on the body section  286  of the positioning apparatus is aligned with the end surface  356  ( FIG. 4 ) on the guide tube  264 . 
         [0115]    The guide tube  264  is then slid axially outward, that is toward the right as viewed in  FIG. 4 , along the guide rod  250 . During this sliding movement of the guide tube  264  along the guide rod  250 , the guide rod is manually held against movement relative to the patient&#39;s mouth  212  and trachea  228 . The positioning apparatus  256  is moved away from the patient along with the guide tube  264 . 
         [0116]    Once the guide tube  264  has been separated from the guide rod  250  ( FIG. 9 ), the tracheal tube  238  is slid along the guide rod  250  into the patient&#39;s trachea  228 . Thus, the end of the guide rod  250  remote from the patient&#39;s mouth  212  and trachea  228  is inserted into the tracheal tube  238 . As this is done, the guide rod  250  is manually held against movement relative to the patient&#39;s mouth  212  and trachea  228 . The tracheal tube  238  is then moved axially along the guide rod  250  while the leading end portion  252  of the guide rod remains stationary in the patient&#39;s trachea. If desired, the magnet  260  may be utilized to attract the leading end portion  252  of the guide rod  250 , in the manner illustrated in  FIG. 9 , to facilitate maintaining of the leading end portion of the guide rod stationary in the patient&#39;s trachea  228 . 
         [0117]    As the tracheal tube  238  is moved axially along the guide rod  250 , the guide rod directs the leading end portion of the tracheal tube along a bend  360  ( FIG. 9 ) formed in the guide rod. After the leading end portion of the tracheal tube  238  has moved around the bend  360 , the leading end portion of the tracheal tube enters the patient&#39;s larynx and moves past the vocal cords  232 . The leading end of the tracheal tube  238  is centered in the space between the vocal cords and the entrance to the patient&#39;s trachea by the guide rod  250 . This minimizes irritation of the patient&#39;s vocal cords  232 . The tracheal tube  238  is moved along the guide rod  250  at least until the leading end of the tracheal tube engages the leading end portion  252  of the guide rod  250 . 
         [0118]    It is contemplated that it may be desired to move the tracheal tube  238  further into the patient&#39;s trachea than the distance which the guide rod  250  is moved into the patient&#39;s trachea. If this is the case, the tracheal tube  238  is pushed axially along the guide rod  250  past the leading end portion  252  of the guide rod. As this occurs, the leading end portion  252  of the guide rod  250  is compressed slightly and enters the tracheal tube  238 . 
         [0119]    Once the tracheal tube  238  has been moved to a desired depth into the patient&#39;s trachea  228 , the guide rod  250  is removed from the tracheal tube ( FIG. 10 ). The tracheal tube  238  then provides a passage for the conduction air, other gases, and/or medication to the patient&#39;s lungs. 
       Method of Utilization 
       [0120]    When the tracheal tube  238  is to be inserted into a patient&#39;s trachea  228 , the guide rod  250  is first positioned relative to the guide tube  264  at a location spaced from the patient. At this time, the leading end portion  252  of the guide rod  250  is disposed in abutting engagement with the leading end portion  268  of the guide tube  264 . The upper section  280  of the positioning apparatus  256  is loosely positioned on the guide tube  264 . The lower or base section  278  of the positioning apparatus  256  is separate and spaced from the upper section  280  of the positioning apparatus. A suitable lubricant may be applied to the leading end portion  252  of the guide rod  250  and to the leading end portion  268  of the guide tube  264 . 
         [0121]    The guide tube  264  is then inserted into the patient&#39;s mouth  212 . As the guide tube  264  is inserted into the patient&#39;s mouth, the leading end portion  268  of the guide tube  264  and the leading end portion  252  of the guide rod  250  move from the patient&#39;s mouth into the pharynx  220  of the patient. As the leading end portion  268  of the guide tube  264  moves into the pharynx  220  of the patient, the natural resilience of the material of the guide tube causes the guide tube to spring back to its initial or free configuration illustrated in  FIGS. 3 and 4 . 
         [0122]    As the guide tube  264  and guide rod  250  are manually moved together into the patient&#39;s mouth  212 , the guide tube bends itself around the upper (as viewed in  FIG. 3 ) portion of the patient&#39;s epiglottis  242 . This results in the leading end portion  252  of the guide rod  250  being pointed downward (as viewed in  FIG. 3 ) toward the lower end portion of the patient&#39;s pharynx  220 . A person initially inserting the guide tube  264  and guide rod  250  into the patient&#39;s mouth  212  can visually ascertain when the guide tube and guide rod have moved to the position illustrated in  FIG. 3   
         [0123]    When the guide tube  264  and guide rod  250  have been positioned in this manner relative to the patient&#39;s mouth  212  and pharynx  220 , the positioning apparatus  256  is assembled. To assemble the positioning apparatus, the rod portion  314  of the upper section  280  is telescopically inserted into the chamber  288  in the body section  286  of the positioning apparatus. Contemporaneously therewith, the locating portion  302  of the positioning apparatus  296  is moved into engagement with the patient&#39;s Adam&#39;s apple  234 . The base section  278  and upper section  280  of the positioning apparatus  256  are moved axially along the guide tube  264  and support rod  298  until the base section and upper section of the positioning apparatus  256  are adjacent to the patient&#39;s chin  310  ( FIG. 4 ). At this time, the coincident central axes of the rod portion  314  and body section  286  of the positioning apparatus  256  will extend perpendicular to the central axes of the guide tube  264  and support rod  298 . 
         [0124]    The magnet  260  is then positioned immediately beneath the patient&#39;s Adam&#39;s apple  234 . This enables the magnetic field from the magnet  260  to extend leftward and upward (as viewed in  FIG. 4 ) to the entrance to the patient&#39;s larynx  230 . This results in the magnet  260  and positioning apparatus  256  being disposed in the orientation illustrated in  FIG. 3  relative to the patient. 
         [0125]    Once the positioning apparatus  256 , guide tube  264  and guide rod  250  have been moved to the positions shown in  FIG. 3  relative to the patient&#39;s head  210 , the person using the positioning apparatus  256  visually determines the distance between the patient&#39;s Adam&#39;s apple  234  and the patient&#39;s mouth  212 . This is accomplished by viewing the indicia  324  ( FIG. 6 ) on the rod portion  314  of the positioning apparatus  256 . By determining which of the bands  330 - 340  is aligned with the end surface  328  on the body section  286  of the positioning apparatus  256 , the operator determines the distance between the patient&#39;s Adam&#39;s apple and the patient&#39;s mouth. The distance which the guide rod  250  must be moved into the patient&#39;s trachea  228  is a direct function of the distance between the patient&#39;s Adam&#39;s apple  234  and the patient&#39;s mouth  212 . 
         [0126]    The operator then begins to manually apply force against the rightward (as viewed in  FIG. 4 ) portion of the guide rod  250  while holding the guide tube  264  against movement. This results in the leading end portion  252  of the guide rod moving downward toward the entrance to the patient&#39;s larynx  230 . As the guide rod  250  begins to move downward, the bent leading end portion  268  of the guide tube  60  directs the leading end portion  252  of the guide rod  80  downward around the patient&#39;s epiglottis  242  in a direction toward the entrance to the larynx  230 . 
         [0127]    It is contemplated that the resiliently deflectable guide rod  250  will initially be formed with a bend which is a continuation of the bend in the leading end portion of the guide tube  264 . Therefore, the natural resilience of the guide rod  250  will tend to cause the guide rod to bend rightward toward the patient&#39;s Adam&#39;s apple as the leading end portion  252  of the guide rod begins to move downward toward the larynx  230 . 
         [0128]    As the leading end portion  252  of the guide rod  250  approaches the entrance to the larynx  230 , the field emanating from the magnet  260  attracts the leading end portion  252  of the guide rod  250 . The magnetic attraction forces applied to the leading end portion  252  of the guide rod  250  also promote rightward (as viewed in  FIG. 4 ) bending of the guide rod  250  toward the patient&#39;s Adam&#39;s apple  234 . Thus, the combined effect of the magnet  260  and the natural resilience of the preformed guide rod  250  urge the leading end portions  52  of the guide rod  250  toward the entrance to the larynx  230  and away from the adjacent entrance to the esophagus  226 . This ensures that the leading end portion  252  of the guide rod  250  enters the trachea  228  rather than the esophagus  226 . If desired, the magnet  260  could be positioned above or on the patient&#39;s Adam&#39;s apple  234  and then moved downward as the guide rod  250  advances. 
         [0129]    If desired, the flexible guide rod  250  could initially be formed with a straight configuration and only the magnet  260  would steer the leading end portion  252  of the guide rod into the entrance to the trachea  228 . Alternatively, the use of the magnet  260  could be eliminated and only the preformed configuration of the guide rod  250  would be used to direct the leading end portion  252  of the guide rod into the entrance to the trachea  228 . However, it is believed that it will be preferred to use both the preformed configuration of the guide rod  250  and the magnet  260  to direct the leading end portion  252  of the guide rod into the patient&#39;s trachea  228 . 
         [0130]    The colored bands  342 - 350  ( FIG. 8 ) on the guide rod  250  cooperate with the end surface  356  ( FIG. 4 ) of the guide tube  264  to provide an indication of the location of the leading end portion  252  of the guide rod relative to the patient&#39;s Adam&#39;s apple  234 . As the leading end portion  252  of the guide rod  250  moves downward from the position shown in  FIG. 3  toward the entrance to the larynx  230 , the indicia bands  342 - 350  will move toward the end surface  356  of the guide rod  250 . As the leading end portion  252  of the guide rod  250  moves through the entrance to the larynx  230 , the indicia on the guide rod  250  will be approaching the end surface  356  of the guide tube  264 . 
         [0131]    Continued axial movement of the guide rod  250  relative to the stationary guide tube  264  moves the leading end portion  252  of the guide rod to a position immediately above the patient&#39;s vocal cords  232 . As this occurs, the leading end portion  252  of the guide rod  250  is strongly attracted by the magnetic field emanating from the magnet  260 . Due to the approach of the indicia on the guide rod  250  toward the end surface  356  of the guide tube  264 , the operator realizes that the leading end portion  252  of the guide rod  250  is adjacent to the magnet  260  and moves the magnet downward (as viewed in  FIG. 4 ) along the neck  216  of the patient as the guide rod  250  continues to be moved leftward through the stationary guide tube  264 . As the magnet  260  is manually moved downward (as viewed in  FIG. 4 ) with the leading end portion  252  of the guide rod  250 , the magnet continues to attract the leading end portion of the guide rod. 
         [0132]    One of the bands  330 - 340 , having a particular color, for instance, red, on the rod portion  314  ( FIG. 6 ) will be adjacent to the end surface  328  on the body section of the positioning apparatus  256 . When a correspondingly colored band, that is, when the red band  344  on the guide rod  250  ( FIG. 8 ), is partially covered by the guide tube  264  and extends axially outward from the end surface  356 , the operator will know that the leading end portion  252  of the guide rod  250  will have moved past the vocal  232  to the desired position relative to the patient&#39;s trachea. Insertion of the guide rod  250  into the guide tube  264  is then interrupted. 
         [0133]    After the guide rod  250  has been inserted for the desired distance into the patient&#39;s trachea  228 , the guide tube  264  and positioning apparatus  256  are separated from the guide rod  250 . During separation of the guide tube  264  and positioning apparatus  256  from the guide rod  250 , the guide rod is maintained stationary relative to a patient&#39;s trachea  228 . In the illustrated embodiment of the invention, the guide tube  264  is merely moved rightward (as viewed in  FIG. 4 ) along the stationary guide rod  250  to disengage the guide tube and the positioning apparatus from the guide rod. 
         [0134]    If desired, a slot could be provided in the guide tube  264  to facilitate disengagement of the guide tube from the guide rod. A corresponding slot could be formed in the end section  316  of the positioning apparatus  256 . The slots in the guide tube  264  and end section  316  could be partially or fully blocked during insertion of the guide rod  250  into the guide tube  264 . When the guide tube  264  is to be separated from the guide rod  250 , that is after the guide rod has been inserted for the desired distance into the patient&#39;s trachea  228 , latch or closure members for the slots could be moved to open positions and the guide tube  264  and apparatus  256  moved out of engagement with the stationary guide rod  250 . 
         [0135]    Once the guide tube  264  and positioning apparatus  256  have been disengaged from the guide rod  250 , the guide rod is utilized to guide movement of the tracheal tube  238  into the patient&#39;s trachea  228 . The tracheal tube  238  has a substantially larger diameter than the guide tube  264  to provide for a relatively large central opening through which air or other gas may pass into the patient&#39;s trachea  228 . 
         [0136]    When the tracheal tube  238  is to be moved into the patient&#39;s trachea  228 , the guide rod  250  is telescopically inserted into the leading end of the tracheal tube. At this time, the right end (as viewed in  FIG. 4 ) of the guide rod  250  will extend beyond the far right end of the tracheal tube  238 . Therefore, the guide rod  250  can be manually grasped and the tracheal tube  238  moved axially along the guide rod while the guide rod remains stationary relative to the patient&#39;s trachea  228 . 
         [0137]    The tracheal tube  238  is moved leftward, in the manner indicated by the arrow in  FIG. 9 , along the stationary guide rod  250  into the patient&#39;s mouth  212 . The tracheal tube  238  is then moved around the bend  360  in the stationary guide rod  250  and into the patient&#39;s trachea  228 . Since the guide rod  250  extends from the patient&#39;s pharynx  220  into the trachea  228 , the guide rod  250  blocks movement of the leading end portion of the tracheal tube  238  into the patient&#39;s esophagus  226 . The guide rod  250  acts as a track along which the tracheal tube  238  moves into the patient&#39;s larynx  230  and not into the adjacent esophagus  226 . 
         [0138]    As the leading end portion of the tracheal tube  238  approaches and moves past the vocal cords  232 , the guide rod  250  guides movement of the leading end portion of the tracheal tube in such a manner as to minimize irritation of the vocal cords. Thus, the guide rod  250  centers the leading end portion of the tracheal tube  238  in the space between the vocal cords. By lubricating the leading end portion of the tracheal tube  238  and centering the leading end portion of the tracheal tube in the space between the vocal cords  232 , the tracheal tube can be moved into the patient&#39;s trachea  228  with a minimal amount of irritation to the vocal cords. 
         [0139]    As the tracheal tube  238  is moved through the patient&#39;s larynx  230 , the magnet  260  is disposed adjacent to the leading end portion  252  of the guide rod  250 . Therefore, the leading end portion  252  of the guide rod  250  is attracted by the magnet  260  and tends to remain stationary in the patient&#39;s trachea  228 . As the tracheal tube  238  is inserted into the patient&#39;s trachea  228 , the leading end portion of the tracheal tube  238  moves past the leading end portion  252  of the guide rod  250 . As this occurs, the leading end portion  252  of the guide rod  250  is slightly compressed and moves into the tracheal tube  238 . Once the tracheal tube  238  has moved to a desired position relative to the trachea  228 , the guide rod  250  is withdrawn from the tracheal tube  238  while the tracheal tube is maintained stationary relative to the patient&#39;s trachea. 
         [0140]    In the embodiment of the invention illustrated in  FIGS. 4-10 , the magnet  260  ( FIG. 4 ) is utilized to attract the leading end portion  252  of the guide rod  250 . However, it is contemplated that the magnet  260  could be used for other purposes if desired. For example, the magnet  260  could be used to position a suture anchor relative to body tissue. 
         [0141]    When the magnet  260  is to be utilized to position a suture anchor relative to body tissue, a leading end portion of the suture anchor is formed of a magnetizable material, such a ferrite. Alternatively, the leading end portion of the suture anchor could be formed of a magnetic material such as cobalt, neodymium, cerium, praseodymium, and/or samarium. If this was done, the magnet  260  would be oriented relative to the magnet on the suture anchor to have a pole of the magnet  260  of opposite polarity to the leading end of the suture anchor toward the suture anchor. 
         [0142]    The trailing end portion of the suture anchor may be formed of a nonmagnetic material, such as a biodegradable polymer. The suture would extend through an opening in the nonmagnetic material of the trailing end portion of the suture anchor. Once the suture anchor had been moved to a desired position relative to body tissue by attraction of the magnet  260  for the leading end portion of the suture anchor, the leading end portion of the suture anchor may be separated from the trailing end portion of the suture anchor. The leading end portion of the suture anchor could then be removed from the patient&#39;s body to eliminate the possibility of an undesired interaction in the future with a magnetic field device, such as a magnetic resonance imaging device (MRI). The suture would be held in place by the nonmagnetic trailing end portion of the suture anchor 
       Embodiment of FIG.  11   
       [0143]    In the embodiment of the invention illustrated in  FIGS. 4-10 , a guide tube  264  is utilized to guide movement of the guide rod  250  as the guide rod is moved from the patient&#39;s pharynx  220  into the patient&#39;s trachea  228 . The guide tube  264  is then removed and a tracheal tube  238  is slid along the guide rod  250  into the patient&#39;s trachea. In the embodiment of the invention illustrated in  FIG. 11 , the tracheal tube is used to guide movement of the guide rod into the patient&#39;s trachea. This eliminates the need for a separate guide tube. Since the embodiment of the invention illustrated in  FIG. 11  is generally similar to the embodiment of the invention illustrated in  FIGS. 4-9 , similar numerals will be utilized to designate similar components, the suffix letter “a” being associated being associated with the numerals of  FIG. 11  to avoid confusion. 
         [0144]    A patient&#39;s head  210   a  ( FIG. 11 ) includes a mouth  212   a  which is connected with a throat  214   a  in a neck  216   a  of the patient. A pharynx  220   a  is connected with an esophagus  226   a  and a trachea  228   a . A larynx  230   a  forms an upper end portion of the trachea  228   a  and contains vocal cords  232   a . An Adam&#39;s apple  234   a  is formed by laminae of cartilage in the patient&#39;s larynx  230   a.    
         [0145]    A positioning apparatus  256   a  is utilized to position a tracheal tube  238   a  and a guide rod or wire  250   a  during insertion of the guide rod and during insertion of the tracheal tube into the patient&#39;s trachea  228   a . The tracheal tube  238   a  ( FIG. 11 ) is flexible and is formed of a resilient polymeric material. The tracheal tube  238   a  is initially formed with a bend  380  in a leading end portion of the tracheal tube. When the tracheal tube  238   a  is released or unrestrained, the natural resilience of the tracheal tube causes the bend  380  to form in the manner illustrated in  FIG. 10 . However, the tracheal tube  238   a  is flexible so that the bend  380  is easily removed from the tracheal tube by the application of a relatively small force or pressure against the leading end portion of the tracheal tube. 
         [0146]    In the embodiment of the invention illustrated in  FIG. 10 , the bend  380  in the tracheal tube  238   a  has a greater extent than a corresponding bend in a leading end section  268  of the guide tube  264  ( FIG. 4 ). If desired, the bend in the tracheal tube  238   a  ( FIG. 11 ) could be shortened so that the leading end portion of the tracheal tube  238   a  has a configuration which corresponds to the configuration of the guide tube  264  of  FIG. 4   
         [0147]    The positioning apparatus  256   a  ( FIG. 11 ) includes a base section  278   a  and an upper section  280   a . A rod portion  314   a  of the upper section  280   a  is telescopically received in a chamber  288   a  in the base section  278   a . Indicia  324   a  on the rod portion  314   a  cooperates with a body section  286   a  of the base section  278   a  to provide a visual indication of the distance between the patient&#39;s Adam&#39;s apple  234   a  and the patient&#39;s mouth  212   a  in the manner previously described in conjunction with the positioning apparatus of  FIG. 4 . 
         [0148]    The base section  278   a  of the positioning apparatus  256   a  includes a positioning section  96   a  which engages the patient&#39;s Adam&#39;s apple  234   a . The positioning section  96   a  includes a locating portion  302   a  which engages the patient&#39;s Adam&#39;s apple  234   a . The locating portion  302   a  includes a dome  304   a  and a soft annular collar  306   a . Rather than using the collar  306   a , it may be preferred to utilize a pair of positioning fingers which engage the neck  216   a  of the patient at laterally opposite sides of the Adam&#39;s apple  234   a.    
         [0149]    Indicia (not shown) is provided on the guide rod  250   a  to indicate the position of the guide rod relative to a proximal end of the tracheal tube  238   a , that is, the right end as viewed in  FIG. 11 . It should be understood that the tracheal tube  238   a  and the guide rod  250   a  extend toward the right from the fragmentary end portions illustrated in  FIG. 11 . The indicia on the guide rod  250   a  is formed by bands corresponding to the bands  342 - 350  of  FIG. 8 . Rather than cooperating with the end  156  ( FIG. 4 ) of a guide tube  264 , the bands on the guide rod  250   a  ( FIG. 11 ) cooperate with an end (not shown) of the tracheal tube  238   a  to indicate the position of the guide rod  250   a  relative to the tracheal tube  238   a.    
         [0150]    When the guide rod  250   a  is to be moved from the patient&#39;s pharynx  220   a  into the patient&#39;s trachea  228   a , the guide rod is moved axially relative to the stationary tracheal tube  238   a . As this occurs, a leading end portion  252   a  of the guide rod  250   a  moves downward (as viewed in  FIG. 11 ) past the patient&#39;s vocal cords or folds  32   a  and into the patient&#39;s trachea. As the leading end portion  252   a  of the guide rod  250   a  moves from the patient&#39;s pharynx  220   a  into the patient&#39;s trachea  228   a , the leading end portion of the guide rod gently deflects body tissue. For example, the leading end portion  252   a  of the guide rod  250   a  may gently engage and slightly deflect the patient&#39;s vocal cords or folds  32   a.    
         [0151]    A magnet  260   a  is initially positioned adjacent to the patient&#39;s Adam&#39;s apple  234   a , in the manner indicated in dashed lines in  FIG. 11 . Ferrite particles in the soft, resiliently compressible leading end portion  252   a  of the guide wire  250   a  are attracted by the magnet  260   a . This attraction causes the leading end portion  252   a  of the guide wire  250   a  to move into the open upper end portion of the trachea  228  rather than into the adjacent open upper end portion of the esophagus  226   a . In addition, movement of the leading end portion  252   a  of the guide wire  250   a  into the open upper end portion of the trachea  228  is promoted by the bend  380  in the tracheal tube  238   a . If desired, the magnet  260   a  could initially be positioned on or above the patient&#39;s Adam&#39;s apple  234   a  and moved downward from there. 
         [0152]    As the guide wire continues to be inserted into the tracheal tube  238   a , the guide wire moves downward in the patient&#39;s trachea  228   a . At the same time, the magnet  260   a  is moved downward along the outer side of the patient&#39;s neck  216   a . The indicia (not shown) on the guide rod  250   a  provides an indication to an operator of the position of the leading end portion  252   a  of the guide rod. This enables the operator to follow the leading end portion  252   a  of the guide rod  250   a  with the magnet  260   a  as the guide rod continues to be moved through the tracheal tube  238   a  into the patient&#39;s trachea  228   a.    
         [0153]    Once the guide rod  250   a  has been moved for a desired distance into the trachea  228   a , the guide rod  250   a  is held stationary relative to the patient&#39;s trachea. The tracheal tube  238   a  is then moved axially toward the left (as viewed in  FIG. 11 ) and downward into the patient&#39;s trachea  228   a . During this downward movement of the tracheal tube  238   a , the guide rod  250   a  blocks sidewise movement of the leading end of the tracheal tube so that the tracheal tube enters the larynx  230   a  rather than the adjacent open upper end of the esophagus  226   a . As the tracheal tube  238   a  continues to be inserted into the trachea  228   a , the leading end of the tracheal tube  238   a  moves into engagement with the leading end portion  252   a  of the guide rod  250   a . The leading end portion  252   a  of the guide rod  250   a  is then compressed somewhat by the leading end portion of the tracheal tube  238   a  and moves into the passage in the tracheal tube. The tracheal tube  238   a  is then moved further into the trachea  228   a.    
         [0154]    After the tracheal tube  238   a  has been positioned relative to the patient&#39;s trachea, the guide rod  250   a  is withdrawn from the tracheal tube while the tracheal tube remains stationary relative to the patient&#39;s trachea  228   a . The positioning apparatus  256   a  is then separated from the tracheal tube  238   a.    
       Embodiment of FIG.  12   
       [0155]    In the embodiment of the invention illustrated in  FIG. 1 , a leading end portion  52  of the guide wire or rod  50  is inserted between the vocal cords or folds in the respiratory system  11  of the patient. It&#39;s contemplated that movement of the leading end portion  52  of the guide rod  50  between the vocal cords  32  to a desired depth in the patient&#39;s trachea  28  may be facilitated by transmitting images of body tissue adjacent to the leading end portion of the guide rod to a viewing location outside of the patient&#39;s body. Since the embodiment of the invention illustrated in  FIG. 12  is generally similar in the embodiment invention illustrated in  FIGS. 1 and 2 , similar numerals will be utilized to designate similar components, the suffix letter “b” being added to the numerals of  FIG. 12  in order to avoid confusion. 
         [0156]    A positioning apparatus  56   b  is utilized to position a flexible guide rod  50   b  relative to the patient&#39;s respiratory system  11   b . The positioning apparatus  56   b  includes a base section  78   b  which is connected with a positioning section  96   b . The positioning section  96   b  engages the patient&#39;s Adam&#39;s apple  34   b . An arcuate member  108   b  is connected with the base section  78   b . The guide rod  50   b  is moveable relative to a guide section  114   b  connected with arcuate member  108   b . The construction and the manner of using the positioning apparatus  56   b  and guide rod  50   b  is the same as was previously described in conjunction with the embodiment invention illustrated in  FIGS. 1 and 2 . 
         [0157]    In accordance with a feature the embodiment invention illustrated in  FIG. 12 , light from a light source  400  is conducted through a fiber optic tube  402  to a leading end portion  52   b  of the flexible guide rod  50   b . The light transmitted from the light source  400  through the fiber optic tube  402  to the leading end portion  52   b  of the guide rod  50   b  is directed from the leading end portion of the guide rod on to adjacent body tissue, in the manner indicated schematically at  404  in  FIG. 12 . If desired, a plurality of fiber optic tubes  402  could be provided to conduct light from the light source  400  to the leading end portion  52   b  of the guide rod. These fiber optic tubes could be bundled together or could be spaced part at the leading end portion  52   b  of the guide rod  50   b.    
         [0158]    The light  404  which illuminates the body tissue immediately ahead of the leading end portion  52   b  of the guide rod  50   b  is reflected from the body tissue and is transmitted through a fiber optic tube  408  to the eye  410  of a viewer. This results in the transmission of an image of the body tissue adjacent to the leading end portion  52   b  of the guide rod  50   b  to the viewer to facilitate visualization, by the viewer, of the body tissue. If desired, a plurality of fiber optic tubes  408  could be provided to conduct light from the leading end portion  52   b  of the guide rod to the eye  410  of the viewer. These fiber optic tubes could be bundled together or could be spaced apart at the leading end portion  52   b  of the guide rod  50   b.    
         [0159]    By visualizing the body tissue immediately ahead of the leading end portion  52   b  of the guide rod  50   b , the viewer can determine the location of the leading end portion of the guide rod relative to the larynx  30   b  and vocal chords  32   b  of a patient as the leading end portion of the guide rod moves into the larynx and between the vocal chords. Since the light  404  illuminates body tissue immediately ahead of the leading end portion  52   b  of the guide rod  50   b , the light enables the viewer to continuously visualize where the leading end portion  52   b  of the guide rod  50   b  is located along the insertion path in the respiratory system  11   b  of the patient. 
         [0160]    In the embodiment invention illustrated in  FIG. 12 , the fiber optic tubes  402  and  408  extend through the guide rod  50   b  to enable an image of body tissue immediately ahead of the leading end portion  52   b  of the guide rod to be transmitted to a viewer. It is contemplated that movement of a tracheal tube, corresponding to tracheal tube  38  of  FIG. 2 , along the guide rod  50   b  into the patient&#39;s respiratory system  11   b  will be facilitated by illuminating body tissue immediately ahead of the leading end portion of the tracheal tube. Therefore, the side wall of the tracheal tube may be provided with fiber optic tubes which transmit light from a light source, such as a light source  400 , to a location immediately ahead of the leading end portion of the tracheal tube and transmit an image of illuminated body tissue immediately ahead of the leading end portion of tracheal tube to a viewer. 
         [0161]    As the tracheal tube is moved along the guide rod  50   b  into the patient&#39;s respiratory system, in the manner previously explained in conjunction with the embodiment invention illustrated in  FIG. 2 , body tissue immediately ahead of the leading end portion  52   b  of the stationary guide rod  50   b  is illuminated and body tissue immediately ahead of the tracheal tube is illuminated. Therefore, as the leading end portion of the tracheal tube approaches the vocal chords  32   b , a surgeon or other viewer can easily determine the location of the leading end portion of the tracheal tube relative to the vocal chords. As the leading end portion of the tracheal tube approaches the leading end portion  52   b  of the guide rod, the image transmitted to the viewer will be of body tissue illuminated by both light transmitted from the leading end portion  52   b  of the guide rod and light transmitted from the leading end portion of the tracheal tube. 
         [0162]    The leading end portion of the tracheal tube may be inserted into trachea  28   b  of a patient for greater distance than the distance which the guide rod  50   b  is inserted into the trachea. As the leading end portion of the tracheal tube moves past the leading end portion  52   b  of the guide rod  50   b , illumination from the leading end portion of the guide rod  50   b  will be at least partially blocked from transmission back to the viewer through fiber optics in the tracheal tube. Therefore, the viewer will easily be able to determine when the leading end portion of the tracheal tube has moved past the leading end portion of the guide rod  50   b.    
         [0163]    Although the eye  410  of a viewer has been schematically illustrated in  FIG. 12 , it is contemplated that the image transmitted through the fiber optic tube  408  may be displayed on a viewing screen. If this was done, the image transmitted through the fiber optic tube  408  would be transmitted to a computer and a viewing screen associated with the computer would display an image of the body tissue immediately ahead of the leading end portion  52   b  of the guide rod  50   b . As the tracheal tube is moved along the guide rod into the patient&#39;s respiratory system  11   b , an image of body tissue immediately ahead of the leading end portion of the tracheal tube may also be transmitted to the computer. 
         [0164]    A second computer screen may be utilized to display an image of the body tissue immediately ahead of the leading end portion of the tracheal tube. If this is done, the surgeon or other viewer would be able to see an image of body tissue immediately ahead the leading end portion  52   b  of the guide rod  50   b  and an image of body tissue immediately ahead of the leading end portion of the tracheal tube. When simultaneously viewing the two images on two separate screens or on separate portions of a single screen, the surgeon or other viewer would be able to determine the positions of the leading end portions of both the guide rod  50   b  and the tracheal tube relative to each other and to the respiratory system  11   b  of a patient. 
         [0165]    Although it&#39;s preferred to utilize the tracheal tube and it&#39;s associated illumination system in conjunction with the guide rod  50   b , the tracheal tube may be utilized by itself. Thus, fiber optic tubes which extend through the side wall of the tracheal tube and correspond to the fiber optic tubes  402  and  408  of  FIG. 12 , would provide an image of the body tissue immediately ahead of the leading end portion of the tracheal tube as the tracheal tube is moved into the patient&#39;s respiratory system  11   b  along an insertion path. The image transmitted from the leading end portion of the tracheal tube to the eye of the viewer or to a display screen would enable a surgeon or other viewer to determine the location of the leading end portion of the tracheal tube relative to the patient&#39;s respiratory system  11   b.    
         [0166]    When the tracheal tube and it&#39;s associated illumination and image transmitting systems are utilized without guide rod  50   b , the positioning apparatus  56   b  may be modified to guide movement of the tracheal tube in much the same manner as in which the positioning apparatus  56   b  is utilized to guide movement of the guide rod  50   b . If this is done, colored bands or other indicia could be provided on the tracheal tube to indicate the position of the tracheal tube in the same manner as previously discussed in connection with the guide rods  50  and  250 . 
         [0167]    It is contemplated that the positioning apparatus  56   b  may be used for purposes other than tracheal intubination. Thus, the positioning apparatus  56   b  may be used to position devices other than the guide rod  50   b  during endoscopic, arthroscopic, or fiber optic surgery at any one of many locations in a patient&#39;s body. A magnet, similar to the magnet  260  of  FIGS. 4 and 7  may be used to steer a leading end portion of the device being positioned in the patient&#39;s body. The leading end portion of the device being positioned in the patient&#39;s body may be located at a position adjacent to or spaced a desired distance from a positioning section, corresponding to the positioning section  96   b , by the use of suitable indicia, which may be similar to the indicia used in conjunction with the guide rods  50  and  250 . 
         [0168]    When the positioning apparatus  50   b  is to be used to position a medicant or a device of any desired type at a selected location in a patient&#39;s body, the positioning section  96   b  is positioned in engagement with a selected portion of the patient&#39;s body. The selected portion of the patient&#39;s body may be a portion of the patient&#39;s body other than the Adam&#39;s apple  34   b . Although it is believed that it will probably be preferred to engage an exterior surface on the patient&#39;s body with the positioning section  96   b , the positioning section could be placed in engagement with a surface disposed within the patient&#39;s body if desired 
         [0169]    While the positioning section  96   b  is engaging the selected portion of the patient&#39;s body, the guide rod  50   b  or a similar elongated member is moved relative to the guide section  114   b  connected with the arcuate member  108   b . The leading end portion  52   b  of the guide rod  50   b  or similar elongated member is then moved into the patient&#39;s body. The leading end portion  52   b  may be moved into the patient&#39;s body through a naturally occurring opening or through an incision formed in the patient&#39;s body. 
         [0170]    The image transmitted through the guide rod or similar elongated member  50   b  to the viewer will indicate when the leading end portion  52   b  has moved to a desired position in the patient&#39;s body. Once the leading end portion  52   b  of the guide rod or similar elongated member  50   b  has moved to the desired position relative to the patient&#39;s body, any desired procedure may be performed in the patient&#39;s body. For example, a surgical procedure could be conducted with one or more devices connected with the leading end portion  52   b  of the guide rod or similar elongated member. The positioning apparatus  56   b  may be used to position a therapeutic agent or device at the desired position in the patient&#39;s body. 
       Embodiment of FIGS.  13  and  14   
       [0171]    In the embodiment invention illustrated in  FIG. 12 , the light source  400  and fiber optic tube  402  function as an emitter which emits illumination  404  onto body tissue immediately ahead of the leading end portion  52   b  of the guide rod  50   b  to facilitate visualization of the body tissue. In the embodiment invention illustrated in  FIGS. 13 and 14 , a plurality of emitters are positioned adjacent to an outer side surface of the patient&#39;s neck. A detector on a leading end portion of a guide rod is moved into the patient&#39;s respiratory system. Since the embodiment invention illustrated in  FIGS. 13 and 14  is generally similar to the embodiment invention illustrated in  FIGS. 1, 2 and 12 , similar numerals will be utilized to identify similar components, the suffix letter “c” being associated with the numerals of  FIGS. 13 and 14  to avoid confusion 
         [0172]    A positioning apparatus  56   c  ( FIG. 13 ) is utilized to position a flexible guide wire or rod  50   c  relative to a respiratory system  11   c  of a patient. The respiratory system  11   c  of the patient extends from the mouth  12   c  through a larynx  30   c  to a trachea  28   c  of the patient. The positioning apparatus  56   c  engages an Adam&#39;s apple  34   c  of a patient to locate the guide rod  50   c  relative to the patient&#39;s respiratory system  11   c.    
         [0173]    The positioning apparatus  56   c  has the same general construction and mode operation as the positioning apparatus  56  of  FIGS. 1 and 2 . The positioning apparatus  56   c  includes a base section  78   c  having a body section  86   c  which is pivotally connected with a positioning section  96   c . The positioning section  96   c  engages an outer surface of the neck of the patient adjacent to the Adam&#39;s apple  34   c  to locate the positioning apparatus  56   c  relative to the patient&#39;s respiratory system  11   c . If desired, the positioning apparatus  96   c  could include a collar which would extend around the patient&#39;s Adam&#39;s apple  34   c  in the matter previously described in conjunction with the embodiment invention illustrated in  FIG. 7 . Alternatively, the positioning apparatus  96   c  could include a pair of fingers which engage opposite lateral sides of the patient&#39;s Adam&#39;s apple. 
         [0174]    An arcuate member  108   c  is connected with and is moveable relative to the body section  86   c  of the positioning apparatus  56   c  at a connection  110   c . A flexible guide rod  50   c  is axially slidable relative to a guide section  114   c  which is connected with the arcuate member  108   c . The construction of the positioning apparatus  56   c  is the same as was previously described in conjunction with the embodiment invention illustrated in  FIGS. 1 and 2 . 
         [0175]    In accordance with a feature of the embodiment invention illustrated in  FIG. 13 , a sensor assembly  420  is provided to inform a surgeon or other user of the positioning apparatus  56   c , of the position of the guide rod  50   c  relative to the patient&#39;s respiratory system  11   c . The sensor assembly  420  includes an emitter portion  424  ( FIG. 14 ) which provides an output and a detector portion  426  ( FIG. 13 ) which responds to the output from the emitter portion  424 . In the embodiment of invention illustrated in  FIGS. 13 and 14 , the emitter portion  424  is positioned on an outer side surface of the neck of the patient adjacent to the Adam&#39;s apple  34   c . The detector portion  426  is connected with a leading end portion  52   c  of a guide rod  50   c . However, it should be understood that the emitter portion  424  could be connected with the guide rod  50   c  and the detector portion  426  positioned adjacent to the Adam&#39;s apple  34   c  of the patient. 
         [0176]    In the illustrated embodiment invention, the emitter portion  424  of the sensor assembly  420  includes a plurality of emitters units  430  which are positioned an array which extends around the Adam&#39;s apple  34   c  ( FIG. 14 ) of the patient. The emitter units  430  are secured to the neck of the patient by a suitable adhesive. The emitter units  430  may be positioned in any desired spatial relationship with the patient&#39;s Adam&#39;s apple  34   c.    
         [0177]    Alternatively, the emitter units  430  may be connected with the positioning section  96   c . Thus, the positioning section  96   c  of the positioning apparatus  56   c  is provided with three fingers which engage the neck of the patient adjacent to the Adam&#39;s apple  34   c . Each of the emitter units  430  may be connected with one of the fingers of the positioning section  96   c . The positioning section  96   c  would accurately locate the emitter units  430  relative to the patient&#39;s Adam&#39;s apple  34   c.    
         [0178]    In the embodiment of the invention illustrated in  FIG. 13 , the positioning section  96   c  engages the Adam&#39;s apple  34   c  and the emitter units are disposed in a generally circular array which extends around the Adam&#39;s apple  34   c . However, it should be understood that the emitter units  430  could be connected with a collar, similar to the collar  306  of  FIG. 7 . The collar may be connected with the positioning section  96   c  ( FIG. 13 ). Alternatively, the collar could be separate from the positioning apparatus. 
         [0179]    Although it is preferred to utilize the positioning apparatus  56   c  in conjunction with the guide rod  50   c , in the manner previously described in conjunction with the embodiment of the invention illustrated in  FIG. 1 , it is contemplated that the positioning apparatus  56   c  may be omitted and the guide rod  50   c  moved along an insertion path into the patient&#39;s respiratory system without benefit of the assistance provided by the positioning apparatus. If this is done, the emitter units  430  ( FIG. 14 ) could be connected with a support structure which holds the emitter units  430  in a fixed relationship relative to each other and facilitates positioning of the emitter units relative to the patient&#39;s Adam&#39;s apple  34   c . For example, a positioning section having a plurality of fingers, could be manually centered on the patient&#39;s Adam&#39;s apple  34   c  to locate the emitter units  430  relative to the Adam&#39;s apple. Similarly, a collar, corresponding to the collar  306  of  FIG. 7 , could be provided on a circular or oval support which would extend around the patient&#39;s Adam&#39;s apple  34   c  to locate the emitter units  430  relative to the patient&#39;s Adam&#39;s apple. Regardless of the specific structure which is utilized to position the emitter units  430  relative to each other, this apparatus could be manually positioned relative to the patient&#39;s Adam&#39;s apple  34   c  without being connected with a positioning apparatus having a construction similar to the construction of the positioning apparatus  56   c.    
         [0180]    When the positioning apparatus  56   c  is to be utilized to assist in the positioning of the guide rod  50   c  relative to the patient&#39;s respiratory system  11   c , the positioning section  96   c  is positioned in engagement with the patient&#39;s Adam&#39;s apple  34   c . The emitter units  430  may be suitably mounted on the positioning section  96   c . This would locate the emitter units  430  relative to the patient&#39;s Adam&#39;s apple  34   c  ( FIG. 14 ). It should be understood that the emitter units  430  could be mounted on a support other than the positioning section  96   c  if desired. Of course, the emitter units  430  may be secured directly to the neck of the patient by a suitable adhesive, as illustrated in  FIG. 14 . When this is done, a support structure interconnecting the emitter units  430  may be used to facilitate positioning of the emitter units relative to the patient&#39;s Adam&#39;s apple  34   c.    
         [0181]    The arcuate member  108   c  is then positioned axially along the body section  86   c . When the arcuate member  108   c  has been moved to a desired position relative to the body section  86   c , the connection  110   c  is secured to hold the arcuate member against axial movement along the body section. The arcuate member  108   c  is then moved relative to the body section  86   c  to position the guide section  114   c  and the leading end portion  52   c  of the guide rod  50   c  in alignment with the entrance to the patient&#39;s mouth  11   c . The guide rod  50   c  is then moved into the patient&#39;s respiratory system  11   c  along an insertion path. 
         [0182]    As the guide rod  50   c  is moved along the insertion path into the patient&#39;s respiratory system  11   c , the detector portion  426  of the sensor assembly  420  approaches the emitter units  430 . As this occurs, the detector portion provides an output over leads  434  and  436  to a computer or micro processor  438 . The computer or micro processor has an output, indicated schematically at  440 , which can be viewed by a surgeon or other individual moving the guide rod  50   c  along the insertion path into the patient&#39;s respiratory system  11   c.    
         [0183]    The computer output may include a display having a schematic illustration of a typical patient&#39;s respiratory system. The positions of the emitter units  430  relative to the typical respiratory system and the position of the detector portion  426  relative to the emitter units  430  would be indicated on the display. Thus, a display screen connected with the computer  438  has an illustration representative of the patient&#39;s respiratory system  11   c . A plurality of indicators are provided on the display screen to indicate the positions of the emitter units  430  relative to the schematic illustration of the patient&#39;s trachea. An indicator is provided to indicate the position of the leading end of the guide rod  50   c  relative to the schematic illustration of the patient&#39;s respiratory system. The display screen has one illustration of the patient&#39;s respiratory system  11   c  as viewed in a medial plane and another illustration of the patient&#39;s respiratory system as viewed in a frontal plane. Indicators corresponding to the emitter units  430  and detector  426  are provided in both illustrations. 
         [0184]    As the leading end portion  52   c  of the guide rod  50   c  moves along the insertion path into the patient&#39;s respiratory system  12   c , the detector portion  426  of the sensor assembly  420  approaches the emitter portion  424  of the sensor assembly. As this occurs, the strength of the output from the detector portion  426  through the leads  434  and  436  increases. As the strength of the output from the detector portion  426  increases, the computer and the associated display indicates to an operator of the apparatus  56   c  that the leading end portion  52   c  of the guide rod  50   c  is approaching a junction between the patient&#39;s esophagus  26   c  and the pharynx. 
         [0185]    If the guide rod continues movement along its intended course of insertion, that is, into the patient&#39;s larynx  30   c  and not into the patient&#39;s esophagus  26   c , the strength of the output signal provided by the detector portion  426  will increase. However, if the leading end portion  52   c  of the guide rod  50   c  enters the patient&#39;s esophagus  26   c , the strength of the output signal from the detector portion  426  will decrease. The decreasing strength of the signal from the detector portion  426  provides a clear indication to the operator of the apparatus  56   c  that the leading end portion  52   c  of the guide rod  50   c  has deviated from its intended course. 
         [0186]    As the detector portion  426  of the sensor assembly  420  moves between the patient&#39;s vocal chords  32   c  into alignment with the emitter portion  424  of the sensor assembly  420 , the strength of the signal transmitted to the computer  438  will be maximized. As the guide rod  50   c  continues to be moved into the patient&#39;s trachea  28   c  along the insertion path, the strength of the signal transmitted through the leads  434  and  436  to the computer  438  will decrease to indicate to the operator of the apparatus  56   c  that the leading end portion  52   c  of the guide rod has moved past the patient&#39;s Adam&#39;s apple  34   c.    
         [0187]    Although it is believed that it will be preferred to display the output of the computer  438  in association with one or more illustrations of the patient&#39;s respiratory system  11   c  in the manner previously mentioned, the computer output information could be transmitted in a different manner if desired. For example, the computer  438  could have a light display system which indicates how close the detector  426  is to the emitter units  430 . Similarly, the computer  438  could have an audio output which indicates how close the detector  426  is to the emitter units. Of course, the computer could have an output which is a combination of a display screen, lights and/or audio signals. 
         [0188]    Once the guide rod  50   c  has been moved to the desired position along the patient&#39;s respiratory system  11   c , the positioning apparatus  56   c  may be disconnected from the guide rod  50   c . A tracheal tube, corresponding to tracheal tube  38  of  FIG. 2 , is then moved along the guide rod  50   c  into the patient&#39;s trachea  28   c . The manner in which the tracheal tube is moved along the guide rod  50   c  into the patient&#39;s trachea  28   c  is the same as was previously discussed in conjunction with the embodiment of the invention illustrated in  FIGS. 1 and 2 . A magnet, corresponding to the magnet  260  of  FIGS. 4 and 7 , may be utilized to steer the leading end portion of the guide rod  50   c . If desired, an electromagnet which can be turned on and off may be utilized. 
         [0189]    The tracheal tube which is utilized in association with the guide rod  50   c  of  FIG. 13  may have the same construction as the tracheal tube  38  utilized with the guide rod  50  of  FIG. 2 . Alternatively, the tracheal tube utilized with the guide rod  50   c  may have a second detector portion, having the same construction as the detector portion  426  of the guide rod  50   c . If the tracheal tube is provided with a second detector portion, the emitter portion  424  of the sensor assembly  420  is maintained in position relative to the patient&#39;s Adam&#39;s apple  34   c.    
         [0190]    By providing the tracheal tube with a second detector portion, and by maintaining the emitter portion  424  in position relative to the patient&#39;s Adam&#39;s apple  34   c , the output from the second detector portion may be utilized to locate the leading end portion of the tracheal tube as the tracheal tube is moved along the guide rod  50   c  into the patient&#39;s respiratory system  11   c . If this is done, leads, corresponding to the leads  434  and  436  would extend along the side wall of the tracheal tube from the second detector portion to the computer  438 . The output from the computer  438  would indicate the position of the leading end portion of the tracheal tube relative to the emitter  424 . The output from the second detector portion on the leading end portion of tracheal tube would indicate the position of the leading end portion of the tracheal tube relative to the position of the leading end portion of the guide rod  50   c.    
         [0191]    The output from the computer may be a display having the construction previously described in conjunction with the guide rod  50   c . Thus, a display screen connected with the computer  438  has an illustration representative of the patient&#39;s respiratory system  11   c . A plurality of indicators are provided on the display screen to indicate the positions of the emitter units  430  relative to the patient&#39;s trachea. An indicator is provided to indicate the position of the leading end of the tracheal tube relative to the patient&#39;s respiratory system. The display screen has one illustration of the patient&#39;s respiratory system  11   c  as viewed in a medial plane and another illustration of the patient&#39;s respiratory system as viewed in a frontal plane. Indicators corresponding to the emitter units  430  and detector on the tracheal tube are provided in both illustrations. 
         [0192]    In the embodiment of the invention illustrated in  FIGS. 13 and 14 , the emitter units  430  are magnets which emit a magnetic field. The detector portion  426  is a magnetometer which responds to variations in the strength of a magnetic field. Thus, the output from the detector portion  426  increases as the detector portion moves closer to the patient&#39;s Adam&#39;s apple  34   c  and the magnets forming the emitter units  430 . The detector portion  436  may be Hall effect device, magnetoresistor, or a galvanometer device. Regardless of what specific type of magnetic field responsive device is utilized to form the detector portion  426  of the sensor assembly, the output from the detector portion will vary as the distance between the leading end portion  52   c  of the guide rod  50   c  and the magnets in the emitter units  430  varies. 
         [0193]    In the embodiment of the invention illustrated in  FIGS. 13 and 14 , the sensor assembly  420  is the type which responds to a magnetic field. However, it is contemplated that the sensor assembly  420  could be constructed so as to respond to other types of emissions. For example, light sources could be utilized as the emitter units  430  and the detector portion  436  may be a photo cell which responds to variations in the amount of light received. Alternatively, the emitter units  430  could be sources of radio frequency radiation and the detector portion  426  could be constructed so as to have an output which varies as the distance between the detector portion and the sources of radio frequency radiation varies. If desired, the emitter units  430  could be ultrasonic transducers and the detector  426  could respond to ultrasonic energy. 
         [0194]    The sensor assembly  420  has been illustrated in  FIGS. 13 and 14  in association with the positioning apparatus  56   c . However, it should be understood that the sensor assembly  420  could be utilized in association with the positioning apparatus  256  of  FIGS. 4-10  or the positioning apparatus  256   a  of  FIG. 11 . If this was done, the use of the magnet  260  or  260   a  ( FIGS. 4, 7 and 11 ) may be eliminated to avoid interference with magnetic fields from the emitter units  430 . Of course, if the emitter units provided outputs which were not affected by the magnetic field from the magnets  260  and  260   a , the magnets  260  and  260   a  could still be utilized. 
         [0195]    The positioning apparatus  56   c  and sensor assembly  420  have been illustrated in association with a tracheal intubination procedure. It is contemplated that the positioning apparatus  56   c  and/or sensor assembly  420  may be used in association with other medical procedures if desired. For example, the positioning apparatus  56   c  and/or sensor assembly  420  may be used in the performance of endoscopic, arthroscopic or fiber optic surgical procedures. The positioning apparatus  56   c  and/or sensor assembly  420  may be used in association with surgery on joints or other portions of a patient&#39;s body. The positioning apparatus  56   c  and/or sensor assembly  420  may be used to deliver medicants to a desired location in a patient&#39;s body 
       Embodiments of FIGS.  15  and  16   
       [0196]    In the embodiment of the invention illustrated in  FIGS. 13 and 14 , the emitter portion  424  of the sensor assembly  420  is disposed adjacent to the outer surface of the neck of the patient while the detector portion  426  of the sensor assembly is connected with the guide rod  50   c . In the embodiment of the invention illustrated in  FIGS. 15 and 16 , the detector portion of the sensor assembly is disposed adjacent to the outer surface of the patient&#39;s neck and the emitter portion of the sensor assembly is connected with the leading end portion of the guide rod. Since the embodiment of the invention illustrated  FIGS. 15 and 16  is generally similar to the embodiment of the invention illustrated in  FIGS. 1, 2, 13 and 14 , similar numerals will be utilized to identify similar components, the suffix letter “d” being associated with the numerals of  FIGS. 15 and 16  to avoid confusion. 
         [0197]    The positioning apparatus  56   d  is utilized to position a flexible guide rod  50   d  relative to a patient&#39;s respiratory system  11   d . The positioning apparatus  56   d  includes a base section  78   d  having a body section  86   d  and a positioning section  96   d . An arcuate member  108   d  is connected with the body section  86   d  at a connection  110   d . When the arcuate member  108   d  has been moved to a desired position along the base section  86   d , the connection  110   d  is actuated to hold the member  108   d  against axial movement along the body section  86   d . When the guide section  114   d  has been moved into alignment with the patient&#39;s mouth  12   d , the connection  110   d  is again actuated to hold the arcuate member  108   d  against movement relative to the base section  86   d.    
         [0198]    The guide section  114   d  cooperates with the flexible guide rod  50   d  to position the guide rod during movement of the guide rod into the patient&#39;s respiratory system  11   d  along an insertion path. The general construction and mode of operation of the positioning apparatus  56   d  is the same as was previously described in conjunction with the positioning apparatus  56  of  FIGS. 1 and 2 . 
         [0199]    In accordance with a feature of this embodiment of the invention, a sensor assembly  420   d  is provided to sense when the guide rod  50   d  has moved to a desired position relative to the patient&#39;s respiratory system  11   d . The sensor assembly  420   d  includes a detector portion  426   d  ( FIG. 16 ) and an emitter portion  424   d  ( FIG. 15 ). 
         [0200]    The sensor portion  426   d  of the sensor assembly  420   d  is positioned on the outer surface of a neck of a patient ( FIG. 16 ) adjacent to the patient&#39;s Adam&#39;s apple  34   d . The emitter portion  424   d  is connected with a leading end portion  52   d  of the guide rod  50   d  ( FIG. 15 ). The sensor portion  426   d  ( FIG. 16 ) is mounted directly on the patient&#39;s neck by a suitable adhesive. However, if desired, the sensor portion  426   d  could be connected with the positioning section  96   d  of the positioning apparatus  56   d . If this is done, when the positioning section  96   d  of the positioning apparatus  56   d  is positioned in engagement with the patient&#39;s Adam&#39;s apple  34   d , the sensor portion  426  of the sensor assembly  420   d  would also positioned relative to the patient&#39;s Adam&#39;s apple. However, if desired, the sensor portion  426   d  could be mounted on a support and positioned relative to the patient&#39;s Adam&#39;s apple  34   d  independently of the positioning section  96   d  of the positioning apparatus  56   d.    
         [0201]    The sensor portion  426   d  of the sensor assembly  420   d  includes a plurality of sensor units  440  which are disposed in an array around the patient&#39;s Adam&#39;s apple  34   d  ( FIG. 16 ). The sensor units  440  have leads  442  which are connected with a computer or micro processor  444 . The computer or micro processor  444  has an output, indicated schematically in  446  in  FIG. 16 , which is indicative of the position of the emitter portion  424   d  of the sensor assembly  420   d  relative to the position of the sensor portion  426   d  of the sensor assembly. The emitter portion  424   d  of the sensor assembly  420   d  is connected with the leading end portion  52   d  of the guide rod  50   d.    
         [0202]    During use of the positioning apparatus  56   d , the leading end portion  52   d  of the flexible guide rod  50   d  is aligned with the mouth  12   d  of the patient. The guide rod  50   d  is then moved into the patient&#39;s respiratory system  11   d  along an insertion path. As the guide rod  50   d  is moved into the patient&#39;s respiratory system  11   d , the emitter portion  424   d  of the sensor assembly  420   d  approaches the sensor portion  426   d  of the sensor assembly  420   d . As this occurs, the strength of the output from the sensor units  440  increases. 
         [0203]    The increasing strength of the output from the sensor units  440  results in a change in the output  446  from the computer  444 . The output  446  from the computer  444  may take the form of a display which schematically indicates the position of the emitter portion  424   d  of the sensor assembly  420   d  relative to the sensor portion  426   d  of the sensor assembly. Thus, a display screen for the computer  444  may have a schematic illustration representative of a typical patient&#39;s respiratory system. The display screen would indicate the position of the sensor portion  426   d  of the sensor assembly  420   d  relative to the patient&#39;s respiratory system and the position of the emitter portion  424   d  of the sensor assembly  420   d  relative to the patient&#39;s respiratory system. Since the emitter portion  424   d  is connected with the leading end portion  52   d  of the guide rod  50   d , the display for the computer  444  would indicate the position of the leading end portion  52   d  of the guide rod relative to the patient&#39;s Adam&#39;s apple  34   d.    
         [0204]    Although it is believed that the use of a display screen may be preferred, the output  446  from the computer  444  could take a different form if desired. For example, the computer could have an audio output. Alternatively, a display graph formed of a series of lights could provide a visual output. As the emitter portion  424   d  approaches the sensor units  440 , the number of illuminated lights in the series of lights would increase. When the emitter portion  424   d  is aligned with the center of the array of sensor units  440  and the patient&#39;s Adam&#39;s apple  34   d , the entire series of lights would be illuminated. Of course, the output  446  from the computer  444  could include both audio and visual outputs. 
         [0205]    In the embodiment of the invention illustrated in  FIGS. 15 and 16 , the emitter portion  424   d  of the sensor assembly  420   d  is a magnet which emits a magnetic field. The sensor portion  426   d  of the sensor assembly  420   d  has an output which varies as a function of the strength of the magnetic field at the sensor units. Therefore, as the leading end portion  52   d  of the guide rod  50   d  approaches the patient&#39;s Adam&#39;s apple  34   d , the strength of the magnetic field to the sensor units  440  increases and the output transmitted to the computer  444  increases. 
         [0206]    In the specific embodiment of the invention illustrated in  FIG. 16 , the sensor units  440  are Hall effect devices. However, it is contemplated that other known devices which respond to variations in a magnetic field may be utilized in place of the Hall effect devices which form the sensor units  440 . For example, magnetoresistors could be utilized as the sensor units  440  in place of the Hall effect devices. 
         [0207]    Once the guide rod  50   d  has been positioned relative to the patient&#39;s respiratory system  11   d , the positioning apparatus  56   d  is disconnected from the guide rod  50   d  while the guide rod is maintained stationary relative to the patient&#39;s respiratory system  11   d . A flexible tracheal tube, corresponding to the tracheal tube  38  of  FIG. 2 , is then moved along the guide rod  50   d  into the patient&#39;s respiratory system  11   d . The manner of insertion of the tracheal tube into the patient&#39;s respiratory system  11   d , by sliding the tracheal tube along the guide rod  50   d , is the same as was previously described in conjunction with the embodiment of the invention illustrated in  FIG. 2 . 
         [0208]    It is contemplated that the sensor portion  426   d  of the sensor assembly  420   d  can be utilized in association with the tracheal tube. Thus, the tracheal tube can be provided with a second emitter portion having the same construction as the emitter portion  424   d . In the embodiment of the invention illustrated in  FIGS. 15 and 16 , a magnet, which emits a magnetic field, would be mounted on a leading end portion of the tracheal tube. 
         [0209]    As the tracheal tube having an emitter, is moved along the guide rod  50   d , the magnet on the leading end portion of the tracheal tube would have an effect on the sensor units  440 . The effect on the magnet on the sensor units  440  increases as the leading end portion of the tracheal tube approaches the patient&#39;s Adam&#39;s apple  34   d . It is contemplated that the tracheal tube may be inserted into the patient&#39;s trachea  28   d  further than the guide rod  50   d . If this is done, the output from the sensor units  440   d  diminishes in magnitude as the leading end portion of the tracheal tube is moved down the patient&#39;s trachea past the sensor units. 
         [0210]    Although it is preferred to utilize the sensor assembly  420   d  in association with the positioning apparatus  56   d , the sensor assembly could be utilized separately from the positioning apparatus. For example, the sensor units  440  may be mounted in an array on a separate support structure. The support structure would be positioned in an engagement with the exterior of the patient&#39;s neck with the array of sensor units  440  centered about the patient&#39;s Adam&#39;s apple, in the manner illustrated schematically in  FIG. 16 . 
         [0211]    The guide rod  50   d  would then be moved along the patient&#39;s respiratory system  11   d  without benefit of the positioning apparatus  56   d . As the guide rod  50   d  moves along the patient&#39;s respiratory system  11   d , the strength of the magnetic field from the emitter portion  424   d  of the sensor assembly  420   d  detected by the sensor units  440  would increase. This would result in an increase in the output from the sensor units  440  to the computer  444 . The output  446  from the computer  444  would indicate to the operator moving the guide rod  50   d , the position of the guide rod along an insertion path into the patient&#39;s respiratory system  11   d.    
         [0212]    Once the guide rod  50   d  has been positioned in the foregoing manner relative to the patient&#39;s respiratory system  11   d , without benefit of the positioning apparatus  56   d , the tracheal tube would be moved along the guide rod into the patient&#39;s respiratory system  11   d . The tracheal tube could have the same construction and move in the same manner as the tracheal tube  38  of  FIG. 2 . 
         [0213]    Alternatively, the tracheal tube could be provided with a second emitter portion, corresponding to the emitter portion  424   d  of the sensor assembly  420 . Thus, a magnet could be provided on the leading end portion of the tracheal tube. As the leading end portion of the tracheal tube moves along the insertion path into the patient&#39;s respiratory system  11   d , the magnetic field detected by the sensor units  440  would increase due to the magnet connected with the leading end portion of the tracheal tube approaching the magnet on the leading end portion  52   d  of the guide rod  50   d.    
         [0214]    It is also contemplated that the tracheal tube could be positioned relative to the patient&#39;s respiratory system  11   d  without benefit of the guide rod  50   d . The tracheal tube would be provided with an emitter corresponding to the emitter  424   d . As tracheal tube is moved into the patient&#39;s respiratory system  11   d  without benefit of the guide rod  50   d , the output from the emitter connected to the leading end portion of the tracheal tube would be detected by the sensor units  440 . The output from the sensor units  440  would indicate the position of the leading end portion of the tracheal tube relative to the patient&#39;s respiratory system  11   d.    
         [0215]    In the embodiment of the invention illustrated in  FIGS. 13-16 , magnets have been utilized as emitter units. The magnets which form the emitter portion  424  of the sensor assembly  420  are permanent magnets formed of a strongly magnetizable material such as cobalt or neodymium. Of course, other know magnetizable materials having saturation magnetization values, such as cerium, praseodymium and or samarium with cobalt and/or other materials could be used. Alternatively, the magnets in the emitter portion  424  ( FIG. 14 ) and  424   d  ( FIG. 15 ) could be electromagnets. 
         [0216]    The detector portion  426  ( FIG. 13 ) and  426   d  ( FIG. 16 ) of the sensor assemblies  420  and  420   d  may be any known device which respond to changes in the strength and/or direction of a magnet field. For example, the detector portions  426  include one or more Hall effect devices and/or one or more magnetoresistors. 
         [0217]    Although the emitter portions  424  and  424   d  of the sensor assemblies  420  and  420   d  have been described herein as emitting magnetic fields, it is contemplated that the emitter portions  424  and  424   d  could have outputs other than a magnetic field. For example, the emitter portions  424  and/or  424   d  ( FIGS. 14 and 15 ) could be miniaturized radio frequency devices. Thus, the emitter portions of the sensor assemblies could be formed by radio signal transmitters having miniaturized radio circuitry which provide a radio frequency output signal. If a radio frequency transmitter is utilized in the emitter portion  424  or  424   d  of the sensor assemblies, the sensor portion  426  or  426   d  would be a radio frequency receiver. The radio frequency receiver could include a receiving antenna which receives radio frequency signals. The field of the antenna may be controlled by appropriate placement, orientation, and/or configuration of the antenna. 
         [0218]    Alternatively, the emitter portions  424  and  424   d  could emit ultrasonic energy. The sensor portion  426  or  426   d  would respond to ultrasonic energy. 
       Embodiment of FIGS.  17  and  18   
       [0219]    In the embodiment of the invention illustrated in  FIGS. 13 and 14 , the sensor assembly  420  includes a detector portion  426  which is disposed on the leading end portion  52   c  of the guide rod  50   c  and responds to a magnetic field. The operator of the positioning apparatus  56   c  is informed, by a display system connected with the computer  438 , of the position of the leading end portion  52   c  of the guide rod  50   c  relative to the patient&#39;s respiratory system  11   c . In the embodiment of the invention illustrated in  FIG. 17  an  18 , the leading end portion of the guide rod is steerable to enable the other operator to alter the course of movement of the leading end portion of the guide rod to maintain the leading end portion of the guide rod on a desired insertion path into the patient&#39;s respiratory system. Since the embodiment of the invention illustrated in  FIGS. 17 and 18  is generally similar in the embodiment of the invention illustrated in  FIGS. 13-16 , similar numerals will be utilized to designate similar components, the suffix letter “e” being associated with the numerals of  FIGS. 17 and 18  to avoid confusion. 
         [0220]    The embodiment of the invention illustrated in  FIGS. 17 and 18  is utilized with a positioning apparatus having the same construction as the positioning apparatus of  FIGS. 1, 2 , and  13 - 16 . However, the embodiment of the invention illustrated in  FIGS. 17 and 18  could be used with the positioning apparatus  256  and/or  256   a  of  FIGS. 4-11  if desired. The guide rod  50   e  of  FIGS. 17 and 18  is provided with a steering apparatus  460 . The steering apparatus  460  is operable to change the course of movement of the leading end portion  52   e  of the flexible guide rod  50   e  as the guide rod moves along the insertion path into the patient&#39;s respiratory system. 
         [0221]    The steering apparatus  460  applies force against body tissue in the patient&#39;s respiratory system to deflect the leading end portion  52   e  of the flexible guide rod  50   e  away from an undesired course of movement. For example, when the leading end portion of the guide rod  50   e  is approaching a junction between the patient&#39;s esophagus  26  ( FIG. 1 ) and trachea  28 , the steering apparatus  460  ( FIGS. 17 and 18 ) may be activated to deflect the leading end portion  52   e  of the guide rod  50   e  away from the entrance to the patient&#39;s esophagus. Similarly, when the leading end portion  52   e  of the guide rod  50   e  is approaching the larynx  30 , the steering apparatus  460  may be activated to align the leading end portion  52   e  of the guide rod with an opening between vocal chords in the patient&#39;s larynx. 
         [0222]    In the illustrated embodiment of the invention, the steering apparatus  460  includes a plurality of expandable elements  464 ,  466  and  468  ( FIG. 18 ). Although three expandable elements  464 - 468  have been illustrated as being disposed in a circular array about the leading end portion  52   e  of the guide rod  50   e , a greater or lesser number of expandable elements could be provided in association with the leading end portion of the guide rod if desired. 
         [0223]    The expandable elements  464 ,  466  and  468  are individually activatable so that one, two or all three of the expandable elements can be expanded. For example, just the expandable element  464  ( FIG. 18 ) may be expanded to apply force against the leading end portion  52   e  of the guide rod  50   e  to move the guide rod downward (as viewed in  FIG. 18 ) relative to a path of movement of the guide rod through the patient&#39;s respiratory system. Alternatively, the expandable elements  466  and  468  may be expanded at the same time to deflect the leading end portion  52   e  of the guide rod  50   e  upward (as viewed in  FIG. 18 ). It is believed that it may be desired to center the leading end portion  52   e  of the guide rod  50   e  in a passage in the patient&#39;s respiratory system. When this is to be done, all three expandable elements  464 ,  466 , and  468  would be expanded. 
         [0224]    In the illustrated embodiment of the invention, the expandable elements  464 ,  466  and  468  are balloons or bladders which are expanded under the influence of fluid pressure, that is, under the influence of either a gas or a liquid. To enable the expandable elements  464 ,  466  and  468  to be individually expanded, conduits  472 ,  474  and  476  are each connected in fluid communication with one of the expandable elements  464 ,  466  or  468 . For example, when the expandable element  464  is to expanded, fluid under pressure is connected through the conduit  472  to the expandable element  464 . Similarly, when the expandable element  466  is to expanded, fluid under pressure is connected through the conduit  474  to the expandable element  466 . Finally, when the expandable element  468  is to be expanded, fluid under pressure is connect through the conduit  476  to the expandable element  468   
         [0225]    After one or more of the expandable element  464 - 468  have been expanded to steer the leading end portion  52   e  of the guide rod  50   e , the expandable elements  464 ,  466  and/or  468  are contracted. This may be accomplished by connecting the conduits  472 ,  474  and/or  476  with a source of suction or low pressure. The expandable elements  464 ,  466  and  468  are contracted under the influence of their own natural resilience. If desired, springs could be provided in association with the expandable elements to contract the expandable elements  464 - 468 . 
         [0226]    The contracted expandable elements  464 ,  466  and  468  are disposed in engagement with an outer side surface of the leading end portion  52   e  of the guide rod  50   e . If desired, recesses could be provided in the leading end portion of the guide rod  50   e  to receive each of the expandable elements  464 ,  466  and  468  when the expandable elements are in their contracted condition. 
         [0227]    It is believed that it will be preferred to form the expandable elements  464 ,  466  and  468  of a resiliently stretchable polymeric material so that the expandable elements can be expanded, under the influence of fluid pressure, by stretching the material of the expandable elements. When the expandable elements are to be deflated, the resiliently stretched elastomeric material of the expandable elements  464 - 468  will tend to force fluid out of the expandable elements and cause them to return to their contracted conditions. When the retracted, the expandable elements  464 ,  466  and  468  are disposed in either separate recesses or a single annular recess which extends around the leading end portion of the guide rod  50   e . The contracted expandable elements do not project outward from the outer side surface of the guide rod  50   e . Alternatively, the contracted expandable elements  464 - 468  could be contracted, under the influence of their own natural resilience, into tight abutting engagement with the outer side surface of the guide rod  50   e.    
         [0228]    It is contemplated that the conduits  472 ,  474  and  476  and expandable elements  464 ,  466  and  468  may be formed in a manner similar to that disposed in U.S. patent application Ser. No. 08/470,142 filed Jun. 6, 1995 by Peter M. Bonutti et al. and entitled Method Of Using Expandable Cannula. The disclosure of the aforementioned application Ser. No. 08/470,142 is hereby incorporated herein in its entirety by this reference thereto. Alternatively, the expandable elements  464 ,  466  and  468  could be formed in manners similar to that disclosed in U.S. Pat. Nos. 3,833,003 and/or 5,197,971. 
         [0229]    Although the illustrated expandable elements  464 - 468  are expanded under the influence of fluid pressure, they could be expanded in a different manner if desired. For example, mechanical actuators could be provided. The mechanical actuators may be utilized to move members which are not balloons. 
         [0230]    In order to enable an operator of the positioning apparatus to determine the location of the leading end portion  52   e  of the guide rod  50   e  relative to the patient&#39;s respiratory system, a sensor assembly, similar to the sensor assembly  420  of  FIGS. 13 and 14 , is utilized in association with the steering apparatus  460 . In the embodiment of the invention illustrated in  FIG. 17 , the detector portion  426   e  of the sensor assembly includes a detector  480  which responds to an output from an emitter portion of the sensor assembly. The detector  480  is enclosed by a soft dome or cap  482  which forms part of the leading end portion  52   e  of the guide rod  50   e . The dome or cap  482  cushions engagement of the leading end portion  52   e  of the guide rod  50   e  with body tissue along the patient&#39;s respiratory system. In addition, the dome  482  protects the detector portion  426   e.    
         [0231]    The detector  480  may be a Hall effect device which cooperates with emitters, which are magnets, in the manner described in conjunction with  FIGS. 13 and 14 . Alternatively, the detector  480  may respond to radio frequency radiation. If desired, the detector  480  could be constructed so as to respond to ultrasonic energy. Rather than providing a detector  480  on the leading end portion  52   e  of the guide rod  50   e , an emitter could be provided in the manner described in conjunction with  FIGS. 15 and 16 . 
         [0232]    The detector portion  426   e  ( FIG. 17 ) is connected with a computer, similar to the computer  438  of  FIG. 13 , by a lead  486  ( FIG. 17 ). The output from the computer indicates to an operator the position of the leading end portion  52   e  of the guide rod  50   e  relative to the patient&#39;s respiratory system. The output of the computer will also indicate to the operator when the leading end portion  52   e  of the guide rod  50   e  may deviate from the intended course of insertion of the guide rod into the patient&#39;s respiratory system. 
         [0233]    When the output from the computer indicates that the leading end portion of the guide rod may not move along the intended insertion path, the operator may initiate expansion of one or more of the expandable elements  464 - 468 . The expandable elements will apply force against the patient&#39;s body tissue and against the leading end portion  52   e  of the guide rod  50   e  to deflect the guide rod in such a manner as to maintain the guide rod on its intended insertion path into the patient&#39;s respiratory system. 
         [0234]    As was previously described in conjunction with the embodiments of the invention illustrated in  FIGS. 13-16 , a visual display system, illustrative of the patient&#39;s respiratory system, may be connected with the computer which receives the output from a sensor assembly  420  or  420   d . By viewing an illustration depicting the location and path of movement of the leading end portion  52   e  of the flexible guide rod  50   e , an operator will know when to expand one or more of the expandable elements  464 ,  466  and  468 . 
         [0235]    It is contemplated that the steering apparatus  460  and position sensing assembly may be used with devices for purposes other than tracheal intubination. For example, the steering apparatus  460  and position sensing assembly used with the guide rod  50   e  of  FIG. 17  could be used in association with a device which is used to position medicant at a selected location in a patient&#39;s body. It is also contemplated that the steering apparatus  460  and position sensing assembly could be used in conjunction with endoscopic, arthroscopic, or fiber optic surgery. 
       Embodiment of FIG.  19   
       [0236]    In the embodiment of the invention illustrated in  FIGS. 17 and 18 , the steering apparatus  460  is disclosed in conjunction with the guide rod  50   e  which is used with a sensor assembly, corresponding with the sensor assembly  420  of  FIG. 13 , in which the detector portion is disposed on the leading end portion  52   e  of the guide rod. In the embodiment of the invention illustrated in  FIG. 19 , the steering apparatus is disposed in association with a guide rod having an emitter portion of a sensor assembly disposed on the leading end portion of the guide rod in the manner illustrated in  FIGS. 15 and 16 . Since the embodiment of the invention illustrated in  FIG. 19  is generally similar to the embodiments of the invention illustrated in  FIG. 13-18 , similar numerals will be utilized to designate similar components, the suffix letter “f” being associated with the numerals of  FIG. 19  in order to avoid confusion. 
         [0237]    A guide rod  50   f  has a leading end portion  52   f  The guide rod  50   f  is used with a positioning apparatus similar to the positioning apparatus  56   d  of  FIG. 15 . The flexible guide rod  50   f  ( FIG. 19 ) is associated with a sensor assembly corresponding to the sensor assembly  420   d  of  FIG. 15 . Thus, the guide rod  50   f  has an emitter portion  424   f  ( FIG. 19 ) which is connected with the leading end portion  52   f  of the guide rod. The output from the emitter portion  424   f  is detected by suitable detectors disposed adjacent to the exterior surface of the patient&#39;s neck and to the patient&#39;s Adam&#39;s apple, in the manner illustrated schematically in  FIG. 16 . 
         [0238]    In the embodiment of the invention illustrated in  FIG. 19 , the emitter portion  424   f  includes a light source  490 . The light source  490  is connected with source of electrical energy by a lead  492 . The light source  490  has been illustrated schematically in  FIG. 19  as being an incandescent light source. However, it may be preferred to provide a solid state device as a light source  490 . For example, one or more light emitting diodes could be disposed on the leading end portion  52   f  of the guide rod  50   f  to function as a light source. 
         [0239]    It is contemplated that the electrical energy conducted over the lead  492  to the light source  490  may be varied as the light source moves along the insertion path into the patient&#39;s respiratory system. For example, if the light source is pulsed from a maximum light emission level to a minimum light emission level, detection of the location of the leading end portion  52   f  of the guide rod  50   f  may be facilitated. 
         [0240]    The light source  490  may be detected by suitable photo optic devices, such as photo cells or may be visually detected by the operator of the apparatus associated with the guide rod  50   f . When the light source  490  is to be detected by the operator of the positioning apparatus, that is, when the operator is to function as the detector portion of the sensor assembly, it is believed that pulsing the light source will facilitate visual detection of the light source by the operator. It should be understood that both photo electric detection apparatus and visual detection by the operator could be utilized to locate the position of the leading end portion  52   f  of the guide rod  50   f  as the guide rod is moved into the patient&#39;s respiratory system. 
         [0241]    A steering apparatus  460   f  ( FIG. 19 ) is connected with the leading end portion  52   f  of the guide rod  50   f  The steering apparatus  460   f  includes a plurality of expandable elements  464   f  and  466   f  Although only two expandable elements  464   f  and  466   f  have been illustrated schematically in  FIG. 19 , it should be understood that a third expandable element, corresponding to the expandable element  468  of  FIG. 18 , is connected with the leading end portion  52   f  of the guide rod  50   f . The expandable elements are connected with a source of inflation fluid by conduits  472   f ,  474   f  and  476   f.    
         [0242]    When one or more of the expandable elements connected with the leading end portion  52   f  ( FIG. 19 ) of the guide rod  50   f  are to be expanded, fluid under pressure is conducted to the expandable elements. For example, when the expandable element  464   f  is to be operated from a contracted condition to an expanded condition, fluid under pressure, which may be either a gas or liquid, is conducted through the conduit  472   f  to the expandable element  464   f . As the expandable element  464   f  is operated from a contracted condition to an expanded condition of the influence of fluid pressure, the expandable element applies force against the adjacent body tissues in the patient&#39;s respiratory system and applies force against the leading end portion  52   f  of the guide rod  50   f . The force applied against the leading end portion  52   f  of the guide rod  50   f  deflects the leading end portion  52   f  of the guide rod  50   f  downward (as used in  FIG. 19 ) to maintain the guide rod on the intended path of insertion into the patient&#39;s respiratory system. The output from the emitter portion  424   f  of the sensor assembly enables the operator to determine when it is necessary to expand one or more of the expandable elements and to determine which of the expandable elements to be expanded. 
         [0243]    In the embodiment of the invention illustrated in  FIG. 19 , the emitter on the leading end portion of the guide rod  50   f  is a light source  490 . However, a different type of emitter could be provided if desired. For example, the emitter could be a magnet which cooperates with detectors in the manner previously described in conjunction with  FIGS. 15 and 16 . Alternatively, the emitter could be a miniaturized radio frequency transmitter. 
       Embodiment of FIG.  20   
       [0244]    In the embodiment of the invention illustrated in  FIGS. 13 through 19 , sensor assemblies have been illustrated as being associated with a guide rod of a positioning apparatus. In the embodiment of the invention illustrated in  FIG. 12 , fiber optics are utilized in association with a light source to enable an operator to view images of body tissue immediately ahead of the leading end portion of a guide rod  50   b . In the embodiment of the invention illustrated in  FIG. 20 , a light source and fiber optics are associated with a tracheal tube to enable an operator to view images of body tissue immediately ahead of a leading end portion of the tracheal tube during of insertion of the tracheal tube into a patient&#39;s respiratory system. Since the embodiment of the invention illustrated in  FIG. 20  is generally similar to the embodiments of the invention illustrated in  FIGS. 1, 2 and 12 , similar numerals will be utilized to designate similar components, the suffix letter “g” being associated with the numerals of  FIG. 20  to avoid confusion. 
         [0245]    A flexible tracheal tube  38   g  ( FIG. 20 ) has a leading end portion  500 . A light source  400   g  is disposed on the leading end portion  500  of the tracheal tube  38   g . The light source  400   g  is connected with a source of electrical energy by leads  504  and  506 . When the tracheal tube  38   g  is moving along an insertion path into a patient&#39;s respiratory system, the light source  400   g  illuminates body tissue immediately ahead of the leading end portion  500  of the tracheal tube  38   g.    
         [0246]    In the embodiment of the invention illustrated in  FIG. 20 , the light source  400   g  is mounted on the leading end portion of the tracheal tube  38   g . However, it is contemplated that the light source could be disposed at a location remote from the leading end portion  500  of the tracheal tube  38   g  and illumination transmitted from the light source to the leading end portion of the tracheal tube through a fiber optic tube, corresponding to the fiber optic tube  402  of  FIG. 12 . Of course, a plurality of fiber optic tubes could be utilized if desired. 
         [0247]    The light source  400   g  has been illustrated schematically in  FIG. 20  as being an incandescent light source. However, it is contemplated that one or more solid state devices, such as light emitting diodes, could form the light source  400   g  if desired. A plurality of light sources  400   g  could be disposed in a circular array on the leading end portion  500  of the tracheal tube  38   g.    
         [0248]    A prismatic lens  510  is also mounted on the leading end portion  500  of the tracheal tube  38   g . The lens  510  is enclosed by a transparent dome  512  which is connected with the leading end portion  500  of the tracheal tube  38   g . Light is transmitted from the lens  510  through a fiber optic tube  408   g  to the eye of a viewer or to a display unit associated with a computer. The lens  510  is oriented so that images of body tissue immediately ahead of the leading end portion  500  of the tracheal tube  38   g  are transmitted through the fiber optic tube  408   g . Although only a single light source  400   g  and single lens  510  have been illustrated schematically in  FIG. 20 , it should be understood that a plurality of light sources and/or a plurality of lenses may be mounted on the leading end portion  500  of the tracheal tube  38   g.    
         [0249]    The flexible tracheal tube  38   g  may be utilized in association with the positioning apparatus  56  of  FIGS. 1 and 2  or with the positioning apparatus  256  of  FIG. 4 . Alternatively, the tracheal tube  38   g  may be utilized by itself, that is without a positioning apparatus. If the tracheal tube  38   g  is utilized with a positioning apparatus similar to the positioning apparatus  56  or  256 , the tracheal tube may be moved along a guide rod similar to the guide rod  50  or the guide rod  250  as the tracheal tube is moved into a patient&#39;s respiratory system. However, the tracheal tube may be moved along a guide rod into a patient&#39;s respiratory system without utilizing a positioning apparatus, similar to the positioning apparatus  56  or  256  of  FIGS. 1 and 4 . 
         [0250]    The tracheal tube  38   g  may be moved along an insertion path into a patient&#39;s respiratory system without benefit of a guide rod. If desired, a steering apparatus, corresponding to the steering apparatus  460  and  460   f  of  FIG. 17-19 , may be associated with the leading end portion of the tracheal tube  38   g . Thus, expandable elements, corresponding to the expandable elements  464 ,  466  and  468  of  FIG. 18  may be connected with the leading end portion  500  of the tracheal tube  38   g . The expandable elements connected with the leading end portion  500  of the tracheal tube  38   g  may be connected in fluid communication with a source of fluid under pressure through conduits disposed in the side wall of the tracheal tube. Since images of body tissue immediately ahead of the leading end portion of the tracheal tube are transmitted through the fiber optic tube  408   g , an operator who is positioning the tracheal tube relative to a patient&#39;s respiratory system will be able to view images of the body tissue and, from these images, be able to determine when to activate one or more expandable elements of a steering apparatus connected with the leading end portion  500  of the tracheal tube  38   g.    
       Embodiment of FIG.  21   
       [0251]    In the embodiment of the invention illustrated in  FIG. 20 , images of patient&#39;s body tissue are transmitted from the leading end portion of the tracheal tube for viewing by an operator who is inserting the tracheal tube into the respiratory system of a patient. In the embodiment of the invention illustrated in  FIG. 21 , the tracheal tube is associated with a sensor assembly having the same construction as the sensor assembly  420  of  FIGS. 13 and 14 . Since the embodiment of the invention illustrated in  FIG. 21  is generally similar to the embodiment of the invention illustrated in  FIGS. 13, 14 and 20 , similar numerals will be utilized to designate similar components, the suffix letter “h” being associated with the numerals of  FIG. 21  to avoid confusion. 
         [0252]    A tracheal tube  38   h  ( FIG. 21 ) has a leading end portion  500   h . A detector portion  426   h  is provided on the leading end portion  500   h  of the tracheal tube  38   h . The detector portion  426   h  cooperates with an emitter portion of a sensor assembly having the same construction as the emitter portion  424  ( FIG. 14 ) of the sensor assembly  420 . 
         [0253]    The tracheal tube  38   h  includes a plurality of magnetic flux sensor units  440   h  which respond to variations in a magnetic flux field in which the sensor units are exposed. In the illustrated embodiment of the invention, the sensor units  440   h  are Hall effect devices. However, the sensor units  440   h  could be other known types of devices which respond to a magnetic flux field 
         [0254]    The sensors  440   h  are connected with a computer, similar to the computer  438  of  FIG. 13 , by a plurality of leads  442   h . The computer to which the leads  442   h  are connected has a display unit which displays an image of a typical respiratory system. The display indicates the position of the leading end portion  500   h  of the tracheal tube  38   h  relative to the patient&#39;s respiratory system 
         [0255]    In addition, the computer display may also indicate the position of a guide rod, corresponding to the guide rod  50   c  of  FIG. 13 , relative to the patient&#39;s respiratory system. Therefore, the computer display shows the position of the leading end portion  500   h  of the tracheal tube  38   h  relative to the leading end portion  52   c  ( FIG. 13 ) of the guide rod  50   c . Although the tracheal tube  38   h  may advantageously be utilized in association with a guide rod, similar to the guide rod  50   c , it is contemplated that the tracheal tube  50   h  could be utilized by itself without an associated guide rod. Of course, if the tracheal tube  38   h  was utilized by itself without a guide rod similar to the guide rod  50   c  of  FIG. 13 , the output from the computer would indicated the position of the leading end portion  50   h  of the tracheal tube  38   h  relative to the patient&#39;s respiratory system and would not indicate the location of the guide rod. 
         [0256]    It is contemplated that a steering apparatus similar to the steering apparatus  460  of  FIG. 17  may be utilized with the tracheal tube  38   h  ( FIG. 21 ). A plurality of expandable elements, corresponding to the expandable elements  464 ,  466  and  468  of  FIG. 18 , would be connected with the leading end portion  50   h  of the tracheal tube  38   h . The cooperation between the Hall effect devices forming the sensor units  440   h  and the magnets of an associated detector portion of a sensor assembly would enable an operator inserting the tracheal tube  38   h  into a patient&#39;s respiratory system to determine when one or more of the expandable elements should be expanded to steer the leading end portion  500   h  of the tracheal tube  38   h.    
       Embodiment of FIG.  22   
       [0257]    In the embodiment of the invention illustrated in  FIG. 19 , a light source  490  and steering apparatus  460   f  is associated with the leading end portion  52   f  of a guide rod  50   f . In the embodiment of the invention illustrated in  FIG. 22 , a plurality of light sources and a steering apparatus are associated with the leading end portion of a tracheal tube. Since the embodiment of the invention illustrated in  FIG. 22  is generally similar to the embodiments of the invention illustrated in  FIGS. 19-21 , similar numerals will be utilized to designate similar components, the suffix letter “j” being associated with the numerals of  FIG. 22  to avoid confusion. 
         [0258]    A tracheal tube  38   j  has a leading end portion  500   j . A plurality of light sources  490   j  are mounted on the leading end portion  500   j  of the tracheal tube  38   j . The light sources  490   j  are energized by electrical energy connected over leads  492   j . Although the light sources  490   j  have been indicated schematically in  FIG. 22  as being incandescent light sources, it is contemplated that solid state devices, such as light emitting diodes, could be utilized as the light sources if desired. 
         [0259]    The steering apparatus  460   j  is mounted on the leading end portion  500   j  of the tracheal tube  38   j . The steering apparatus  460   j  includes a plurality of expandable elements  464   j  and  466   j . Although only two expandable elements  464   j  and  466   j  have been illustrated schematically in  FIG. 22 , it should be understood that there are three expandable elements connected with the leading end portion  500   j  of the tracheal tube  38   j . The expandable elements are disposed in an array around the end of the tracheal tube in much the same manner as illustrated schematically in  FIG. 18  in association with the guide rod  50   e    
         [0260]    The expandable elements  464   j  and  466   j  are connected with conduits  472   j  and  474   j . The conduits  472   j  and  474   j  are formed in the side wall of the tracheal tube  38   j  in the manner indicated schematically in  FIG. 22 . Of course, a third conduit is provided to conduct fluid to and from a third expandable element on the end portion  500   j  of the tracheal tube  38   j . It should be understood that the conduits  472   j  and  474   j  could be formed separately from the tracheal tube  38   j  if desired. 
         [0261]    When the steering apparatus  460   j  is to be utilized to change the course of movement of the leading end portion  500   j  of the tracheal tube  38   j  relative to a patient&#39;s respiratory system, one or more of the expandable elements in the steering apparatus  460   j  is inflated under the influence of fluid pressure conducted through an associated conduit. For example, if the expandable element  464   j  is to be operated from a contracted condition to the expanded condition illustrated schematically in  FIG. 22 , fluid pressure is connected through the conduit  472   j . As the expandable element  464   j  expands, forces are applied against tissue in the patient&#39;s respiratory system by the expandable element  464   j . At the same time, the expandable element  464   j  is effective to apply force against the leading end portion  500   j  of the tracheal tube  38   j  to deflect the tracheal tube downward (as viewed in  FIG. 22   
         [0262]    It is contemplated that the tracheal tube  38   j  may be utilized in association with a guide rod, such as the guide rod  50   f  of  FIG. 19  or the guide rod  50  of  FIG. 1 . However, if desired, the tracheal tube  38   j  could be inserted into a patient&#39;s respiratory system without the benefit of a guide rod. 
         [0263]    When the tracheal tube  38   j  is to be inserted into a patient&#39;s respiratory system, either with or without a guide rod, the light sources  490   j  are energized. Energization of the light sources  490   j  results in the emission of light which can be detected by photo cells or similar devices positioned adjacent to the outside of the patient&#39;s neck. If desired, the photo cells could be eliminated and an operator could visually locate the leading end portion  50   j  of the tracheal tube  38   j  by viewing the illumination conducted through the patient&#39;s body tissues to the surface of the patient&#39;s neck. It is contemplated that an operator will, in all probability, locate the leading end portion  500   j  of the tracheal tube  38   j  by a combination of the output from photo detectors and visually viewing the patient&#39;s neck. If desired, the light sources  490  can be pulsed to provide a variation in the illumination from the light sources to facilitate visual locating of the leading end portion of the tracheal tube  38   j  by an operator. 
         [0264]    When the inflatable elements  464   j  and/or  466   j  are to be operated from the expanded condition illustrated in  FIG. 22  to a contracted condition, the conduits  472   j  and  474   j  may be exhausted to atmosphere. It is believed that it may be preferred to connect the conduits  472   j  and  474   j  with a source of low pressure or suction so that fluid is drawn out of the expandable elements. 
         [0265]    As the fluid pressure in the expandable elements  460   j  and  466   j  is reduced, the natural resilience of the expandable elements causes them to contract tightly against the leading end portion  500   j  of the tracheal tube  38   j . If desired, a plurality of recesses may be provided in the leading end portion  500   j  of the tracheal tube  38   j  to receive the expandable elements  464   j  and  466   j . Of course, if additional expandable elements are associated with the leading end portion  500   j  of the tracheal tube  38   j , additional recesses would be provided to receive these expandable elements when they are contracted. 
         [0266]    Various types of emitters and detectors have been illustrated in  FIGS. 20, 21 and 22  in association with the tracheal tube  38   j . It should be understood that any of the emitters or detector systems previously described in association with a guide rod may be utilized in association with a tracheal tube. For example, a radio frequency transmitter and a receiver may be utilized as the emitter portion and the sensor portion of a sensor assembly which is utilized to detect the location of the leading end portion of a tracheal tube relative to a patient&#39;s respiratory system. 
         [0267]    Although it is believed that it will probably be preferred to utilize a steering apparatus, similar to the steering apparatus  460   j  in association with the tracheal tube, the steering apparatus could be omitted if desired. 
       Positioning Apparatus—General—Mode of Operation 
       [0268]    The general mode operation of the positioning apparatus  56  of  FIG. 1  is illustrated schematically in  FIG. 23 . As was previously explained, the positioning apparatus  56  includes an arcuate member  108 . The arcuate member  108  has a center of curvature indicated at  600  in  FIG. 23 . 
         [0269]    The body section  86  of the positioning apparatus  56  has a central axis which extends through the center  600 . The positioning section  96  is connected with an end of the body section  86  which is disposed closest to the center  600  of curvature of the arcuate member  108 . The indicia  124  ( FIG. 1 ) on the body section  86  is effective to indicate the length of the body section  86 . 
         [0270]    The guide rod  50  also has a central axis which extends through the center  600  of curvature of the arcuate section  108 . The indicia  142  ( FIG. 1 ) on the guide rod  50  indicates the distance from the leading end portion  52  of the guide rod  50  from the arcuate member  108 . The guide rod  50  and body section  86  of the positioning apparatus  56  are both radiuses from the center  600  of curvature of the arcuate member. When the indicia  142  ( FIG. 1 ) indicates that the guide rod  50  ( FIG. 23 ) extends from the arcuate member  108  for the same distance as the body section  86 , the leading end portion  52  of the guide rod  50  is aligned with the positioning apparatus  96 . Since the positioning apparatus  96  is accurately located relative to the patient&#39;s respiratory system  11  ( FIG. 1 ) by engagement with the patient&#39;s Adam&#39;s apple  34 , the position of the leading end portion  52  of the guide rod relative to the patient&#39;s larynx  30  is known when the leading end portion  52  of the guide rod  50  is aligned with positioning apparatus  96 . 
         [0271]    An alternative embodiment of the positioning apparatus  56  is illustrated in  FIG. 24 . Since the embodiment of the positioning apparatus illustrated in  FIG. 24  is generally similar to the embodiment of the positioning apparatus  56  illustrated in  FIGS. 1 and 23 , similar numerals will be utilized to indicate similar components, the suffix letter “k” being associated with the components of  FIG. 24  to avoid confusion. 
         [0272]    A positioning apparatus  56   k  includes a body section  86   k . A positioning section  96   k  is connected with an end portion of the body section  86   k . The positioning section  96   k  engages the patient&#39;s Adam&#39;s apple, in the manner previously described in conjunction with the apparatus  56  of  FIG. 1 . 
         [0273]    In the embodiment of the invention illustrated in  FIG. 24 , a member  108   k  is fixedly connected with the body section  86  and extends at a known angle, indicated at  604  in  FIG. 24 . A guide section  114   k  is disposed at an end of the member  108   k  opposite from the connection  606  with the body section  86   k . The guide rod section  114   k  guides movement of a guide rod  50   k  along a path which extends through a center  600   k.    
         [0274]    The center  600   k  is disposed at the intersection of a longitudinal central axis of the body section  86   k  and a longitudinal central axis of the guide rod  50   k . An angle, indicated at  610  in  FIG. 24 , formed between the longitudinal central axis of the body section  86   k  and the guide rod  50   k  is known. The distance from the positioning section  96   k  to the connection  606  between the body section  86   k  and member  108   k  is known. The angles  604  and  610  are known. The length of the member  108  is also known. Therefore the distance which the guide rod  50   k  must extend from the guide section  114   k  to have the leading end portion  52   k  of the guide rod aligned with the positioning section  96   k  can readily be determined by trigonometric functions. 
         [0275]    It should be understood that features of any one embodiment of the invention may be used with features of other embodiments of the invention. For example, the positioning apparatus  256  of  FIGS. 4-10  could have the same construction as the positioning apparatus  56  of  FIGS. 1-3 . Similarly, the magnet  260  of  FIG. 4  could be used with the embodiment of the invention illustrated in  FIGS. 1-3 . The sensor assemblies  420  could be used with either the positioning apparatus  56  of  FIG. 1  or the positioning apparatus  256  of  FIGS. 4-10 . Other combinations of features of the invention will undoubtedly be utilized. 
       Embodiment of FIGS.  25  and  26   
       [0276]    In the embodiments of the invention illustrated in  FIGS. 1-24 , the positioning apparatus  56  has a positioning section  96  which engages the patient&#39;s Adam&#39;s apple  34 . In the embodiment of the invention illustrated in  FIGS. 25 and 26 , the positioning apparatus engages a plurality of locations on the patient&#39;s neck. Since the embodiment of the invention illustrated in  FIGS. 25 and 26  is generally similar to the embodiments of the invention illustrated in  FIGS. 1-24 , similar numerals will be utilized to designate similar components, the suffix letter “m” being associated with the numerals of  FIGS. 25 and 26  to avoid confusion. 
         [0277]    A positioning apparatus  56   m  is utilized to position a guide rod  50   m  corresponding to the guide rod  50  of  FIG. 1 , relative to a patient&#39;s trachea  28   m  during insertion of the guide rod into the patient&#39;s trachea. In addition, the positioning apparatus  56   m  provides an indication of the distance which the guide rod  50   m  is to be moved into the patient&#39;s trachea  28   m . The positioning apparatus  56   m  includes a base section  78   m  which is connected with an arcuate upper section, corresponding to the arcuate upper section  80  of  FIG. 1 . The base section  78   m  includes a tubular cylindrical body section  86   b . The base section  78   m  also includes a positioning section  96   m . The positioning section  96   m  locates the positioning apparatus  56   m  relative to the patient&#39;s Adam&#39;s apple  34   m.    
         [0278]    In accordance with a feature of the embodiment of the invention illustrated in  FIGS. 25 and 26 , the positioning section  96  includes a pair of positioning fingers  622  and  624  which engage the neck  16   m  of the patient at locations disposed on laterally opposite sides of the Adam&#39;s apple  34   m . Thus, the positioning finger  622  is provided with a relatively soft resilient spherical end portion  628  which is pressed against the patient&#39;s neck  16   m  at a location adjacent to the left (as viewed in  FIG. 26 ) side of the patient&#39;s Adam&#39;s apple. Similarly, the positioning finger  624  has a soft resilient spherical end portion  630  which is pressed against the patient&#39;s neck  16   m  at a location adjacent to the right (as viewed in  FIG. 26 ) side of the patient&#39;s Adam&#39;s apple  34   m . The positioning fingers  622  and  624  cooperate with the patient&#39;s Adam&#39;s apple  34   m  to locate the positioning section  96   m  laterally relative to the patient&#39;s Adam&#39;s apple  34   m.    
         [0279]    In the embodiment of the positioning section  96   m  illustrated in  FIGS. 25 and 26 , the positioning section is provided with a straight center positioning finger  634  which is formed as a continuation of the tubular cylindrical body section  86   m  of the positioning apparatus  56   m . Thus, the body section  86   m  and center positioning finger  634  are integrally formed as one piece. The center positioning finger  634  has a soft resilient spherical end portion  636  which is pressed against the patient&#39;s Adam&#39;s apple  34   m  at the center of the patient&#39;s Adam&#39;s apple. 
         [0280]    Force may be applied against the body section  86   m  of the positioning apparatus  56   m  and transmitted to the patient&#39;s neck  16   m  to straighten the trachea of the patient. Thus, a slight bend in the trachea can be minimized by the manual application of a relatively small force to the positioning apparatus  56   m . This force is transmitted through the end portions  628  and  630  of the positioning fingers  622  and  624  to the patient&#39;s neck to straighten the patient&#39;s neck. In addition, a portion of the force will be transmitted through the center positioning finger  634  directly to the patient&#39;s Adam&#39;s apple  34   m.    
         [0281]    The position of the end portions  628  and  630  of the positioning fingers  622  and  624  relative to the body section  86   m  of the base section  78   m  of the positioning apparatus  56   m  ( FIG. 25 ) can be varied. Thus, the positioning fingers  622  and  624  are fixedly connected to a slide block  640  which is axially movable along the body section  86   m . The body section  86   m  extends through a cylindrical central opening in the slide block  640 . A set screw  642  ( FIG. 25 ) having manually engagable wings or flanges can be tightened to hold the positioning fingers  622  and  624  in a desired position relative to the body section  86   m  of the positioning apparatus  56   m . This enables the length of the center positioning finger  634  to be adjusted. By adjusting the length of the center finger  634 , a relatively small amount of force can be transmitted through the center finger  634  directly to the patient&#39;s Adam&#39;s apple  34   m  and substantially larger forces can be transmitted through the positioning fingers  622  and  624  to the patient&#39;s neck  16   m  to locations disposed on opposite sides of the patient&#39;s Adam&#39;s apple  34   m.    
         [0282]    It should be understood that the positioning section  96   m  of  FIGS. 25 and 26  can be utilized in any of the positioning apparatus disclosed in  FIGS. 1 through 24  herein. When the positioning section  96   m  is to be associated with the positioning apparatus  56   c  of  FIG. 13 , the emitter units  430  ( FIG. 14 ) could be mounted on or adjacent to the end portions  628 ,  630  and  636  ( FIGS. 25 and 26 ) of the positioning fingers  622 ,  624  and  634 . Similarly, when the positioning section  96   m  is utilized in association with the positioning apparatus  56   d  of  FIGS. 15 and 16 , the sensor units  440  may be disposed adjacent to and connected with the end portions  628 ,  630  and  636  ( FIG. 25 ) of the positioning fingers  622 ,  624  and  634 . 
         [0283]    It should be understood that the positioning apparatus  56   m  ( FIGS. 25 and 26 ) may be associated with guide rods having the construction of the guide rod  50  of  FIG. 1 , the guide rod  250  of  FIGS. 4 and 8 , the guide rod  50   e  of  FIGS. 17 and 18 , or the guide rod  50   f  of  FIG. 19 . It should also be understood that the positioning apparatus  56   m  may be associated with a tracheal tube having the construction of any one of the tracheal tubes  38  ( FIG. 2 ),  238  ( FIGS. 9 and 10 ),  38   g  ( FIG. 20 ),  38   h  ( FIG. 21 ), or  38   j  ( FIG. 22 ). 
       Embodiment of FIGS.  27  and  28   
       [0284]    In the embodiment of the invention illustrated in  FIGS. 25 and 26 , the positioning fingers  622  and  624  are fixedly connected with the body section  86   m  of the positioning apparatus  56   m  by the slide block  640  while the positioning fingers  634  is integrally formed as one piece with the body section  36   m . In the embodiment of the invention illustrated in  FIGS. 27 and 28 , the positioning fingers are movable relative to the body section of the positioning apparatus. Since the embodiment of the invention illustrated in  FIGS. 27 and 28  is generally similar to the embodiments of the invention illustrated in  FIGS. 1-26 , similar numerals will be utilized to designate similar components, the suffix letter “r” being associated with the numerals of  FIGS. 27 and 28  to avoid confusion. 
         [0285]    A positioning apparatus  56   r  positions a guide rod, corresponding to the guide rod  50  of  FIG. 1 , relative to a patient&#39;s trachea during insertion of the guide rod into the patient&#39;s trachea. In addition, the positioning apparatus  56   r  provides an indication of the distance which the guide rod is to be moved into the patient&#39;s trachea. Although only a portion of the positioning apparatus  56   r  is illustrated in  FIGS. 27 and 28 , it should be understood that the positioning apparatus may have the same general construction as the positioning apparatus of any one of the embodiments illustrated in  FIGS. 1-19 . 
         [0286]    The positioning apparatus  56   r  includes a base section  78   r  which is connected with an arcuate upper section corresponding to the arcuate upper section  80  of  FIG. 1 . The upper section of the positioning apparatus  56   r  guides movement of a guide rod, corresponding to the guide rod  50  of  FIG. 1 , during insertion of the guide rod into the patient&#39;s trachea. 
         [0287]    In accordance with a feature of the present invention, a positioning section  96   r  is connected with the base section  78   r . The positioning section  96   r  locates the positioning apparatus  56   r  relative to the patient&#39;s Adam&#39;s apple  34   r  ( FIG. 28 ). The positioning section  96   r  is connected with an end of a body section  86   r  of the positioning apparatus  56   r  by a universal pivot connection  652 . The pivot connection  652  allows the orientation of the base section  78   r  of the positioning apparatus  56   r  to be changed in any direction relative to the positioning section  96   r . Thus, the body section  86   r  of the positioning apparatus  56   r  can be raised or lowered (as viewed in  FIG. 27 ) or pivoted to the left or right (as viewed in  FIG. 28   
         [0288]    The positioning section  96   r  includes a plurality of positioning fingers  622   r ,  624   r  and  634   r . The positioning fingers  622   r ,  624   r  and  634   r  are provided with soft resilient spherical end portions  628   r ,  630   r , and  636   r . Although the positioning section  96   r  may be located in any one of many different orientations relative to the patient&#39;s Adam&#39;s apple  34   r , the position section  96   r  is illustrated in  FIG. 28  with the end portions  628   r  and  630   r  disposed on laterally opposite sides of the patient&#39;s Adam&#39;s apple  34   r . The end portion  636   r  is disposed adjacent to the lower end portion of the patient&#39;s Adam&#39;s apple  34   r . If desired, the orientation of the positioning section  96   r  could be rotated by 180 degrees from the orientation illustrated in  FIG. 28 . If this was done, the end portion  636   r  on the positioning finger  634   r  would be disposed adjacent to the upper portion of the patient&#39;s Adam&#39;s apple  34   r . It is believed that it will probably be preferred to align the pivot connection  652  with the center of the patient&#39;s Adam&#39;s apple  34   r . However, if desired, the pivot connection  652  could be offset from the center of the patient&#39;s Adam&#39;s apple  34 . 
         [0289]    In the embodiments of the invention illustrated in  FIGS. 25-28 , the positioning sections  96   m  and  96   r  have been illustrated as having three positioning fingers. However, it is contemplated that the positioning sections could have either a greater number of positioning fingers or a lesser number of positioning fingers if desired. For example, the center positioning finger  634  of the embodiment of the invention illustrated in  FIGS. 25 and 26  could be omitted. If this was done, the positioning finger  622  would be positioned on one side of the patient&#39;s Adam&#39;s apple  34   m  and the positioning finger  624  would be positioned on the laterally opposite side of the patient&#39;s Adam&#39;s apple, in the manner illustrated in  FIG. 26 , without engaging the central portion of the patient&#39;s Adam&#39;s apple. Alternatively, the positioning section  96   m  or  96   r  could be provided with four positioning fingers. If this was done, two of the positioning fingers would be positioned in engagement with the neck of the patient adjacent to one side of the patient&#39;s Adam&#39;s apple and the other two positioning fingers would be positioned in engagement with the patient&#39;s neck on a laterally opposite side of the patient&#39;s Adam&#39;s apple. 
       CONCLUSION 
       [0290]    An improved method and apparatus for use in tracheal intubination or other medical procedures may include a positioning apparatus  56 ,  256 . When the positioning apparatus  56 ,  256  is used for tracheal intubination, the positioning apparatus is located relative to a patient&#39;s trachea  28 ,  228  by engaging a portion of the patient&#39;s body, such as the Adam&#39;s apple  34 ,  234 . A flexible guide rod  50 ,  250  may be moved relative to the positioning apparatus until a leading end portion  52 ,  252  of the guide rod has moved into the patient&#39;s trachea. A tracheal tube  38 ,  238  is slid along the guide rod into the patient&#39;s trachea. 
         [0291]    During movement of the guide rod  50 ,  250  relative to the positioning apparatus  56 ,  256 , the guide rod may be moved through either a tubular guide member  264  or a tracheal tube  38 ,  238  which extends through the patient&#39;s mouth into the patient&#39;s pharynx. Before beginning to move the guide rod  50 ,  250 , the distance which the guide rod is to be moved may advantageously determined. This may be done as a function of spacing between locations on the positioning apparatus  56 ,  256 . If desired, indicia  124 ,  324  may be provided on the positioning apparatus  56 ,  256  and cooperating indicia  142 ,  342 - 350  may be provided on the guide rod  50 ,  250 . 
         [0292]    A magnet  260  may be utilized to attract a leading end portion  252  of the guide rod  250 . The magnet  260  is disposed outside of the patient&#39;s body and may be positioned adjacent to an anterior side of the trachea. Magnetic attraction between the magnet  260  and the leading end portion  252  of the guide rod deflects the guide rod. This steers the leading end portion of the guide rod  250  into the entrance to the patient&#39;s trachea. A magnet may be used to steer a member relative to a patient&#39;s body tissue during performance of operations other than tracheal intubination. 
         [0293]    In order to locate the guide rod  50 ,  250  and/or tracheal tube  38 ,  238  relative to the patient&#39;s trachea, an image of body tissue adjacent to the leading end portion of the guide rod and/or tracheal tube may be transmitted to a location outside of the patient&#39;s body ( FIGS. 12 and 20 ). Movement of the guide rod  50 ,  250  and/or tracheal tube  38 ,  238  into the patient&#39;s trachea is interrupted when the image transmitted from the leading end portion of the guide rod or tracheal tube indicates that the leading end portion of the guide rod or tracheal tube has been moved to a desired position relative to the patient&#39;s trachea. 
         [0294]    It is believed that transmission of an image of body tissue adjacent to the leading end portion of the tracheal tube  38 ,  238  may advantageously be performed when the tracheal tube is utilized without benefit of the positioning apparatus  56 ,  256 . However, the transmission of an image of body tissue adjacent to the leading end portion of the tracheal tube  38 ,  238  may be performed when the positioning apparatus is used in association with the tracheal tube. Positioning of the guide rod  50 ,  250  relative to the patient&#39;s trachea may also be facilitated by the transmitting of images of body tissue adjacent to a leading end portion of the guide rod. 
         [0295]    Detectors and emitters  424 ,  426  may be utilized to detect the position of the leading end portion of the guide rod  50 ,  250  and/or the tracheal tube  38 ,  238  relative to the patient&#39;s trachea. When this is done, an emitter  424 , such as a magnet or a light source, may be connected with a leading end portion  52 ,  252  of the guide rod  50 ,  250  and/or the tracheal tube  38 ,  238 . One or more detectors  426  may be provided on the outside of the patient&#39;s neck to detect the output from the emitter  424  when the guide rod  50 ,  250  and/or the tracheal tube  38 ,  238  are in a desired position relative to the patient&#39;s trachea. Alternatively, a detector  426  may be connected with the leading end portion of a guide rod  50 ,  250  and/or tracheal tube  38 ,  238  and one or more emitters  424  positioned relative to the outside of the patient&#39;s neck. The detector  426  would provide an output indicating when the guide rod  50 ,  250  and/or tracheal tube  38 ,  238  is moved to a desired position relative to the patient&#39;s trachea. 
         [0296]    During movement of the guide rod  50 ,  250  and/or tracheal tube  38 ,  238  along the patient&#39;s respiratory system and into the patient&#39;s trachea, force may be applied against the leading end portion  52 ,  252  of the guide rod and/or tracheal tube to steer the leading end portion of the guide rod and/or tracheal tube. The application of force against the leading end portion  52 ,  252  of the guide rod  50 ,  250  and/or tracheal tube  38 ,  238  may be accomplished by expanding an expandable element  464 - 468  connected with the guide rod  50 ,  250  and/or the tracheal tube  38 ,  238 . 
         [0297]    It should be understood that any one of the features of the present invention may be used separately or in combination with other features of the invention. It&#39;s believed that various combinations of the features, other than those disclosed herein, may advantageously be utilized and will be apparent to those skilled in the art from the description contained herein. In addition, it should be understood that features of the present invention may be used for purposes other than tracheal intubination. From the above description of the invention, those skilled in the art will perceive improvements, changes and modifications. Such improvements, changes and modifications within the skill of the art are intended to be covered by the appended claims.