File:The diagnosis and treatment of diseases of women (1907) (14597740768).jpg

Identifier: diagnosistreatmecros (find matches)
Title: The diagnosis and treatment of diseases of women
Year: 1907 (1900s)
Authors: Crossen, Harry Sturgeon, 1869-
Subjects: Genital Diseases, Female Gynecology Gynecology Women Generative organs, Female
Publisher: St. Louis : Mosby
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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mass. After locating the adnexa, as above described, it is sometimes advantageous totry to trace the tube out from the uterus. The fundus uteri is located, theexamining fingers (vaginal and abdominal making united counter-pressure) pass tothe upper outer angle and then feel for the tube as it leaves the uterus and runsalong the top of the broad ligament. The best place to locate it usually, when DEEP PALPATION IN THE PELVIS 61 not abnormally indurated^ is just beyond the angle of the uterus. It is amuch firmer cord here than farther out, where the cavity becomes large and thetube soft. The normal Fallopian tube may be felt in a suitable case (thin patient with re-laxed abdominal Avail and relaxed pelvic floor) in the position indicated, as a smallsoft cord about the size of a slate-pencil. It presents very much the consistencyof a piece of rubber tubing. It may, in a suitable case, be traced outward and isthen lost in the region of the ampulla, where the tube becomes very soft and the
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Fig. 76. Use of tliii mauoavcr for iuvaginating tlic pelvic floor, iu the ueep bi:nanual palpation. ovary comes into prominence as a soft rounded movable body, a trifle larger thanthe end of the thumb and sensitive to pressure. When the tube is inflamed, it be-comes harder and larger and is more easily felt. It then feels very much like arather firm piece of rubber tubing of about the size of a lead-pencil or larger, ex-tending outward from the angle of the uterus, with irregular curves and bendingsand enlargements. From this size, it may enlarge to a mass that fills all that sideof the pelvis. Usually, however, when the inflammation is at all severe, adhesionsor plastic exudate surround the tube and ovary, binding them and the surroundingstructures together in one mass and making their separate differentiation impos-sible. If on examination the pelvic tissues are all soft and yielding and no particular 62 THE PHYSICAL EXAMINATION pain is caused by the palpation, you may be certain th

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