File:Aseptic surgical technique- with especial reference to gynæcological operations (1902) (14763563834).jpg

Identifier: asepticsurgica00robb (find matches)
Title: Aseptic surgical technique: with especial reference to gynæcological operations
Year: 1902 (1900s)
Authors: Robb, Hunter. (from old catalog)
Subjects: Surgery, Aseptic and antiseptic Women
Publisher: Philadelphia, J. B. Lippincott company
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

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Text Appearing Before Image:
tor being withdrawn from the specu-lum, the bladder immediately becomes distended withair, and by properly directing the reflected light it be-comes possible to examine every portion of it. Thereis usually, even after the most careful catheterization,a little residual urine, which can be removed by thesuction apparatus, or, if the amount be trifling, bymeans of little balls of absorbent cotton held in thelong mouse-toothed forceps. After a little practice onthe normal bladder, the operator becomes acquaintedwith the distribution of blood-vessels in the mucousmembrane, and with certain landmarks which enablehim to recognize without difficulty the sites of theureteral orifices. Thus, on elevating the handle of thespeculum, so that the base of the bladder comes intoview, the region of the inter-ureteric ligament becomesvisible. This is often to be distinguished by a slightlyelevated transverse fold or by the difference in colorof the mucous membrane of that region. After this PLATE XXIV.
Text Appearing After Image:
Hips in moderate elevation for cystoscopic examination and direct catheteriza-tion of ureters. Cystoscopic and ureteral instruments on tray in foreground. CATHETERIZATION OF URETER. 233 landmark has been found, the ureteral orifice oneither side may be discovered by turning the specu-lum laterally through an angle of some thirty de-grees, and looking sharply. Under normal conditionslittle jets of urine may sometimes be seen comingfrom the orifice, and in some pathological cases pusor blood can be detected as it trickles from it intothe bladder. The appearance of the ureteral orificevaries considerably. It may look like a dimple ora little pit in the mucous membrane, while at othertimes it resembles an inverted V lying obliquely withthe apex pointing outward and a little upward. Incases in which there has been inflammation it maypresent the appearance of a small round hole in acushioned eminence. In some instances when it isdifficult to see it at all its situation may be easilyrecogniz

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