File:Diseases of the kidneys, ureters and bladder, with special reference to the diseases of women (1922) (14765523072).jpg

Identifier: diseasesofkidney01kell (find matches)
Title: Diseases of the kidneys, ureters and bladder, with special reference to the diseases of women
Year: 1922 (1920s)
Authors: Kelly, Howard A. (Howard Atwood), 1858-1943 Brödel, Max, 1870-1941 Burnam, Curtis Field, 1877-
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Publisher: New York, London : D. Appleton and company

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Fig. 116.—Demonstration of the OpeningsOF Skenes Ducts by Hairpin Specula. 244 EXAMINATION OF THE URINARY TRACT IN WOMEN. mucosa, resulting in a thickening and eversion of the orifice, which bleedsreadily on touch and is often extremely sensitive. Enlarged Skenes glandssometimes look like a pea lodged under the mucosa, and the orifice may beeverted. By inspection the bulging of a suburethral abscess into the vagina isplainly visible. Above the external urethral orifice no portion of the urinarytract is visible to the naked eye unaided by instruments. A couple of benthairpins (Fig. 116), grasped by artery forceps, form excellent retractors, ex-posing the outer 1 or 2 cm. of the urethra. The best instrument for inspection
Text Appearing After Image:
Fig. 117. Kellys No. 10,Vesical Speculum. Note pointed tip of obturator, one-halfnatural size. of the urethra (Fig. 117) is a short speculum of an average size, about 1 cm.in diameter and 4l/> cm. in length. The necessary instruments for an examination are these: (1) cali-brator and dilator in one; (2) head-mirror; (3) speculum; (4) evacuator;(5) searcher; (G) forceps; (7) pledgets of cotton (Figs. 117, 118, 119). The examination is conducted with the patient on her back and placed onthe table or at the edge of the bed, with flexed tliiiihs in the lithotomy posi-tion. A ten per cent, solution of cocain is injected into the urethra with asimple medicine dropper, or is carried in on a pledget of cotton and left insitu for ten minutes (Fig. 120). If it is necessary to dilate the urethra, this isthen done quickly on removal of the cotton with a conical dilator. The urethralspeculum is then plunged well up into the bladder and the obturator withdrawn.If any urine is left in the bladder,

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