Gynecological diagnosis . ities of the ischia andis measured with the patient inthe lithotomy position, the pelvi-meter being employed as in theother external measurements. The Capacity of the Pelvic Cav-ity.—This is an estimate formedby vaginal examination with tworingers in the vagina. When theoblique conjugate is being measured the opportunity should beseized to palpate the interior of the pelvis and form an idea of itscapacity, as well as a search made for abnormalities in the shapeof new growths, old fractures, caries, or necrosis. The Oblique Diagonal Diameters (8| to 9J inches, or 22 to
Gynecological diagnosis . ities of the ischia andis measured with the patient inthe lithotomy position, the pelvi-meter being employed as in theother external measurements. The Capacity of the Pelvic Cav-ity.—This is an estimate formedby vaginal examination with tworingers in the vagina. When theoblique conjugate is being measured the opportunity should beseized to palpate the interior of the pelvis and form an idea of itscapacity, as well as a search made for abnormalities in the shapeof new growths, old fractures, caries, or necrosis. The Oblique Diagonal Diameters (8| to 9J inches, or 22 to 23centimeters).—These are measured by the pelvimeter with thepatient lying first on one side and then on the other. One end ofthe pelvimeter is placed on the posterior superior iliac spine on oneside and on the anterior superior iliac spine on the other. Theright oblique diagonal is generally a trifle longer than the posterior superior spinous processes are often marked bydistinct dimples on the womans Fig. 42.—The Pelvimeter. CHAPTER VIII THE INVESTIGATION OF THE URETHRA, BLADDER, AND URETERS Instruments used, p. 99. Anatomy, p. 100. The urethra, p. 100. The bladder, p. 101. Land-marks in the bladder, p. 102. The ureters, p. 104. The examination, p. 107. Catheterization of the bladder, p. 108. Search-ing the urethra and the bladder, p. 108. Direct endoscopy and cystoscopywith air distended urethra and bladder, p. 110. Catheterization of theureters, p. 115. Indirect cystoscopy with water distended bladder, p. , p. 119. In this chapter we will consider only direct urethroscopy andcystoscopy by means of a simple tube (the Kelly cystoscope) andreflected light, as a means for the inspection of the urethra andbladder, for it has been found in the authors experience, to meetsatisfactorily the gynecologists requirements for diagnosis. More-over, the method is easily learned and simpler than cystoscopy witha Nitze cystoscope or instrument of t
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