Minor surgical gynecology : a manual of uterine diagnosis and the lesser technicalities of gynecological practice : for the use of the advanced student and general practitioner . rtable and unpleasant to the patient, it is advisable to try theordinary flat dorsal position with sharply flexed and but slightly separatedthighs first. The clothes should be drawn down to the symphysis, andthe abdomen completely bared, as in inspection, auscultation, and percus-sion, which, indeed, should generally precede palpation. There are otherpositions in which palpation is practicable, such as the erect, late
Minor surgical gynecology : a manual of uterine diagnosis and the lesser technicalities of gynecological practice : for the use of the advanced student and general practitioner . rtable and unpleasant to the patient, it is advisable to try theordinary flat dorsal position with sharply flexed and but slightly separatedthighs first. The clothes should be drawn down to the symphysis, andthe abdomen completely bared, as in inspection, auscultation, and percus-sion, which, indeed, should generally precede palpation. There are otherpositions in which palpation is practicable, such as the erect, lateral,genu-pectoral, but they are used chiefly to ascertain the mobility or changeof position of a tumor, and are attended with the difficulties which the in-creased abdominal pressure entails in the erect posture, and the weight ofthe abdominal walls and viscera in the genu-pectoral position. Insome instances the latter proves useful in dislodging a tumor or theuterus from the pelvic brim, and making it accessible to the palpatinghand. The patient being prepared in the ordinary dorsal position with re-cently evacuated bladder and rectum, the physician steps to her side and. Fia. 16.—Manner of using hands in abdominal palpation. (Prom MundSs ,; Obstetric Palpation.) places his warmed and soft hands gently on the abdomen, using only thetips of the four fingers for palpation. Proceeding with a pawing motionhe explores region after region of the abdomen, preferably following aregular routine in order not to overlook any portion. Thus he may firstpalpate the supra-umbilical portion, then proceed to the umbilical, hypogas-tric and the inguino-ovarian regions. The supra-umbilical portions are pal-pated with the finger-tips pointing upward, the median parts with thefinger-tips pressing backward toward the vertebral column, and the infra- 36 A TREATISE ON MINOR SURGICAL GYNECOLOGY. umbilical regions with the tips pointing downward into the pelvic region after region is expl
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Keywords: ., bookcentury1800, bookdecade1880, bookpubli, booksubjectgynecology
