. Essentials of gynecology, arranged in the form of questions and answers prepared especially for students of medicine ... Brewers Speculum. its introduction in nulliparae is painful. It is sometimes used forintroducing gauze packing into the vagina. How would you introduce a Fergusson speculum ? In this country the Fergusson speculum is usually employed withthe patient in the dorsal position. 54 ESSENTIALS OF GYNAECOLOGY, Separate the labia with the iingers of tlie left hand ; holding thetrumpet-shaped with the right hand, introduce thebeveled extremity into the vaginal orifice, ha
. Essentials of gynecology, arranged in the form of questions and answers prepared especially for students of medicine ... Brewers Speculum. its introduction in nulliparae is painful. It is sometimes used forintroducing gauze packing into the vagina. How would you introduce a Fergusson speculum ? In this country the Fergusson speculum is usually employed withthe patient in the dorsal position. 54 ESSENTIALS OF GYNAECOLOGY, Separate the labia with the iingers of tlie left hand ; holding thetrumpet-shaped with the right hand, introduce thebeveled extremity into the vaginal orifice, having the shorter sideanterior ; depress well the perineum, directing the speculum towardthe hollow of the sacrum; by slight vertical, horizontal or rotatorymotion of the speculum while looking into it, the cervix is nowusually brought into view without difficulty. It is occasionallyconvenient to draw the cervix more fulh into view bj^ means of atenaculum. Some gynaecologists use the Fergusson speculum with the i)atientin Sims position. Fig. 9*.. Kellys speculum ready for introduction (a); b. speculum with obturator removed. What is one of the best examples of a bivalve speculum ?Describe it. The Brewer bivalve (see Fig. 9) is probably the best speculumof its class; it consists of two blades, the outer extremities beingtnimpet-shaped where they are jointed ; the anterior blade is shorterthan the posterior, and has a slot in its outer half, to avoid pressureon the urethra ; this also facilitates the introduction of the sound orprobe. The speculum is opened by approximating the handles ofthe blades and held there by a thumb-screw. There are two sizesof Brewers speculum, the long and short. INSTRUMENTS—SPECULA. 55 How would you introduce a Brewer speculum ? Place patient in dorsal position; pass speculum into vaginai orificewith the blades lateral, then rotate till are antero-posterior;begin to open blades just before they reach the cervix; when com-pletely open, hold with
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