Manual of gynecology . peritoneum to bladder during parturition (Braune). a, vagina; d, bladder; c, anus. toneum ; the second part is only partially covered, , the peritoneumgradually leaves the rectum, quitting first the posterior surface, then thesides, and finally passing from the anterior surface on to the posteriorvaginal wall as already described. Over the bladder and anterior abdominal wall the peritoneum is easilyseparable. According to Spiegelberg, above the os internum uteri pos-teriorly it is closely blended with the uterus, below this quite loosely. Practical Points.—In no oper
Manual of gynecology . peritoneum to bladder during parturition (Braune). a, vagina; d, bladder; c, anus. toneum ; the second part is only partially covered, , the peritoneumgradually leaves the rectum, quitting first the posterior surface, then thesides, and finally passing from the anterior surface on to the posteriorvaginal wall as already described. Over the bladder and anterior abdominal wall the peritoneum is easilyseparable. According to Spiegelberg, above the os internum uteri pos-teriorly it is closely blended with the uterus, below this quite loosely. Practical Points.—In no operative procedure involving the anteriorvaginal wall can the peritoneal cavity be opened into. In the upper thirdor so of the posterior vaginal wall the peritoneum may be opened has indeed been done by the most skilful operators, but the risks at- u MANUAL OF GYNECOLOGY. tending it are not so considerable as usually alleged, especially whendrainage-tubes are employed. When the fingers are passed into the pos-. Fig. 44. Relation of bladder and peritoneum when bladder is distended (Pirogoff). a, vagina; 6, uterus; c, anus; d, bladder; e, symphysis. terior fornix vaginae, only about ?£ inch of tissue intervenes between themand the peritoneum. The possibility of there being a deep dip of the peri-toneum, as shown at Fig. 41, should not be forgotten. CONNECTIVE TISSUE OF PELVIS. By this we understand (I.) the Fascia described so elaborately by thehuman anatomist as the Pelvic Fascia ; and (II.) the loose ConnectiveTissue padding the interstices between the muscles, lying round the cervixuteri and spreading out beneath the Pelvic Peritoneum. I. The Pelvic Fascia of the anatomist is carefully described in theordinary systematic and dissecting-room manuals, to which the student istherefore referred. IT. The loose connective tissue found lying subperitoneally, surround-ing the cervix uteri and spreading out between the layers of the broadligament, is of the highest importance
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Keywords: ., bookcentury1800, bookdecade1, booksubjectgynecology, bookyear1883
