Gynecological diagnosis and pathology . nob,or beyond it. finger of the right hand is placed in the vagina on the anterior lip of thecervix and the sound, held in the left hand with its curvature directedbackwards, is introduced for one inch into the cervix. Should the uterusbe to the front, the handle of the sound is now swept round in a widecurve, and then carried backwards towards the perineum so that thepoint, following the uterine curvature, passes into the uterus. If theuterus is turned backwards, the handle is carried forwards towards thepubes without rotation. With the patient in the d
Gynecological diagnosis and pathology . nob,or beyond it. finger of the right hand is placed in the vagina on the anterior lip of thecervix and the sound, held in the left hand with its curvature directedbackwards, is introduced for one inch into the cervix. Should the uterusbe to the front, the handle of the sound is now swept round in a widecurve, and then carried backwards towards the perineum so that thepoint, following the uterine curvature, passes into the uterus. If theuterus is turned backwards, the handle is carried forwards towards thepubes without rotation. With the patient in the dorsal posture, thesound is introduced between the patients thighs, the left hand which holds DILATATION OF THE CERVIX 25 ii being carried over the abdomen, while the guiding finger is passed intothe vagina underneath the drawn-upright leg. 7. Dilatation of the Cervix with Curettage.—Dilatation of thecervix is another method of examination which we owe to Sir J. The sponge tent was the parent of the safer metal dilator born. Fig. 16.—Bimanual Examination combined with the Sound.—(A. E. Simpson.)The Sound is used to define the uterine cavity so that the fingers of the externalhand may determine the exact position of the fundus. This is specially usefulwhen, from the presence of small fibroids or pelvic deposits, there is doubt as towhat is the fundus uteri. of the aseptic principle. Graduated metal bougies are better than anexpanding metal dilator, which is more liable to tear tissues. The idea ofdilatation is to bring the uterine cavity within reach either of the fingeror of the curette, which, aided by the microscope, demonstrates thecondition of the mucosa. For Dilatation anaesthesia is necessary. The patient is placed in the 26 GYNECOLOGICAL DIAGNOSIS lithotomy posture, the Sims speculum introduced, the cervix drawn downand steadied by volsella. After douching the cervix the dilators areintroduced, care being taken that they follow exactly the curvature of th
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectgynecology, bookyear1
