Gynecological diagnosis . can stand up and make his inspection, palpa-tion, percussion, and mensuration when in a position comfortableto himself; not, as in the case where the patient is on a low bed orcouch, with bent back and strained muscles, conditions which arenot conducive to most careful investigation. The patient on atable is comfortable enough for the brief time required for theexamination. All the patients clothing has been loosened and the corsets 64 INSPECTION OF THE ABDOMEN 65 removed, as previously described. The sheet covers the legs,thighs, and pubic region. The raised skirts c
Gynecological diagnosis . can stand up and make his inspection, palpa-tion, percussion, and mensuration when in a position comfortableto himself; not, as in the case where the patient is on a low bed orcouch, with bent back and strained muscles, conditions which arenot conducive to most careful investigation. The patient on atable is comfortable enough for the brief time required for theexamination. All the patients clothing has been loosened and the corsets 64 INSPECTION OF THE ABDOMEN 65 removed, as previously described. The sheet covers the legs,thighs, and pubic region. The raised skirts cover the chest, or,if the skirts have been removed, another sheet is used for this pur-pose. To investigate the abdomen to the best advantage the patientshead should be raised a little on a pillow and the thighs should beslightly flexed. Too much flexing of the thighs or raising the headand thorax high will decrease the portion of the abdomen availablefor examination. For purposes of description the abdomen may be divided. Margin of ribs B Crest of ilium Fig. Spine of pubes 18.—The Abdomen Divided into Quadrantsand the Bony Landmarks Indicated. arbitrarily into four regions, by two lines, one a vertical line pass-ing through the ensiform cartilage, the umbilicus, and the symphysispubis, and the other passing through the umbilicus at right anglesto the vertical line. The four regions so made may be called theright upper quadrant, the right lower quadrant, the left upperquadrant, and the left lower quadrant. On observing the abdomen one notices symmetry or asymmetry,distention or retraction, increased or diminished motion of theabdominal walls on respiration, and the appearance of the 66 PHYSICAL EXAMINATION To detect symmetry, stand at the foot of the examining table andlook at the abdomen from below. Tumors of the ovary as well astumors of the kidney are apt to cause asymmetrical enlargementof the abdomen; whereas, tumors of the uterus and ascites morecommonly produce
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectwomen, bookyear1910
