Gynaecology for students and practitioners . osition shown inFig. 75 is more convenient and occasions less distress than the other. The body of the uterus is first to be identified, and it is naturallyfirst sought in its normal position of anteversion. The uterus usuallylies roughly in the obstetric axis of the pelvic cavity. In thin subjectsit will be readily felt in this position ; if not found at once, the vaginal VAGINAL EXAMINATION 121 finger should be used to push up the uterus towards the abdominalwall ; this is much more effectual than attempting forcibly to over-come the resistance of
Gynaecology for students and practitioners . osition shown inFig. 75 is more convenient and occasions less distress than the other. The body of the uterus is first to be identified, and it is naturallyfirst sought in its normal position of anteversion. The uterus usuallylies roughly in the obstetric axis of the pelvic cavity. In thin subjectsit will be readily felt in this position ; if not found at once, the vaginal VAGINAL EXAMINATION 121 finger should be used to push up the uterus towards the abdominalwall ; this is much more effectual than attempting forcibly to over-come the resistance of the powerful abdominal muscles, by pressurewith the external hand. When the body of the uterus is thus heldbetween the fingers of the two hands, it is possible to determine itsposition, size, shape, consistence, and mobility ; minor points alsoto be noted are sensitiveness to pressure, and pain provoked by move-ment. It is by no means easy to make a satisfactory bimanualexamination of a retroverted uterus without first pushing it up to the. Fig. 75. Method op making the Bibianual ExAMnsrATiON, the examinerstanding at the side of the couch. (From a photograph.) level of the pelvic brim, and this can sometimes be done more effectu-ally jper rectuTYi than jper vaginam. The uterine appendages should be identified next, and these arefound by bimanual examination of the lateral fornices. In thosesubjects who have lax abdominal walls, and who tolerate the exami-nation without difficulty, three structures may be made a thin cord which can be rolled between the fingers repre-sents the round ligament ; behind this is a softer, cylindrical structure—the Fallopian tube ; tracing the latter outwards, the ovary maybe felt in its usual position, close to the lateral pelvic wall : itwill be recognized by its round or oval shape, soft consistence, andready mobility, slipping easily between the fingers of the two the ovary cannot be felt in its normal position, it
Size: 1846px × 1354px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1910, booksubjectgynecology, bookyear1
