File:Diseases of the kidneys, ureters and bladder, with special reference to the diseases of women (1922) (14742844096).jpg

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Identifier: diseasesofkidney01kell (find matches)
Title: Diseases of the kidneys, ureters and bladder, with special reference to the diseases of women
Year: 1922 (1920s)
Authors: Kelly, Howard A. (Howard Atwood), 1858-1943 Brödel, Max, 1870-1941 Burnam, Curtis Field, 1877-
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Publisher: New York, London : D. Appleton and company

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l. Other measurements are madein the same way. A bladder with measurements decidedly below those givenis contracted. The method of measuring and measurements are shown in Figs.130, 131, 132. Examining the Interior of the Bladder.—The examination ofthe interior of the bladder ought now to proceed in an orderly manner, and toinclude the entire inner surface, namely, the posterior hemisphere, the ver-tex, the right and left lateral walls, the base, the trigonum, the area behind thesymphysis and around the urethra. Figs. 133, 131:, 135 show diagrammatically 256 EXAMINATION OF THE URINARY TRACT IN WOMEN. the various j^arts of the bladder to be inspected. Keeping the funnel-shaped ori-fice of the vesical speculum well within the larger circle of light reflected fromthe head-mirror, and occasionally touching the mirror to change its angleslightly, the walls of the bladder are at all times easily seen by means of thereflected light. The inspection is made by moving the speculum from side to
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Fig. 128.—Figure Showing Patient in Knee-breast Posture with Speculum FullyIntroduced. Note position of light, and head-mirror for illuminating bladder. side, or up and down, in such a way as to pass rapidly in survey the entiremucous surface of the posterior wall, although at any one time a surface but alittle larger than the end of the speculum is under observation. By moving thespeculum about a continual visual impression is made which is practicallyequivalent to seeing the entire vesical surface at a glance, much in the samemanner in which the eye roams about the room and secures accurate informationas to all its complements by passing from object to object. This is due tothe facility of persistence of vision. After viewing the posterior hemi-sphere in this manner the vertex is next inspected by turning the speculum INSPECTION. 257 from side to side, then the riglit hiteral wall, and, after this, the left lateral wall,turning the speculum a little moi-c decidedly to one side or

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