File:Operative surgery, for students and practitioners (1913) (14779400982).jpg

Identifier: operativesurgery1913mcgr (find matches)
Title: Operative surgery, for students and practitioners
Year: 1913 (1910s)
Authors: McGrath, John J. (John Joseph), b. 1866
Subjects: Surgery, Operative
Publisher: Philadelphia, Davis
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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When thebladder is distended it reaches above the symphysis and is then inrelation, in front, with the anterior abdominal wall. Passing from the summit of the bladder to the umbilicus is theurachus, which occasionally remains patent after birth. The peritoneum covers the sides, part of the posterior surfaces,and the summit of the bladder, but does not cover its anterior surface,being reflected from the summit of the bladder over on to the poste-rior surface of the anterior abdominal wall. When the bladder is SURGICAL ANATOMY OF THE BLADDER. 673 well distended, it rises upward into the al)domen; its summit, as itapproaches the umbilicus, carries the peritoneum with it and its ante-rior surface, which is devoid of peritoneum, then comes into relationwith the abdominal wall; so that under these circumstances the blad-der may be entered through an incision in the anterior abdominalwall, low down, close to the symph3^sis, without molesting the peri-toneum or entering the peritoneal cavity.
Text Appearing After Image:
Fig. .305.—An Antero-posterior Section Showing Relations of the Peritoneumto the Bladder, etc. Bladder moderately distended. P., prostate gland sur-rounding commencement of the urethra (neck of the bladder), course of theejaculatory duct; T.S., vesiculse seminales. The higher the bladder ascends into the abdomen, the larger thearea of its anterior, non-peritoneal surface which is presented foroperation. The Interior of the Bladder.—In the contracted state thewall of the bladder is seen to be very thick, and the cavity is prac-tically obliterated, the walls being almost in direct contact with eachother. The mucous lining of the bladder is but loosely connected 43 674 URINARY SYSTEM. with the muscular coat by a loose^ elastic, submucous layer, alnd inthe contracted state is thrown into numerous folds and rugse. Thefloor of the bladder presents a triangular area which is smooth, devoidof rugae, and which is more firmly attached to the muscular coat.This smooth, triangular area is cal

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