File:An American text-book of genito-urinary diseases, syphilis and diseases of the skin (1898) (14780296024).jpg

Identifier: americantextbook00bang (find matches)
Title: An American text-book of genito-urinary diseases, syphilis and diseases of the skin
Year: 1898 (1890s)
Authors: Bangs, Lemuel Bolton, 1842-1914 Hardaway, W. A. (William Augustus), 1850-1923
Subjects: Urogenital System Urination Disorders Syphilis Skin Diseases
Publisher: Philadelphia, W. B. Saunders
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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Text Appearing Before Image:
ated with theallantois), while the. other end com-municates by a short tube with theprimitive intestine. The upper end,the remains of the upper part of theallantoic stalk, becomes obliteratedand constitutes the urachus. Thecanal which communicates with theprimitive intestine becomes the firstpart of the urethra. It is in con-nection with closure of the anteriorwall, the urachus, and the posteriorconnections of the primitive bladderthat the malformations of this organoccur. Exstrophy of the bladder isthe most important malformation.The general condition, exstrophy,implies a cleft in the anterior ab-dominal and vesical walls. There are,however, many degrees of this mal-formation. There may, in the firstplace, be a simple lack of union of the abdominal parietes, so that thebladder projects into the cleft. This is known as ectopia vesica urinaria: ;the bladder is normally formed, the defect is entirely in the abdom-inal wall. Another form is the absence of union of the pubic bones, 22 337
Text Appearing After Image:
Fig. 105.—Complete exstrophy of bladder, kid-neys suspended by ureters (Wistar Institute ofAnatomy, Univ. of Penn.). 338 DISEASES OF THE BLADDER. together with the cleft in the parietes just described. When the divisionaffects not only the parietes, but also the anterior wall of the bladder, thecondition of true exstrophy exists. When the cleft in the bladder is at thetop of the anterior wall and the symphysis is closed, the condition is termedfissura vesicae superior. When the cleft is in the lower anterior wall of thebladder, the symphysis pubis being normally united, the condition is namedfissura vesicae inferior. The third degree, eversio vesicae (Winckel), designatesthe condition in which there is a cleft in the parietes and the anteriorbladder-wall, together with lack of union of the symphysis pubis. Abovethe bladder there is often an area in the median line composed of connectivetissue, but not covered in by skin. With this malformation others are commonly associated : epispa

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