File:Anatomy, descriptive and surgical (1877) (14579136557).jpg

Identifier: anatomydescripti1877gray (find matches)
Title: Anatomy, descriptive and surgical
Year: 1877 (1870s)
Authors: Gray, Henry, 1825-1861 Holmes, Timothy, 1825-1907
Subjects: Anatomy Human anatomy
Publisher: (London : Longmans, Green)
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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and tlie position of the stone ascer-tained, the forceps is introduced over the finger into the bladder. If the stoneis very large, the opposite side of the prostate may be notched before the forcepsis introduced : the finger is now withdrawn, and the blades of the forceps openedand made to grasp the stone, which must be extracted by slow and cautions un-dulating movements. Parts divided in the operation. The various structures divided in this operationare as follows :—the integument, superficial fascia, external hasmorrboidal vesselsand nerves, the posterior fibres of the Accelerator urinse, the Transversus perinasimuscle and artery (and, probably, the superficial perinseal vessels and nerves), thedeep perinseal fascia, the anterior fibres of the Levator ani, part of the Compressorurethrae, the membranous and prostatic portions of the urethra, and part of theprostate gland. 425.—A Transverse Section of the Pelvis, showing the Pelvic Fascia. ia^rcr Crural Aj I-.mo-rnl Iio„&
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OliuKatef Fasetn liUsn~tfil- pu^i<t Vessels & A Parts to he avoided in the Operation. In making the necessary incisions in theperinaBumi for the extraction of a calculus, the following parts should be avoided.The primary incisions should not be made too near the middle line, for fear ofwounding the bulb of the corpus spongiosum or the rectum; nor too far externally,otherwise the pudic artery may be implicated as it ascends along the inner borderof the pubic arch. If the incisions are carried too far forwards, the artery of thebulb may be divided ; if carried too far backwards, the entire breadth of theprostate and neck of the bladder may be cut through, which allows the urine tobecome infiltrated behind the pelvic fascia into the loose cellular tissue betweenthe bladder and rectum, instead of escaping externally ; diffuse inflammation isconsequently set up, and peritonitis from the close proximity of the recto-vesicalperitoneal fold is the consequence. If, on the contraiy, the

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