File:Anatomy, descriptive and surgical (electronic resource) (1860) (14784893063).jpg

Identifier: b20386424 (find matches)
Title: Anatomy, descriptive and surgical (electronic resource)
Year: 1860 (1860s)
Authors: Gray, Henry, 1825-1861 Carter, H. V., ill Westmacott, John Guise, Dr, ill
Subjects: Anatomy
Publisher: London : J.W. Parker
Contributing Library: Wellcome Library
Digitizing Sponsor: Wellcome Library

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bladder; the staff having beenwithdrawn, and the position of the stone determined upon, the forceps are intro-duced over the finger into the bladder. If the stone is very large, the oppositeside of the prostate should be notched before the forceps is introduced; the fingeris now withdrawn, the blades of the forceps opened, and made to grasp the stone,which must be extracted by slow and cautious undulating movements. Parts divided in the operation. The various structures divided in this operationare as follows: the integument, superficial fascia, external hfemorrhoidal vesselsand nerve, the posterior fibres of the Accelerator urinai, the Transversus perinaaimuscle and artery, (and, probably, the superficial perinasal vessels and nerves), thedeep perineeal fascia, the anterior fibres of the Levator ani, part of the Compressorurethrse, the membranous and prostatic portions of the urethra, and part of theprostate gland. 394.—A Transverse Section of the Pelvis; shewing the Pelvic Fascia.
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Parts to be avoided in the operation. In making the necessary incisions in theperinaeum 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 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 forward, the artery of thebulb may be divided; if carried too far backwards, the entire breadth of the PELVIC FASCIA. 753 prostate and neck of the bladder may be cut through, which allows of infiltrationof urine behind the pelvic fascia into the loose cellular tissue between the bladderand rectum, instead of escaping externally; diffuse inflammation is consequentlyset up, and peritonitis from the close proximity of the recto-vesical peritoneal foldis the consequence. If, on the contrary, the prostate is divided in front of thebase of the gla

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