File:Aseptic surgical technique, with especial reference to gynæcological operations (1916) (14754433726).jpg

Identifier: asepticsurgic00robb (find matches)
Title: Aseptic surgical technique, with especial reference to gynæcological operations
Year: 1916 (1910s)
Authors: Robb, Hunter, 1863- (from old catalog)
Subjects: Surgery, Aseptic and antiseptic. (from old catalog) Women
Publisher: Philadelphia, J. B. Lippincott company
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

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condition ofthe structures when making an examination undercomplete anaesthesia, for often that which at firstseems to be an unusual condition of the pelvic organsis found, after a more thorough examination, to benormal. For these reasons anaesthetics which actquickly and have but a transitory effect should not beused. The position of the patient is of great importance.During the examination she should lie across themattress or on a table, so that the buttocks rest onone edge, the legs being separated and flexed on thethighs, which are in turn flexed on the abdomen. Inthis position the abdominal walls are well relaxed. Ifit is impossible to have the legs supported by assist-ants, the leg-holder can be employed. After the patienthas been placed in position, a sheet is arranged overthe lower extremities so that they are covered. (PlateXIX.) The external genitalia are first inspected.It is best to adopt a certain order in the examina-tion. Beginning with the vagina, and passing thence H
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■ J METHODS OF EXAMINATION. 215 to the cervix, one next endeavors to palpate the uterusand its appendages, and afterwards the ureters. Theurine having been drawn off with a sterile glass cathe-ter, the index finger or, more commonly, the indexand the middle finger, previously anointed with vase-line, are introduced just within the vulva, and weendeavor to ascertain whether any laceration or cica-tricial tissue exists at the orifice or along the vaginalwall. The hand is then turned so that the palmarsurfaces of the examining fingers come in contactwith the anterior vaginal wall. The lateral walls andfornices are next examined, and the existence in thevagina of any viscid or abnormal secretion is noted.We next come to the cervix, and note (1) the positionwhich it occupies with relation to the axis of the va-gina; (2) its shape and consistence, whether it is coni-cal or flattened, soft or hard; (3) whether it is lacer-ated, and the extent of such lacerations if they exist;(4) whether t

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