File:The diagnosis and treatment of diseases of women (1907) (14597836667).jpg

Identifier: diagnosistreatmecros (find matches)
Title: The diagnosis and treatment of diseases of women
Year: 1907 (1900s)
Authors: Crossen, Harry Sturgeon, 1869-
Subjects: Genital Diseases, Female Gynecology Gynecology Women Generative organs, Female
Publisher: St. Louis : Mosby
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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bdominal surface with the rib margins and the iliaccrests outlined. troublesome tension of the wall. As the examination proceeds, deep palpation ismade in various parts of the abdomen, in order to exclude disease in the variousregions. Palpation with both hands (Fig. 25) assists much in determining the char-acter and consistency of the tissues between them and under them, particularlywhen the abdomen is rather full. If a resisting area is found, work the fingersaround it, depressing the wall and examining all portions of it (Fig. 26). The pal-pation should always be made gently for if the manipulations cause pain or frighten 18 THE PHYSICAL EXAMINATION the patient, the wall is immediately made tense and then no satisfactory examina-tion is possible. Having determined the general tension and tenderness, search is made for localtenderness. The exact location of the tenderness should be carefully determined,and also whether it is circumscribed to that area or extends to other areas. When
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Fig. 22. Another abdominal surface, with the ribs and crests outlined.This patient is rather stout. Notice how much the land marks differ fromthose in Fig. 21. the area of tenderness has been accurately located, we know what organs are likelyto be affected, and the further differentiation between affections of those organsmay be proceeded with. Regions of the Abdomen. For convenience in designating the location of tender-ness or of a mass, the abdomen is divided into regions. There are many methods METHOD OF PALPATION 19 of division. A simple and useful one is the division of the surface into quad-rants, by an imaginary horizontal line passing through the umbilicus and a verticalline through the same point (Fig. 27). This is very convenient for designating in a general way the location of lar^e

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