File:The diagnosis and treatment of diseases of women (1907) (14597924687).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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f it. When thickened, theappendix is felt as a small tender roll, deeply placed. Fig. 153. Another method of palpating the Appendix.Beginning near the umbilicus, the fingers are carried indeeply and then brought slowly outward toward theanterior superior iliac spine. As the appendix passesunder the examining fingers, it is felt as a small rollbetween the fingers and the posterior abdominal wall. TENDERNESS IN ABDOMEN. For the purpose of studying the significance of tenderness in the abdomen, it isconvenient to divide thecavity as previously explained,into nine regions: the right,left, and central portions of the lower abdomen; the right, left and central por-tions of the upper abdomen; the central portion of the abdomen (umbilicalregion); and the right and left lumbar regions (Fig. 30). In any of these, a local tenderness takes on particular significance. Again, there are certain diseases that cause a diffuse tenderness, extendingthroughout the whole abdomen. 138 GYNECOLOGIC DIAGNOSIS
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Fig. 154. Indicating the site to search for Tenderness of tlie RightUreter. This may be found anywhere from the point indicated tosome distance inside the circle, towards the umbilicus. Tenderness in Right Lower Abdomen (Fig. 147). Tubal or Ovarian orBroad Ligament Disease (inflammation, tumor,extrauterine pregnan-cy). The tenderness ismost marked low inthe side near Poupartsligament (tubo-ovarianregion, Figs. 148, 149).It does not ordinarilyextend to the appen-dix region though itmay, in exceptionalcases, involve both re-gions. A mass may befelt on vagino-abdom-inal palpation betweenthe uterus and the pel-vic wall. There is ahistory of uterine andpelvic inflammation orother pelvic disturb-ance. Appendicitis. Tenderness ismost marked at about the middleof a line drawn from the rightiliac spine to the umbilicus(McBurneys point. Figs. 150,151). By sinking the fingers deeply into the abdomen near the um-bilicus and then carrying themoutward toward the iliac spine,the appendix may often b

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