Title: Cunningham's Text-book of anatomy
Identifier: cunninghamstextb00cunn (find matches)
Year: 1914 (1910s)
Authors: Cunningham, D. J. (Daniel John), 1850-1909; Robinson, Arthur, b. 1862, ed
Subjects: Anatomy
Publisher: New York, W. Wood
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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1432 SUEFACE AND SUKGICAL ANATOMY. part of which is dilated to form the ampulla. The transverse folds of the rectum or valves of Houston, three in number, project into the cavity of the bowel in the form of prominent crescentic shelves, which are produced by the three permanent or true flexures into which the rectum is thrown (Birmingham); the inferior valve, which may be sufficiently prominent to impede the passage of the finger, must not be mistaken for a pathological condition. Through the anterior wall the finger can palpate from below up- wards the bulb of the urethra, the membranous part of the urethra, the bulbo-urethral glands (when inflamed and enlarged), the apex and lateral lobes of the prostate, the vesiculae seminales, and the external trigone of the bladder. With the left forefinger in the rectum, an instrument passed into the bladder can be distinctly felt as it traverses the mem- Posterior superior spine Upper lateral inflexion Peritoneum (pararectal fossa) Superior hemorrhoidal artery Rectum Sacro-tuberous ligament Ischio-rectal fossa Anal canal
Text Appearing After Image:
B "1 \^ Third sacral vertebra Fourth sacral vertebra (cut) §â 1 Inferior border of piriformis (cut) Superior hemorrhoidal artery- Lateral inflexion Coccygeus Levator ani External sphincter Fig. 1108.âThe Eectum from behind. The sacrum has been sawn across through the 4th sacral vertebra, and its inferior part'removed with the coccyx. The posterior portions of the coccygei, levatores ani, and of the external sphincter have been cut away. The "pinching in " of the inferior end of the rectum by the medial edges of the levatores ani, resulting in the formation of the flattened anal canal, is suggested in the illustration, which has been made from a formalin-hardened male body, aged thirty. The lateral inflections of the rectum, corresponding to Houston s rectal valves, are also shown. (From Birmingham.) branous urethra; as it lies in the prostatic urethra it is separated from the finger by the prostate. Hence, when a, false passage is made through the bulbous or membranous portion of the urethra, the instrument, if pushed onwards towards the bladder, will be felt immediately outside the rectum between it and the prostate. In the child, owing to the rudimentary condition of the prostate, the instrument is distinctly felt close to the rectum, as it lies in the prostatic as well as in the membranous portion of the urethra. When the prostate is not enlarged the tip of the finger can just reach the external trigone, which is most distinctly felt when the bladder is full. The vesiculse seminales, indistinctly felt when healthy, may be readily palpated when enlarged and indurated from disease. Through the lateral wall of the rectum may be palpated the ischio-rectal fossa, the bony wall of the pelvis minor, and, when enlarged, the hypogastric lymph glands; through the posterior Avail the hollow of the sacrum and coccyx, and the lymph glands lying in the retro- rectal cellular tissue.

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