Identifier: diseasesofkidney01kell (find matches)
Title: Diseases of the kidneys, ureters and bladder, with special reference to the diseases of women
Year: 1922 (1920s)
Authors: Kelly, Howard A. (Howard Atwood), 1858-1943 Brödel, Max, 1870-1941 Burnam, Curtis Field, 1877-
Subjects:
Publisher: New York, London : D. Appleton and company

View Book Page: Book Viewer
About This Book: Catalog Entry
View All Images: All Images From Book
Click here to view book online to see this illustration in context in a browseable online version of this book.

Text Appearing Before Image:
. This serves in the first place to measure the size of the external urethral orifice,which is the only portion ofthe urethra that offers anyresistance to the introduc-tion of the vesical specu-lum. Often the urethra»measures 10 mm. in diam-eter or more in women whohave borne children. Inthis case no dilatation isnecessary. In a urethra,however, which measures 8or 9 mm., if the calibratorAvhich has been lubricatedwith glycerin is gentlypushed inward with a littletwisting motion, a dilata-tion up to 10 mm. is easilyeffected within one or twoseconds of time. If theurethra is a very small one,measuring only 6 or 7 mm.,the dilatation need not beso great. In young womenwe have been able to examine the bladder and catheterize the ureters through aspeculum only 6 mm. in diameter. The instrument and its method of use arewell shown in Fig. 121. The patient should be put on a bed with a board under the mattress, or ona table of such a height that when she is kneeling in the knee-breast posture
Text Appearing After Image:
Fig. 124.—Use of Calibrator in Knee-breastPosture. Upper figure shows caUbrator, one-halfnatural size. The calibrator is also used as a dilatorin most cases. INSPECTION. 253 the urethral orifice is about opposite the face of the examiner seated in achair. To this end a table about two feet in hei£>ht is used. The operatortakes his phice wliile the ))ntiont is in ))osition witli vortical thighs and backarched in and elbows s))read out and face turned to one side. The bladderhas been emptied by catheterization. He now deftly lifts up the buttocks nearthe posterior vaginal orifice and lets air into the vagina, dropping the anteriorwall of the vagina with the bladder wall on a level with the plane of vision(Fig. 125). The room is darkened by pulling down the shades, or an undjrellamay be held over the head of the examiner to shut out the light. The speculumis now gTasped between the thumb and first two fingers, pushing in the obturatorwith the handle turned down. It is then cni-ricd

Note About Images