Landmarks, medical and surgical / by Luther Holden.

  • Luther Holden
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: Landmarks, medical and surgical / by Luther Holden. Source: Wellcome Collection.

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    89. Spermatic cord.—The spermatic cord can be felt as it emerges through the external ring, and its course can be tracked into the scrotum. Thevas deferens can be distinctly felt at the back of the cord, and separated from its other component parts. 90. Spig-astric artery The direction of the deep epigastric artery corresponds with a line drawn from the inner border of the internal ring up the middle of the rectus muscle, towards the chest. 91. Abdominal viscera.—Now let us see how far we can make out externally the position and size of the abdominal viscera. To make this examination with anything like success, it is desirable to relax the abdominal muscles. The man should be on his back, the head, shoulders and thorax being well raised, to relax the recti muscles ; and the thighs bent on the abdomen, to relax the several fasciae attached to the crural arch. To induce complete relaxation, where a very careful examination is desired, chloroform should be given. In manipulating the abdomen we should not use the tips of the fingers. This is sure to excite the contraction of the muscles. The flat hand should be gently pressed upon it, and with an undulating movement. 92. It is well to bear in mind that the central tendon of the diaphragm is about the level of the lower end of the sternum at its junction with the seventh costal cartilage ; that the right half of the diaphragm rises to about the level of the fifth rib—that is, about an inch below the nipple; that the left half does not rise quite so high. In tranquil breathing the diaphragm descends about half an inch. The position of the abdominal viscera varies, to a certain extent, in different persons. The space occupied by the stomach naturally varies in the same person at different times. Let us take, first, the largest of the abdominal viscera— the liver. 93. Liver.—The liver lies under the right hypochondrium, and passes across the middle line over the stomach into the left hypochondrium, generally speaking, as far as the left