The surgical anatomy of the principal regions of the human body / by Thomas Morton and William Cadge.

  • Morton, Thomas, 1813-1849.
Date:
1850
Catalogue details

Licence: Public Domain Mark

Credit: The surgical anatomy of the principal regions of the human body / by Thomas Morton and William Cadge. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    entia ; it is limited in front by the posterior edge of the prostate gland, and behind by the recto-vcsical cul-de-sac of the perito- nseum. On each side the ureters pierce the tunics of the blad- der obliquely, in their course to reach its interior. The base, in the adult subject, is the most depending portion of the bladder, and it is much more so in some subjects than in others ; so that it not unfrequently occurs that a calculus, espe- cially when of inconsiderable size, may lie so deeply here that it eludes for some time all the attempts of the surgeon to touch it with the sound. From the same circumstances also, some delay may be produced in seizing the stone with the forceps in the operation of lithotomy, as it cannot be reached with the finger. It is of importance to be observed, that the triangular space through which the point of the trocar can be safely introduced into the bladder, when it is punctured from the rectum, is ex- ceedingly limited in its extent; as the cul-de-sac of the perito- naeum frequently descends between the vesiculse seminales much nearer towards the posterior edge of the prostate gland than is commonly supposed from the usual descriptions which are given of it in books. The neck of the bladder (cervix vesicae) is that part of it which is surrounded by the prostate gland ; as it comprises within its limits the greater part of the trigone vesical, and is continuous anteriorly with the prostatic portion of the urethra. In infancy this is the lowest part of the bladder ; but, in the adult and old subject, the bas-fond most frequently lies upon a plane inferior to it. The neck of the bladder is cut in the lateral operation of lithotomy. The ligaments of the bladder are several in number, and admit of being divided into two classes, the true and the false ligaments. The first of these consist of the anterior and lateral ligaments, formed by the pelvic fascia, as already described. The urachus and the ligamentous remains of the hypogastric arteries also serve the purpose of ligaments by connecting the summit of the bladder to the umbilicus ; while inferiorly the membranous portion of the urethra, with the dense sheath which it receives from the pelvic fascia covering the prostate gland, firmly fix its base behind the arch of the pubes. The latter class, or the false ligaments, are formed by the peri- tonscum where it is reflected on each side from the posterior sur-