La chirurgie abdominale . Les ligaments larges, carryingthese et le péritoine en continuité avec elle. Les ligaments ronds,considérablement augmentée et élon-gated, descendre dans l'ante-vant des plis de la liga large-ment en lignes droites fromtheir insertion à la cornuato les anneaux internes. No-où vont-ils descendre. bord pelvien accueilli Ils ont peut-être considéré comme instrumen-tal en augmentant le peritoneumfrom les fosses iliaques. Les artères sont beaucoup en-larged - le plus l'ovaire,en proportion, de l'uter-ine. L'artère utérine est elevatedso isstraightened, et qu'il est, en partie, removedfrom la paroi pelvienne. Il

• Contributeur: The Reading Room / Alamy Banque D'Images
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Abdominal surgery . the broad ligaments, carryingthese and the peritoneum continuous with it. The round ligaments, greatly enlarged and elon-gated, descend in the ante-rior folds of the broad liga-ments in straight lines fromtheir insertion at the cornuato the internal rings. No-where do they descend belowthe pelvic brim. They maybe considered as instrumen-tal in raising the peritoneumfrom the iliac fossae. The arteries are much en-larged — the ovarian more, in proportion, than the uter-ine. The uterine artery isstraightened, and is elevatedso that it is, in part, removedfrom the pelvic wall. Itsrelations to the ureter arenot much changed. Theovarian artery, after itreaches the bifurcation ofthe iliac runs upwards andforwards to the elevated cor-nu in the posterior border ofthe expanded upper portion of the broad ligament. The relations of the ureters are, in one of these operations, exceedingly important. They are, at full term, detached fromthe pelvic wall and elevated along with the vagina and bladder.. Outline drawing from dried preparation of uterus near termination of first stageof labour. (Bristol Infirmary Museum.) ut., uterus; v., vagina; b!, , bladder; r., rectum; d.p., Douglas pouch; ;/;•., ureter;dotted line at level of external os ; .r, at line ofincision through vagina in Laparo-Elytrotomy.Shading is placed on the areas closely investedby peritoneum. 234 CESAREAN SECTION. They lie very closely to the vagina on its antero-lateral aspects^and strike the bladder about three-quarters of an inch below thecervico-vaginal junction. These relations are not much changedduring labour. As the head descends and fills the parturientcanal, the ureters are pushed apart. They now lie in closecontact with the vaginal and uterine walls, amongst the plexusof vessels. The relation of ureter to external os at the end ofthe first stage of labour—that is to say, at the most importantsurgical period—is shown in the accompanying diagram, madefrom a special dissection. (Fig.

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• bookcentury1800
• bookdecade1880
• bookpublisherlondo
• bookyear1887