Rectal Palpation 93 



ate the urine. The small or extra-small Albrechtsen uterine 

 catheter answers the purpose satisfactorily. 



Sometimes great care is necessary in order to avoid con- 

 fusion on account of the bladder. It may give the impression 

 at first of the distended pregnant uterus, and the examiner, 

 off his guard, may fall into a very embarrassing error. His 

 safety is assured only by the clear recognition of the cervix 

 and uterus. When the urinary bladder is empty, it forms a 

 flattened, pear-shaped body, palpable beneath the cervix, 

 about three to four inches long, rather firm in consistency, 

 and finely irregular, due to the wrinkling of the mucosa and 

 contracted muscle bands. Then follows every gradation in 

 size, up to four or more quarts of contents, when the dis- 

 tended organ may fall over the pubic brim and hang down in 

 the abdomen. 



The cervix is recognizable by palpation as a very firm, al- 

 most cartilaginous, cylindrical organ, three to six inches 

 long, and one to three or four inches in diameter. In heifers 

 it is very small and firm, usually about three to three and 

 one-half inches long, and one to one and one-half inches in 

 diameter. With age, and yet more with disease, it increases 

 in all its diameters. In health, owing to the amplitude of its 

 broad ligaments, the organ may be picked up per rectum, 

 and virtually its entire circumference freely palpated. In 

 disease, it may be adherent in varying degrees and difficult 

 of clear identification. Behind, the cervix is continued by 

 the flaccid, empty vagina. Sometimes the inexperienced 

 practitioner may be confused on account of the ballooned 

 vagina, which has already been mentioned. The cervix is 

 then pushed forward by the ballooning and the operator 

 feels beneath the rectum, filling more or less completely the 

 pelvic cavity, a moderately tense, inflated sac, which he may 

 at first mistake for the urinary bladder or be otherwise mis- 

 led. Traction upon the cervix with the forceps pushes the 

 air out through the vulva, or it may be readily evacuated by 

 gentle pressure from the rectum. 



a. The Uterus. Forward, the cervix ends in the usually 

 somewhat broader and markedly softer uterine body. In 



