BLADDER. 111 
of the tubules and Bowman’s capsules, due probably to occlusion of 
the tubules. 
In adult life there may be one or more cysts which do not seem to 
interfere with the function of the kidney. In chronic diffuse nephritis 
there may be an occlusion of the tubules and a production of cystlike 
cavities. 
What is a peri-nephritis ? 
The loose tissue surrounding the kidney may become the seat of’ an 
exudative inflammation. Primarily it may occur from exposure to 
cold or from great muscular éxertion ; secondarily, from the extension 
of exudative inflammation in its vicinity. The kidney may be com- 
pressed by the abscess, or may become the seat of a suppurative 
inflammation. 
What tumors have been seen in the kidney and pelvis of the 
kidney ? 
Fibromata, lipomata, papillomata, adenomata, angiomata, myxo- 
sarcomata, myomata, lymphomata, sarcomata and carcinomata. 
BLADDER. 
Give changes in size and position of the bladder with causes. 
The bladder may be the seat of a general dilatation from an accumu- 
lation of urine due to obstruction, or the dilatation may occur in 
circumscribed spots producing diverticula. The walls of these di- 
verticula may include all the layers of the bladderwall, or may consist 
of the mucous membrane alone which has protruded between the bun- 
dles of muscle fibres. The bladderwall may be thickened by mechan- 
ical obstruction to the outflow of urine. Hernia of the bladder may 
accompany intestinal hernia, or, as in the female, may press upon the 
vaginal wall, causing a protrusion (vaginal cystocele). 
What disturbances of circulation may occur in the bladder ? 
There may be a chronic hyperzemia due to an obstructed venous 
circulation, or there may be hemorrhages caused by pressure or by the 
presence of calculi or tumors, or there may be small hemorrhages into 
the mucous membrane of the bladder. 
Classify the different forms of inflammation as occurring in the 
bladder. 
Acute cystitis. 
Chronic cystitis. 
