In sheep this examination requires special care.
Examination of the internal urinary organs must be made through the rectum. It should be undertaken slowly and gently. In the male the hand detects the condition of the organs contained within the pelvic cavity, the fulness or emptiness of the bladder, or the existence of calculi within it. More deeply seated can be felt the entire length of the right ureter; its state of dilatation can be felt, and the existence of diverticula of inflammation, if any, can be ascertained. The left ureter cannot readily be examined, on account of the position of the rectum, except as regards the posterior part, close to the bladder and the rumen.
Fig. 226.—Genito-urinary organs in the male (pelvic cavity exposed). Cp, Peritoneal cavity (posterior cul-de-sac); Vs, vesicula seminalis; R, rectum; U, ureter; Ip, line of insertion of the peritoneum; Cd, vas deferens; V, bladder; Agt, testicular artery; Ci, inguinal canal; P, penis; Cv, neck of the bladder; Ic, accelerator urinæ muscle; Gc, prostate gland.
In the abdominal cavity the rectum, or rather the floating colon, turns to the right, in such a way that, in spite of the shortness of the meso-rectum and meso-colon, the hand can be passed as far as the right kidney. It is, then, easy to discover whether this organ is sensitive to pressure, hypertrophied, atrophied, cystic, etc. The paunch interferes with examination on the left side.
Fig. 227.—Relations of the abdominal organs in the female. RR, rectum; D, duodenum; P, pancreas; Rd, right kidney; FF′F″, liver; Di, diaphragm (showing the extent to which the diaphragm projects upwards); Fe, omasum; Id, line of insertion of the diaphragm; C, abomasum; Vb, gall bladder; U, gravid uterus; I, small intestine.
In females the ureters and kidneys can be examined in the same way, but the bladder and the canal of the urethra must be reached through the vagina. About 2 or 2¼ inches from the vulva on the floor of the vagina is the entrance to the urethra, covered with a special valve. The meatus becomes visible by separating the lips of the vulva and the vaginal walls. For this purpose a speculum ad hoc can advantageously be used. It is clear that if it is thought desirable to examine the bladder through the rectum, which is not absolutely impossible, the vagina will be interposed between the arm and the urinary organs, and the sensations experienced will, therefore, be much less clearly defined (Fig. 226).
In passing a catheter for the purpose of emptying the bladder the end of the sound should be introduced under the valve of the meatus. By slightly lowering the back end of the sound, the front end is lifted above the cul-de-sac, and the operator at the same time pushes gently forwards. It is then only necessary to lift the hand, and the sound passes readily into the urethra and the bladder.
Examination of the urine and even chemical analysis are of great importance in diagnosing diseases of the urinary tract.