160 



NORMAL ANATOMY OF THE LIVER. 



De generatione animalium, Lond. 1651. Glisson, 

 De vita naturali, Lond. 1672. Stahl, De vita, 

 Halle, 1701. De Gorter, De actione viventium 

 particular;, Amstel. 1748. Hoffman, Dissertatio 

 vitae animalis, Halle, 1731. Bonnet, sur les corps 

 organises, Amst. 1776. Brown, Elementa medi- 

 cine, Edinb. 1780. Priestley, On matter and spirit, 

 Birm. 1782. Hunter, On the animal economy, 

 Lond. 1786. Darwin, Zoonomia, Lond. 1794. Cu- 

 vier, Le9ons d' anat. comp., Paris, 1799. Bichat, 

 Sur la vie et la mort, Paris, 1802. Oken, Abriss 

 <les Systems der Biologic, Goett. 1805. Wolff, 

 Ideen iiber Lebenskraft, Altona, 1806. Abcrnethy, 

 On Hunter's Theory of Life, Lond. 1814. Law- 

 rence, Lectures on physiology, &c. Lond. 1816. 

 Philip, On the laws of the vital functions, Lond. 

 1817. Pring, On the laws of organic life, Lond. 

 1819. Barclay, On life and organisation, Edinb. 

 1822. Good, Study of medicine, Lond. 1825. 

 Prichard, On the vital principle, Lond. 1829. Bell, 

 Bridgwater treatise, Lond. 1833. Prout, Bridg- 

 water treatise, Lond. 1834. Roberton, On life and 

 mind, Lond. 1836. Clark, Report on physiology to 

 Brit. Assoc. 1834. Reil, Von der Lebenskraft, in 

 Archiv. I. B. 



( W. B. Carpenter.) 



LIVER, NORMAL ANATOMY. Syn. Gr. 

 }7ra; Lat. jecur, hepar ; Fran, foie; Germ. 

 Lel/er ; Ital. fegato. The liver is a conglo- 

 merate gland of large size, appended to the 

 alimentary canal, and performing the double 

 office of separating certain impurities from the 

 venous blood of the chylopoietic viscera, pre- 

 viously to its return into the general circulation, 

 and of secreting a fluid necessary to digestion 

 the bile. 



It is situated in the abdomen, in the right 

 hypochondriac region, and extends across the 

 epigastrium into the left hypochondriac region. 

 Superiorly it ascends to a level with the sixth 

 or seventh rib, diminishing the cavity of the 

 chest on the right side, and inferiorly it ap- 

 proaches by its anterior border, the lower mar- 

 gin of the thorax. 



The general form of the liver is flattened, 

 being broad and thick towards the right ex- 

 tremity, and narrow and thin towards the left. 

 Glisson compared its shape to the segment of 

 an ovoid cut obliquely in the direction of its 

 length, and Dr. Alexander Monro to the hoof 

 of an ox rounded superiorly. Its superior 

 surface is convex ; the inferior irregularly con- 

 cave ; the posterior border is thick and rounded, 

 and the anterior thin and sharp. 



Its position in the abdomen is oblique, the 

 convex surface, in the erect posture of the body, 

 being directed upwards and forwards, and the 

 concave downwards and backwards. The broad 

 border is posterior and superior, and the thin 

 margin anterior and inferior. If the trunk be 

 inclined forwards the free edge of the liver 

 may be felt, extending below the margin of the 

 thorax. 



It is in relation by its convex surface, su- 

 periorly with the diaphragm, which separates it 

 from the under surface of the right lung and 

 from the heart ; anteriorly with the diaphragm 

 and transversalis muscle, and with the sheath 

 of the rectus and linea alba at the epigastrium ; 

 and on the right side with the diaphragm and 

 transversalis muscle, which are interposed be- 

 tween it and the seven or eight lower ribs. 

 Its inferior or concave surface is in relation 



with the anterior aspect of the stomach, the 

 ascending portion of the duodenum, the trans- 

 verse colon, the right supra-renal capsule, and 

 the right kidney, and sometimes by its left 

 extremity with the upper end of the spleen. 

 The posterior border rests against the dia- 

 phragm, which intervenes between it and the 

 vertebral column, and is in contact with the 

 inferior vena cava, oesophagus, and right pneu- 

 mogastric nerve. The anterior border is free 

 and in relation with the transversalis muscle, 

 which separates it from the cartilages of the 

 lower ribs, with the round ligament at the 

 notch, and with the sheath of the rectus and 

 linea alba at the epigastrium. 



The liver is retained in its place by duplica- 

 tures of peritoneum which pass between its 

 convex surface and posterior border and the 

 diaphragm, and by a fibrous cord which 

 crosses from the linea alba to the inferior vena 

 cava. These are the ligaments of the liver ; 

 they are five in number, the broad, the two 

 lateral, the coronary, and the round ligament. 



Fig. 32. 



The upper or convex surface of the liver. 



No 1, the right lobe ; 2, the left lobe ; 3, a part 

 of the lobus Spigelii seen projecting beyond its 

 posterior border ; 4, 4, the anterior or narrow 

 border ; 5, the notch in the anterior border that 

 gives passage to the round ligament 12 ; 6, 6, the 

 posterior or rounded border; 7, the broad liga- 

 ment; 8, the left lateral ligament; 9, the right 

 lateral ligament ; 10, the point of separation 

 of the layers of the right lateral ligament to in- 

 close the oval space, 11, 11 ; 12, the round liga- 

 ment; 13, the fundus of the gall-bladder pro- 

 jecting beyond the anterior margin of the liver. 

 The notch upon the anterior margin corresponding 

 with the gall-bladder is also seen ; 14, the inferior 

 vena cava emerging from the liver in the centre ot 

 the oval space of the coronary ligament. The 

 small vessels seen ramifying upon the surface of 

 the organ are superficial lymphatics. 



The broad ligament, (Jig. 32, 7) (falci- 

 form, longitudinal, 1. latum, 1. suspensorium 

 hepatis) is an antero-posterior duplicature of 

 peritoneum which extends from the notch on 

 the anterior margin of the liver to the superior 

 part of its posterior border. It is broad in 

 front where it incloses the round ligament, and 

 becomes narrow as it passes backwards ; hence 

 its synonym, falciform. It serves to connect 

 the convex surface of the liver with the linea 

 alba and diaphragm. 



The literal ligaments (fig. 32, 8, 9) 



