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348 THE PERITONEUM. 



fThe large end of the stomach, with the spleen 

 I and narrow extremity of the pancreas, the 

 ^ . , p ' splenic fiexiire of the colon, and the upper 



hypocaondnac, lett . . ^ ^^^^^ ^^ ^^^ ^^^^ kidney with' the left supra- 

 renal capsule. Sometimes also a joart of 

 the left lobe of the liver. 



iPart of the omentum and mesentery, the 

 transverse jiart of the colon, lower part of 

 the duodenum, with some convolutions of 

 the jejunum and ileum. 

 . , ^ The ascending colon, lower half of the kidney, 



Lumbar, riglit . . . . -^ ^^^ ^^^^^ ^^ ^^^ duodenum and jejunum. 



„ \ The descending colon and lower part of the 



Lumbar, lett . . . . j ^^^^ kidney, with part of the jejunum. 



( The convolutions of the ileum, the bladder in 



Ey|30gastric childi-en. and, if distended, in adults also ; 



( the uterus when in the gravid state. 

 . . \ The ca3cum, with the api^endix vermifonnis, 



Iliac, right I ^^^ ^j^g termmation of the ileum. 



Iliac, left The sigmoid flexure of the colon. 



THE PERITONEUM. 



The peritoneum or serous membrane of the abdominal cavity is by 

 far the most extensive and complicated of the serons membranes. Like 

 the others it may be considered to form a shut sac, on the outside of 

 ■which are placed the viscera which it coders. • In the female, however, 

 the two Fallopian tubes open at their free extremities into the cavity 

 of the peritoneum. The internal surface is free, smooth, and moist. 

 The external or attached surface adheres partly to the parietes of the 

 abdomen and pelvis, and partly to the outer surface of tlie viscera 

 situated within them. The pariefal portion is connected with the 

 fascia lining the abdomen and pelvis by means of a layer of areolar 

 tissue, distinct from the abdominal fascia3, and named the suhpcritoneal 

 layer ; it is more firmly adlierent along the middle line of the body in 

 front, as well as to the under surface of the diaphragm. The visceral 

 portion, which is thinner than the other, affords a more or less complete 

 covering to most of the abdominal and pelvic organs. 



TJie folds of the peritoneum are of various kinds. Some of them, 

 constituting the mesenteries, connect certain portions of the intestinal 

 canal with the posterior wall of the abdomen ; they are, the mesentery 

 properly so called for the jejunum and ileum, the meso-cfficum, trans- 

 verse and sigmoid meso-colon, and the meso-rectum. Other duplica- 

 tures exist, which are called omenta; they are the great omentum or 

 epiploon, the small omentum, and the gastro-splenic omentum. Lastly, 

 certain reflexions of the peritoneum from the walls of the abdomen or 

 pelvis to viscera which are not portions of the intestinal canal, are 

 named ligaments: such are the ligaments of the liver, spleen, uterus, and 

 bladder. 



These folds or ligaments will be specially described with the viscera 

 witli which they are connected. 



Like other serous membranes the peritoneum is continuous through- 

 out its whole extent, and its continuity may be traced from any one 

 point to any other near or distant ; but the description of this will 

 be most readily understood after an account has been given of the 

 several viscera to which the membrane is related. 



