416 



APPLIED ANATOMY. 



appendix ; its tip may be anywhere. It can be enucleated from its root out to its tip. 

 A ligature is to be placed around the meso-appendix because the appendicular artery, 

 especially its recurrent branch, may bleed quite freely. The root of the appendix 

 may sometimes be at, instead of below, the ileocsecal junction. The small intestine 

 and caecum almost always overlie the appendix. 



THE COLON. 



The ascending colon lies in contact with the anterior abdominal wall from its 

 lower end to above the iliac crest ; here it dips down to lie on the kidney and 

 form the hepatic flexure above (Fig. 427). At this point some of the coils of the 

 small intestine may lie in front of the hepatic flexure, between the beginning of the 

 transverse colon above and the ending of the ascending colon below. The ascend- 



Transverse colon 



Colica media artery 



Appendices epiploicae 



Superior mesenteric 

 artery 



Colica dextra artery 



Hepatic flexu 



Cut edge of 

 mesentery. 



Ascending colon. 



Cfecurn 1 

 Ileoc.-Ecal junction-^ 



Base of appendix. 



L Splenic flexure 



Colica sinistra artery 



1 



PIG. 427. View of the interior of the abdomen; the mesentery has been cut, the small intestines removed, and 

 the transverse colon turned upward. The pelvic colon and iliac colon together form the sigmoid flexure. 



ing colon lies on the quadratus lumborum muscle and kidney behind and has the psoas 

 to its inner side. It has no mesentery or peritoneum on its posterior surface in 64 

 per cent, of the cases (Treves) and in tumors of the kidney it may be pushed forward 

 and across their anterior surface. This is a point to be remembered in diagnosis. 



The transverse colon passes diagonally up and to the left across the abdo- 

 men. It starts at the hepatic flexure on the under surface of the liver to the outer 

 side of the gall-bladder. It runs parallel with the lower edge of the liver and stom- 

 ach and its lower border may reach nearly or quite to the level of the umbilicus. 

 The great omentum passes over the transverse colon, so that to see the latter it is 

 necessary to raise the omentum and look on its under surface. The omentum as it 



