APPLIED ANATOMY. 



region, and an inflamed gall-bladder being directly beneath caused pain to be experi- 

 enced 'at McBurney's point. This condition is liable to be mistaken for appendicitis. 

 The fissures of the liver are best understood by examining its under surface, 

 where they can be seen arranged in the form of the letter H. They are as follows: ( i ) 

 The umbilical fissure, running from the umbilical notch on the anterior edge to the left 

 end of the portal (transverse) fissure; it contains the round ligament. (2) Iks fissure 

 of the ductus venosus, running upward from the left end of the portal fissure be- 

 tween the left and Spigelian lobes; it contains the remains of the fetal ductus venosus. 



Right lateral ligament 



Right lobe 



Left lateral or triangular 

 ligament 



Left lobe 



Falciform ligament 

 Round ligament 



Fissure of the gall-bladder 

 FIG. 428. View of the anterior and upper surfaces of the liver. 



(3) The fissiire of the gall-bladder, separating the quadrate from the right lobe and 

 ending at the right extremity of the portal fissure; in it lies the gall-bladder. (4) 

 The fissure of the vena cava, between the Spigelian and right lobes, lodging the vena 

 cava. (5) The portal fissure, this forms the transverse bar of the H. Its left end 

 receives the umbilical and ductus venosus fissures and its right end the fissures of the 

 gall-bladder and vena cava. It contains the portal vein, hepatic artery, hepatic duct, 

 nerves, and lymphatics; attached to its sides is the lesser or gastrohepatic omen turn. 

 The portal fissure is also called the transverse fissure, and the name longitudinal 



Vena cava 



Caudate lobe of process 



Spigelian lobe 



Left lobe 



Gastric impression 

 Fissure of the ductus venosus 



Portal vein 



Hepatic artery 



Umbilical fissure 



Round ligament 



Coronary ligament 

 Right lobe 



Renal impression 

 Duodenal impression 



olic impression 



Portal fissure 



Quadrate lobe 



Gall-bladder 

 FIG. 429. View of the posterior and inferior surfaces of the liver. 



fissure is sometimes applied to the combined umbilical and ductus venosus fissures. 

 (In the recent anatomical nomenclature these fissures are called fossa?.) (Fig. 429.) 

 The ligaments of the liver are five in number: (i) the coronary, (2) the 

 triangular, (3) the falciform, (4) the round, and (5) the ligament of the ductus 

 venosus. The coronary ligament surrounds the posterior surface which is not 

 covered by peritoneum. It is 4 to 6 cm. (i^ to 2^ in.) wide and extends from 

 the vena cava 7.5 to 10 cm. (3 to 4 in.) to the right, terminating in a pointed 

 end which has been called the right lateral ligament. The triangular ligament, also 



