71 8 A MANUAL OF ANATOMY 



peritoneum which is derived from the left or inferior layer of the 

 mesentery proper near the terminal part of the ileum. It is 

 triangulai, and usually lies obliquely. Its right end reaches in a 

 pointed manner to the ileo-caecal junction, and its left end forms a 

 concave free border which transmits the appendicular vessels and 

 sympathetic plexus of nerves. It seldom extends for more than 

 half or two-thirds along the appendix, which is thus rendered more 

 or less convoluted or serpentine. It may, however, extend along 

 its entire length. In some cases it lies vertically, and then it loses 

 its hold upon the mesentery proper, its attachment being transferred 

 to the caecum, or right fascia iliaca, or even to the back of the 

 ascending colon. The base of the appendix is sometimes destitute 

 of a mesentery, in which cases that portion of it is closely connected 

 to the posterior aspect of the caecum. Occasionally the entire 

 meso-appendix is awanting, and then the appendix is found adhering 

 to the back of the caecum. The meso-appendix may present a small 

 opening through which a portion of bowel may pass and become 

 strangulated. In very rare cases the meso-appendix is disposed in 

 such a manner as to divide the ileo-caecal fossa into an upper and 

 a lower compartment. 



The transverse meso-colon is a broad fold of peritoneum which 

 extends between the transverse colon and the posterior abdominat 

 wall at the anterior border of the pancreas. Its layers contain 

 between them the middle colic vessels, sympathetic nerves, and 

 the lymphatics of the transverse colon. Mesenteric holes may be 

 present in the transverse meso-colon, under which circumstances a 

 meso-colic hernia may occur. 



The pelvic meso-colon is a fold of peritoneum which attaches 

 the pelvic colon to the front of the sacrum. It extends from the 

 inner border of the left psoas magnus (covered by the left fascia 

 iliaca) near the left sacro-iliac articulation to the front of the third 

 sacral vertebra, and its length is such as to render the pelvic colon 

 freely movable. Its line of attachment posteriorly extends obliquely 

 from left to right, and it is composed of two layers disposed laterally, 

 and containing between them the superior hemorrhoidal vessels, 

 sympathetic nerves, lymphatic vessels, and a certain amount 

 of fat. 



The ascending colon, descending colon, and iliac colon are each, 

 in normal circumstances, devoid of a mesentery. Occasionally, 

 however, an ascending meso-colon, a descending meso-colon, and 

 an iliac meso-colon are present. 



Peritoneal Ligaments — Ligaments of the Liver. — The peritoneal 

 ligaments of the liver are four in number (the round ligament not 

 being regarded as of a peritoneal nature), and they are as follows : 

 the falciform ligament, the coronary ligament, the right lateral 

 ligament, and the left lateral ligament. 



The falciform ligament is also known as the ligamentum latum 

 and suspensory ligament. It extends between the inferior surface 

 of the diaphragm and the posterior surface of the anterior abdominal 



