THE ABDOMEN 7»9 



wall on the one hand and the superior and anterior surfaces of the 

 liver on the other. Its base, which is free, extends from the um- 

 bilicus to the interlobar notch of the liver, and contains between 

 its two layers the obliterated umbilical vein or round ligament. 

 The line of attachment of the ligament to the anterior and superior 

 surfaces of the liver map the organ out into a right and left lobe, 

 and along tliis line the two layers of the ligament separate from each 

 other, the right layer extending over the right lobe and the left qver 

 the left lobe. Near the postero-superior border of the liver the two 

 layers of the ligament diverge somewhat abruptly, and leave between 

 them a small triangular area which is destitute of peritoneum. 

 Thereafter they become continuous, on either side, with the superior 

 layer of the coronary ligament. 



The coronary ligament is also known as the posterior ligament. 

 It is composed of two layers of peritoneum, superior and inferior, 

 which are attached to the postero-superior and postero- inferior 

 borders of the liver on the one hand, and the diaphragm on the other. 

 These layers are separated from each other by an interval, which 

 corresponds with the uncovered area of the right lobe of the liver. 

 The superior layer is continuous with the falciform ligament, and 

 the inferior layer is continuous with the peritoneum which covers 

 the inferior vena cava and the fiont of the right kidney. 



The right and left lateral or triangular ligaments are situated at 

 the extreme right and ^left ends of the coronary ligament, and 

 are formed by the meeting, at these points, of the two layers of that 

 ligament. 



The round ligament of the liver, though not a peritoneal ligament, 

 may here be described. It is a fibrous cord formed by the obliterated 

 umbilical vein, and is contained \\ithin the base of the falciform 

 ligament between the umbilicus and the interlobar notch of the liver, 

 its course between these points being upwards, backwards, and to 

 the right. At the interlobar notch it enters the umbilical fissure 

 on the inferior surface of the liver, and terminates by joining the 

 left branch of the vena portae. 



A minute portion of the lumen of the left umbilical vein remains pervious 

 within the round Ugament of the Uver. This per\'ious portion communicates 

 at the portal fissure of the liver with the left division of the portal vein, and 

 at the umbihcus it is connected with the epigastric veins of the anterior 

 abdominal wall. It thus forms a channel of communication between the 

 left division of the portal vein and the systemic veins of the anterior abdominal 

 wall. Through this pervious portion of the left umbiUcal vein the blood can 

 flow towards the umbihcus. The anastomosis thus estabhshed between the 

 left umbihcal vein and the epigastric veins of the anterior abdominal wall 

 explains the enlargement of the veins of the anterior abdominal wall in cases 

 of portal obstruction within the liver. 



A small portion of the right primitive umbiUcal vein near the umbilicus also 

 remams pervious, and this portion hkewise forms an anastomosis with the 

 epigastric veins of the anterior abdominal wall. 



On the surface of, or within, the round hgament of the Uver there are a few 

 very smaU veins, called parambilical veins. These anastomose at the um- 

 bihcus with the epigastric veins of the anterior abdominal wall, and superiorly 

 mey are connected with the left division of the portal vein. They are also 

 concerned in the enlargement of the veins of the anterior abdominal wall in 

 cases of portal obstruction within the Uver. 



