THE ABDOMEN 731 



Lymphatic Vpssels of Descending, Iliac, and Pelvi Colon. — The 



lymphatics of the descending colon terminate in two ways, as 

 follows : those of the upper part pass to the meso-colic glands, 

 whilst those of the lower part join the left lymphatic trunk from the 

 median lumbar glands. The lymphatics of the iliac and pelvic colon 

 also join the left hnnphatic trunk from the median Itmibar glands. 



Lymphatic Glands of Large Intestine (colic glands). — These 

 glands are arranged in groups, named according to the portion of 

 intestine to which they are related, and they are situated behind the 

 respective parts, except those belonging to the transverse colon 

 which lie between the two layers of the transverse meso-colon, and 

 are known as the meso-colic glands. 



Position and Connections of the Duodenum. — The duodemmi is 

 the first part of the small intestine. It measures from 10 to 11 

 inches in length, and is the widest and least movable part. It 

 extends from the pylorus to the left side of the body of the second 

 lumbar vertebra, where it ends in the jejimtun. It describes a 

 somewhat U-shaped cur\'e with the concavity directed upwards 

 and to the left in close adaptation to the head of the pancreas. 

 It is devoid of a mesentery, and is divided into three parts, first, 

 second, and third. 



First or Superior Part. — ^The first part extends from the pylorus 

 to the right side of the neck of the gall-bladder. It lies in the epi- 

 gastric region, and is about 2 inches in length, its direction being 

 upwards, backwards, and to the right when the stomach is empty, 

 but directly backwards when that organ is distended. The gastro- 

 hepatic omentum furnishes a complete covering to about the first 

 inch, and the remainder is covered by peritoneum only in front. 

 The first part is therefore comparatively movable. 



Relations — Superior and Anterior.— The quadrate lobe of the 

 liver and the gall-bladder. Posterior. — ^The vena portae, gastro- 

 duodenal artery, common bile-duct, and neck of the pancreas. 

 Inferior. — ^The head of the pancreas. The first part lies below the 

 foramen of Winslow. 



Second or Descending Part. — This part extends from the right side 

 of the neck of the gall-bladder to the right side of the body of the third 

 (sometimes fourth) lumbar vertebra. It lies at first in the epigastric, 

 and subsequently in the umbilical, region ; its length is from 3 to 4 

 inches, and its direction is almost vertically downwards behind the 

 right extremity of the transverse colon. The anterior surface is 

 covered by peritoneum, except opposite the transverse colon. If 

 there is no transverse meso-colon at this point, there is a distinct 

 strip near the centre left uncovered and connected to the colon 

 by areolar tissue. If, however, there is a transverse meso-colon 

 present at this point, the bare area is trifling. The posterior surface 

 is destitute of peritoneum. The second part is therefore very 

 immovable. 



Relations — Anterior. — From above downwards the gall-bladder 

 near its neck, the right extremity of the transverse colon, and some 

 coils of the small intestine. Posterior. — ^The anterior sm-face of the 

 right kidney near the hilwn, and the inferior vena cava. Right. — 



