9i8 A MANUAL OF ANATOMY 



The portion of gut removed is to be cleansed by allowing water to flow 

 through it, and small portions are to be separated, inflated, and dried for 

 future inspection. These portions are to be taken from the following regions : 

 (i) the upper and lower ends of the jejunum ; (2) the upper end, and near the 

 lower end, of the ileum ; and (3) two pieces from the ascending colon. One 

 of these pieces, from the small intestine, is to be dissected in the inflated and 

 moist condition, in order to show the longitudinal and circular muscular fibres. 

 One of the pieces from the ascending colon, when inflated, should also be 

 dissected in the moist condition. 



The sacculated appearance and the three muscular taeniae having been 

 noted, the peritoneum is to be carefully removed, and the arrangement of 

 the muscular fibres studied. Thereafter the three taeniae are to be divided, and 

 the elongation which then takes place in the wall of the gut is to be observed. 



The small intestine is to be opened along the mesenteric border by 

 means of a pair of scissors, one of the points of which has been guarded with 

 a piece of cork. The gut is then to be spread out upon a board, and the 

 characters of the mucous membrane are to be studied. A small portion should 

 be examined under water with the aid of an ordinary lens, which will make 

 clear the villi. With the exception of the caecum and the first 2 inches of the 

 ascending colon, the large intestine is to be treated in a similar manner. 

 The cscum and 2 inches of the ascending colon, along with the last 2 inches 

 of the ileum, are to be treated in a different manner. The bowel is to be 

 filled with water from the colic end, the ileal end being left free. It will then 

 be seen that, in distension of the caecum, no water escapes into the ileum, 

 thus demonstrating the action of the ileo-caecal valve. The exact attachment 

 of the base of the vermiform appendix should be noted, and the meso-appendix 

 should receive attention. The caecum and colon are then to be laid open along 

 the right wall, or that opposite the ileum, and the ileo-caecal valve is to be 

 studied. The opening of the vermiform appendix should be examined, and 

 the valve of Gerlach, guarding it, noted. The extent to which the appendix is 

 pervious should also be attended to. 



It is advisable that the dissectors should associate themselves with the dis- 

 sectors of another abdomen, in order that the caecum and parts of the ascending 

 colon and ileum from one abdomen may be inflated and dried, so as to allow 

 of the ileo-caecal valve being examined in the dried state. 



The intestines having been studied, the dissector is to cut away the 

 remainder of the mesentery proper, leaving only small portions of the superior 

 mesenteric vessels, as well as of the inferior mesenteric vein, for future refer- 

 ence. A blow-pipe having been introduced into the small portion of the 

 jejunum which has been left, the duodenum and stomach are to be moderately 

 inflated, and the stomach is to be turned upwards. When this has been done, 

 the position and connections of the duodenum are to be studied, the musculus 

 suspensorius duodeni is to be shown passing between the duodeno-jejunal 

 flexure and the left crus of the diaphragm, and the peritoneal fossae in this 

 region are to be revised. The position and connections of the pancreas are 

 next to receive attention, followed by the spleen and the liver. 



The blood-supply of the foregoing viscera should be shown bj' displa^dng 

 the coeliac axis without injuring the important plexus of nerves which sur- 

 rounds it. The axis will be found appearing at the superior border of the 

 pancreas, where it breaks up into gastric, splenic, and hepatic branches, 

 which are to be followed out in the order named. The gastric artery will be 

 seen to pass upwards and to the left behind the small cavity of the peritoneum, 

 and it is to be followed out. The splenic artery is recognised by taking a 

 tortuous course to the left along the superior border of the pancreas, and its 

 pancreatic, left gastro-epiploic, vasa brevia, and proper splenic branches are 

 all to be shown. The hepatic artery is next to be dissected as far as the 

 portal fissure of the liver. In displaying the vessel in front of the foramen of 

 Winslow, opportunity is to be taken to show the common bile-duct descending 

 on its right side, and the vena porta; ascending behind the two. The follow- 

 ing branches are to be shown arising from the hepatic artery, all of which are 

 to be followed out: (i) pyloric; (2) gastro-duodenal, dividing into superior 



