1722 



HTMAX AX ATOMY. 



On the under side of the liver the end of the round ligament lies in its fissure cov- 

 ered by a slight fold of peritoneum. The same is true of the gall-bladder. Some- 

 times the latter is more or less surrounded, and it may be almost completely so, 

 hanging from the fossa by a fold. The lesser or gastro-hcpatic amentum is a fold 

 enclosing the vessels in the portal fissure and passing to the lesser curvature of the 

 stomach and the first part of the duodenum. A secondary fold containing the 

 cystic duct, the duodena-cystic fold, joins it on the right. Near this it presents a 

 free border forming the edge of the foramen of Winslow. On the left it runs along 

 the fissure of the ductus venosus to the notch in the liver made by the passage of 

 the oesophagus. There its left layer is reflected as the under one of the left coro- 

 nary ligament, while the 1 right layer descends along the left of the vena cava to join 

 the right inferior coronary ligament. The posterior surface of the Spigelian lobe is 

 covered with 'peritoneum which is almost surrounded by these lines of attachment, 

 but is continuous, by means of the caudate lobe, with the serous coat of the under 

 surface of the right lobe. Thus a pocket is roofed in behind the lobe of Spigelius. 



FIG. 1457. 



Pericardial fat 



IV rib 



Cavity of__ 

 pericardium 



V rib- 



-Inferior vena 

 cava 



VI rib 





IX rib 



Major a/ygos vein 



X thoracic vertebra 



Transverse section at level of tenth thoracic vertebra, upper surface of diaphragm exposed, showing relation of 

 vi>ivra ; outline of liver ; of stomach, ; of colon, o oooo; of spleen, x x x x x. 



The hepatic duct lies within the lesser omentum to the right and in front of the 

 portal vein. It is joined by the cystic duct in its fold, already mentioned. As it 

 waves the gall-bladder, the duodeno-cystic fold is a distinct duplicature which joins 

 tlu- lesser omentum at an angle ; but at the lower part, where the cystic duct opens 

 into tin- hepatic, the folds become one. The common bile-duct may be in the very 

 lowest part of the lesser omentum, where it is attached to the postero-inner surface 

 of the duodenum where the first part bends down to become the second ; but the 

 relations are variable, and the common duct may have no peritoneal relation. 



Position of the Liver. The relations to other organs have been treated in 

 the account of the surfaces. The relations to the walls of the abdomen can be 

 gi\en only in general, owing to the variations of both the organ and the thorax in 

 si/.- and shape. The liver lies under the dome of the diaphragm, which separates 

 it from the ribs, n, casionallv it extends across the whole breadth of the abdomen, 

 but the left lobe may end at the left mammary line. The highest point is on the 



