PERITONEUM REFLECTIONS. 



491 



In the inferior zone is the lower part of the omentum and small in- 

 testines, the cascum, ascending and descending colon with the sigmoid 

 flexure, and ureters. 



The smooth and polished surface, which the viscera and parietes 

 of the abdomen present, is due to the peritoneum which should in 

 the next place be studied. 



PERITONEUM. 



The Peritoneum (irsjwsi'vew to extend around) is a serous membrane, 



and therefore a shut sac : a 



i ,- x ^i Fig. 148.* 



single exception exists m the 



human subject to this character, 

 viz. in the female, where the 

 peritoneum is perforated by the 

 open extremities of the Fallo- 

 pian tubes, and is continuous 

 with their mucous lining. 



The simplest idea that can be 

 given of a serous membrane, 

 which may apply equally to all, 

 is, that it invests the viscus or 

 viscera, and is then reflected 

 upon the parietes of the contain- 

 ing cavity. If the cavity con- 

 tain only a single viscus, the 

 consideration of the serous 

 membrane is extremely simple. 

 But in the abdomen, where 

 there are a number of viscera, 

 the serous membrane passes 

 from one to the other until it 

 has invested the whole, before 

 it is reflected on the parietes. 

 Hence its reflections are a little 

 more complicated. 



In tracing the reflections of 

 the peritoneum in the middle 



* The reflections of the peritoneum. D. The diaphragm. L. The liver. S. The stomach. 

 C. The Iransverse colon. D. The transverse duodenum. P. The pancreas. I. The 

 small intestines. R. The rectum. B. The urinary bladder. 1. The anterior layer of 

 the peritoneum, lining- the under surface of the diaphragm. 2. The posterior layer. 

 3. The two layers passing to the posterior border of the liver, and forming the coronary 

 ligament. 4. The lesser omentum : the two layers passing from the under surface of 

 the liver to the lesser curve of the stomach. 5. The two layers meeting at the greater 

 curve, then passing downwards and returning upon themselvas, forming (6) the greater 

 omentum. 7. The transverse meso-colon. 8. The posterior layer, traced upwards in 

 front of D, the transverse duodenum, and P, the pancreas, to become continuous with 

 the posterior layer $). 9. The foramen of Winslow ; the dotted line bounding this 

 foramen infcriorly, marks the course of the hepatic artery forwards, to enter between 

 the layers of the lesser omentum. 10. The mesentery encircling the small -intestine. 

 11. The recto-vesical fold, formed by the descending anterior layer. 12. The anterior 

 layer traced upwards upon the internal surface of the abdominal parietes to the layer. 

 (1), with which the examination commenced. 



