SMALL INTESTINE. 



301 



Small 

 intestine : 



extent and 

 divisions. 



Duodenum 



beginning, 



to be fully- 

 seen later. 



column, which the late Professor Birmingham aptly called "the 

 stomach bed." 



The SMALL INTESTINE reaches from the stomach to the right iliac 

 region, where it ends in the large intestine. It is arbitrarily divided 

 into three parts, duodenum, jejunum, and ileum. 



The duodenum comprises the first nine or ten inches of the small 

 intestine (fig. 112, J to 4 , p. 305). By raising the liver it may be traced 

 from the pylori c end of the stomach, at first backwards and then 

 downwards, until it disappears beneath the transverse colon. If the 

 great omentum, with the attached transverse colon, be turned up over and ending 

 the margin of the thorax, and the mass of small intestine be drawn 

 to the right, the lower end of the duodenum will be seen on the 

 left of the spine. It here ascends for a short distance, and at the 

 level of the second lumbar vertebra passes into the jejunum, forming 

 a sharp bend forwards and downwards ; the duodeno- jejunal fle'jmre. 

 The relations of the duodenum cannot, however, be satisfactorily 

 seen at present, and 

 will be examined later 

 (p. 327). 



The jejunum and 

 ileum include the re- 

 mainder of the small 

 intestine, two-fifths be- 

 longing to the jejunum 

 and three-fifths to the 

 ileum, but there is no 

 natural division be- 

 tween them. This part 

 of the intestinal tube 

 forms many convolu- 

 tions in the umbilical, 

 hypogastric, left lum- 

 bar, and iliac regions 



of the abdomen ; and it descends commonly, but more extensively in 

 the female, into the cavity of the pelvis. In front of the convolu- 

 tions is the great omentum; behind, they are fixed to the spine by a relations; 

 large fold of peritoneum containing the-vessels and nerves, and named 

 the mesentery. The termination of the ileum is more fixed than the 

 rest ; it ascends slightly from the pelvis to the right iliac fossa, 

 crossing the external iliac vessels and the psoas muscle, to open into 

 the large intestine just below the intersection of the intertubercular 

 and right lateral lines, as marked on the surface of the. body. 



The LARGE INTESTINE or COLON (fig. Ill) is more fixed than 

 the jejunum and ileum, from which it is to be distinguished by 

 its sacculated appearance, and by its being furnished with small 

 processes of peritoneum containing fat the appendices epiploUcce. 

 It begins in the right iliac region in a rounded part or head 

 (caecum), and ascends to the liver through the right iliac and lumbar 

 regions. Then crossing the abdomen below the stomach, it reaches 



IT'S V?* 



situation ; 



110. THE STOMACH OF A CHILD. 



end of 

 ileum. 



Surface 



marking. 



Large 

 intestine : 

 how dis- 

 tinguished 



