330 DISSECTION OF THE ABDOMEN. 



anterior Its anterior surface is for the most part concave, corresponding to 



urface, tne sumach . ] 3U t a t its upper border, in front of the vertebral 

 column, it forms a projection (omental tuber osity, His) opposite the 

 small curvature and lesser omentum. 



inferior, Its inferior surface is in contact with the duodeno-jejunal flexure 



and coils of the jejunum, as well as sometimes at its left extremity 

 with the splenic flexure of the colon. 



posterior. Its posterior surface rests on the vena cava, the termination of the 

 right renal vein, the aorta, the solar plexus, the pillars of the 

 diaphragm, the left kidney, and the lower part of the left suprarenal 

 body with the renal and suprarenal vessels. The splenic vein and 

 the beginning of the vena portse lie also behind it, and are often 

 somewhat embedded in its substance. 



Relations to Projecting above the pancreas, where it crosses the aorta, is the 

 cosliac axis, from which the splenic artery runs to the left along the 

 upper border (fig. 123) ; while on the right side the hepatic artery 

 and the first part of the duodenum lie above it. At the lower border 

 is the third part of the duodenum ; and the superior mesenteric 

 vessels emerge between the two, usually passing in front of a portion 

 of pancreatic substance (lesser pancreas) (fig. 122) which extends more 

 or less over the front of the fourth part of the duodenum, occasionally 

 even reaching into the root of the mesentery. 



The common bile-duct lies between the duodenum and the head of 

 the pancreas for a short distance behind, and will be traced out later. 



THE STOMACH BED (FIG. 122). 



With the stomach lifted well up and the parts behind it exposed, 

 the student will realise the character of the hollow in which it lies 



Stomach to the left of the vertebral column. The floor of the stomach bed 

 (Birmingham) is formed (1) internally by the diaphragm covering the 

 vertebral column and (2), further outwards and above, by the gastric 

 surface of the spleen. Below this is (3) a portion of the left supra- 

 renal body resting against the crus of the diaphragm, and, it may be, 

 (4) a small part of the left kidney above the pancreas (tig. 121). 

 Below these is (5) the gastric surface of the pancreas, which, in 

 passing to its prominent anterior border, forms the commencement of 

 a shelf supporting the stomach below ; arid the shelf is completed by 

 (6) the transverse meso-colon passing forwards and downwards from 

 the anterior border of the pancreas to (7) the transverse colon. This 

 shelf is itself supported by the small intestines below the transverse 

 meso-colon. 



Variations The shape of the body of the pancreas is much determined by the 



in the shape J J 



and position pressure oi the stomach above and that of the small intestines below. 



pancreas. When the stomach is low and distended the pancreas becomes 

 flattened out and pushed down on the left kidney. On the contrary, 

 when the stomach is high up and the small intestines distended, 

 the pancreas becomes pushed up and its anterior border more 

 prominent. 



