THE EXCRETORY APPARATUS OF THE LIVER 



1333 



collecting trunks. One group of deep collecting trunks accompanies the portal vein, there being 

 fifteen to eighteen of them emerging from the transverse fissure. They empty into the lymph 

 nodes of the hilum. Another group accompanies the hepatic veins. There are five or six 

 trunks which pass through the Diaphragm and terminate in the lymph nodes about the inferior 

 vena cava (intrathoracic nodes). The superficial trunks of the superior surface are divided 

 into posterior, anterior, and superior trunks. Some of the posterior trunks terminate in the 

 nodes about the cceliac axis, others in the nodes about the lower portion of the inferior vena cava 

 in the thorax; others in the nodes about the abdominal portion of the oesophagus. The anterior 

 trunks which are limited to the right lobe pass to the nodes of the hilum. The superior trunks 

 ascend in the suspensory ligament. Some pass to the nodes about the inferior vena cava, just 

 above the Diaphragm; others to the hepatic nodes. The balance unite to form a very large 

 trunk, which passes through the Diaphragm and divides into branches which enter the nodes 

 back of the base of the ensiform cartilage. 



The nerves of the liver are derived from the left vagus and sympathetic. The branches of the 

 left vagus ascend from in front of the stomach within the lesser omentum. The sympathetic nerves 

 pass along the hepatic artery, enter the liver at the transverse fissure, and accompany the vessels 

 and ducts to the interlobular spaces. Here, according to Korolkow, the myelinic fibres are dis- 

 tributed almost exclusively to the coats of the bloodvessels, while the amyelinic fibres enter the 

 lobules and ramify between the cells. 



The Excretory Apparatus of the Liver. 



The excretory apparatus of the liver consists of (1) the hepatic duct, formed, as 

 we have seen, by the junction of the two main ducts, which pass out of the liver 

 at the transverse fissure; (2) the gall-bladder, 

 which serves as a reservoir for the bile; (3) 

 the cystic duct, or the duct of the gall-blad- 

 der; and (4) the common bile duct, formed by 

 the junction of the hepatic and cystic ducts. 



The Hepatic Duct (ductus hepaticus) (Figs. 

 1078 and 1079). Two main trunks of nearly 

 equal size issue from the liver at the transverse 

 fissure, one from the right, the other from the 

 left lobe ; these unite to form the hepatic duct, 

 which then passes downward and to the right 

 for about an inch and a half or two inches 

 (3.75 to 5 cm.), between the layers of the 

 lesser omentum, where it is joined at an acute 

 angle by the cystic duct, and so forms the 

 common bile duct (diictus communis chole- 

 dochus). The hepatic duct is accompanied 

 by the hepatic artery and portal vein (Fig. 

 1070). 



The Gall-bladder (vesica fellea) (Figs. 

 1064 and 1078). The gall-bladder is the 

 reservoir for the bile; it is a conical or pear- 

 shaped musculomembranous sac, lodged in a 

 fossa on the under surface of the right lobe of 

 the liver, and fixed in it by connective tissue, 

 and extending from near the right extremity of 

 the transverse fissure to the anterior border of 

 the organ. It is from three to four inches 

 (7.5 to 10 cm.) in length, one inch (2.5 cm.) 

 in breadth at its widest part, and holds from 

 eight to ten drams (30 to 40 c.c.). It is 



divided into a fundus, body, and neck. The fundus (fundus vesicae felleae), or 

 broad extremity, is directed downward, forward, and to the right, and projects 



FIG. 1078. The gall-bladder and bile ducts, 

 opened up. (Spalteholz.) 



