1170 



THE DIGESTIVE SYSTEM. 



its extent by the left cupola of the diaphragm, which arches gradually downwards behind 

 and on the left to meet the floor. 



The floor or "stomach bed" (Fig. 921) is a sloping shelf on which the posterior surface of the 

 stomach rests, and by which it is supported. The bed is formed posteriorly by the superior pole of 

 the left kidney (with the supra-renal gland) and the gastric surface of the spleen ; anterior to 

 this, by the wide anterior surface of the pancreas ; and more anteriorly still, by the transverse 

 mesocolon running forwards above the small intestine, from the anterior edge of the pancreas to 

 the transverse colon (Fig. 921), which completes the floor anteriorly. 



Finally, the anterior wall of the stomach chamber is formed by the abdominal wall, between 

 the ribs on the left and the liver on the right side. 



This chamber is completely filled by the stomach, when that organ is distended. When, on 

 the other hand, the stomach is empty and contracted, it still rests on the floor, or stomach bed, 

 but occupies only the inferior portion of the chamber, whilst the rest of the space is filled by the 

 transverse colon, which turns gradually upwards as the stomach retracts, and finally comes to 

 lie both above and in front of that organ and immediately beneath the diaphragm a fact to be 

 remembered in clinical examinations of this region. 



Peritoneal Relations. The stomach is almost completely covered by 



A. epigastrica superior Xiphoid process 



7th costal cartilage 

 7th costal cartilage Diaphragm, cut edge 



Lobus hepatis dexter 



Cut surface of liver 



Lobus caudatus 



A. gastrica sinistra 



A. cceliaca 



Lig. hepato-duodenale 



A. hepatica propria 



Vena port* 



Ductus choledochus 



Fundus vesicae felleas 



Lig. triansrulare 



sinistrum 



Diaphragm 



(Esophagus 

 Spleen 



O-landula suprarenalis 

 Left kidney 

 A. lienalis 



Flexura coli sinistra 

 Cauda pancreatis 

 A. lienalis 



Peritoneum divided 

 transversum 



A. gastro-duodenalis 

 Pars desceudeus duodeni 



A. gastrica dextra 



Pars superior duodeni 



A. hepatica 



Colon transversum ! 



Pancreas 

 Facies anterior panureatis 



FIG. 921. STOMACH CHAMBER VIEWED FROM THE FRONT AND FROM BELOW. 

 From the specimen figured in Fig. 912, after removal of the stomach. 



peritoneum the anterior surface being clothed by that of the general peritom 

 sac, and the posterior surface by the anterior layer of the bursa omen tails (see p. 1161 

 From the lesser curvature the hepato-gastric ligament extends to the liver, whil 

 to the greater curvature the gastro-lienal and gastro-colic ligaments are attacl 

 Finally, a small peritoneal fold, known as the gastro-phrenic ligament, is foui 

 running from the stomach up to the diaphragm along the left side of tl 

 oesophagus. 



A small irregularly triangular area (Fig. 919), about 2 inches wide and 1| inches from abov< 

 downwards, during moderate distension of the stomach, on the posterior surface below and to t) 

 left of the cardia, is not covered with peritoneum, and over it the organ is in direct contact wit 

 the diaphragm, occasionally also with the superior extremity of the left kidney and the supra 

 renal gland. From the left angle of this " uncovered area " the attachment of the gastro-liena 

 ligament starts ; and at the right angle is the commencement of a fold through which the I 

 gastric artery passes to the stomach. This fold is called the left gastro -pancreatic fold. 



The right gastro -pancreatic fold is a fold of peritoneum passing from the right extremity o 



