420 ARTERIES. 



PLAN OF THE RELATIONS OF THE ABDOMINAL AORTA. 



In front. 



Lesser omentum and stomach. 



Branches of coaliac axis and solar plexus. 



Splenic vein. 



Pancreas. 



Left renal vein. 



Transverse duodenum. 



Mesentery. 



Aortic plexus. 



Right side. Left side. 



Right crus of Diaphragm. f ^\ Sympathetic nerve. 



Inferior vena cava. / \ Left semilunar ganglion. 



Vena azygos. 

 Thoracic duct. 

 Eight semilunar ganglion. 



Behind. 



Left lumbar veins. 

 Receptaculum chyli. 

 Thoracic duct. 

 f Vertebral column. 



Surgical Anatomy. Aneurisms of the abdominal aorta near the cceliac axis communicate in 

 nearly equal proportion with the anterior and posterior parts of this vessel. 



When an aneurismal sac is connected with the back part of the abdominal aorta, it usually 

 produces absorption of the bodies of the vertebrae, and forms a pulsating tumor, that presents 

 itself in the left hypochondriac or epigastric regions, accompanied by symptoms of disturbance 

 of the alimentary canal. Pain is invariably present, and is usually of two kinds, a fixed and 

 constant pain in the back, caused by the tumor pressing on or displacing the branches of the 

 solar plexus and splanchnic nerves, and a sharp lancinating pain, radiating along those branches 

 of the lumbar nerves pressed on by the tumor; hence the pain in the loins, the testes, the hypo- 

 gastrium, and in the lower ifinb. usually of the left side. This form of aneurism usually bursts 

 into the peritoneal cavity, or behind the peritoneum, in the left hypochondriac region ; or it may 

 form a large aneurismal sac, extending down as low as Poupart's ligament ; hemorrhage in these 

 cases being generally very extensive, but slowly produced, and never rapidly fatal. 



When an aneurismal sac is connected with the front of the aorta, near the coeliac axis, it forms 

 a pulsating tumor in the left hypochondriac or epigastric regions, usually attended with symptoms 

 of disturbance of the alimentary canal, as sickness, dyspepsia, or constipation, and accompanied- 

 by pain, which is constant but nearly always fixed in the loins, epigastrium, or some part of the 

 abdomen ; the radiating pain being rare, as the lumbar nerves are seldom implicated. This form 

 of aneurism may lyurst into the peritoneal cavity, or behind the peritoneum, between the layers 

 of the mesentery, or, more rarely, into the duodenum ; it rarely extends backwards so as to affect 

 the spine. 



BRANCHES OF THE ABDOMINAL AORTA. 



Phrenic. Renal. 



( Gastric. Spermatic. 



Coeliac axis. -\ Hepatic. Inferior mesenteric. 



( Splenic. Lumbar. 



Superior mesenteric. Sacra media. 

 Supra-renal. 



The brandies of the abdominal aorta may be divided into two sets : 1. Those 

 supplying the viscera. 2. Those distributed to the walls of the abdomen. 



Visceral Branches. Parietal Branches. 



( Gastric. Phrenic. 



Cceliac axis. -| Hepatic. Lumbar. 



( Splenic. Sacra media. 



Superior mesenteric. 

 Inferior mesenteric. 

 Supra-renal. 

 Renal. 

 Spermatic. 



