296 ABDOMEN 



complication of the folds has been produced by changes 

 form and position of the viscera, and by the fusion and partial 

 disappearance of some of the primitive folds. 



The portion of the peritoneum which lines the inner 

 surface of the abdominal wall is called parietal peritoneum. 

 The portion which covers the viscera is termed visceral 

 peritoneum ; and the folds which connect the viscera with 

 each other or with the wall of the abdomen are defined as 

 omenta, mesenteries, and ligaments. 



The term mesentery is generally applied to folds of peri- 

 toneum which connect portions of the intestine with the 

 posterior wall of the abdomen. 



The term omentum has usually been applied, in English 

 terminology, to folds of peritoneum which connect the 

 stomach with other viscera. The term ligament was limited 

 to any fold which did not fall into either of the two first 

 divisions ; now, however, it is becoming customary to extend 

 the term to folds and portions of folds which connect the 

 stomach to adjacent viscera ; thus the lesser omentum is 

 said to consist of the hepato-gastric and the hepato-duodenal 

 ligaments, the two terms being applied respectively to the 

 parts which connect the liver to the stomach and the liver 

 to the duodenum. The gastro-splenic omentum becomes the 

 gastro-splenic ligament, and the greater omentum is sometimes 

 spoken of as the gastro-colic ligament. 



The relations of the layers of the visceral and parietal 

 peritoneum to each other, and the relations of the layers 

 which bound the omental bursa to those which limit the 

 cavity of the great sac, can be easily followed in Figs. 134, 

 J 35> X 3 6 > an d 137. The dissector should study the figures 

 and confirm their accuracy by following the peritoneum in 

 his " part " at the levels, and in the planes, indicated in them. 



Dissection. After examining the various parts of the peri- 

 toneal cavity, and the different folds of the peritoneal membrane, 

 the dissector should remove the peritoneum of the posterior 

 wall of the omental bursa, above the level of the root of the 

 transverse meso-colon. Commence immediately above the line 

 of attachment of the transverse meso-colon to the lower border 

 of the pancreas, which can be seen through the thin peritoneum, 

 and work upwards, taking care not to injure either the pancreas 

 itself or the blood-vessels which lie behind the posterior wall 

 of the upper part of the omental bursa. Remove also the 

 medial layer of the gastro-splenic ligament, and the medial 

 layer of the lieno-renal ligament. The object of this dissection 



