368 ABDOMEN 



fossa for the umbilical vein with the posterior part of the fossa 

 for the gall-bladder. The portion of the right lobe which lies 

 in front of the porta, and between the fossa for the gall-bladder 

 on the right and the fossa for the umbilical vein on the left, 

 is the quadrate lobe, which frequently bears impressions made 

 by the pylorus and the first part of the duodenum. Behind 

 the porta hepatis, and between the lower ends of the fossa for 

 the ductus venosus and the fossa for the inferior vena cava, is 

 the lower end of the caudate lobe, which is usually divided, 

 by a shallow sulcus, into a nodular left or papillary process, 

 which projects downwards into the cavity of the omental 

 bursa, and a right, band-like caudate process, which connects 

 the lower end of the caudate lobe with the main part of 

 the inferior surface of the right lobe. The remainder of 

 the inferior surface of the right lobe is marked by three 

 shallow impressions : (i) at the right extremity of the porta 

 hepatis is an antero-posterior sulcus, the duodenal impression, 

 for the second part of the duodenum ; (2) to the right of the 

 fossa for the gall-bladder is the colic impression, for the right 

 flexure of the colon ; (3) behind the colic impression is the 

 renal impression, for the upper part of the anterior surface of 

 the right kidney. Occasionally a fourth impression exists 

 behind the duodenal impression ; it is the suprarenal im- 

 pression, which is always present on the posterior surface and 

 may extend on to the inferior surface. 



The inferior surface of the left lobe is marked by an 

 elevation, the tuber omentale, and a depression, the gastric 

 impression. The tuber omentale adjoins the left extremity 

 of the porta hepatis and, when the liver is in position, it rests 

 against the lesser omentum, immediately above the lesser 

 curvature of the stomach. The gastric impression occupies 

 the remainder of the lower surface of the left lobe lying in 

 front and to the left of the tuber omentale. 



The Posterior Surface of the Liver (Figs. 172 and 173). 

 The posterior surface is moulded upon the front of the 

 vertebral column, from which it is separated by the diaphragm 

 and the lower part of the descending thoracic aorta. It 

 presents, therefore, a deep hollow corresponding to the bodies 

 of the vertebrae and the structures in front of them. Im- 

 mediately to the left of the fossa of the ductus venosus there 

 is a smooth notch or groove, the cesophageal impression, which 

 leads downwards into the gastric impression on the under 



