2G6 IMPORTANT ANATOMICAL LANDMARKS. 



t rated to a variable degree, by the forefinger, invaginating 

 the scrotum, and carried up beneath the abdominal integu- 

 ment, in a direction upward and outward, along the side 

 of the spermatic cord, which serves as a guide to the posi- 

 tion of the ring. 



The regions of the abdomen are indicated by arbitrary 

 lines, viz : two vertical lines, each, from the most depen- 

 dent portion of the cartilages of the eighth ribs to the 

 centre of Poupart's ligament; a transverse line, corre- 

 sponding to the summits of the ilia ; a second transverse 

 line, corresponding to the cartilages of the ninth ribs. We 

 thus have three zones, each subdivided into three regions. 

 These are named, in the upper zone, the right and left 

 hypochondriac, and in the centre, the epigastric; in the 

 middle zone, the right and left lumbar, and in the centre, 

 the umbilical ; in the lower zone, the right and left inguinal, 

 and in the centre, the hypogastric. The parts which, within 

 the abdomen, correspond to these regions may be tabulated 

 as follows : 



R. Hypochondriac. 



Right lobe of liver, 

 and gall-bladder ; up- 

 per part of ascending 

 colon ; upper part of 

 right kidney ; right 

 supra-renal capsule. 



R. Lumbar. 

 Ascending colon ; 

 lower part of right 

 kidney ; small intes- 

 tines. 



R. Inguinal. 

 Csecum and appen 

 dix. 



Epigastric. 

 Middle and pyloric 

 end of stomach ; left 

 lobe of liver; cooliac 

 axis ; semi-lunar gan- 

 glion; pancreas; aorta; 

 vena cava inferior. 



Umbilical. 



Transverse colon ; 

 duodenum ; great om- 

 entum ; mesentery ; 

 small intestines. 



Hypogastric. 

 Small intestines ; 

 bladder, when disten- 

 ded; uterus, in female. 



L. Hypochondriac. 



Cardiac end of sto- 

 mach ; spleen; head 

 of pancreas; upper part 

 of descending colon ; 

 upper part of left kid- 

 ney; left supra-renal 

 capsule. 



L. Lumbar. 

 Descending colon ; 

 lower part of left kid- 

 ney ; small intestines. 



L. Inguinal. 

 Sigmoid flexure of 

 colon. 



Directly above the pubes the bladder may be reached, 

 especially when distended, and may be punctured, without 

 fear of wounding the peritoneum, which, in being reflected 

 from the abdominal parietes to the pelvic viscera, leaves 

 quite an interval above the pubic bones. 



The vas defer ens may be felt as a constituent part of 

 the spermatic cord; it is hard and round, usually situated 



