THE LIVER. 



935 





of this it is indented for the inferior vena cava, which is often partly imbedded in 

 its substance. Close to the right of this indentation and immediately above the 

 renal impression is a small triangular depressed area (impressio suprarenalis), the 

 greater part of which is devoid of peritoneum;, it lodges the right suprarenal 

 capsule. To the left of the inferior vena cava is the Spigelian lobe, which lies 

 between the fissure for the vena cava and the fissure for the ductus venosus. 

 Below and in front it projects and forms part of the posterior boundary of the 

 transverse fissure. Here, to the right, it is connected with the under surface of 

 the right lobe of the liver by the caudate lobe, and to the left it presents a tubercle, 

 the tuber papillaire. It is opposite the tenth and eleventh dorsal vertebra, and 

 rests upon the aorta and crura of the Diaphragm, being covered by the peritoneum 

 of the lesser sac. The lobe is nearly vertical in position, and is directed back- 

 ward : it is longer from above downward than from side to side, and is somewhat 

 concave in the transverse direction. On the posterior surface to the left of the 

 Spigelian lobe is a groove indicating the position of the cesophageal orifice of the 

 stomach. 



(Esophageal groove 



Suprarenal 

 impression 

 (non-peritoneal). 



Suprarenal 

 impression 

 (peritoneal). 

 Tuberculum 

 caudatum. 



Tube 

 papillare. 



Umbilical fissure. Transverse fissure. 



FIG. 512. The liver. Posterior and inferior surfaces. (Drawn from His's models.) 



The inferior border is thin and sharp, and marked opposite the attachment of 

 the falciform ligament by a deep notch, the umbilical notch, and opposite the 

 cartilage of the ninth rib by a second notch for the fundus of the gall-bladder. In 

 adult males this border usually corresponds with the margin of the ribs in the 

 right nipple line ; but in women and children it usually projects below the ribs. 



The left extremity of the liver is thin and flattened from above downward. 



Fissures (Fig. 512). Five fissures are seen upon the under and posterior sur- 

 faces of the liver, which serve to divide it into five lobes. They are, the umbilical 

 fissure, the fissure of the ductus venosus, the transverse fissure, the fissure for the 

 gall-bladder, and the fissure for the inferior vena cava. They are arranged in the 

 form of the letter H. The left limb of the H is known as the longitudinal fissure. 

 The right limb is formed in front by the fissure for the gall-bladder, and behind 

 by the fissure for the inferior vena cava; these two fissures are separated from 

 each other by the caudate lobe. The connecting bar of the H is the transverse or 

 portal fissure. It separates the quadrate lobe in front from the caudate and 

 Spigelian lobes behind. 



The longitudinal fissure is a deep groove, which extends from the notch on the 

 anterior margin of the liver to the upper border of the posterior surface of the 

 organ. It separates the right and left lobes; the transverse fissure joins it, at 

 right angles, and divides it into two parts. The anterior part is called the 

 umbilical fissure ; it is deeper than the posterior, and lodges the umbilical vein in 



