Stomach. 209 



Relations of stomach. The fundus lies beneath 

 the diaphragm, about on a level with the left extrem- 

 ity of the liver, and is posterior to, and on a higher level 

 than the apex of the heart, from which it is separated by 

 the pericardium, the diaphragm and the peritoneum cover- 

 ing the diaphragm. The anterior surface is directed 

 upwards, forwards and to the left, and is, in the empty 

 state, behind the diaphragm, the left lobe of the liver and 

 the anterior abdominal wall, but, when the organ is dis- 

 tended, this surface becomes more or less superior, while 

 the posterior surface becomes inferior, and the pyloric end 

 is shifted to the right so as to lie beneath the quadrate 

 lobe. 



The posterior surface looking downwards, backwards 

 and to the right, rests on a concave bed formed by the up- 

 per layer of the transverse mesocolon, hence this meso- 

 colon, with the colon below it, supports the organ. This 

 surface is in front of and in contact with the diaphragm, 

 the spleen, the left suprarenal capsule, the upper end of 

 the left kidney, the pancreas and the splenic flexure of the 

 colon. Measurements. The stomach when moderately 

 filled is about ten or twelve inches long and measures 

 about four or five inches at its widest part. 



Landmarks for Stomach on the anterior surface 

 of the body. (Fig 8.) The cardiac orifice is situated op- 

 posite the lower part of the tenth dorsal vertebra and lies 

 behind the seventh costal cartilage of the left side, about 

 one inch from the sternum. It is about four and a half 

 inches from the anterior thoracic wall and about one inch 

 below the oesophageal opening in the diaphragm. The 

 pylorus is about two and a half inches below the junction 

 of the sternum with the ensiform cartilage, in a line drawn 

 downwards from the right side of the former, and is oppo- 

 site to the twelfth dorsal vertebra. The summit, or, high- 



