THE ABDOMEN. 23 



the most prominent- points (laterally) of the two iliac crests. A horizontal plane 

 containing the infracostal line usually cuts some part of the third lumbar vertebra, 

 while the bi-iliac line lies in a plane passing through the body of the fifth lumbar 

 vertebra about the middle of its anterior surface, and about an inch and a quarter 

 below the highest point of the iliac crest. The umbilicus is generally from an inch 

 and a quarter to an inch and a half (3 4 cm.) above the bi-iliac line. The vertical 



Fig. 11. OUTLINE OF THE FRONT OF THE ABDOMEN, SHOWING 



THE DIVISION INTO REGIONS. 



1, epigastric region ; 2, umbilical ; 3, hypogastric ; 4, 4, right 

 and left hypochondriac ; 5, 5, right and left lumbar ; 6, 6, right 

 and left iliac. 



distance between the infracostal and bi-iliac planes 

 raugesfrom one and a half to four inches (4 10 cm.), 

 with an average of two inches and three-quarters 

 (7 cm.) 1 . The vertical lines (mid-Poupart lines) are 

 drawn upwards from the centre of Poupart's ligament 

 on each side : above the bi-iliac line they nearly 

 coincide with the lineae semilunares, and are usually 

 a little external to the outer borders of the recti. 



Of the spaces bounded by these lines, the three 

 central are called respectively, from above down- 

 wards, epigastric, umbilical, and hypogastric, and the 

 lateral ones, right and left hypochondriac, lumbar or lateral abdominal, and iliac. 

 The lowest portion of the hypogastric region, being covered with hair, is also referred 

 to as thepubes or pubic region ; and the adjacent parts of the iliac and hypogastric 

 regions together constitute what is known as the inguinal region or the groin. 



The viscera which 

 following table : 



Epigastric region .... 



Hypochondriac, right . . 

 Hypochondriac, left . . 



Umbilical . 



Lumbar, right ........ 



Lumbar, left 

 Hypogastric 



Iliac, right 

 Iliac, left. . 



are contained in the several regions are shown in the 



The greater part or the whole of the left lobe, and part of the 

 right lobe of the liver, with the gall-bladder, part of the stomach, 

 including both orifices, the first and second parts of the duodenum, 

 the duodeno-jejunal flexure, the pancreas, upper or inner end of the 

 spleen, parts of the kidneys, and the suprarenal bodies. 



The greater part of the right lobe of the liver, the hepatic flexure 

 of the colon, and part of the right kidney. 



Part of the stomach, with the greater portion of the spleen and 

 the tail of the pancreas, the splenic flexure of the colon, part of the 

 left kidney, and sometimes a part of the left lobe of the liver. 



The greater part of the transverse colon, the third part of the 

 duodenum, some convolutions of the jejunum and ileum, with 

 portions of the mesentery and great omentum, and part of the 

 right, or sometimes of both kidneys. 



The ascending colon, part of the right kidney, and sometimes 

 part of the ileum. 



The descending colon, part of the jejunum, and sometimes a small 

 part of the left kidney. 



The convolutions of the ileum, the bladder in children, and when 

 distended in adults also, the uterus when in the gravid state, and 

 behind, the sigmoid loop and upper part of the rectum. 



The cascum with the vermiform appendix, and the termination of 

 the ileum. 



The sigmoid colon, convolutions of the jejunum and ileum. 



Abdominal wall. The wall of the abdomen is formed at the front and sides 

 mainly by muscles, and the forms to be recognized on the surface are for the most 



1 See D. J. Cunningham, Delimitation of the Regiom of the Abdomen, Journal of Anatomy, xxviii, 

 1893. 



