826 



THE ABDOMEN. -THE PERITONEUM. 



PARTS SITUATED IN EACH REGION OF THE ABDOMEN. 



Epigastric region 



Hypochondriac, right 



Hypochondriac, left . 



Umbilical .... 



Lumbar, right 

 Lumbar, left . . . 



Hypogastric . . 



Iliac, right . . . 

 Iliac, left . 



The middle part of the stomach, with its pyloric 

 extremity, the left lobe of the liver, the hepatic 

 vessels and lobulus Spigelii, the pancreas, the 

 coeliac axis, the semilunar ganglia, part of the 

 vena cava, and also, as they lie between the crura 

 of the diaphragm, part of the aorta, the vena 

 azygos and thoracic duct. 



The right lobe of the liver, with the gall-bladder, 

 part of the duodenum, the hepatic flexure of the 

 colon, the right suprarenal capsule, and part of 

 the corresponding kidney. 



The large end of the stomach, with the spleen and 

 narrow extremity of the pancreas, the splenic 

 flexure of the colon, the left suprarenal capsule 

 and upper part of the left kidney. Sometimes 

 also a part of the left lobe of the liver. 



Part of the omentum and mesentery, the transverse 

 part of the colon, transverse part of the duodenum, 

 with some convolutions of the jejunum and ileum. 



The ascending colon, lower half of the kidney and 

 part of the duodenum and jejunum. 



The descending colon and lower part of the left kidney, 

 with part of the jejunum. 



The convolutions of the ileum, the bladder in 

 children, and, if distended, in adults also ; the 

 uterus when in the gravid state. 



The caecum, appendix vermiformis, ileo-caecal valve, 

 ureter, and spermatic vessels. 



The sigmoid flexure of the colon, the ureter and 

 spermatic vessels. 



THE PERITONEUM. 



The peritoneum or serous membrane of the abdominal cavity is by far the 

 most extensive and complicated of the serous membranes. Like the others 

 it may be considered to form a shut sac, on the outside of which are placed 

 the viscera which it covers. In the female, however, the two Fallopian 

 tubes open at their free extremities into the cavity of the peritoneum. The 

 internal surface is free, smooth, and moist, and is covered by a thiu 

 squamous epithelium. The external or attached surface adheres partly to 

 the parietes of the abdomen and pelvis, and partly to the outer surface of 

 the viscera situated within them. The parietal portion is connected loosely 

 with the fascia lining the abdomen and pelvis by means of a layer of areolar 

 tissue, distinct from the abdominal fasciae, and named the subperitoneal or 

 retro-peritoneal layer ; but it is more firmly adherent along the middle line 

 of the body in front, as well as to the under surface of the diaphragm. Tho 

 visceral portion, which is thinner than the other, forms a more or less 

 perfect investment to most of the abdominal and pelvic viscera. 



The folds of the peritoneum are of various kinds. Some of them, 

 constituting the mesenteries, connect certain portions of the intestinal canal 

 with the posterior wall of the abdomen ; they are, the mesentery properly 

 so called for the jejunum and ileum, the rneso-csecum, transverse and sig- 

 moid meso-colon, and the meso-rectum. * Other dnplicatures, which are 

 called omenta, proceed from one viscus to another ; they are distinguished 

 as the great omeutum, the small omentum, and the gastro-spleuic orneiituni. 

 Lastly, certain reflexions of the peritoneum from the walls of the abdomen or 

 pelvis to viscera which are not portions of the intestinal canal, are named liga- 

 ments : these include the ligaments of the liver, spleen, uterus, and bladder. 



