866 THE LIVER. 



corresponding thus with the elevated position of the diaphragm on the right 

 side. By means of the diaphragm, the liver is separated from the concave 

 base of the right lung, the thin margin of which descends so as to intervene 

 between the surface of the body and the solid mass of the liver a fact well 

 known to the auscultator. 



The convex surface of the liver is protected, on the right, by the six or 

 seven lower ribs, and in front by the cartilages of the same and by the 

 ensiform cartilage the diaphragm, of course, being interposed. Being 

 suspended by ligaments to the diaphragm above, and supported below, in 

 common with the rest of the viscera, by the abdominal muscles, the situa- 

 tion of the liver is modified by the position of the body, and also by the 

 movements of respiration ; thus, in the upright or sitting posture, the liver 

 reaches below the margin of the thorax ; but in the recumbent position, the 

 gland ascends an inch or an inch and a half higher up, and is entirely 

 covered by the ribs, except a small portion opposite the substernal notch. 

 Again, during a deep inspiration, the liver descends below the ribs, and in 

 expiration retires upwards behind them. In females the liver is often per- 

 manently forced downwards below the costal cartilages, owing to the use 

 of tight stays ; sometimes it reaches nearly as low as the crest of the 

 ilium ; and, in many such cases, its convex surface is indented from the 

 pressure of the ribs. 



To the left of the longitudinal fissure the liver is supported on the pyloric 



Fig. 605. 



Fig. 605. LOWER SURFACE OF THE LIVER WITH THE PRINCIPAL BLOOD-VESSELS AND 

 DUCTS (from Sappey). 



The liver has been turned over from left to right so as to expose the lower surface. 

 1, left lobe; 2, 3, 4, 5, right lobe; 6, lobulus quadratus ; 7, pons hepatis; 8, 9, 10, 

 lobulus Spigelii; 11, lobulus caudatus ; 12, 13, transverse or portal fissure with the 

 great vessels ; 14, hepatic artery ; 15, vena portee ; 16, anterior part of the longitudinal 

 fissure, containing 17, the round ligament or obliterated remains of the umbilical vein ; 

 18, posterior part of the same fissure, containing 19, the obliterated ductus venosus; 20, 

 21, 22, gall-bladder ; 23, cystic duct ; 24, hepatic duct ; 25, fossa containing 26, the 

 vena cava inferior; 27, opening of the capsular vein ; 28, small part of the trunk of the 

 right hepatic vein ; 29, trunk of the left hepatic vein ; 30, 31, openings of the right and 

 left diaphragmatic veins. 



