126 TOPOGRAPHIC AND APPLIED ANATOMY. 



FIG. 59. First diagram for the representation of the peritoneum. The bursa omentalis is outlined in red, the re- 

 maining portion of the peritoneal cavity in blue. 



FIG. 60. Second diagram for the representation of the peritoneum. As in Fig. 59, the bursa omentalis is outlined 

 in red. 



that they are separated only by capillary spaces; complementary spaces or sinuses, similar to 

 those found in the pleural cavities, do not exist. These capillary spaces between the viscera 

 are filled normally by a sparing amount of peritoneal fluid ; a pathologic increase in the amount 

 of this fluid is known as abdominal dropsy or ascites. 



In the median line above the navel (Fig. 60) the parietal layer of the peritoneum passes 

 from the inner surface of the anterior abdominal wall to the under surface of the diaphragm, 

 which it covers as far as the openings for the esophagus and inferior vena cava. Since nothing 

 but the thin lamina of the diaphragm separates the peritoneum from the pleura and pericardium, 

 it will be understood that an inflammation originating in the peritoneum may pass through the 

 diaphragm and extend to the pleura and pericardium. In the median plane the peritoneum above 

 the navel, between the inner surface of the anterior abdominal wall and the inferior surface of 

 the liver, forms the falciform or suspensory ligament of the liver (ligamentum falciforme hepatis), 

 in the free posterior margin of which is situated the round ligament (ligamentum teres), originally 

 the umbilical vein. From the inferior surface of the diaphragm the peritoneum passes to the 

 posterior surface of the liver, which is in relation with the posterior abdominal wall, and thus 

 forms the upper layer of the broad coronary ligament of the liver (ligamentum corona rium hepatis). 

 The right and left free margins of this ligament are known as the ligamenta triangularia* From 

 the upper surface of the liver the visceral peritoneum is reflected about the free anterior margin 

 of the viscus to the inferior surface, which it covers as far as the porta hepatis, from which it 

 passes to the lesser curvature of the stomach and to the upper portion of the duodenum, forming 

 the anterior layer of the lesser or gastrohepatic omentum (ligamentum hepatogastricum and liga- 

 mentum hepatoduodenale). It then covers the anterior surface of the stomach and reaches the 

 transverse colon in front of the greater curvature. From the transverse colon it passes down- 

 ward as the anterior layer of the great or gastrocolic omenlum, then upward from the free margin 

 of the great omentum to the transverse colon, from which it passes backward to the posterior 

 abdominal wall, forming the lower layer of the transverse mesocolon. Upon reaching the pos- 

 terior abdominal wall, the peritoneum covers the anterior surface of the ascending portion of the 

 duodenum. Below this region the peritoneum is reflected from the vertebral column about the 

 small intestine, forming both layers of the mesentery. The attachment of the mesentery to the 

 posterior abdominal wall, the radix mesenterii, extends downward from the left border of the 

 second lumbar vertebra to the right sacroiliac articulation. As a result of this oblique insertion, 

 extravasations of blood originating upon the right side of the mesentery pass into the right iliac 

 region, while those upon the left side find an open path to the pelvic cavity. The longest portion 

 of the mesentery is situated about twenty centimeters above the appendix, and this portion of 

 the ileum is consequently the one most frequently found in inguinal hernia. [According to Treves, 

 the longest part of the mesentery is found at two points, one six, the other eleven feet from the 

 duodenum. The folds of small intestine corresponding to these may and often do reach the 



*The right and left lateral ligaments of the liver. 



