128 TOPOGRAPHIC AND APPLIED ANATOMY. 



PLATE 14. 



The position of the abdominal viscera of a boy. Anterior view. The lungs, the heart, and the anterior half of the 

 diaphragm have been removed ; the small intestine has been cut away at the root of the mesentery. From an accurate 

 Leipzig model made from an original dissection (His). 



PLATE 15. 



The position of the kidneys, pancreas, spleen, duodenum, and colon as seen after the removal of the liver, stomach, 

 and transverse colon. From the model of Plate 14. 



lienale. The spleen is almost completely enveloped by the peritoneum, which passes back to the 

 stomach as the anterior layer of the ligamentum gastrolienale. At the inferior pole of the spleen 

 the ligamentum phrenicolicum passes from the diaphragm to the splenic flexure of the colon; 

 this is the ligament which supports the spleen from below. After covering the splenic flexure 

 of the colon, the peritoneum passes to the descending colon, which, like the ascending colon, 

 possesses only an anterior and lateral peritoneal covering, so that neither colon is visible from 

 in front after opening the peritoneal cavity. The long mesocolon of the sigmoid flexure (S. 

 romanum), on the contrary, permits a wider range of motion, so that this portion of the intestine 

 is often found in the dead subject to the right of the median line. 



THE CONTENTS OF THE ABDOMEN. 



The Stomach. The stomach is situated in the epigastrium and the left hypochondriac 

 region in such a manner that only one-sixth of the viscus is to the right of the median line. The 

 jundus of the stomach touches the diaphragm (Fig. 49) and borders indirectly upon the heart 

 and the left lung; this partly explains the increased cardiac activity and accelerated respiration 

 which are produced by the pressure of a full stomach. A large portion of the anterior gastric 

 surface is covered by the liver. Toward the left, the fundus is in relation with the concave jades 

 gastrica of the spleen (Plates n, 13, 14, 15, and 16). 



The cardia lies to the left of the median line at the level of the eleventh dorsal vertebra and 

 at quite a distance (about 12 centimeters dorsalward) from the inner surface of the anterior 

 abdominal wall (Plate 17). When projected upon the anterior surface of the body, the cardia 

 is situated one fingerbreadth below the sternal attachment of the left seventh costal cartilage. 



The pylorus is below and in front of the cardia (Plate 17); it lies to the right of the median 

 line at the level of the body of the first lumbar vertebra ; in the right sternal line this point corre- 

 sponds to the level of the anterior extremity of the ninth costal cartilage. From the relative posi- 

 tion of the cardia and pylorus it will be seen that the lesser curvature of the stomach pursues 

 more of a vertical than of a horizontal direction. The greater curvature, the lower limit of the 

 normal stomach, reaches to the transverse line connecting the lowest points of the ninth or tenth 

 ribs (Plate n); it consequently does not extend to the transverse line connecting the lowest points 

 of the inferior aperture of the thorax. In this line is found the transverse colon, which borders 

 upon the greater curvature (Plate n). [The pyloric portion of the stomach is bisected by a. 

 horizontal plane, the transpyloric, which passes through the abdomen midway between the supra- 

 sternal notch and the pubic symphysis. ED.] 



The anterior surface of the stomach below the lesser curvature is covered by the left, and 

 also by a part of the right lobe of the liver. In the epigastrium, below the xiphoid process, the 



