I 3 2 



TOPOGRAPHIC AND APPLIED ANATOMY. 



FIG. 61. The porta hepatis, the pancreas, the duodenum, the kidneys, the spleen, and the suprarenal bodies with their 



vessels (formalin preparation). 



interest: (i) The falciform ligament, which is attached to the superior surface, does 

 not lie in the median sagittal plane of the body, but somewhat to the right; it may hinder 

 exploration of the superior surface of the right lobe through a median incision, and to 

 secure better access to this surface it may be necessary to cut this ligament; correspond- 

 ing as it does to the umbilical fissure, it serves as a guide to the latter and therefore 

 to the gall-bladder, which lies, of course, further to the right. (2) Subphrenic abscesses 

 between the diaphragm and right lobe, and abscesses of the right lobe itself, are frequently more 



Spinous process of 

 vertebra 



Spinal cord 



Body of vertebra 

 Diaphragm 



Ascending aorta 



Inferior vena cava 



Pylorus 



Pleural cavity 



Liver 



Inferior lobe of right 

 lung 



Falciform ligament 



of liver 



Cavity of pericar- 

 dium 



Sternum - 



- Latissimus dorsi 

 muscle 



-- Spleen 



Omental bursa 



Pleural cavity 

 - Teres major muscle 

 ft Stomach 



{ Diaphragm 



Abdominal cavity 



Lower lobe of left 

 lung 



Serratus anticus m. 

 Pericardium 



Pleural cavity 

 Apex of the heart 



FIG. 62. A cross-section of the trunk at the level of the xiphoid process of the sternum. 



easily and safely drained by removing a rib and crossing the pleural cavity transpleural drain- 

 age than by the abdominal route. Particularly is this true when the abscess is pointing pos- 

 teriorly and has not caused the liver to project far beneath the costal arch. (3) The gall-bladder 

 is beneath the abdominal wall opposite the angle between the outer edge of the rectus and the 

 ninth costal cartilage, where, when enlarged, it may be felt ; its duct, the cystic, is tortuous, which, 

 together with the arrangements of valves of mucous membrane in the calibre of the duct, prevents, 

 as a rule, its exploration with a probe or sound. This duct joins in the portal fissure with the 

 hepatic duct to make the common duct ductus communis choledochus. The common duct in 

 the first portion of its course lies in the right edge of the gastrohepatic omentum, the hepatic 

 artery lying alongside and to the left, the portal vein behind and between the two. In the second 

 part of its course it lies behind the first portion of the duodenum ; in the third it is placed between 



