138 



TOPOGRAPHIC 



The position of the liver (a portion 

 deeper layer ofgthe model of Plate 16. 



The relation to the duodenum 

 transverse mesocolon should 

 the transverse 

 transverse colon 



y - ' ' 



borne in mind, sis^e it is re 



gftovable. than the ascending or <:\ The 



In Contact "with the anter\>r abdominal 1, if its 



is consequenTJF in comaci 



mesocolon is long enough, may form a loop the convexity of wAich is d. 

 either end the mesentery of the transverse colon becomes shorter, <3fcproa< 1 

 the ascending an(MkK*ebflmg ctotona, which are* Usually Without 



The descending colon (Platesi 11-17) is longei 



the left kidney. It runs downward upon the qua^dratus lumborun 

 from the mediaf! TO MgRft l $ffi 1 h :> 'tfi'e' ( ^qcendmg colon, reaches thp ^'f' 'H 



I a.wtwwi-1 



you! 



4tM% 



course toward the middle line, becomes continuous with the sigmoip colon (omega lo< 

 external iliac vessels. m ^!f?^ aUachiiieiiL lu Lilt posterior abdominal yall is similar to i; 

 ascending colon. Since, the broaq posterior surfaces of the ascendiyg arid descendin.-.' 

 of the large intestine are attached 

 sible to open thdyg^bftfoilg of the 

 This is done in the operation of lui 

 ing colon to the wWep ^siftp of tin 

 this location in Plate 16.) It shouk 



the posterior abdominal wall byj connective tissue, it i> 

 toGtinc from behind without cntpringbthakgbdominal cavity. 



X9 



I 'I 



#r colotomy v/hen a*n artificial anus"is made in the descend- 

 tmrrbomTri rmmrlo ahovfj t Vy^fijfa iliac crest. (Find 

 be noted, however, that these pArtrotas 1 g)ft'h'e :) ifflffitine may 



in which 

 The sig- 



occasionally have a 9 snort mesocolor, =the peritoneal reflection being 



case the operation is very difficult t|):perform without opening the 



moid colon is iu lne u mosl Tavorable, and the one generally preferred fojr the '^rfe'fmance of this 



for example, where the int 

 It 

 dis 



operation, in 



/T-I i sbaum * 



anus (Plates n aria 14-1 

 colon with the rectum, and is 

 in contact with the 



tine is occluded above the 



s situated in the right iliac region /connecting the descending 

 inguished from the Wmpr hy ii^ InWp; n^^ynlnn It is usually 



wall upon the left side abave Poupart's ligament, and 



can be exposed and opened in/this situation. This operation is ne/essarily preceded by a lapar- 

 v. In making an. artificial anus the opening made in the in/estine mustoe united with the 



S'C f. -, . '- JT Y1E/U jrfyiK 



:r,inal incisnon so that nom of tin- intestinal Contents r^a^qji^^thci' 



"operation the f.mall intofitir muot 



mis : r the 



the peritoneal cavity. "Trf 



into three ba aaja/ 



is depicted itf . the la^ge intestine. _a re: its sactu 



f the colon are that its longitudinal musgutlar co; 

 -. :>iplo.ic appendages c;on,t L aj i mj^g 1t /at . This 



more fixed position, in tl \ more movable divisions, their continuity with the 

 parts relatively fixed, an<; ^s^_^ 'Hbrr. Iir cTddjtiun, tlie^feryyffr^estine is more 

 liable to contain hardened * : cn that tlv. longitudinal bands fta v nia 

 coli) above referred to spread out 01 ring com- 

 plete except for a narrow strip alo bands have been 

 reduced to two wider ones, an anterior bands practically 

 disappear. ED.] In cutting from wit! -livided: skin, 



