ABDOMEN AND PELVIS 



493 



What are its peritoneal relations? Examine 



(a) Duodenorenal ligament (ligamentum duodenorenale) . 



(b) Duodenocolic ligament (ligamentum duodenocolicum) . (Inconstant.) 



The latter has been dissected away. Examine model and other 

 cadavers and determine its location, if present. 



FIG. 259. 



Pars superior duodeni- 

 Flexura duodeni superior -- 



Papilla duodeni 

 (Santorini) 



Pars descendens ._ 

 duodeni 



Noduli lymph- 

 atici solitarii 



Plica longitudi-.- 

 nalis duodeni 



Plicae circulares_.~ 

 (Kerkringi) 



Flexura duodeni 



inferior 



.Pylorus 



-Pars pylorica ventriculi 



Flexura dupdeno- 

 jejunalis 



-Intestinum 

 jejunum 



Pars ascendens duodeni 



Pars horizontalis (inferior) 

 duodeni 



The duodenum seen from in front. The descending part has been cut open and its anterior wall 

 turned back to the left. (After Toldt, Anat. Atlas, Wien, 1900, 2 Aufl., p. 424, Fig. 694.) 



The duodenum is never displaced en masse, for the flexura 

 duodenojejunalis is attached to the vertebral column. The first 

 two portions are often displaced laterally or prolapsed second- 

 ary to the downward displacement of the stomach and liver. 

 Determine by what means the duodenum is held in position. 



Dissect out the suspensory muscle of the duodenum (M. sus- 

 pensorius duodeni). 



This muscle was described by Treitz in 1853. It arises from the supe- 

 rior border of the flexura duodenojejunalis and the superior half of the 

 pars ascendens. Passing upward behind the head of the pancreas and in 

 front of the aorta, it is attached to the left pillar of the diaphragm by a 

 tendon composed of elastic and fibrous tissue. It is composed of smooth 

 muscle-fibres. According to Braune, it is derived from both coats of the 

 intestine. 



