THE LIVER 



079 



wliich part it is concave. It includes that part of the liver behind the transverse 

 lissure, and consists of the following ])arts (tig. 581): — 



(1) The posterior portion of the left lobe, not very well defined; it ])resents a 

 protuberance (the tuber omenUde) in front, which projects against the lesser omen- 

 tum; behind, a concavity coming in contact with the cardia. 



Tliis ])()rti(>ii is separated by means of the fissure of the ductus venosus from 

 (2) the Spigelian lobe, which lies between tliis lissun; and that of the vena cava. 

 This lobe is directed l)ackwards, is longer from above dow'uwards than from side to 

 side, and is somewhat concave from side to side. It is opjjosite to the tenth and 

 eleventh thoracic vertebrae, and rests on the crura of the diaphragm. Behind its 

 up})er left-hand corner the oesophagus passes to enter the stomach. Below, it pro- 

 jects and forms part of the posterior boundar}^ of the transverse fissure. It is con- 

 nected with that part of the right lobe which enters into the posterior surface ])y 

 means of (3) the caudate lobe, Avhich is a small mass of liver substance rurming 

 from left t<^ right l)eliind the transverse fissure. It lies directly over the foramen of 

 W'inslow. It varies a good deal in form; is sometimes well defined, at other times 

 hardly to be seen. When well defined, it is about two to three inches long; behind 

 is tiie termination of the fissure of the vena cava. 



Fic4. 581. — Posterior Surface of the Liver. 



LEFT LOBE Vena cava 



SPIGELIAN LOBE 



(4) The portion of the right lobe taking part in the posterior surface consists of 

 a strip two and a half to three inches broad (Quain). This is uncovered by peri- 

 toneum, except at the extreme right. Lying betAveen the two layers of the coro- 

 nary ligament close to the vena cava and near the caudate lobe is an imju-ession for 

 the right suprarenal capsule {iinprcs.^io suprarenalk). 



Fissures. — The tissui'es on the inferior and posterior surfaces of the liver are 

 arrange(l very like a cajiital letter H. The left upright of the H is formed by the 

 longitudinal fissure; the anterior portion containing the umlalical vein is seen on 

 the inferior surface, and is known as the umbilical fissure ; the ])osterior portion, 

 seen on the ])osterior surface, contains the ductus venosus, and is therefore called 

 the fissure of the ductus venosus. Tlie transverse bar of the H is formed by the 

 transverse or portal fissure, which runs across at right angles to the longitudinal 

 tissurc, and contains the vessels entering the liver, viz., the portal vein, hepatic 

 artery, and hepatic duct (fig. oSO). . 



The right u))right of the H is formed by the fossa of the gall bladder in front; 

 it is interrupted l)y the caudate lobe; and is continued ])ehind as the fissure of 

 the vena cava, containing, as its name imi)lies, the inferior vena cava. 



General position. — The liver is situated in the right hypochondriac and epi- 

 gastric regions, and usually extends into the left hypochondrium (fig. 582). It is 



