440 ABDOMEN 



rectum ; or that the first loop, instead of lying on the upper 

 surface of the bladder, hangs down into the pelvis close to 

 its left lateral wall. The rectum commences at the termina- 

 tion of the pelvic colon and runs downwards and forwards to 

 end in the anal canal. Only its upper part can be seen at 

 present, the lower part being concealed by the bladder (see 

 Fig. 171)- 



If the subject is a female the uterus will be found occupy- 

 ing the central part of the pelvis. It lies between the rectum 

 behind, and the bladder in front, and is connected on each 

 side to the lateral wall of the pelvis by a fold of peritoneum 

 called the broad ligament (see, Figs. 171 and 247). 



The dissector should notice that the caecum presents the 

 appearance of a blind diverticulum surrounded on all sides 

 by peritoneum ; that the transverse colon and the pelvic 

 colon are attached to the posterior wall of the abdomen by 

 folds of peritoneum called mesenteries ; that the vermiform 

 process is attached to the posterior surface of the mesentery 

 of the ileum by a fold of peritoneum called the meso-appendix 

 or mesentery of the appendix, and that the remaining parts of 

 the large intestine are not, as a rule, provided with mesenteries, 

 but that they lie against the posterior wall of the abdomen, 

 projecting forwards against the peritoneum which covers them 

 only anteriorly and on either side. 



After he has familiarised himself with the positions, 

 continuity, and attachments of the various parts of the 

 abdominal portion of the alimentary canal the dissector 

 should proceed to locate the kidneys. Throw the omentum 

 upwards, pull the small intestine downwards and to the right, 

 and examine the concavity of the left colic flexure, where a 

 considerable part of the lower portion of the left kidney can 

 be seen and felt, lying behind the peritoneum. Pull the small 

 intestine over to the left and downwards, examine the con- 

 cavity of the right colic flexure, and note that only a small 

 part of the lower portion of the right kidney can be 

 felt and seen in this situation, behind the peritoneum. 

 Replace the small intestine and the omentum, pull the liver 

 upwards and to the right, and the greater part of the upper 

 portion of the right kidney will be exposed or can be felt in 

 the region immediately above the right colic flexure. Re- 

 place the liver and pass the hand backwards into the 

 posterior part of the left hypochondrium to the back of 



