442 ABDOMEN 



axillary line. The flattened apex lies to the left, at the level 

 of the left sixth rib in or near to the left lateral plane. The 

 anterior and superior surfaces are smooth and convex. The 

 anterior is attached to the anterior abdominal wall, and the 

 superior to the under surface of the diaphragm, by a fold 

 of peritoneum, the falciform ligament, which separates each 

 surface into a smaller left and a larger right portion, the 

 right and left lobes of the liver. 



The anterior surface is triangular in outline. It passes 

 gradually, over rounded and indistinct borders, into the 

 superior surface and the base, but it is separated from the 

 inferior surface by a sharp and definite margin. Its left and 

 right portions are in contact with the diaphragm, and the 

 intermediate part is in contact with the anterior wall of the 

 abdomen in the region of the subcostal angle. Its position 

 can be indicated on the surface by three lines, (i) The 

 first commences at the level of the left sixth rib in the left 

 lateral plane, and ends to the level of the right sixth rib 

 midway between the right lateral plane and the right border 

 of the body. (2) The second commences at the same point 

 as the first and passes obliquely downwards and to the right 

 to the tip of the tenth right costal cartilage. (3) The third 

 connects the right extremities of the first and second. 



The superior surface is accurately adapted to the lower 

 surface of the diaphragm, which separates it from the lungs 

 and pleurae, and from the heart and pericardium. Immedi- 

 ately below the heart it is slightly concave, but to the right 

 and left of the cardiac concavity it is markedly convex, and 

 more convex on the right than on the left side. Pass the 

 hand backwards over the upper surface of the right lobe and 

 note that in the right lateral plane it rises to the level of the 

 fourth intercostal space, and even to the lower border of the 

 fourth rib. 



Pass the hand still further back over the upper surface, 

 and note that at the junction of the superior and posterior 

 surfaces a layer of peritoneum, the upper layer of the coronary 

 ligament, passes from the liver to the diaphragm. Carry the 

 fingers to the right along the coronary ligament round to the 

 base where, at the junction of the base with the posterior 

 surface, a triangular fold of peritoneum, the right triangular 

 ligament, will be found, connecting the liver with the 

 diaphragm. Now pass the hand over the upper surface of the 



