260 THE DIGESTIVE SYSTEM 



relative size of the viscus (p. 304) and partly by the fact that 

 the ribs are more nearly horizontal. 



The right lateral surface of the liver lies opposite the 

 seventh, eighth, ninth, tenth and eleventh ribs in the mid- 

 axillary line, and it is separated from them by the lower limit 

 of the pleural sac and the diaphragm. Hepatic dulness can 

 be obtained as high as the sixth intercostal space in the mid- 

 axillary line, but in the sixth and seventh spaces it is masked 

 by the resonant note of the lung, which intervenes between the 

 upper part of this aspect of the liver and the chest wall. In 

 the lower spaces, where the viscus is separated from the 

 parietes only by the diaphragm and pleura, light percussion is 

 sufficient to bring out the dull liver note. 



The posterior surface of the liver is in contact with the 

 upper part of the posterior abdominal wall, from which it is 

 separated by the oesophagus, on the left side, and the inferior 

 vena cava, on the right side. Little can be learnt from per- 

 cussion with reference to the extent of this surface, because, 

 to the right side of the median plane, the hepatic dulness 

 merges into the dull note produced by the right kidney 

 (PI. III.). 



The lowest part of the descending thoracic aorta is only 

 separated from the liver by the lower and posterior part of the 

 diaphragm, and its pulsations may be transmitted to the 

 anterior abdominal wall when the left portion of the liver is 

 the site of new growth. 



The inferior surface of the liver is very oblique and looks 

 downwards, backwards and to the left. On this surface the 

 obliterated umbilical vein (ligamentum teres) lies in a cleft 

 which serves to separate the liver into right and left lobes 

 (PI. I.). This subdivision, however, is purely superficial, and 

 the two lobes are directly continuous with one another. 



The inferior surface of the left lobe is related to the anterior 

 surface of the stomach, which it overlaps in the neighbourhood 

 of the lesser curvature when the body is in the supine posi- 

 tion. The inferior surface of the right lobe is related, in its 



