Fig. 124. Position of Abdominal Viscera, from in front. 



Cf. Fi^. Ill for Topography. 



In the right h3-pochondrium lies the Liver wliich even extends further 

 (however, the 12th rib, costal cartilages of gth, loth, 1 1 th ribs should be excepted). 

 The liver lies in contact with the diaphragm, and indirectly with the Thoracic 

 wall, the lower border of the viscus varies with its size and .shape — this depends 

 upon the shape of the Thorax — and with respiration. In the nipple line it may 

 correspond to the costal arch or extend below it Vr.t^s to r'-,ths inch). In the 

 Axillary line it reaches to the loth intercostal space or extends ''/jths to rV.-.ths inch 

 lower down. The lower concave surface of the Viscus is in relation with the 

 right kidney, right supra-renal body (cf. Renal Impression Fig. 136) ai.d hepatic 

 flexure of Colon. 



In the left Hypochondrium lie the Kidney, Suprarenal bod\-. Stomach, 

 Spleen, Splenic Flexure of Colon, Tail of the Pancreas and usually a part of the 

 left lobe of the Liver. This region is occupied bv about -/^rds of the Stomach 

 i. e. Cardia and Fundus. The Cardia lies behind the outer end of the 7th Costal 

 Cartilage, the inner concave surface of the Spleen is in relation with the upper 

 part of the left kidne\', its outer convex surface with the Diaphragm (Phrenico- 

 Splenic ligament), cf. Figs. 125, 126, 136. As a rule the liver does not extend 

 further to the left than the inner half of the 7th Costal Cartilage. The Splenic 

 flexure is anchored bv the Phrenico-colic fold to the loth and iith ribs. This 

 fold also forms a platform upon which the spleen reposes, but this fold becomes 

 stretched when the spleen is enlarged and any alteration occurs in the position 

 of the Colon. 



The form and size of the Epigastric regions varj' with the individual and 

 the sex ; the subcostal angle varies widel}' between 30 " and 70 ". The shape of the 

 Xiphoid Process offers many variations, it may be directed forwards, backwards 

 or laterally, presenting an opening, or be bifurcated, curved or crooked. 



In the Epigastric region are found a part of the Liver. Gall-Bladder, 

 Stomach, Duodenum and Transverse Colon. 



The lower border of the Liver extends at the 8th costal cartilage bevond 

 the right costal arch and often reaches to a point midway between the Umbilicus 

 and the top of the Xiphoid Process. At the lower border of the Liver near the 

 gth and loth costal cartilages is situated the gall-bladder (cf. Figs. 131 and 132). 



Behind the Liver are situated: Lesser Curvature of Stomach, Small 

 Omentum. Omental Sac, Aorta, Coeliac Plexus of Sympathetic; a part of the Stomach, 

 (Antrum Pylori) touches the Abdominal Wall. 



To the right of the Middle line, normally, Transverse Colon as well as 

 Duodenum lie in this region. The former is often curved and extends downwards 

 into the Umbilical region. In some cases it lies wholly outside the Epigastriuin. 



The Umbilical Region contains a great portion of small intestine (mostly 

 Ileum) which is usually covered by the Great Omentum. The Iliac Region 

 contains the ascending (right) and descending (left) Colon with Small Intestine. 



The Hypogastric region lodges in its middle, small intestine, bladder (when 

 distended) and uterus (when pregnant) — on the right the Appendix and on the 

 left the Sigmoid Flexure. The greater part of the anterior wall of the Bladder 

 is imcovered by Peritoneum (cf. Fig. B): when the bladder is much distended 

 this region corresponds to a A Vs^hs to 2 ins. high with a base corresponding to 

 the interval between the 2 pubic spines (about i^l^th inch). Cf. Figs. 143, 144. 



