Fig. 126. Left Lung and Spleen. — Side View. 



The figure shews the diaphragm during extreme expiration (cadaveric 

 expiration); the vault extends as high as the 4th left intercostal space and the 

 left lung to the same degree. The fissure of the Lung — the left boundar\- of 

 the pleura, cf. Figs. 116 and 117 — and especially the normal position of a normal 

 spleen are shewn. 



The inner concave surface of the spleen lies against the Fundus of the 

 Stomach and the upper part of the left kidney (cf. Fig. 135), the convexity is in 

 relation with the Diaphragm connected with it by the Phrenico-.Splenic Ligament. 

 The spleen e.xtends from (cf. Fig. 125) the 9th to the iith rib with its long axis 

 corresponding to the long axis of the loth rib. in a downward and forward 

 direction, so that the inferior pole points towards the Umbilicus. A normal spleen 

 does not extend beyond the costo-chondral line — i. e. a line drawn from the 

 left Sterno-clavicular articulation to the top of the 1 ith rib. 



Through the Sacro-Sciatic Foramen the lower part of the*Sigmoid Flexure 

 and the Rectum are visible. 



The convex diaphragmatic surface of the spleen is shewn; as the spleen 

 is a viscus subject to man}' forms of enlargement, it is desirable to learn the 

 direction in which its increase in size must extend. 



The upper concave surface is in relation with the fundus of the Stomach; 

 this frequently pre\'ents a permanent enlargement upwards. The lower surface 

 rests upon solid viscera — left kidneA', Pancreas and left Supra-renal glands — 

 which under normal conditions caimot ea.sily be pushed aside. 



The Phrenico-Splenic Ligament prevents expansion vertically downwards, 

 but it affords a gliding surface along which the spleen may when enlarged slide 

 forwards and downwards. It is thus that the anterior jjole of an enlarged spleen 

 is mo.st readily felt at the anterior border of the loth iMb. 



