1184 DIGESTIVE SYSTEM 



lobe of the inferior surface; that posterior to the cross-bar to the caudate lobe of 

 the posterior surface; while the remainder of the liver, to the right of the H, is 

 the right lobe (in the narrower sense). 



The right lobe [lobus hepatis dexter] makes up the greater part of the hver. Its relations 

 on the superior and posterior surfaces have already been mentioned. On the inferior or visceral 

 surface (fig. 942), there appears posteriorly a large concavity [impressio renalis] for the right 

 kidney; medially a faint impression [impressio duodenalis] for the descending duodenum; and 

 antero-inferiorly a variable area [impressio colica] of contact with the right (hepatic) flexure 

 of the colon. The caudate process joins the right with the caudate lobe. 



The left lobe [lobus hepatis sinister] lies to the left of the left sagittal fissure and the falci- 

 form ligament. It is flattened but variable in form and size, and makes only about one-fifth 

 of the entire liver. In children and especially in early foetal life, it is relatively much larger. 

 At the left extremity, there is usually found in the adult liver a variable fibrous band [appendix 

 fibrosa hepatis] representing the atrophied remnant of the more extensive gland in earlier life. 

 In this fibrous appendix (and in other parts of the liver) the bile ducts of the atrophied liver 

 substance persist as vasa aherrantia hepatis. 



The left lobe is related superiorly, through the diaphragm, with the heart and the base of 

 the left lung. Inferiorly (fig. 942) it presents a large concavity [impressio gastrica] which is 

 in contact with the anterior surface of the stomach. Above and behind the gastric impression 

 is the rounded tuber omentale which is placed above the lesser curvature of the stomach and re- 

 lated, through the lesser omentum, with a corresponding tuberosity on the pancreas. To the 

 left of the tuber omentale, and near the posterior aspect of the liver, is a small inconspicuous 

 groove [impressio oesophagea] for the abdominal part of the oesophagus. 



The quadrate lobe [lobus quadratus] lies, as before mentioned, on the inferior surface of 

 the liver (fig. 942) in the anterior or inferior area of the H. It is in contact with the pylorus 

 and the first part of the duodenum. 



Fig. 946. — Relation of Structures at and Below the Transverse or Portal 

 Fissure. Anteior view. (Thane.) 



Gall-bladder 



Common bile-duct— — T — ^^ / — ! Hepatic artery 



Portal vein 



The caudate or Spigelian lobe [lobus caudatus; Spigeli] was described on the posterior sur- 

 face of the liver (fig. 943). Inferiorly, the caudate lobe, behind the portal fissure, is divided 

 by a notch into two processes. The left or papillary process [processus papillaris] is short and 

 rounded, and lies opposite the tuber omentale. In the foetus it is relatively much larger and is 

 in contact with the pancreas. The right or caudate process [processus caudatus] is of variable 

 size, and joins the caudate with the right lobe of the liver. It is usually small and inconspicuous. 

 In the foetus, however, it is relatively much larger, and extends downward to a variable extent 

 behind the duodenum and head of the pancreas. In the adult, it forms the upper boundary of 

 the epiploic foramen (of Winslow). 



Peritoneal relations. — The liver in the adult is almost entirely surrounded by 

 peritoneum. Although it develops together with the diaphragm in the common 

 septum transversum (as explained previously, see figs. 951,952), the peritoneum 

 soon extends in bctwcc^ii liver and diaphragm, so that they remain in immediate 

 contact only in the so-called 'uncovered area.' This is an irregular area on the 

 posterior surface of the liver (chiefly on the right lobe), the margins of which cor- 

 respond to the coronary ligament (figs. 905, 944). The posterior surface of the 

 liver is therefore chiefly retroperitoneal, excepting the caudate (Spigelian) lobe, 

 which is in contact with the recessus superior of the bursa omentalis (fig. 905). 

 The superior and inferior surfaces of the liver are entirely covered with peritoneum, 

 excepting the lines of attacliment of the various peritoneal ligaments, and the 

 fossa for the gall-bladder, which is usually directly in contact with the gall blad- 

 der with no intervening periton(!um. 



Ligaments. — ^The liver is attached by five peritoneal ligaments — coronary, 

 right and left triangular (lateral) and falciform ligaments and lesser omentum—* 

 and two accessory ligaments — teres and venosum. 



The coronary ligament [lig. coronarium hepatis], as before mentioned, corre- 



