TOPOGRAPHY OF THE THORAX AND ABDOMEN 37 



of the vena cava superior, and is also somewhat larger. 

 At its origin the vein rests upon the anterior surface of 

 the vertebral column and the right psoas major muscle. 

 Over the second and first lumbar vertebrae, the right crus 

 separates it from the vertebral column. From this level 

 up to where it pierces the diaphragm it is separated from the 

 centra by the lumbar portion of the diaphragm. It is 

 crossed anteriorly by the third portion of the duodenum 

 and the head of the pancreas and lies just internal to the 

 first and second portions of the duodenum, and anteroin- 

 ternal to the right kidney, from which it is separated by 

 the suprarenal gland. Above the level of these structures 

 it is embedded in the posterior surface of the liver be- 

 tween the right and Spigelian lobes. 



THE OESOPHAGUS 



The oesophagus begins at the lower part of the sixth 

 cervical vertebra and ends opposite the upper half of the 

 tenth thoracic vertebra. It lies just anterior to the ver- 

 tebral column near the midplane of the body. In the region 

 of the last cervical and the fiirst three thoracic vertebrae 

 more than half of the oesophagus is to the left of the mid- 

 plane. Over the fourth and fifth vertebrae it is pushed to 

 the right of the midplane by the arch of the aorta. In the 

 remainder of its course it deviates to the left and crosses 

 the anterior surface of the aorta in front of the ninth ver- 

 tebra. It pierces the diaphragm at this level and enters 

 the cardiac portion of the stomach to the left of the 

 tenth vertebra. Above the root of the lung it lies be- 

 tween the trachea and the vertebral column, with both of 

 which it is in contact. It is in relation by its lateral sur- 

 faces above with the lateral lobes of the thyreoid gland 



