TOPOGRAPHY OF THE THORAX AND ABDOMEN 4 1 



bral column than to the anterior wall, since nearly every 

 anatomist locates it near the seventh left sternochondral 

 articulation. The pylorus in this subject is lower and fur- 

 ther from the midplane than the above mentioned anat- 

 omists place it, but when it is remembered that the pylorus 

 moves downward and to the right as the stomach is filled 

 and that the stomach was moderately distended in this casCj 

 it will appear that the, position of the pylorus as shown in 

 these plates agrees more or less closely with the usual con- 

 dition. 



DUODENUM AND JEJUNOILEUM 



The duodenum is seen in Plates XVII and XVIII. 

 It begins at the pylorus opposite the first lumbar vertebra, 

 rises about 1 cm. and turns backward and downward and 

 runs by the side of the vertebral column as far as the disc 

 between the second and third vertebrae. In its course up- 

 ward and to the left it crosses the vertebral column oppo- 

 site the lower half of the second and the upper half of the 

 third lumbar vertebrae and ends about 5 cm. to the left of 

 the midline opposite the first lumbar vertebra. The organ 

 when viewed from the front (Plates XXVIII and XXXII) 

 is roughly U-shaped with the right limb of the U nearly 

 vertical, the two ends at about the same level and about 

 10 cm. apart. The lowest point of the U is in front of and 

 a little to the right of the middle of the third lumbar ver- 

 tebra. 



The first portion lies between the liver externally, the 

 head of the pancreas internally, the pylorus anteriorly and 

 the kidney, suprarenal gland and vena cava inferior poster- 

 iorly. (Plate XVII). Above it, is the inferior surface of the 

 right lobe of the liver, to which it is bound by the hepatodu- 



