THE STOMACH. ggg 



membranes: an external, or serous; a middle, or muscular; and an internal 

 or mucous. ' 



1. Serous memhrane.—This membrane, derived from the peritoneum 

 adheres closely to the muscular layer, except towards the lesser curvature' 

 where it is constantly covered by an expansion of yellow elastic tissue' 

 whose use appears to be to maintain the two extremities of the stomach 

 near each other ; for when this is destroyed the lesser cm'vature becomes 

 considerably elongated. Along the whole of the greater curvature is 

 a triangular space occupied by connective tissue; this space disappears 

 more or less completely as the organ becomes distended. 



It has three folds, which are detached from the stomach and carried on 

 to the adjacent parts, and which are formed in the manner indicated 

 in the general description of the peritoneum. These folds constitute 

 the cardiac ligament, the gastro-hepatic ligament or omentum, and the great 

 omentum. 



The cardiac ligament is a short, serous band developed around the 

 terminal extremity of the oesophagus, and strengthened by fibres of yellow 

 fibrous tissue. It attaches the stomach to the posterior face of the 

 diaphragm, and is continuous, on each side, with the two folds about to be 

 described. 



The gastro-hepatic (or lesser') ligament is a band composed of two layers, 

 which leave the lesser curvature of the stomach, and are inserted into the 

 posterior fissure of the liver. It is prolonged posteriorly, and to the right, 

 along the duodenum, where it constitutes a peculiar serous frsenum which 

 will be studied with the small intestine. 



The great, or gastro-colic omentum, is detached from the whole extent 

 of the great curvature, from the cardia to the pylorus, beyond which it 

 extends to the duodenum. The portion surrounding the left cul-de-sac is 

 excessively short, and is carried to the sublumbar wall of the abdomen, to 

 which the stomach is fixed. For the remainder of its extent, this omentum 

 is greatly developed, and hangs freely in the abdominal cavity, among the 

 intestinal convolutions. The border opposed to the stomach is attached 

 to the terminal portion of the large colon, and to the origin of the lesser 

 colon. For further details, see the description of the peritoneum. These 

 three ligaments fix the stomach in the abdominal cavity, in addition to the 

 oesophagus and duodenum, which are continuous with it. ' 



2. Muscular membrane. — This tunic, comprised between the serous and 

 mucous layers, is lined internally by a covering of condensed connective 

 tissue which adheres intimately to it, and which may be regarded as the 

 fibrous membrane of the stomach. Dissection shows this muscular tunic to 

 be composed of three superposed planes. 



The superficial plane envelops all the right sac, and the majority of the 

 fibres composing it are spread in loops around the left cul-de-sac, their 

 extremities being lost on the surfaces of the organ. Some of them even 

 extend over the great curvature, to the surface of the right sac; while 

 others are evidently continuous with the superficial fibres of the oesophagus 

 (Fig. 185, a). 



The middle plane (Fig. 185, b) is formed of circular fibres spread 

 over the whole of the organ. In the right sac, they are placed immediately 

 below the serous membrane ; in the left sac, they pass beneath the fibres 

 of the superficial plane, and finish by becoming confounded so intimately 

 with these, that towards the tuberosity formed by the left extremity it is 

 impossible to distinguish them. By their aggregation around the pylorus, 

 28 



