Anatomy, Surgical and topographical -- Atlases; Surgery -- Atlases; Surgery, Operative -- Atlases
The thoracic aorta descends along the left side of the spine, as far as
the last dorsal vertebra, at which situation the pillars of the
diaphragm overarch the vessel. From this place the aorta passes
obliquely in front of the five lumbar vertebrae, and on arriving
opposite the fourth, it divides into the two common iliac branches. The
aorta, for an extent included between these latter boundaries, is named
the abdominal aorta, and from its fore part arise those branches, which
supply the viscera of the abdomen.
The branches which spring from the abdominal aorta to supply the viscera
of this region, are considerable, both as to their number and size. They
are, however, of comparatively little interest in practice. To the
anatomist they present many peculiarities of distribution and form
worthy of notice, as, for example, their frequent anastomosis, their
looping arrangement, and their large size and number compared with the
actual bulk of the organs which they supply. As to this latter
peculiarity, we interpret it according to the fact that here the vessels
serve other purposes in the economy besides that of the support and
repair of structure. The vessels are large in proportion to the great
quantity of fluid matter secreted from the whole extent of the inner
surface of this glandular apparatus--the gastro-intestinal canal, the
liver, pancreas, and kidneys.
As anatomists, we are enabled, from a knowledge of the relative position
of the various organs and bloodvessels of both the thorax and abdomen,
to account for certain pathological phenomena which, as practitioners,
we possess as yet but little skill to remedy. Thus it would appear most
probable that many cases of anasarca of the lower limbs, and of dropsy
of the belly, are frequently caused by diseased growths of the liver, P,
obstructing the inferior vena cava, R, and vena portae, rather than by
what we are taught to be the "want of balance between secreting and
absorbing surfaces." The like occurrence may obstruct the gall-ducts,
and occasion jaundice. Over-distention of any of those organs situated
beneath the right hypochondrium, will obstruct neighbouring organs and
vessels. Mechanical obstruction is doubtless so frequent a source of
derangement, that we need not on many occasions essay a deeper search
for explaining the mystery of disease.
In the right hypochondriac region there exists a greater variety of
organs than in the left; and disease is also more frequent on the right
side. Affections of the liver will consequently implicate a greater
number of organs than affections of the spleen on the left side, for the
spleen is comparatively isolated from the more important blood vessels
and other organs.
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