The Anatomy of the Human Peritoneum and Abdominal Cavity: Considered from the Standpoint of Development and Comparative AnatomyHuntington, George S. (George Sumner)
Science
The Anatomy of the Human Peritoneum and Abdominal Cavity: Considered from the Standpoint of Development and Comparative Anatomy
Huntington, George S. (George Sumner)
Abdomen; Peritoneum
II. In the next place, in order to understand the arrangement of the
peritoneum in this lower larger compartment of the abdomen, disregard
for the present the peritoneal connections of the stomach, liver,
pancreas and spleen, and the folds of the great omentum entirely. This
latter membrane is adherent in the adult human subject by its dorsal
surface to the upper margin of the transverse colon, so that in turning
the omentum up over the ventral chest wall the transverse colon will be
carried with the omentum and the lower layer of the transverse mesocolon
will be put upon the stretch. This membrane forms in adult man by its
transverse attachment to the abdominal background the cephalic limit of
the larger lower compartment of the abdomen, which is framed laterally
by ascending and descending colon, continuous below with the pelvic
cavity and occupied chiefly by the freely movable coils of the
jejuno-ileum.
Remember that the duodenum starting from the pyloric extremity of the
stomach first turns cephalad and dorsad in contact with the caudal
surface of the right lobe of the liver, forming the first portion or
hepatic angle of the duodenum; that in the next place the second or
descending portion of the duodenum passes down in front of the medial
part of the ventral surface of the right kidney and the inferior vena
cava, but _behind_ the right extremity (hepatic flexure) of what after
rotation and formation of the ascending colon appears as the transverse
colon; that consequently the descending duodenum is divided by its
intersection with the transverse colon into a cephalic supra-colic and a
caudal infra-colic segment.
Also remember that the second angle of the duodenum (transition between
the descending and transverse portions) is consequently situated to the
right of the vertebral column below the level of the transverse colon
and the secondary attachment presently to be considered of the
transverse mesocolon to the background of the abdominal cavity.
The third portion of the duodenum extends from this point more or less
transversely--depending upon the type--to the left, across the vertebral
column and aorta. This transverse portion, after the rotation of the
primitive loop at the duodeno-colic angle, is crossed in the direction
caudad and ventrad by the superior mesenteric vessels, which hence
divide this portion of the intestine into a right and left segment.
The latter turns cephalad and ventrad on the left side of the vertebral
column (4th or ascending portion) to become continuous at the
duodeno-jejunal angle with the free or floating small intestine
(jejunum).
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