The Anatomy of the Human Peritoneum and Abdominal Cavity: Considered from the Standpoint of Development and Comparative AnatomyHuntington, George S. (George Sumner)
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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
Begin by following the caudal layer of the transverse mesocolon dorsad
on the right side. In the angle between ascending and transverse colon
(hepatic flexure) pressure will locate the caudal portion of the ventral
surface of the right kidney. Remember that the peritoneum touched in
these procedures appears in the adult as parietal prerenal peritoneum,
but that in reality it is the left leaf of the originally free ascending
mesocolon, whereas the original right leaf of this membrane and the
primitive parietal peritoneum have, by adhesion of their serous
surfaces, been converted into the loose subserous connective tissue
covering the ventral aspect of the kidney beneath what now appears as
parietal peritoneum.
Mesad of the resistance offered to the finger by the right kidney the
caudal (infra-colic) portion of the descending duodenum and the angle of
transition between it and the third or transverse portion will be found,
invested in the same way by secondary (mesocolic) parietal peritoneum.
It will be seen, especially if the duodenum is injected or inflated,
that the hepatic flexure of the colon lies ventrad of the vertical
descending second portion of the duodenum, so that one part of this
intestine is situated cephalad the other caudad of the colon. (Supra-
and infra-colic segments of descending duodenum.)
Individual differences are observed in the area of colic attachment to
the duodenum. Usually the two intestines are in contact with each other
and adherent over a considerable surface. Exceptionally the transverse
mesocolon extends across to the right so as to include the hepatic
flexure. In this latter case the uncovered non-peritoneal surface of the
descending duodenum is small, represented by the interval between the
layers of the transverse mesocolon, and the hepatic flexure is then not
directly adherent to the gut.
If we now trace the transverse duodenum from right to left we will
encounter the right layer of the root of the jejuno-ileal mesentery. The
caudal layer of the transverse mesocolon, the right leaf of the
mesentery and the secondary parietal peritoneum investing the ventral
surface of the transverse duodenum all meet at this point. Surround the
mesentery of the free small intestine with the fingers of one hand so
that the entire mass of intestinal coils can be swung alternately from
side to side.
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