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
We have already seen that the transverse colon and mesocolon effect a
general division of the adult human abdominal cavity into a cephalic
supra-colic compartment, situated between the diaphragm and the level of
the transverse colon and mesocolon, comprising in general the
hypochondriac and epigastric regions, and a larger caudal infra-colic
space which includes the entire rest of the abdominal cavity and is
continued caudad into the pelvic cavity. The arrangement of the
peritoneum and viscera in this latter space has just been considered.
The fact will be recalled that the second or descending portion of the
duodenum, passing dorsad of the hepatic colic flexure, forms so to speak
the visceral connection between the portions of the alimentary tube
situated in the supra-colic compartment and those situated in the
infra-colic space. The fixation of this segment of the duodenum and its
consequent secondary retroperitoneal position in the adult human subject
masks this continuity of the alimentary canal to a certain extent so
that it requires more than a superficial examination in order to trace
correctly the course of the duodenum from the pylorus to the
duodeno-jejunal angle, dorsad of the colon, root of transverse mesocolon
and mesentery, and under cover of the secondary parietal peritoneum.
We have now to turn our attention to the viscera contained in the
cephalic or supra-colic compartment of the abdomen and to consider the
disposition of the serous membrane investing them and connecting them
with each other and with the abdominal parietes.
The visceral contents of the supra-colic compartment comprise the
liver, pancreas, spleen, stomach and the proximal portion of the
duodenum, including the hepatic angle and the supra-colic part of the
descending duodenum. Less directly the cephalic portions of the right
and left kidney and the corresponding suprarenal capsules belong to this
visceral group.
In this region of the abdomen we meet with the most extensive
modifications of the primitive dorsal peritoneal membrane, producing
conditions which, considered without reference to development and
comparative anatomy, are complex and difficult of comprehension. These
changes lead to the formation of the so-called "lesser sac," a term
which in some respects is unfortunate as it implies a more complete
degree of separation from the general peritoneal cavity or "greater sac"
than actually exists.
In order to clearly understand the adult arrangement of the peritoneum
in this region it is advisable to consider the subject in two distinct
subdivisions, dealing successively with the two cardinal facts which
contribute to effect the change from the simple primitive to the
complicated adult condition.
These two main elements are:
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