Atlas and text-book of topographic and applied anatomy / by Oskar Schultze ; edited with additions by George D. Stewart.

  • Schultze, Oskar, 1859-1920.
Date:
[1905], ©1905
Catalogue details

Licence: Public Domain Mark

Credit: Atlas and text-book of topographic and applied anatomy / by Oskar Schultze ; edited with additions by George D. Stewart. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    PLATE 16. The position of the thymus gland, heart, liver, stomach, spleen, and intestines of a fifteen-year-old girl as seen from the left. The left lung has been removed. From a Leipzig model from nature (His). hepatic artery also supplies the liver as it runs in the ligamentum hepatoduodenale* as the arteria hepatica propria and enters the liver at the transverse fissure. The third branch of the hepatic artery, the gastroduodenal, divides into the superior pancreatico-duodenal artery for the head of the pancreas and the gastro-epiploica dextra, which passes to the left along the greater curvature of the stomach. The splenic artery, the third terminal division of the cehac axis, runs along the upper margin of the pancreas behind the stomach (see page 129 and Fig. 61) to the hilus of the spleen and gives off the gastro-epiploica sinistra, which runs to the right along the greater cur- vature, supplying the stomach and the great omentum and anastomosing withthe gastro- epiploica dextra. The veins of the stomach are the gastro-epiploica sinistra and dextra, running along the greater curvature, and the vena coronaria ventriculi along the lesser one. At the cardia, the coronary vein anastomoses with the esophageal veins, and through these with the vena azygos major (see page 123 and Fig. 55). All of the gastric veins empty into the portal system. The pneumogastric nerves have been described upon page 116; the left pneumogastric passes chiefly to the anterior surface, while the right one suppHes the posterior surface of the stomach. The Liver.—The relations of the Hver, the largest organ of the abdominal cavity, are of particular importance to the physician on account of the many diseases of this viscus, of which those of the bihary passages in particular are now treated by surgical measures. The organ lies chiefly in the right hypochondrium, but also extends across the epigastrium into the left hypo- chondriac region (Plates 11-14 and 16). The upper convex surface, divided into the right and the left lobe by the falciform ligament, is in immediate relation with the diaphragm (Plates 10, 13, and 14, and Figs. 49 and 62). Since this structure projects upward into the thorax, the greater portion of the Hver is surrounded by the ribs, but the right pleural sac (Figs. 49 and 62 and Plate 14) is interposed between the hver and the thoracic wall, so that penetrating wounds which pass between the ribs and involve the liver, as a rule, open this pleural cavity. The upper surface of the Hver is not only in relation with the right lung, the diaphragm being interposed, but also with the heart, with the pericardial cavity (Fig. 62), and with a portion of the left lung. Hepatic abscesses may consequently per- forate the diaphragm and rupture into the pleural cavities or into the pericardium. Such an occurrence is, of course, preceded by peritoneal adhesions between the upper surface of the liver and the lower surface of the diaphragm. An abscess of the Hver may also perforate into a bron- chus, so that pus from the Hver may be expectorated; in such a case, the inferior surface of the lung must have contracted adhesions to the diaphragm. If one of the pleural cavities becomes filled with an exudate or with air (pneumothorax), the diaphragm and the Hver m^ust be dis- placed downward. The details of the inferior surface of the liver are very pecuHar and best fixed upon the mind when the organ has been left in place. While the inferior surface of a liver which has been * Free edge of lesser omentum.