Henry Gray (18251861). Anatomy of the Human Body. 1918.
right cartilage, and the sides by two lines drawn from the end of the eighth left costal cartilage to the ends of the base line.
A space of some clinical importancethe space of Traubeoverlies the stomach and may be thus indicated. It is semilunar in outline and lies within the following boundaries: the lower edge of the left lung, the anterior border of the spleen, the left costal margin and the inferior margin of the left lobe of the liver.
Duodenum (Fig. 1225).The superior part is horizontal and extends from the pylorus to the right lateral line; the descending part is situated medial to the right lateral line, from the transpyloric line to a point midway between the transpyloric and transtubercular lines. The horizontal part runs with a slight upward slope from the end of the descending part to the left of the middle line; the ascending part is vertical, and reaches the transpyloric line, where it ends in the duodenojejunal flexure, about 2.5 cm. to the left of the middle line.
FIG. 1225 Front of abdomen, showing surface markings for duodenum, pancreas, and kidneys. A A. Plane through joint between body and xiphoid process of sternum. B B. Plane midway between A A and transpyloric plane. C C. Plane midway between transpyloric and transtubercular planes. (See enlarged image)
Small Intestine.The coils of small intestine occupy the front of the abdomen. For the most part the coils of the jejunum are situated on the left side, i.e., in the left lumbar and iliac regions, and in the left half of the umbilical region. The coils of the ileum lie toward the right in the right lumbar and iliac regions, in the right half of the umbilical region, and in the hypogastric region; a portion of the ileum is within the pelvis. The end of the ileum, i.e., the ileocolic junction, is slightly below and medial to the intersection of the right lateral and transtubercular lines.
Cecum and Vermiform Process.The cecum is in the right iliac and hypogastric regions; its position varies with its degree of distension, but the midpoint of a line drawn from the right anterior superior iliac spine to the upper margin of the symphysis pubis will mark approximately the middle of its lower border.
The position of the base of the vermiform process is indicated by a point on the lateral line on a level with the anterior superior iliac spine.
Ascending Colon.The ascending colon passes upward through the right lumbar region, lateral to the right lateral line. The right colic flexure is situated in the upper and right angle of intersection of the subcostal and right lateral lines.
Transverse Colon.The transverse colon crosses the abdomen on the confines of the umbilical and epigastric regions, its lower border being on a level slightly