Henry Gray (18251861). Anatomy of the Human Body. 1918.
2e. The Abdomen
The abdomen is the largest cavity in the body. It is of an oval shape, the extremities of the oval being directed upward and downward. The upper extremity is formed by the diaphragm which extends as a dome over the abdomen, so that the cavity extends high into the bony thorax, reaching on the right side, in the mammary line, to the upper border of the fifth rib; on the left side it falls below this level by about 2.5 cm. The lower extremity is formed by the structures which clothe the inner surface of the bony pelvis, principally the Levator ani and Coccygeus on either side. These muscles are sometimes termed the diaphragm of the pelvis. The cavity is wider above than below, and measures more in the vertical than in the transverse diameter. In order to facilitate description, it is artificially divided into two parts: an upper and larger part, the abdomen proper; and a lower and smaller part, the pelvis. These two cavities are not separated from each other, but the limit between them is marked by the superior aperture of the lesser pelvis.
The abdomen proper differs from the other great cavities of the body in being bounded for the most part by muscles and fasciæ, so that it can vary in capacity and shape according to the condition of the viscera which it contains; but, in addition to this, the abdomen varies in form and extent with age and sex. In the adult male, with moderate distension of the viscera, it is oval in shape, but at the same time flattened from before backward. In the adult female, with a fully developed pelvis, it is ovoid with the narrower pole upward, and in young children it is also ovoid but with the narrower pole downward.
Boundaries.It is bounded in front and at the sides by the abdominal muscles and the Iliacus muscles; behind by the vertebral column and the Psoas and Quadratus lumborum muscles; above by the diaphragm; below by the plane of the superior aperture of the lesser pelvis. The muscles forming the boundaries of the cavity are lined upon their inner surfaces by a layer of fascia.
The abdomen contains the greater part of the digestive tube; some of the accessory organs to digestion, viz., the liver and pancreas; the spleen, the kidneys, and the suprarenal glands. Most of these structures, as well as the wall of the cavity in which they are contained, are more or less covered by an extensive and complicated serous membrane, the peritoneum.
The Apertures in the Walls of the Abdomen.The apertures in the walls of the abdomen, for the transmission of structures to or from it, are, in front, the umbilical (in the fetus), for the transmission of the umbilical vessels, the allantois, and vitelline duct; above, the vena caval opening, for the transmission of the inferior vena cava, the aortic hiatus, for the passage of the aorta, azygos vein, and thoracic duct, and the esophageal hiatus, for the esophagus and vagi. Below, there are two apertures on either side: one for the passage of the femoral vessels and lumboinguinal nerve, and the other for the transmission of the spermatic cord in the male, and the round ligament of the uterus in the female.
Regions.For convenience of description of the viscera, as well as of reference to the morbid conditions of the contained parts, the abdomen is artificially divided into nine regions by imaginary planes, two horizontal and two sagittal, passing through the cavity, the edges of the planes being indicated by lines drawn on the surface of the body. Of the horizontal planes the upper or transpyloric is indicated by a line encircling the body at the level of a point midway between the jugular notch and the symphysis pubis, the lower by a line carried around the trunk at the level of a point midway between the transpyloric and the symphysis pubis. The latter is practically the intertubercular plane of Cunningham, who pointed out1 that its level corresponds with the prominent and easily defined tubercle on the iliac crest about 5 cm. behind the anterior superior iliac spine. By means of these
Note 1. Journal of Anatomy and Physiology, vol. xxvii. [back]