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Home  »  Anatomy of the Human Body  »  pages 1152

Henry Gray (1825–1861). Anatomy of the Human Body. 1918.

pages 1152

Leaving first the sides and then the front of the rectum, it is reflected on to the seminal vesicles and fundus of the urinary bladder and, after covering the upper surface of that viscus, is carried along the medial and lateral umbilical ligaments (Fig. 1036) on to the back of the abdominal wall to the level from which a start was made.


FIG. 1036– Posterior view of the anterior abdominal wall in its lower half. The peritoneum is in place, and the various cords are shining through. (After Joessel.) (See enlarged image)
  Between the rectum and the bladder it forms, in the male, a pouch, the rectovesical excavation, the bottom of which is slightly below the level of the upper ends of the vesiculæ seminales—i. e., about 7.5 cm. from the orifice of the anus. When the bladder is distended, the peritoneum is carried up with the expanded viscus so that a considerable part of the anterior surface of the latter lies directly against the abdominal wall without the intervention of peritoneal membrane (prevesical space of Retzius). In the female the peritoneum is reflected from the rectum over the posterior vaginal fornix to the cervix and body of the uterus, forming the rectouterine excavation (pouch of Douglas). It is continued over the intestinal surface and fundus of the uterus on to its vesical surface, which it covers as far as the junction of the body and cervix uteri, and then to the bladder, forming here a second, but shallower, pouch, the vesicouterine excavation. It is also reflected from the sides of the uterus to the lateral walls of the pelvis as two expanded folds, the broad ligaments of the uterus, in the free margin of each of which is the uterine tube.

Vertical Disposition of the Omental Bursa (lesser peritoneal sac) (Fig. 1035).—A start may be made in this case on the posterior abdominal wall at the anterior border of the pancreas. From this region the peritoneum may be followed upward