Operative surgery . he fourth rib correspondsto the upper limit of the liver on the right side at the mammary line; thejunction of the sixth rib with the cartilage lies close to the upper and outerlimits at the left side and in front. The lung covers the liver behind downto the tenth dorsal spine, or to about the ninth rib; posteriorly the liver liesbehind the lower ribs, extending from the eleventh upward to the fifth orsixth; anteriorly, at the right, it lies behind part of the ensiform cartilageand the costal cartilages of the fifth, sixth, seventh, eighth, and ninth ribs;in front, at the l
Operative surgery . he fourth rib correspondsto the upper limit of the liver on the right side at the mammary line; thejunction of the sixth rib with the cartilage lies close to the upper and outerlimits at the left side and in front. The lung covers the liver behind downto the tenth dorsal spine, or to about the ninth rib; posteriorly the liver liesbehind the lower ribs, extending from the eleventh upward to the fifth orsixth; anteriorly, at the right, it lies behind part of the ensiform cartilageand the costal cartilages of the fifth, sixth, seventh, eighth, and ninth ribs;in front, at the left, it corresponds below to the tip of the eighth costal car-tilage of that side; below the ensiform cartilage it lies superficially and incontact with the abdominal wall, extending downward almost halfway tothe navel. For completer detail in those matters the reader is referred tothe standard works on anatomy. Tlie downward movement of the liver and 792 opp:rative surgery. ;/.J£>V u «i>caaOm»^£UiUK::V^. Va-tjuelirts Ca^uderij Fig. 1004.—Instruinents employed in operations on the liver. a Scalpels, b. Bistouries, c. d. Curved and straight scissors, e. Dis-? seetin- and mouse-tooth forceps. /. Needle forceps. /;. Retractors. *? £PV?e-holder /. Drainage tube. A. Traction loops. /. Chromicized catgut, n. btraigtitand curved needles, o. Silkworm, silk, and catgut sutures, p. Large and smallgauze pads with tails, q. Hypodermic syringe. Sponges, wipers, tenacula, cos-totome, and good light are also essential. OPERATIONS ON VlSCKlfA CONNIKTKI) Willi 793 the iipwaid :iud outward iiiuveiueiits of the lilj-s during iiiripiration suggesttlie jidvisability of contijienient of the ribs iit the right side during opcrutivel)rocedures im the liver if the piitieiits safety will permit. The thinness ofthe liver eai)sule and the fiiability of the liver tissue render elosun^ of woundsof the organ a ditlieult and unsatisfactory procedure. Operations for Ab
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