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    Effath Maria Choyon
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    Dutta Thorax & Abdomen

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    Dutta Thorax & Abdomen

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
    4K views2 pages

    Dutta Thorax & Abdomen

    Uploaded by

    Effath Maria Choyon
    Dutta Thorax & Abdomen

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
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    Dearden coords: O c ch Tia Meso-appendix —— Hiatus muscularis Mucous coat Lymphatic follicles in sub-mucous coat Muscular coat Serous coat L dS Fig, 2.43 : Structure of vermiform appendix. enterochromaffin cells and is devoid of villi. The appendicular lumen is occasionally obstructed by the faecoliths The structures of the appendix suggest that it is not a vestigial organ but a specialised one, but the cause of specialisation in human is not understood, Development The appendix is developed from the lower narrow part of caecal diverticulum which arises from the distal limb of the U-shaped loop of the primitive mid gut. To reach the right iliac fossa, the caecum and appendix undergo 270° rotation around the axis of the superior mesenteric artery (Vide development of caecum). Applied anatomy Inflammation of the appendix known as appendicitis is not uncommon. It is usually ‘manifested by pain, vomiting and temperature. The pain is often felt first in the umbilical region, then settles in the right iliac area due to local peritonitis; it is associated with tenderness and rigidity. In retrocaecal appendix typical clinical features may not be observed: but the patient experiences pain on extension of right hip joint due to tension of the irritated right psoas major muscle (Psoas test). The anatomical factors producing inflammation may be as follows (@ The appendix is ablind tube. A faecolith may obstruct the lumen and precipitate the attack of appendicitis. (©) Supplied by an end artery. (©) Presence of hiatus muscularis. @ Presence of numerous lymphatic follicles in the submucous coat, ESSENTIALS OF HUMAN ae (PART 1) THE COLON The colon consists of the following parts in succession — ascending, transverse, descending and sigmoid [See. Fig. 2.33]. Ascending Coton Itis about 15 cm long and 5 cm in calibre. It extends upwards as a continuation of the caecum from the transtubercular plane to the right colic flexure, where it turns to the left side and is continuous with the transverse colon. The right flexure is situated about 2.5 cm below transpyloric plane and 10 cm to the right side of the middle line, The ascending colon lies just outside the right lateral plane. ‘Taenia libera lies in front, taenia mesocolica on the postero-medial surface and taenia omentalis on the posterolateral surface of ascending colon, Appendi- ces epiploicae are found on the anterior surface usually between taenia libera and taenia mesocolica. The anterior surface and the sides are covered with peritoneum. The posterior surface of the ascending colon is non-peritoneai, and is related to the fascia iliaca covering right ilio-psoas muscle, ilio-lumbar ligament, quadratus lumborum and anterior layer of thoraco-lumbar fascia, right fourth lumbar artery, ilio- inguinal and iliohypogastric nerves, subcostal vessels and nerve, lower pole of the right kidney. The ascending colon is supplied by a part of the marginal artery of Drummond which is formed by the aiastomosis of ileocolic and right colic branches of the superior mesenteric artery. Transverse Colon Ttextends across the abdominal cavity from the right colic to left colic flexures and describes a curve, which is convex downwards and forwards and is suspended from the posterior abdominal wall by a peritoneal fold, the transverse mesocolon (Fig. 2.44). ents Length— 50cm. Breadth — 5 cm, close to the right end; 3.54 cm, close to the left end. Presenting Parts The transverse colon presents right colic flexure, colon proper, and left colic flexure. THE ALIMENTARY SYSTEM [ “Transverse mesocolon Pancreas | Kidney (Right) Duodenum (Second part) Greater omentum Fig. 2.44 RIGHT COLIC FLEXURE (Hepatic flexure) Itis the junction of ascending and transverse colon, and is situated in the right lumbar region ‘Topographically, the flexure is represented by a point about 2.5 cm, below the transpyloric plane and 10 cm, tothe right of the median plane. Relations In front and above, it is covered with peritoneum Behind, itis non-peritoneal, and related to the lower pole of the right kidney. Medially, related to the second part of duodenum and fundus of the gall bladder. COLON PROPER From the right flexure it passes medially for about 5 cm. Between the head of the pancreas and the lateral end of spleen it presents a “V" or “U" shaped loop which extends downwards and forwards to the umbilical or hypogastric region, The loop is suspended from the anterior border of the body of pancreas by transverse mesocolon. Close to the lateral end of spleen it bends abruptly downwards and backwards, and is continuous with the descending colon at the left colic flexure. Sometimes it describes a second “U" shaped loop close tothe left flexure. Relations The transverse colon is covered with peritonenm except. (i) along taeniae omentalis and mesocolica for Right colic flexure WZ

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