The Anatomy of the Human Peritoneum and Abdominal Cavity: Considered from the Standpoint of Development and Comparative AnatomyHuntington, George S. (George Sumner)
Science
The Anatomy of the Human Peritoneum and Abdominal Cavity: Considered from the Standpoint of Development and Comparative Anatomy
Huntington, George S. (George Sumner)
Abdomen; Peritoneum
The two examples differ from each other in some details. In the first
case (Fig. 535, schema, Fig. 509, _III^a_) the caecum is rounded and
globular. The ventral longitudinal muscular band is vertical and
continued to the lowest point of the pouch, which greatly resembles the
caecum of a typical cynomorphous monkey.
In the second case (Fig. 536, schema, Fig. 509, _III^b_) the caecum turns
upwards and to the left, terminating in a sharp point, to which several
lobes of epiploic fat are attached.
We must assume that in these cases the embryonic portion of the caecal
bud was developed just sufficiently to yield the required adult pouch
with nothing to spare, so to speak, which could remain rudimentary in
the form of an appendix.
Instances of exceedingly rudimentary and reduced appendix are also
encountered.
In the case illustrated in Fig. 537 the appendix formed a small conical
elevation without distinct lumen, measuring only 0.5 cm. in length.
[Illustration: FIG. 537.--Human adult. Ileo-colic junction and caecum,
with rudimentary appendix. (Columbia University Museum, No. 1655.)]
=B. Position and Peritoneal Relations of the Appendix.=--Statistical
records of the position of the appendix indicate a wide range of
variation. In general the results obtained by different observers show
that certain positions of the appendix are encountered in a sufficiently
large percentage of the cases to enable us to adopt a classification,
but that a very extensive series of records are required in order to
determine even approximately the preponderant relations of the appendix.
The following are the most frequently observed positions:
1. The appendix is directed upward, inward and to the left, the terminal
portion being frequently coiled under cover of the ileum and mesentery.
This position of the appendix is largely due to the normal crescentic
curve of the caecum, which carries the apex of the pouch and the root of
the appendix upward and to the left. Its production is, moreover,
favored by the tendency of the adult caecum to develop by dilatation of
the ventral and right wall at the expense of the left side of the pouch,
thus relatively shortening the interval between the origin of the
appendix and the ileo-colic junction.
Examples of this commonly encountered position of the appendix are given
in Figs. 512, 513, 514, 520, 521, 523 and 526.
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