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
2. Proximal branch of the same vessel, turning downward to caecum and
root of appendix.
3. Intermediate non-vascular fold.]
Fig. 567 shows the dorsal view of such a preparation. The caecum is
funnel-shaped with the apex, carrying the root of the appendix, turned
upward and to the left, the sacculation to the right of the ventral
muscular band being somewhat dilated. The appendix--7.2 cm. long--turns
sharply upward and to the left, closely applied to the left caecal
sacculation, passes dorsad to the ileo-colic junction and lies in its
terminal part under cover of the ileo-colic mesentery. The ventral
branch of the ileo-colic artery descends over the ileo-colic junction,
supplying the ventral wall of the caecum. The intermediate non-vascular
fold (3) is 3.9 cm. long and entirely free.
The dorsal vascular fold contains the large dorsal branch of the
ileo-colic artery, dividing into two main branches. The first of these
(1) passes distally in the free edge of the fold to the terminal part of
the appendix. The other proximal branch (2) turns downward to the root
of the appendix and the adjacent wall of the caecum, aiding materially in
holding the proximal upturned segment of the appendix in contact with
the left caecal sacculation.
The intermediate fold, short in its caecal attachment, does not meet the
dorsal vascular fold at any point, consequently the ileo-caecal fossa is
not limited caudad toward the root of the appendix. The conditions
presented by this specimen correspond exactly to those found in the
gorilla (Fig. 457) and in the human infantile preparation (Fig. 563).
In comparing Figs. 564 and 567 it will be noticed that the line of
fusion between the intermediate fold and the dorsal vascular fold (Fig.
564, 4) corresponds to the point where the dorsal ileo-caecal artery
divides into its proximal and distal branches (Fig. 567, angle between 1
and 2). Fig. 567 shows that the proximal arterial twig, even without
fusion with the intermediate fold, suffices to influence to a
considerable degree the curves and position of the appendix, inasmuch as
it serves to hold the proximal segment of the tube closely applied in
the erected position to the surface of the left caecal sacculation. The
intermediate segment of the appendix, between the points of accession of
the two arterial branches, is most prone to develop spiral
twists and bends, especially when the usual fusion of the two folds
takes place and still further fixes the parts, while the distal segment,
carrying the narrow crescentic terminal appendicular mesentery, remains
free.
[Illustration: FIG. 568.--Human adult. Ileo-colic junction and caecum.
(Drawn from preparation in Columbia University, Study Collection.)
1. Distal and
2. Proximal branch of dorsal ileo-caecal artery running in dorsal
vascular fold.
3. Intermediate non-vascular fold fusing with 2 and forming a narrow
caudal limit to the posterior ileo-caecal fossa.]
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