The dissector's manual of practical and surgical anatomy / By Erasmus Wilson.

  • Wilson, Erasmus, Sir, 1809-1884.
Date:
1856
Catalogue details

Licence: Public Domain Mark

Credit: The dissector's manual of practical and surgical anatomy / By Erasmus Wilson. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    pelvivS. At about the lower third of the ileum a pouch-like pro- cess or diverticulum of the intestine is occasionally seen. This is a vestige of embryonic structure, and is formed by the oblite- ration of the vitelline duct at a short distance from the cylinder of the intestine. LARGE INTESTINE. The large intestine, about five feet in length, is sacculated in appearance, and is divided into the ccBcum, colon, and rectum. The ccecum (caecus, blind) is the blind pouch, or cul-de-sac, at the commencement of the large intestine. It is situated in the right iliac fossa, and is retained in its place by the peritoneum which passes over its anterior surface; its posterior surface is connected by loose cellular tissue with the iliac fascia. Attached to its extremity is the appendix vermiformis, a long worm-shaped tube, the rudiment of the lengthened caecum found in all mam- miferous animals except man and the higher quadrumana. The appendix varies in length from one to five or six inches; it is about equal in diameter to a goose-quill, and is connected with the posterior and left aspect of the cacum, near the extremity of the ileum. It is usually more or less coiled upon itself, and re- tained in that coil by a falciform duplicature of peritoneum. Its canal is extremely small, and the orifice by which it opens into the caecum not unfrequently provided with an incomplete valve. Occasionally the peritoneum invests the caecum so completely as to constitute a mesoca^cum, which permits of an unusual degree of movement in this portion of the intestine, and serves to ex- plain the occurrence of hernia of the caecum upon the right side. The ciecum is the most dilated portion of the large intestines. The colon is divided into ascending, transverse, and descending. Tlie ascending colon passes upwards from the right iliac fossa, through the right lumbar region, to the under surface of the liver. It then bends inwards (hepatic flexure), and crosses the upper part of the umbilical region, under the name o^ transvei-se colon; and, on the left side (s})lenic flexure), descends (descending colon) through the left lumbar region to the left iliac fossa, where it makes a remarkable curve upon itself, which is called the sigmoid flexure. The ascending colon, the most dilated portion of the large in- testine, next to the ca^'um, is retained in its position in the abdomen either by the peritoneum i)assing sini})ly in front of it, or by a narrow mesocolon. It is in relation, in front, with the small intestine and abdominal ])arietes; behind, with the quad- ratus lumborum muscle and right kidney; intemallg, with the small intestine and the i)crpeiulic'Lilar portion of the duodenum;