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The Anatomy of the Rectum and Anal Canal
BASIC SCIENCE identify the rectosigmoid junction with confidence at operation. The anatomy of the rectum The rectosigmoid junction usually lies approximately 6 cm below the level of the sacral promontory. Approached from the distal and anal canal end, however, as when performing a rigid or flexible sigmoid- oscopy, the rectosigmoid junction is seen to be 14e18 cm from Vishy Mahadevan the anal verge, and 18 cm is usually taken as the measurement for audit purposes. The rectum in the adult measures 10e14 cm in length. Abstract Diseases of the rectum and anal canal, both benign and malignant, Relationship of the peritoneum to the rectum account for a very large part of colorectal surgical practice in the UK. Unlike the transverse colon and sigmoid colon, the rectum lacks This article emphasizes the surgically-relevant aspects of the anatomy a mesentery (Figure 1). The posterior aspect of the rectum is thus of the rectum and anal canal. entirely free of a peritoneal covering. In this respect the rectum resembles the ascending and descending segments of the colon, Keywords Anal cushions; inferior hypogastric plexus; internal and and all of these segments may be therefore be spoken of as external anal sphincters; lymphatic drainage of rectum and anal canal; retroperitoneal. The precise relationship of the peritoneum to the mesorectum; perineum; rectal blood supply rectum is as follows: the upper third of the rectum is covered by peritoneum on its anterior and lateral surfaces; the middle third of the rectum is covered by peritoneum only on its anterior 1 The rectum is the direct continuation of the sigmoid colon and surface while the lower third of the rectum is below the level of commences in front of the body of the third sacral vertebra. -
Gross Anatomy
www.BookOfLinks.com THE BIG PICTURE GROSS ANATOMY www.BookOfLinks.com Notice Medicine is an ever-changing science. As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy are required. The authors and the publisher of this work have checked with sources believed to be reliable in their efforts to provide information that is complete and generally in accord with the standards accepted at the time of publication. However, in view of the possibility of human error or changes in medical sciences, neither the authors nor the publisher nor any other party who has been involved in the preparation or publication of this work warrants that the information contained herein is in every respect accurate or complete, and they disclaim all responsibility for any errors or omissions or for the results obtained from use of the information contained in this work. Readers are encouraged to confirm the infor- mation contained herein with other sources. For example and in particular, readers are advised to check the product information sheet included in the package of each drug they plan to administer to be certain that the information contained in this work is accurate and that changes have not been made in the recommended dose or in the contraindications for administration. This recommendation is of particular importance in connection with new or infrequently used drugs. www.BookOfLinks.com THE BIG PICTURE GROSS ANATOMY David A. Morton, PhD Associate Professor Anatomy Director Department of Neurobiology and Anatomy University of Utah School of Medicine Salt Lake City, Utah K. Bo Foreman, PhD, PT Assistant Professor Anatomy Director University of Utah College of Health Salt Lake City, Utah Kurt H. -
Female Perineum Doctors Notes Notes/Extra Explanation Please View Our Editing File Before Studying This Lecture to Check for Any Changes
Color Code Important Female Perineum Doctors Notes Notes/Extra explanation Please view our Editing File before studying this lecture to check for any changes. Objectives At the end of the lecture, the student should be able to describe the: ✓ Boundaries of the perineum. ✓ Division of perineum into two triangles. ✓ Boundaries & Contents of anal & urogenital triangles. ✓ Lower part of Anal canal. ✓ Boundaries & contents of Ischiorectal fossa. ✓ Innervation, Blood supply and lymphatic drainage of perineum. Lecture Outline ‰ Introduction: • The trunk is divided into 4 main cavities: thoracic, abdominal, pelvic, and perineal. (see image 1) • The pelvis has an inlet and an outlet. (see image 2) The lowest part of the pelvic outlet is the perineum. • The perineum is separated from the pelvic cavity superiorly by the pelvic floor. • The pelvic floor or pelvic diaphragm is composed of muscle fibers of the levator ani, the coccygeus muscle, and associated connective tissue. (see image 3) We will talk about them more in the next lecture. Image (1) Image (2) Image (3) Note: this image is seen from ABOVE Perineum (In this lecture the boundaries and relations are important) o Perineum is the region of the body below the pelvic diaphragm (The outlet of the pelvis) o It is a diamond shaped area between the thighs. Boundaries: (these are the external or surface boundaries) Anteriorly Laterally Posteriorly Medial surfaces of Intergluteal folds Mons pubis the thighs or cleft Contents: 1. Lower ends of urethra, vagina & anal canal 2. External genitalia 3. Perineal body & Anococcygeal body Extra (we will now talk about these in the next slides) Perineum Extra explanation: The perineal body is an irregular Perineal body fibromuscular mass. -
Variant Origins of Arteries in the Carotid Triangle - a Case Report
Case Report 281 Variant Origins of Arteries in the Carotid Triangle - A Case Report B. V. Murlimanju, MD; Latha V. Prabhu, MS; Mangala M. Pai, MD; Dhanya Jayaprakash, MBBS; Vasudha V. Saralaya, MS The left superior laryngeal artery was observed arising from the external carotid artery instead of the superior thyroid artery in the cadaver of an approximately 70 year-old Asian man. In addition, on the same side, the superior thyroid artery arose from the common carotid artery 2 cm before the bifurcation instead of its usual origin from the external carotid artery. From the external carotid artery, the lingual and facial arteries arose from the com- mon linguofacial trunk. The nerves in the carotid triangle were normal in course. No varia- tions were observed on the right side carotid system. The multiple variations in this case have not been previously described. The embryogenesis of this combination of variations is not clear, but the anatomic consequences may have important clinical implications. As angiography has gained popularity in diagnostic approaches in recent years, it is essential to be aware of these variations so that they are not overlooked in differential diagnoses. (Chang Gung Med J 2012;35:281-4) Key words: artery, superior laryngeal, superior thyroid, common carotid, external carotid, vari- ant origin natomical variations in the carotid triangle in the STA from the left CCA is reported here. In the Athe neck are important, especially during surgi- literature, a few variations in origin have been cal and radiological intervention in the region. reported for both arteries,(1-3) but the combination of Normally, the superior laryngeal artery (SLA) is a variations reported in this case has not been previ- branch of the superior thyroid artery (STA). -
By Dr.Ahmed Salman Assistant Professorofanatomy &Embryology My Advice to You Is to Focus on the Diagrams That I Drew
The University Of Jordan Faculty Of Medicine REPRODUCTIVE SYSTEM By Dr.Ahmed Salman Assistant ProfessorofAnatomy &embryology My advice to you is to focus on the diagrams that I drew. These diagrams cover the Edited by Dana Hamo doctor’s ENTIRE EXPLANATION AND WHAT HE HAS MENTIONED Quick Recall : Pelvic brim Pelvic diaphragm that separates the true pelvis above and perineum BELOW Perineum It is the diamond-shaped lower end of the trunk Glossary : peri : around, ineo - discharge, evacuate Location : it lies below the pelvic diaphragm, between the upper parts of the thighs. Boundaries : Anteriorly : Inferior margin of symphysis pubis. Posteriorly : Tip of coccyx. Anterolateral : Fused rami of pubis and ischium and ischial tuberosity. Posterolateral : Sacrotuberous ligaments. Dr.Ahmed Salman • Same boundaries as the pelvic Anteriorly: outlet. inferior part of • If we drew a line between the 2 symphysis pubis ischial tuberosities, the diamond shape will be divided into 2 triangles. Anterior and Anterior and Lateral : Lateral : •The ANTERIOR triangle is called ischiopubic ischiopubic urogenital triangle ramus The perineum ramus •The POSTERIOR triangle is called has a diamond anal triangle shape. ischial tuberosity Posterior and Posterior and Lateral : Lateral : Urogenital sacrotuberous sacrotuberous tri. ligament ligament Anal tri. Posteriorly : tip of coccyx UROGENITAL TRI. ANAL TRI. Divisions of the Perineum : By a line joining the anterior parts of the ischial tuberosities, the perineum is divided into two triangles : Anteriorly :Urogenital -
Lab #23 Anal Triangle
THE BONY PELVIS AND ANAL TRIANGLE (Grant's Dissector [16th Ed.] pp. 141-145) TODAY’S GOALS: 1. Identify relevant bony features/landmarks on skeletal materials or pelvic models. 2. Identify the sacrotuberous and sacrospinous ligaments. 3. Describe the organization and divisions of the perineum into two triangles: anal triangle and urogenital triangle 4. Dissect the ischiorectal (ischioanal) fossa and define its boundaries. 5. Identify the inferior rectal nerve and artery, the pudendal (Alcock’s) canal and the external anal sphincter. DISSECTION NOTES: The perineum is the diamond-shaped area between the upper thighs and below the inferior pelvic aperture and pelvic diaphragm. It is divided anatomically into 2 triangles: the anal triangle and the urogenital (UG) triangle (Dissector p. 142, Fig. 5.2). The anal triangle is bounded by the tip of the coccyx, sacrotuberous ligaments, and a line connecting the right and left ischial tuberosities. It contains the anal canal, which pierced the levator ani muscle portion of the pelvic diaphragm. The urogenital triangle is bounded by the ischiopubic rami to the inferior surface of the pubic symphysis and a line connecting the right and left ischial tuberosities. This triangular space contains the urogenital (UG) diaphragm that transmits the urethra (in male) and urethra and vagina (in female). A. Anal Triangle Turn the cadaver into the prone position. Make skin incisions as on page 144, Fig. 5.4 of the Dissector. Reflect skin and superficial fascia of the gluteal region in one flap to expose the large gluteus maximus muscle. This muscle has proximal attachments to the posteromedial surface of the ilium, posterior surfaces of the sacrum and coccyx, and the sacrotuberous ligament. -
Femoral Triangle Anatomy: Review, Surgical Application, and Nov- El Mnemonic
Journal of Orthopedic Research and Therapy Ebraheim N, et al. J Orthop Ther: JORT-139. Review Article DOI: 10.29011/JORT-139.000039 Femoral Triangle Anatomy: Review, Surgical Application, and Nov- el Mnemonic Nabil Ebraheim*, James Whaley, Jacob Stirton, Ryan Hamilton, Kyle Andrews Department of Orthopedic Surgery, University of Toledo Medical Center, Toledo Orthopedic Research Institute, USA *Corresponding author: Nabil Ebraheim, Department of Orthopedic Surgery, University of Toledo Medical Center, Orthopaedic Residency Program Director, USA. Tel: 866.593.5049; E-Mail: [email protected] Citation: Ebraheim N, Whaley J, Stirton J, Hamilton R, Andrews K(2017) Femoral Triangle Anatomy: Review, Surgical Applica- tion, and Novel Mnemonic. J Orthop Ther: JORT-139. DOI: 10.29011/JORT-139.000039 Received Date: 3 June, 2017; Accepted Date: 8 June, 2017; Published Date: 15 June, 2017 Abstract We provide an anatomical review of the femoral triangle, its application to the anterior surgical approach to the hip, and a useful mnemonic for remembering the contents and relationship of the femoral triangle. The femoral triangle is located on the anterior aspect of the thigh, inferior to the inguinal ligament and knowledge of its contents has become increasingly more important with the rise in use of the Smith-Petersen Direct Anterior Approach (DAA) to the hip as well as ultrasound and fluo- roscopic guided hip injections. A detailed knowledge of the anatomical landmarks can guide surgeons in their anterior approach to the hip, avoiding iatrogenic injuries during various procedures. The novel mnemonic “NAVIgate” the femoral triangle from lateral to medial will aid in remembering the borders and contents of the triangle when performing surgical procedures, specifically the DAA. -
Pleurectomy Through the Triangle of Auscultation
Thorax: first published as 10.1136/thx.37.12.945 on 1 December 1982. Downloaded from Thorax 1982;37:945-946 Pleurectomy through the triangle of auscultation OJ LAU, S SHAWKAT From the Thoracic Surgical Unit, Preston Hall Hospital, Aylesford, Kent The aetiology of primary spontaneous pneumothorax is Outpatient follow-up for one to three years has shown no unknown, though several theories have been proposed. The recurrence of pneumothorax. formation and rupture of "blebs" in the lung are frequently associated with primary pneumothorax, 1-3 but the manage- Discussion ment of the condition remains controversial and depends on its severity and the patient's previous medical history. For For most cases of primary spontaneous pneumothorax, definitive treatment pleurectomy still remains the treatment observation, bed rest, or intercostal tube drainage are of choice.4 5 We have treated 25 young patients with primary adequate; but for patients with persistent air leak, and for spontaneous pneumothorax with apical pleurectomy those with a history of recurrent attacks, some form of through the auscultation triangle, without incision of the definitive treatment is necessary. Various methods have muscles of the chest wall. We have found that this approach been recommended, from artificial obliteration of the has several advantages over a full thoracotomy. pleural space with various chemicals or oils to the stripping of the parietal pleura and closure of the air leak through a Operative technique and results formal thoracotomy. In our experience, these forms of treatment are often Twenty-five young patients with primary spontaneous associated with unnecessary pain and discomfort for the pneumothorax have been treated, of whom 15 were men. -
DEPARTMENT of ANATOMY IGMC SHIMLA Competency Based Under
DEPARTMENT OF ANATOMY IGMC SHIMLA Competency Based Under Graduate Curriculum - 2019 Number COMPETENCY Objective The student should be able to At the end of the session student should know AN1.1 Demonstrate normal anatomical position, various a) Define and demonstrate various positions and planes planes, relation, comparison, laterality & b) Anatomical terms used for lower trunk, limbs, joint movement in our body movements, bony features, blood vessels, nerves, fascia, muscles and clinical anatomy AN1.2 Describe composition of bone and bone marrow a) Various classifications of bones b) Structure of bone AN2.1 Describe parts, blood and nerve supply of a long bone a) Parts of young bone b) Types of epiphysis c) Blood supply of bone d) Nerve supply of bone AN2.2 Enumerate laws of ossification a) Development and ossification of bones with laws of ossification b) Medico legal and anthropological aspects of bones AN2.3 Enumerate special features of a sesamoid bone a) Enumerate various sesamoid bones with their features and functions AN2.4 Describe various types of cartilage with its structure & a) Differences between bones and cartilage distribution in body b) Characteristics features of cartilage c) Types of cartilage and their distribution in body AN2.5 Describe various joints with subtypes and examples a) Various classification of joints b) Features and different types of fibrous joints with examples c) Features of primary and secondary cartilaginous joints d) Different types of synovial joints e) Structure and function of typical synovial -
Vessels in Femoral Triangle in a Rare Relationship Bandyopadhyay M, Biswas S, Roy R
Case Report Singapore Med J 2010; 51(1) : e3 Vessels in femoral triangle in a rare relationship Bandyopadhyay M, Biswas S, Roy R ABSTRACT vein, the longest superficial vein in the body, ends in the The femoral region of the thigh is utilised for femoral vein, which is a short distance away from the various clinical procedures, both open and inguinal ligament after passing through the saphenous closed, particularly in respect to arterial and opening.(2) venous cannulations. A rare vascular pattern was observed during the dissection of the femoral CASE REPORT region on both sides of the intact formaldehyde- A routine dissection in undergraduate teaching of an preserved cadaver of a 42-year-old Indian intact formaldehyde-preserved cadaver of a 42-year-old man from West Bengal. The relationships and Indian man from West Bengal revealed a rare pattern patterns found were contrary to the belief that of relationship between the femoral vessels on both the femoral vein is always medial to the artery, sides. The femoral artery crossed the femoral vein deep just below the inguinal ligament and the common to the inguinal ligament, such that the artery was lying femoral artery. The femoral artery crossed the superficial to the vein at the base of the femoral triangle. vein just deep to the inguinal ligament so that The profunda femoris artery was seen lying lateral, and the femoral vein was lying deep to the artery at the great saphenous vein medial, to the femoral vessels the base of the femoral triangle. Just deep to the in the triangle. -
Parts of the Body 1) Head – Caput, Capitus 2) Skull- Cranium Cephalic- Toward the Skull Caudal- Toward the Tail Rostral- Toward the Nose 3) Collum (Pl
BIO 3330 Advanced Human Cadaver Anatomy Instructor: Dr. Jeff Simpson Department of Biology Metropolitan State College of Denver 1 PARTS OF THE BODY 1) HEAD – CAPUT, CAPITUS 2) SKULL- CRANIUM CEPHALIC- TOWARD THE SKULL CAUDAL- TOWARD THE TAIL ROSTRAL- TOWARD THE NOSE 3) COLLUM (PL. COLLI), CERVIX 4) TRUNK- THORAX, CHEST 5) ABDOMEN- AREA BETWEEN THE DIAPHRAGM AND THE HIP BONES 6) PELVIS- AREA BETWEEN OS COXAS EXTREMITIES -UPPER 1) SHOULDER GIRDLE - SCAPULA, CLAVICLE 2) BRACHIUM - ARM 3) ANTEBRACHIUM -FOREARM 4) CUBITAL FOSSA 6) METACARPALS 7) PHALANGES 2 Lower Extremities Pelvis Os Coxae (2) Inominant Bones Sacrum Coccyx Terms of Position and Direction Anatomical Position Body Erect, head, eyes and toes facing forward. Limbs at side, palms facing forward Anterior-ventral Posterior-dorsal Superficial Deep Internal/external Vertical & horizontal- refer to the body in the standing position Lateral/ medial Superior/inferior Ipsilateral Contralateral Planes of the Body Median-cuts the body into left and right halves Sagittal- parallel to median Frontal (Coronal)- divides the body into front and back halves 3 Horizontal(transverse)- cuts the body into upper and lower portions Positions of the Body Proximal Distal Limbs Radial Ulnar Tibial Fibular Foot Dorsum Plantar Hallicus HAND Dorsum- back of hand Palmar (volar)- palm side Pollicus Index finger Middle finger Ring finger Pinky finger TERMS OF MOVEMENT 1) FLEXION: DECREASE ANGLE BETWEEN TWO BONES OF A JOINT 2) EXTENSION: INCREASE ANGLE BETWEEN TWO BONES OF A JOINT 3) ADDUCTION: TOWARDS MIDLINE -
Repair of a Grynfeltt-Lesshaft Hernia with the PROCEED
Glatz et al. Surgical Case Reports (2018) 4:50 https://doi.org/10.1186/s40792-018-0456-x CASE REPORT Open Access Repair of a Grynfeltt-Lesshaft hernia with the PROCEED™ VENTRAL PATCH: a case report Torben Glatz* , Hannes Neeff, Philipp Holzner, Stefan Fichtner-Feigl and Oliver Thomusch Abstract Background: Primary hernias in the triangle of Grynfeltt are very rare and therefore pose a difficulty in diagnosis and treatment. Due to the lack of systematic studies, the surgical approach must be chosen individually for each patient. Here, we describe an easy and safe surgical approach. Case presentation: We report the case of a 53-year-old male patient with a history of mental disability and pronounced scoliosis, who presented with a Grynfeltt-Lesshaft hernia with protrusion of the ascending colon and the right ureter. The hernia was repaired via a dorsal, extraperitoneal approach. The hernia gap with a diameter of approximately 1 cm was closed with insertion of a 6.4 × 6.4 cm PROCEED™ VENTRAL PATCH (Ethicon, Norderstedt, Germany). The operating time was 33 min and the patient was discharged the next day and showed no signs of recurrence at 1-year follow up. Conclusion: The technique described here is favorable because it requires very little dissection of the surrounding tissue and no trans-/intraabdominal dissection. The technique was chosen in this particular case to guarantee a fast postoperative recovery and prompt hospital discharge. Keywords: Grynfeltt-Lesshaft hernia, Lumbar hernia, PROCEED™ VENTRAL PATCH Background incarceration and a right lumbar protrusion with the Lumbar hernias are a very rare cause of abdominal com- clinical appearance of a soft tissue mass.