DOCSLIB.ORG

Intestinal Phase of Superior Mesenteric Artery Blood Flow in Man Gut: First Published As 10.1136/Gut.33.4.497 on 1 April 1992

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Intestinal Phase of Superior Mesenteric Artery Blood Flow in Man Gut: First Published As 10.1136/Gut.33.4.497 on 1 April 1992 Gut, 1992,33,497-501 497 Intestinal phase of superior mesenteric artery blood flow in man Gut: first published as 10.1136/gut.33.4.497 on 1 April 1992. Downloaded from C Sieber, C Beglinger, K Jager, G A Stalder Abstract variety of test meals." The different responses Duplex ultrasound was used to investigate observed may be related to meal composition, the superior mesenteric artery haemodynamics in method used to measure blood flow, or they humans in order to study the contribution could be the result of species differences. of the smali intestine to the postprandial The primary objective of this study was to splanchnic hyperaemia, and to determine the investigate the contribution ofthe small intestine relative potencies of the major food com- to postprandial splanchnic hyperaemia and to ponents in the postprandial mesenteric flow determine the relative potencies of the major response. Duplex parameters of vessel dia- nutrient stimuli in healthy human subjects. meter, mean velocity, and volume flow were determined serially in the basal state and after stimulation. Flow parameters were signifi- METHODS cantly (p<005) increased after liquid and solid Subjects oral meals. Modified sham feeding did not alter Six healthy male volunteers, aged 21-27 years mesenteric blood flow. Intestinal perfusion of (mean 23 years), and with body weights averag- an isocaloric liquid test meal induced flow ing 64 kg (range 58-76 kg) were studied on increases comparable with oral intake. different days and in random order in the morn- Superior mesenteric artery blood flow also ing after overnight fasting in resting conditions, significantly (p<0O05) increased after iso- lying in the supine position. Each subject was caloric and iso-osmolar loads of intraduodenal within 10% of his ideal body weight, and none carbohydrate, fat, and protein meals. was taking any medication or had a history of Responses were similar after the test meal, fat, gastrointestinal or endocrine disorder. The and protein, but were significantly (p<0-05) studies were approved by the local Ethical less for carbohydrates. Different osmolar Human Research Committee on 16 October http://gut.bmj.com/ loads of saline did not affect flow responses. 1987, and informed consent was obtained in each We conclude that the intestinal phase is the case. major regulator of the postprandial mesenteric blood flow response in healthy humans and that the chemical nature of food determines the EXPERIMENTAL DESIGN mesenteric response pattern. The examinations were started after overnight fasting with the subjects at rest for 30 minutes. on September 23, 2021 by guest. Protected copyright. SMABF was measured by the duplex technique Interest in the intestinal circulation has grown consisting ofa real time sector scanner (3 5 MHz) very rapidly in recent years,'2 but data in man and a pulsed Doppler flowmeter (3 0 MHz) have been rare because of technical problems in (Diasonics DRF-400, CRV). The vessel of inter- measuring splanchnic blood flow in humans. The est can be identified with the real time B-mode introduction of the ultrasonic pulsed Doppler image. The B-mode picture allows detection of technique (duplex scanning) for mesenteric anatomical variations and measurement of the blood flow measurements has made it possible to diameter ofthe artery. It is also used to adjust the study the relation between intestinal function size of the sample volume of the Doppler beam and intestinal blood flow in health and disease.?5 into the artery and to ascertain the angle between The method is non-invasive, and gives consistent the incident Doppler beam and the long axis of and reproducible results after physiological the vessel.712 The orientation of the Doppler stimuli such as food intake.67 beam, the Doppler angle, and the sample volume The intake of food results in an increase in are electronically displayed on the screen. The superior mesenteric artery blood flow (SMABF) Doppler signals are analysed by real time in man after liquid meals."' The relative contri- spectrum analyser that employs a digital fast bution of different food components to the Fourier transform technique. With the Doppler Divisions of postprandial mesenteric blood flow has, how- equation, the system then computes the blood Gastroenterology and ever, not been thoroughly investigated up to now flow velocity. The instantaneous velocity as well Angiology and Department of Research, in humans. There are extensive data from animal as the mean velocity can be determined by the University Hospital, experiments. From these, it is clear that the software. The product of the mean velocity and CH-4031 Basel, hydrolytic products offood digestion are primar- the cross-sectional area of the vessel lumen then Switzerland C Sieber ily responsible for the food induced hyperaemia.' yields the volume flow. To achieve accurate C Beglinger Considerable variations in the magnitude of the measurements, the vessel must follow a straight K Jager intestinal vascular responses have been reported course of about 2 cm and no bifurcation should G A Stalder in these various experiments. The response be present. Correspondence to: Dr C Beglinger. seems to be greater in conscious than in anaes- In all studies, SMABF was measured at 15 Accepted for publication thetised animals.9"' Likewise, various increases minute intervals, with measurements being per- 29 July 1991 have been reported in conscious dogs after a formed while the subject was holding his breath. 498 Sieber, Beglinger,jager, Stalder The superior mesenteric artery was identified random order, the following experiments were and the diameter measured 1 to 2 cm distally to performed after a 30 minute basal period: iso- its origin but proximally to the first side branches. caloric solutions (178 kcal/l) of Ensure plus, The ECG-triggered diameter was recorded be- carbohydrate, fat, and protein were used. All fore the pulsed Doppler beam that encompassed solutions were adjusted to pH 7-4 and had an Gut: first published as 10.1136/gut.33.4.497 on 1 April 1992. Downloaded from the vessel lumen was placed. At each time point, osmolarity of 280 mOsm/l (Table I). In all the three separate measurements ofthe diameter and experiments, the perfusion rate was 5 ml/minute time averaged velocity (TAV) were performed giving a caloric load of 53 4 kcal per hour. and the results were averaged. The TAV was Normal saline and a hyperosmolar solution of computed from the envelope of the Doppler saline (560 mOsm/l) were also tested in further spectra over three heart beats with the software of experiments. Gastric contents were aspirated as the duplex unit. Blood pressure and heart rate described above to quantitate duodenal reflux were monitored throughout in all studies. into the stomach. SMABF was recorded at 15 minute intervals. EXPERIMENTAL PROCEDURE Materials Ensure plus was purchased from Abbott Co Ltd, Ingestion ofa liquid test meal Zug, Switzerland, Intralipid from Globopharm, All subjects ingested 270 ml of a liquid test meal Kusnacht, Switzerland, and bovine serum (Ensure plus) after a basal period. The meal albumin (>96% pure) from Fluka, Buchs, contained 16-7% protein, 30% fat, and 53-3% Switzerland. carbohydrate giving a total caloric value of 405 kcal (equivalent to 1648 kJ). The osmolarity of Data analysis the meal was 442 mOsm/l and and pH 7 0. The blood flow responses (SMABF) were SMABF was recorded during a 30 minute basal expressed as percentages of basal responses to period and after the test meal at 15 minute normalise for variations in basal SMABF meas- intervals. urements. For each subject and each test, the area under the blood flow curve (AUC) for the Infusion ofthe liquid meal into the duodenum various stimulants over basal values was then In this part of the study, volunteers swallowed a calculated. Group means (SEM) were deter- double lumen duodenal tube which was posi- mined from these individual subject values and tioned under fluoroscopic observation. The duo- used for statistical analysis. Diameter and TAV denum was perfused at the site between the are expressed as mean (SEM). The significance of second and third portion. The gastric openings differences between the AUC or between mean http://gut.bmj.com/ were placed in the antrum and used for continu- values was tested using Student's paired t test. ous aspiration of gastric contents. After a basal Differences were considered significant if p was period, the test meal (Ensure plus), containing <0 05. Furthermore, analysis of variance for polyethylene glycol 4000 (PEG4000) as a non- repeated measures were used to analyse the data. absorbable marker, was infused over 90 minutes into the duodenum at a rate of 3 ml/minute. This perfusion rate was used to simulate the rate of Results on September 23, 2021 by guest. Protected copyright. gastric emptying of a liquid meal.'3 Gastric contents were continuously aspirated and the MEAL STUDIES PEG4000 concentration in the pooled contents Basal SMABF measurements were similar for was measured. The percentage of reflux of the each of the studies. The mean increase in duodenal contents into the stomach was meas- SMABF in response to the oral intake of both a ured by recovery of PEG4000 in the gastric liquid or a solid meal is shown in Figure 1. An aspirate. immediate and marked increase in mesenteric blood flow was observed, and the maximum was Ingestion ofa solid meal reached within 45 minutes of taking either The meal consisted of two sandwiches - 120 g meal. Sixty minutes after food intake, SMABF bread with 20 g butter and 100 g ham, giving a decreased gradually, but was still significantly total caloric value of 547 kcal (equivalent to 2289 (p<005) above basal values at the end of the kJ). Care was taken to prevent the subjects from experiments.
Load more

Recommended publications
  • Gross Anatomical Studies on the Arterial Supply of the Intestinal Tract of the Goat
    IOSR Journal of Agriculture and Veterinary Science (IOSR-JAVS) e-ISSN: 2319-2380, p-ISSN: 2319-2372. Volume 10, Issue 1 Ver. I (January. 2017), PP 46-53 www.iosrjournals.org Gross Anatomical Studies on the Arterial Supply of the Intestinal Tract of the Goat Reda Mohamed1, 2*, ZeinAdam2 and Mohamed Gad2 1Department of Basic Veterinary Sciences, School of Veterinary Medicine, Faculty of Medical Sciences, University of the West Indies, Trinidad and Tobago. 2Anatomy and Embryology Department, Faculty of Veterinary Medicine, Beni Suef University Egypt. Abstract: The main purpose of this study was to convey a more precise explanation of the arterial supply of the intestinal tract of the goat. Fifteen adult healthy goats were used. Immediately after slaughtering of the goat, the thoracic part of the aorta (just prior to its passage through the hiatus aorticus of the diaphragm) was injected with gum milk latex (colored red) with carmine. The results showed that the duodenum was supplied by the cranial pancreaticoduodenal and caudal duodenal arteries. The jejunum was supplied by the jejunal arteries. The ileum was supplied by the ileal; mesenteric ileal and antimesenteric ileal arteries. The cecum was supplied by the cecal artery. The ascending colon was supplied by the colic branches and right colic arteries. The transverse colon was supplied by the middle colic artery. The descending colon was supplied by the middle and left colic arteries. The sigmoid colon was supplied by the sigmoid arteries. The rectum was supplied by the cranial; middle and caudal rectal arteries. Keywords: Anatomy,Arteries, Goat, Intestine I. Introduction Goats characterized by their high fertility rate and are of great economic value; being a cheap meat, milk and some industrial substances.
    [Show full text]
  • PERIPHERAL VASCULATURE Average Vessel Diameter
    PERIPHERAL VASCULATURE Average Vessel Diameter A Trio of Technologies. Peripheral Embolization Solutions A Single Solution. Fathom™ Steerable Guidewires Total Hypotube Tip Proximal/ UPN Length (cm) Length (cm) Length (cm) Distal O.D. Hepatic, Gastro-Intestinal and Splenic Vasculature 24 8-10 mm Common Iliac Artery 39 2-4 mm Internal Pudendal Artery M00150 900 0 140 10 10 cm .016 in 25 6-8 mm External Iliac Artery 40 2-4 mm Middle Rectal M00150 901 0 140 20 20 cm .016 in 26 4-6 mm Internal Iliac Artery 41 2-4 mm Obturator Artery M00150 910 0 180 10 10 cm .016 in 27 5-8 mm Renal Vein 42 2-4 mm Inferior Vesical Artery 28 43 M00150 911 0 180 20 20 cm .016 in 15-25 mm Vena Cava 2-4 mm Superficial Epigastric Artery 29 44 M00150 811 0 200 10 10 cm pre-shaped .014 in 6-8 mm Superior Mesenteric Artery 5-8 mm Femoral Artery 30 3-5 mm Inferior Mesenteric Artery 45 2-4 mm External Pudendal Artery M00150 810 0 200 10 10 cm .014 in 31 1-3 mm Intestinal Arteries M00150 814 0 300 10 10 cm .014 in 32 Male 2-4 mm Superior Rectal Artery A M00150 815 0 300 10 10 cm .014 in 33 1-3 mm Testicular Arteries 1-3 mm Middle Sacral Artery B 1-3 mm Testicular Veins 34 2-4 mm Inferior Epigastric Artery Direxion™ Torqueable Microcatheters 35 2-4 mm Iliolumbar Artery Female 36 2-4 mm Lateral Sacral Artery C 1-3 mm Ovarian Arteries Usable 37 D UPN Tip Shape RO Markers 3-5 mm Superior Gluteal Artery 1-3 mm Ovarian Veins Length (cm) 38 2-4 mm Inferior Gluteal Artery E 2-4 mm Uterine Artery M001195200 105 Straight 1 M001195210 130 Straight 1 M001195220 155 Straight 1 Pelvic
    [Show full text]
  • Vessels and Circulation
    CARDIOVASCULAR SYSTEM OUTLINE 23.1 Anatomy of Blood Vessels 684 23.1a Blood Vessel Tunics 684 23.1b Arteries 685 23.1c Capillaries 688 23 23.1d Veins 689 23.2 Blood Pressure 691 23.3 Systemic Circulation 692 Vessels and 23.3a General Arterial Flow Out of the Heart 693 23.3b General Venous Return to the Heart 693 23.3c Blood Flow Through the Head and Neck 693 23.3d Blood Flow Through the Thoracic and Abdominal Walls 697 23.3e Blood Flow Through the Thoracic Organs 700 Circulation 23.3f Blood Flow Through the Gastrointestinal Tract 701 23.3g Blood Flow Through the Posterior Abdominal Organs, Pelvis, and Perineum 705 23.3h Blood Flow Through the Upper Limb 705 23.3i Blood Flow Through the Lower Limb 709 23.4 Pulmonary Circulation 712 23.5 Review of Heart, Systemic, and Pulmonary Circulation 714 23.6 Aging and the Cardiovascular System 715 23.7 Blood Vessel Development 716 23.7a Artery Development 716 23.7b Vein Development 717 23.7c Comparison of Fetal and Postnatal Circulation 718 MODULE 9: CARDIOVASCULAR SYSTEM mck78097_ch23_683-723.indd 683 2/14/11 4:31 PM 684 Chapter Twenty-Three Vessels and Circulation lood vessels are analogous to highways—they are an efficient larger as they merge and come closer to the heart. The site where B mode of transport for oxygen, carbon dioxide, nutrients, hor- two or more arteries (or two or more veins) converge to supply the mones, and waste products to and from body tissues. The heart is same body region is called an anastomosis (ă-nas ′tō -mō′ sis; pl., the mechanical pump that propels the blood through the vessels.
    [Show full text]
  • Ascending Aorta to Intestinal Artery Bypass: Technical Aspects
    EJVES Extra 9, 13–15 (2005) doi:10.1016/j.ejvsextra.2005.01.003, available online at http://www.sciencedirect.com on SHORT REPORT Ascending Aorta to Intestinal Artery Bypass: Technical Aspects L. Chiche* and E. Kieffer Department of Vascular Surgery, Pitie´-Salpeˆtrie`re University Hospital, Assistance Publique-Hoˆpitaux de Paris, Paris, France We describe the ascending aorta as an inflow in patients who need a mesenteric bypass and in whom the ascending aorta is the only remaining non-diseased segment. This operation was performed in five patients. Introduction interspace, is the preferred approach. Partial sterno- tomy can be extended by dividing the third costal A number of techniques can be used to treat chronic cartilage or by adding oblique sternotomy. Total intestinal ischemia.1,2 We use the ascending aorta as an sternotomy is necessary if access to the aortic arch or inflow in patients in whom the supraceliac, descend- supra-aortic trunks is required. ing thoracic aorta, the abdominal aorta or iliac arteries Median or subcostal laparotomy provides good are unsuitable due to the presence of extensive lesions access to intestinal artery lesions.1 The celiac trunk or previous surgery. The technique described here was (CT) can be exposed by the interhepatogastric route. performed in five patients (2.4%) out of 211 in whom Its origin is exposed after incision of the right crus of 309 intestinal artery revascularization procedures the diaphragm and division of the arcuate ligament. were carried out between 1990 and 2004. It is similar The superior mesenteric artery (SMA) can be to the classical technique of ascending aorta-abdomi- approached by the pre- or sub-duodenal intramesen- nal aorta bypass used in the management of thoraco- teric route or by a route between duodenum and 3 abdominal aortic lesions.
    [Show full text]
  • Blood Vessels and Circulation
    19 Blood Vessels and Circulation Lecture Presentation by Lori Garrett © 2018 Pearson Education, Inc. Section 1: Functional Anatomy of Blood Vessels Learning Outcomes 19.1 Distinguish between the pulmonary and systemic circuits, and identify afferent and efferent blood vessels. 19.2 Distinguish among the types of blood vessels on the basis of their structure and function. 19.3 Describe the structures of capillaries and their functions in the exchange of dissolved materials between blood and interstitial fluid. 19.4 Describe the venous system, and indicate the distribution of blood within the cardiovascular system. © 2018 Pearson Education, Inc. Module 19.1: The heart pumps blood, in sequence, through the arteries, capillaries, and veins of the pulmonary and systemic circuits Blood vessels . Blood vessels conduct blood between the heart and peripheral tissues . Arteries (carry blood away from the heart) • Also called efferent vessels . Veins (carry blood to the heart) • Also called afferent vessels . Capillaries (exchange substances between blood and tissues) • Interconnect smallest arteries and smallest veins © 2018 Pearson Education, Inc. Module 19.1: Blood vessels and circuits Two circuits 1. Pulmonary circuit • To and from gas exchange surfaces in the lungs 2. Systemic circuit • To and from rest of body © 2018 Pearson Education, Inc. Module 19.1: Blood vessels and circuits Circulation pathway through circuits 1. Right atrium (entry chamber) • Collects blood from systemic circuit • To right ventricle to pulmonary circuit 2. Pulmonary circuit • Pulmonary arteries to pulmonary capillaries to pulmonary veins © 2018 Pearson Education, Inc. Module 19.1: Blood vessels and circuits Circulation pathway through circuits (continued) 3. Left atrium • Receives blood from pulmonary circuit • To left ventricle to systemic circuit 4.
    [Show full text]
  • Unusual Pancreatico-Mesenteric Vasculature: a Clinical Insight
    Clinical Group Archives of Anatomy and Physiology DOI http://dx.doi.org/10.17352/aap.000001 ISSN: 2640-7957 CC By Shikha Singh, Jasbir Kaur, Jyoti Arora*, Renu Baliyan Jeph, Vandana Research Article Mehta and Rajesh Kumar Suri Unusual Pancreatico-Mesenteric Department of Anatomy, Vardhman Mahavir Medical College and Safdarjung Hospital, Ansari Nagar West, Delhi 110029, India Vasculature: A Clinical Insight Dates: Received: 09 November, 2016; Accepted: 03 December, 2016; Published: 06 December, 2016 *Corresponding author: Jyoti Arora, MBBS, MS, Abstract Professor, Department of Anatomy, Vardhman Mahavir Medical College and Safdarjung Hospital, Background: Awareness about the variable vascular anatomy of superior mesenteric artery is Ansari Nagar West, New Delhi, Delhi 110029, India, imperative for appropriate clinical management. Present study not only augments anatomical literature Tel: +91-99-99077775; Fax: +91-11-2375365; E-mail: pertaining to mesenteric vasculature but also adds to the clinical acumen of medical practitioners in their clinical endeavors. Keywords: Superior mesenteric artery; Anomalous Case summary: The present study reports the occurrence of anomalous branch, termed as branch; Inferior pancreatic artery; Inferior accessory inferior pancreatic artery stemming from superior mesenteric artery. Additionally inferior pancreaticoduodenal artery; Ventral splanchnic pancreaticoduodenal artery was seen to be dividing into right and left branches instead of usual anterior arteries and posterior branches. Right branch terminated
    [Show full text]
  • Netter's Anatomy Flash Cards – Section 4 – List 4Th Edition
    Netter's Anatomy Flash Cards – Section 4 – List 4th Edition https://www.memrise.com/course/1577335/ Section 4 Abdomen (31 cards) Plate 4-1 Bony Framework of Abdomen 1.1 Costal cartilages 1.2 Iliac crest 1.3 Anterior superior iliac spine 1.4 Anterior inferior iliac spine 1.5 Superior pubic ramus 1.6 Pubic arch 1.7 Pecten pubis 1.8 Greater trochanter of femur 1.9 Ischial spine 1.10 Iliac crest 1.11 Xiphoid process 1.12 Body of sternum Plate 4-2 Anterior Abdominal Wall: Superficial Dissection 2.1 External oblique muscle: muscular part (A) and aponeurotic part (B) Plate 4-3 Anterior Abdominal Wall 3.1 Internal oblique muscle Plate 4-4 Anterior Abdominal Wall 4.1 Rectus abdominis muscle Plate 4-5 Anterior Abdominal Wall 5.1 Cremaster muscle Plate 4-6 Anterior Abdominal Wall: 6.1 Superior epigastric vessels 6.2 Rectus abdominis muscle 6.3 Transversus abdominis muscle 6.4 Posterior layer of rectus sheath 6.5 Inferior epigastric vessels 6.6 Inguinal ligament (Poupart’s ligament) 6.7 Inguinal falx (conjoint tendon) 6.8 Cremasteric muscle (middle spermatic fascia) 6.9 Lacunar ligament (Gimbernat’s ligament) 6.10 Medial umbilical ligament (occluded part of umbilical artery) 6.11 Arcuate line 6.12 Transversalis fascia 6.13 Anterior layer of rectus sheath 6.14 Linea alba Plate 4-7 Posterior Abdominal Wall: Internal View 7.1 Quadratus lumborum muscle Plate 4-8 Posterior Abdominal Wall: Internal View 8.1 Diaphragm Plate 4-9 Autonomic Nerves and Ganglia of Abdomen 9.1 Right greater and lesser splanchnic nerves 9.2 Right sympathetic trunk 9.3 2nd and
    [Show full text]
  • Chapter 20 Lecture Outline
    Chapter 20 Lecture Outline See separate PowerPoint slides for all figures and tables pre- inserted into PowerPoint without notes. Copyright © McGraw-Hill Education. Permission required for reproduction or display. 1 Introduction • The route taken by blood was a point of much confusion for many centuries – Chinese emperor Huang Ti (2697–2597 BC) correctly believed that blood flowed in a circuit around the body and back to the heart – Roman physician Galen (129–c.199) thought blood flowed back and forth (like air in and out of lungs); he thought the liver created blood out of nutrients and organs consumed it – English physician William Harvey (1578–1657) performed experiments to show that the heart pumped blood and that it traveled in a circuit • Many of Harvey’s contemporaries rejected his ideas • After microscope was invented, capillaries were discovered by van Leeuwenhoek and Malpighi • Harvey’s work was the start of experimental physiology and it demonstrated how empirical science could overthrow dogma 20-2 General Anatomy of the Blood Vessels • Expected Learning Outcomes – Describe the structure of a blood vessel. – Describe the different types of arteries, capillaries, and veins. – Trace the general route usually taken by the blood from the heart and back again. – Describe some variations on this route. 20-3 General Anatomy of the Blood Vessels Copyright © The McGraw-Hill Education. Permission required for reproduction or display. Capillaries Artery: Tunica interna Tunica media Tunica externa Nerve Vein Figure 20.1a (a) © The McGraw-Hill
    [Show full text]
  • Arteries of the Abdomen
    Arteries of the Abdomen Arteries that supply the abdominal organs and abdominal wall structures originate from the abdominal aorta. About half of resting cardiac output flows through these vessels. The abdominal arteries are all in pairs, except for the superior and inferior mesenteric arteries, the celiac trunk, and the median sacral artery. Major Arteries of the Abdomen Artery Area Supplied Description Inferior Inferior surface of Arise from the aorta just below the diaphragm phrenic diaphragm arteries Celiac trunk Branches supply Large unpaired artery divides into common hepatic, splenic, and various abdominal left gastric arteries; A branch of the common hepatic artery, the organs gastroduodenal artery, becomes the hepatic artery proper, whose branches supply the liver; Gastroduodenal and splenic arteries give rise to the right and left gastroepiploic arteries, respectively, that supply the greater curvature of the stomach Superior Branches supply the Large unpaired artery; Branches: intestinal arteries (supply most of mesenteric duodenum, pancreas, small intestine), ileocolic artery (appendix, cecum, and ascending artery and parts of the colon), right and middle colic arteries (part of transverse colon) small and large intestines Middle Adrenal glands Adrenal glands are supplied by the middle suprarenal arteries, as suprarenal well as the superior suprarenal branches of the inferior phrenic arteries arteries and the inferior suprarenal branches of the renal arteries Renal Kidneys The left renal artery is shorter than the right arteries
    [Show full text]
  • Anatomy and Physiology Model Guide Book
    Anatomy & Physiology Model Guide Book Last Updated: August 8, 2013 ii Table of Contents Tissues ........................................................................................................................................................... 7 The Bone (Somso QS 61) ........................................................................................................................... 7 Section of Skin (Somso KS 3 & KS4) .......................................................................................................... 8 Model of the Lymphatic System in the Human Body ............................................................................. 11 Bone Structure ........................................................................................................................................ 12 Skeletal System ........................................................................................................................................... 13 The Skull .................................................................................................................................................. 13 Artificial Exploded Human Skull (Somso QS 9)........................................................................................ 14 Skull ......................................................................................................................................................... 15 Auditory Ossicles ....................................................................................................................................
    [Show full text]
  • A Middle Mesenteric Artery
    View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Springer - Publisher Connector Surg Radiol Anat (2012) 34:973–975 DOI 10.1007/s00276-012-0987-y ANATOMIC VARIATIONS A middle mesenteric artery Stanislaw Milnerowicz • Artur Milnerowicz • Renata Taboła Received: 4 October 2011 / Accepted: 24 May 2012 / Published online: 22 July 2012 Ó The Author(s) 2012. This article is published with open access at Springerlink.com Abstract In 114 cases of the transverse colon isolated and supplying mainly the transverse colon [3, 5, 8]. The from cadavers (50 male, 64 female), anatomical examina- term concerns not only its structure, but also the range of tions of the arterial system of the colon were performed. its delivery. In 3–5 % of the cases the middle colic artery is Arteriograms were obtained after dissecting and contrast- absent [5]. Rarely anatomical studies have detected varia- ing the colonic vessels with Mixobar contrast. In one case, tions in the middle colic artery origin. The artery is thought on arteriography of the colon with its mesentery isolated to be colonic artery when it arises from the celiac trunk or from a 55-year-old male cadaver, a rare anatomical variant its branches. The term middle mesenteric artery is reserved was found. The third mesenteric artery originated directly for the vessel directly originating from the aorta between from the aorta—halfway between the superior and inferior the superior and inferior mesenteric arteries. Origin of the mesenteric arteries and ascended obliquely in the direction middle colic artery from the celiac trunk was first described of the hepatic flexure of the colon.
    [Show full text]
  • The Importance of the Mesentery in Emergency General Surgery: Ignore the Mesentery at Your Peril
    Review Article Page 1 of 12 The importance of the mesentery in emergency general surgery: ignore the mesentery at your peril Rishabh Sehgal, Tara M. Connelly, Helen M. Mohan, Gerard J. Byrnes, Colin Peirce, J. Calvin Coffey Department of Colorectal Surgery, University Hospital Limerick, Limerick, Ireland Contributions: (I) Conception and design: All authors; (II) Administrative support: All authors; (III) Provision of study materials or patients: All authors; (IV) Collection and assembly of data: All authors; (V) Data analysis and interpretation: All authors; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. Correspondence to: Prof. J. Calvin Coffey. University Hospital Limerick, St Nessan’s Rd, Dooradoyle, Co. Limerick, V94 F858, Ireland. Email: [email protected]. Abstract: The mesentery is now accepted as continuous from the duodeno-jejunal flexure to the mesorectum. The new mesenteric model provides an anatomical frame of reference that explains the aetiology and pathology of multiple surgical emergencies of the abdominal cavity. Furthermore, mesenteric continuity simplifies and enhances the radiological interpretation of the abdomen with major implications at diagnostic and interventional levels. The adoption of mesenteric-based surgical treatment strategies greatly enhances the surgeon’s ability to treat emergencies of the abdomen. The following article will demonstrate how recent clarification of mesenteric anatomy and the demonstration of continuity profoundly alter our perspective on surgical emergencies of the abdomen. It will demonstrate how the perspective afforded to us by the new mesenteric model greatly enhances our diagnostic and therapeutic capabilities. Keywords: Mesentery; emergency surgery; appendicitis; obstruction; Crohn’s disease; malrotation; volvulus Received: 09 October 2018; Accepted: 10 October 2018; Published: 24 October 2018.
    [Show full text]