histology of the large intestine and rectum To the lectures for EM 18 and 917 on March 21 and 22 2019 Mainly the parts not emphasized in ID: 934744
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Slide1
Kálmán M:Morphology and histology of the large intestine and rectum
To
the
lectures
for
EM 1-8 and 9-17
on
March
21 and 22, 2019.
Mainly
the
parts
not
emphasized
in
the
textbook
.
Slide2Slide3Slide4The main points
:
The
rectum
is
not
’
rectus
’ i.e.
straight
,
but
S-shaped
,
the
opening
directed
posteriorly
rather
than
downward
!
The
lower
curvature
contacts
the
prostate
or
the
vaginal
fornix
.
The
anal
canal
has 3
parts
intestinal
(
columnar
:
columnae
and
sinuses
) –
intestinal
epithalium
below
it
:
the
pectinate
line –
epi-ectodermal
border
hemorrhoidal
(
venous
plexus
)
stratified
squamous
epithelium
.
below
it
:
white
line, and a
shellow
groove
(
note
:
at
the
border
of
the
2
subdivisions
of
ext
.
sphinter
,
see
later
)
cutaneous
keratinized
stratified
squamous
epithelium
The
anal
canal
is
below
the
floor
of
the
pelvis
(
not
yet
lectured
)
The
external
voluntary
sphincter
onsists
of 3
parts
:
deep
,
supeficial
and
subcutaneous
.
Tha
last
one
is most
important
.
The
longitud
.
smooth
has
tendon-like
elongations
,
which
form
connective
tissue
slings
(
conjoint
fibromuscular
layer
)
around
the
fascicles
of
the
subcutaneous
ext
.
sphincter
)
The
territories
of
arteries
correspond
to
the
developmental
origins
:
superior
rectal
(most part) –
hindgut
derivative
middle
rectal
(
small
,
approx
.
the
sinuses
) -
cloacal
derivative
inferior
rectal
-
proctodeum
derivative
,
ectodermal
,
below
the
pectinate
line
.
The Riolan arcades
The
term
‚
small
’
or
‚
first
’
Riolan
arch
(
the
anastomosis
between
the
sup
. and
inf
.
Pancreaticoduodenal
arteries
is
in
use
actually
only
in
our
institute
;
it
is
not
applied
in
the
textbooks
.
The
mame
‚
arch
of
Riolan
’ is most
probably
incorrectly
applied
on
the
marginal
artery
;
it
is
the
anastomosis
–
or
arch
– of
Drummond
.
Which
artery
was
described
by
Riolan
it
is
already
not
clear
; most
probably
it
was
the
so-called
meandering
mesenteric
artery
,
which
also
interconnects
the
middle
and
left
colic
arteries
but
in
a more
proximal
and
sinuous
line.
For
literature
,
see
the
next
page
.
Note
:
these
and
similar
names
of
authors
(
eponymes
)
are
not
to
be
learned
by
students
;
we
use
them
only
as
a
homage
to
the
elders
.
Slide8Papers
helping
clarify
thr
‚
Riolan
’
question
.
Only
for
enthusianistic
volunteers
!
Note
:
the
first
one
was
written
by
dr. Ágnes Nemeskéri and
her
co-workers
from
our
institute
.
Szuák
, András; Halász, Vanda; Gáti, Endre; Harsányi, László; Nemeskéri, Ágnes (2016)
First
Report
on
Arterial
Anastomosis
Between
Transverse
Pancreatic
and
Left
Colic
Arteries
.
Case
Studies
Journal
Vol
5,
Issue
2,
Page
1
Lange, J.F.,
Komen
, N.,
Akkerman
, G.,
Nout
, E.,
Horstmanshoff
, H.,
Schlesinger
, F.,
Bonjer
, J.,
Kleinrensink
, G.J., 2007.
Riolan’s
arch
:
confusing
,
misnomer
, and
obsolete
. A
literature
survey
of
the
connection
(s)
between
the
superior
and
inferior
mesenteric
arteries
. The American Journal of
Surgery
. 193, 742-748.
Walter, T.G., 2009.
Mesenteric
Vasculature
and
Collateral
Pathways
.
Semin
.
Intervent
.
Radiol
. 26(3), 167-174.
Fisher
Df
,
Fry
WJ.
Collateral
Mesenteric
Circulation
"
Surgery
,
Gyencology
and
Obstetrics
. 1987, 164(5):487-492
Gourley
EJ,
Gering
SA. "The
Meandering
Mesenteric
Artery
: A
Historic
Review
and
Surgical
Implications
."
Disease
of
the
Colon &
Rectum
.
Vol
48:5 (2005) pp
996-1000 (
the
figure
is
taken
from
this
paper
).
Douard
R
,
Chevallier
JM
,
Delmas
V
,
Cugnenc
PH
Clinical
interest of
digestive
arterial
trunk
anastomoses
.
Surg
Radiol
Anat
.
2006
Jun
;28(3):219-27.