Modelling Cecum

Modeling instructions

Cecum

 * 4.0ではCecumはセグメントされず回盲部の回腸の断片にcecumと名付けられています.
 * Macburney の直下に回盲接合部をもってくるのがいいと思います. （回盲部をやや下に）
 * Haustraのちょうどひだの部分で回腸を開口させると好都合です. 　（ピン赤）
 * 以上よりピン青の部位から下を盲腸として（盲腸と虫垂は完全に腹膜でつつまれるように）
 * Appendix は結腸の延長(長い盲腸）が退縮したものなのでもともとは盲腸の真ん中から生えてるはず. ところが結腸紐の右（外側）が左（内）よりよく育ち虫垂は内側に出るように見えている. 　紐の走行も同じように内向きに曲がっているのに注意.
 * The Cecum is the commencement of the large intestine,
 * The Cecum is the large blind pouch situated below the colic valve.
 * The Cecum's blind end is directed downward,
 * The Cecum's open end upward, communicating directly with the colon, of which this blind pouch appears to be the beginning or head, and hence the old name of caput cæcum coli was applied to it.
 * The Cecum's size is variously estimated by different authors, but on an average it may be said to be 6.25 cm. in length and 7.5 cm in breadth.
 * The Cecum is situated in the right iliac fossa, above the lateral half of the inguinal ligament:
 * The Cecum rests on the Iliacus and Psoas major,
 * The Cecum lies in contact with the anterior abdominal wall, but the greater omentum and, if the cecum be empty, some coils of small intestine may lie in front of it.
 * As a rule, The Cecum is entirely enveloped by peritoneum
 * The cecum lies quite free in the abdominal cavity and enjoys a considerable amount of movement
 * The cecum may become herniated down the right inguinal canal.
 * The cecum varies in shape, but, according to Treves, in man it may be classified under one of four types.
 * The third type is the normal type of man. Here the two saccules, which in the second type were uniform, have grown at unequal rates: the right with greater rapidity than the left.
 * In consequence of this an apparently new apex has been formed by the growing downward of the right saccule, and the original apex, with the appendix attached, is pushed over to the left toward the ileocolic junction.
 * The three longitudinal bands still start from the base of the vermiform process,
 * but three longitudinal bands are now no longer equidistant from each other, because the right saccule has grown between the anterior and posterolateral bands, pushing them over to the left. This type occurs in about 90 per cent. of cases.

FIG. 1073– The cecum and vermiform process, with their arteries. (See enlarged image)

Appendix
The Vermiform Process or Appendix (processus vermiformis) is a long, narrow, worm-shaped tube, which starts from what was originally the apex of the cecum, and may pass in one of several directions: upward behind the cecum; to the left behind the ileum and mesentery; or downward into the lesser pelvis.
 * Appendix varies from 2 to 20 cm. in length, its average being about 8.3 cm.
 * Appendix is retained in position by a fold of peritoneum (mesenteriole), derived from the left leaf of the mesentery.
 * This mesenteriole is more or less triangular in shape, and as a rule extends along the entire length of the tube.
 * Between its two layers and close to its free margin lies the appendicular artery (Fig. 1073).
 * The canal of the vermiform process is small, extends throughout the whole length of the tube, and communicates with the cecum by an orifice which is placed below and behind the ileocecal opening. It is sometimes guarded by a semilunar valve formed by a fold of mucous membrane, but this is by no means constant.

MEMO

 * 盲腸だけはオレンジのピンの紐の間を膨らませる. 　前腹壁に接触させる. 場所はiliac fossa on psoas and ileacus muscles.
 * ileo-colic junction ではileum の末端を横扁平につぶして　２枚ビラの弁のようにしてください.
 * http://lifesciencedb.jp/bp3d/API/image.cgi?shorten=O5b0nO5Pj09vr8Tnuu9fOLHv&.gif
 * http://etc.usf.edu/clipart/54200/54228/54228_cecum_md.gif


 * http://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Gray1043.png/250px-Gray1043.png