Book - An Atlas of Topographical Anatomy 15

From Embryology

XV. Transverse section of the same body through the pancreas and kidneys at the level of the first lumbar vertebra

Embryology - 20 Sep 2019    Facebook link Pinterest link Twitter link  Expand to Translate  
Google Translate - select your language from the list shown below (this will open a new external page)

العربية | català | 中文 | 中國傳統的 | français | Deutsche | עִברִית | हिंदी | bahasa Indonesia | italiano | 日本語 | 한국어 | မြန်မာ | Pilipino | Polskie | português | ਪੰਜਾਬੀ ਦੇ | Română | русский | Español | Swahili | Svensk | ไทย | Türkçe | اردو | ייִדיש | Tiếng Việt    These external translations are automated and may not be accurate. (More? About Translations)

Braune W. An atlas of topographical anatomy after plane sections of frozen bodies. (1877) Trans. by Edward Bellamy. Philadelphia: Lindsay and Blakiston.

Plates: 1. Male - Sagittal body | 2. Female - Sagittal body | 3. Obliquely transverse head | 4. Transverse internal ear | 5. Transverse head | 6. Transverse neck | 7. Transverse neck and shoulders | 8. Transverse level first dorsal vertebra | 9. Transverse thorax level of third dorsal vertebra | 10. Transverse level aortic arch and fourth dorsal vertebra | 11. Transverse level of the bulbus aortae and sixth dorsal vertebra | 12. Transverse level of mitral valve and eighth dorsal vertebra | 13. Transverse level of heart apex and ninth dorsal vertebra | 14. Transverse liver stomach spleen at level of eleventh dorsal vertebra | 15. Transverse pancreas and kidneys at level of L1 vertebra | 16. Transverse through transverse colon at level of intervertebral space between L3 L4 vertebra | 17. Transverse pelvis at level of head of thigh bone | 18. Transverse male pelvis | 19. knee and right foot | 20. Transverse thigh | 21. Transverse left thigh | 22. Transverse lower left thigh and knee | 23. Transverse upper and middle left leg | 24. Transverse lower left leg | 25. Male - Frontal thorax | 26. Elbow-joint hand and third finger | 27. Transverse left arm | 28. Transverse left fore-arm | 29. Sagittal female pregnancy | 30. Sagittal female pregnancy | 31. Sagittal female at term
Historic Disclaimer - information about historic embryology pages 
Mark Hill.jpg
Pages where the terms "Historic Textbook" and "Historic Embryology" appear on this site, and sections within pages where this disclaimer appears, indicate that the content and scientific understanding are specific to the time of publication. This means that while some scientific descriptions are still accurate, the terminology and interpretation of the developmental mechanisms reflect the understanding at the time of original publication and those of the preceding periods, these terms and interpretations may not reflect our current scientific understanding.     (More? Embryology History | Historic Embryology Papers)


IN this plate the 1st lumbar vertebra is divided in the middle; on the right side are the sections of the twelfth, eleventh, tenth, ninth, eighth, seventh, seventh and eighth ribs, the seventh and eighth being twice cut ; and anteriorly the arches of the cartilages appear. On the left side the twelfth rib is absent, as from being so short it is not met with in the section, but lies entirely in the preceding lamina. This section, like the preceding, exposes the upper portion of the abdomen, with a part of the spleen, stomach, and a large part of the liver. The diaphragm is divided anteriorly through its attachment opposite the seventh rib, near the transversalis muscle ; afterwards in its free portion, so that a portion of the pleural cavity is seen ; and posteriorly through its arch and crura. The pleural cavity, which is clearly evident at the posterior wall .of the trunk, reaches further downwards there than it does in front; and extends on the left side to the section of the ninth, and on the right side to the seventh rib. It appears as a fine chink, which in pleurisy widens out into a considerable cavity, and may hold a large quantity of fluid (about one pound) before its presence can be demonstrated. A normal lung, however, may fill up this space in deep inspiration.


Besides the rest of the liver, stomach and spleen, in the space included by the diaphragm and the transversalis muscle, are seen the kidneys, pancreas and intestines. The section, of which the upper surface is here represented, is three and a half inches below the preceding, its inferior surface reaching to the navel.


In order to make the cavities of the intestines clear, their frozen contents were with great care broken loose before their walls were thawed by means of warm pincers ; and then the cavities accurately drawn with their folds in the hardened condition. Thus the regular sharply projecting folds of Kerkring, of the small intestine, and the irregular flat processes of the mucous membrane of the large intestine, are easily recognisable. On the liver, on the left side, anteriorly and internally, is the kidney, and the descending colon immediately below its left colic flexure, which is divided transversely. The contents were some green coloured faecal matter and a little gas. Between the ascending colon and the right kidney, is the vertical portion of the duodenum, divided transversely just as it winds round the head of the pancreas. The liver fills up the remaining space externally as far as the diaphragm. Its surface has the impression of the neighbouring structures. Its convex upper surface attaches itself intimately to the line of the diaphragm ; internally, on the other hand, the outline of the liver becomes irregular, owing to certain prominences in front from the impression of the colon, and behind from that of the kidney forms still recognisable after these organs have been removed, but which, however, may disappear from the equalisation of pressure within the peritoneal investment. It is open to proof that the form of the liver is not an independent one, but varies with the pressure and volume of neighbouring organs ; so that in a normal condition it must possess a softness of structure which can be compared with fat and connective tissue, and which yields to the movements and change of position of the organs in contact with it. A series of sections of frozen bodies in the region of the liver should be made, or the plates of Pirogoff (fasc. iii, 1, 2, 3, 5, 7) compared, to show that everywhere it is defined by the neighbouring organs, and entirely fills up all remaining spaces.


Only a small portion of the spleen is seen, entirely covered by peritoneum, and at this point nowhere attached thereto. Its posterior extremity reaches to the section of the eleventh rib, and corresponds also, if the preceding plate be examined, to the course and curves of the ninth, tenth, and eleventh ribs. Hence it agrees with what Luschka has recently published (' Prager Yierteljahrschrift,' Bd. 101, 1869, p. 122).


In the text to Plate XIII I have introduced three woodcuts, figs. 1, 2, 3, which explain the position of the spleen, although not originally with this view. They place its position in the upper compartment of the abdominal cavity in the cupola of the diaphragm in the different states of distension of the stomach, and were made from preparations, of which a view was obtained from above after raising the peritoneum by taking away the upper half of the thorax and part of the diaphragm ; and, although the perspective view of the position of the spleen is not quite correct, it gives the same results. PirogofFs plates (fasc. iii, B.), which represent plastic preparations made by chipping the organs out of frozen bodies must be compared with them. It is shown in all these figures, as Luschka states, that the spleen does not occupy the highest point of the cupola of the diaphragm, and moreover does not lie with its hilus on the fundus of the stomach ; but that the fundus of the stomach, covered by the left lobe of the liver, lies in the highest part of the cupola of the diaphragm, and the spleen takes up its position laterally with it. Correspondingly with the greatest amount of play of the diaphragm, the position of the spleen will not be affected ; and in breathing will be less displaced than if it lay high up in its cupola : at the same time, the influence of respiration is considerable enough to be of practical importance. The size of the normal spleen cannot always be felt with certainty in deep inspiration; if, however, it be enlarged, it can be reached with the finger, on causing the individual to take a deep breath. The determination of the size of the spleen, by percussion, always presents certain difficulties which must not be under-rated. Whilst on this subject I may mention that the kidney, and left colic flexure when distended with faeces, have more than once been mistaken for tumour of the spleen.


A small strip only of the stomach is seen in front of the seventh costal cartilage. The connection between the duodenum lying between the liver, pancreas and right kidney no longer exists. It can be seen, however, from the position of the duodenum that the pylorus must have lain near the middle line of the body, and so also that the pyloric portion of the stomach took an oblique direction from below backwards, hence the pyloric valve could not have lain in an antero-posterior direction directly, but more obliquely forwards (Luschka). In Pirogoff's Atlas (iii, 2, fig. l),is a section which passes exactly through the pylorus and shows this relation clearly. According to this plate the pylorus lies in the anterior half of the abdominal cavity near the eleventh costal cartilage, immediately to the right of the middle line of the body. It agrees, however, exactly with Luschka's statement that the pylorus is not to be sought in the right hypochondrium, as it never reaches the right arch of the ribs ; and from the present plate one can see that it must have had the same position. Hence, it follows that the horizontal portion of the duodenum does not run from left to right in a transverse direction, but more in an antero-posterior one between the ductus choledochus and the gall-bladder, close to the transverse fissure of the liver.


The duodenum is divided in its vertical descending portion at the point of flexure of the upper horizontal part. Between the vena cava and the pancreas is the ductus communis choledochus, which has passed directly over to the left side of the duodenum, in order to open into the vertical portion of the duodenum at the head of the pancreas. If we look into the duodenum we see how it curves round the head of the pancreas, becoming continuous on the left side with the inferior horizontal portion. Owing to the mobility of the stomach, without which the different stages of distension would cause great disturbance, we may expect that the pylorus and the upper portion of the duodenum would change with its condition of distension. I have proved that, whilst in the empty stomach the pylorus lies near the middle line of the body, in greater distension it is pushed half an inch further back. The upper portion of the duodenum possesses a mesentery in the hepatico- duodenal ligament, which permits and follows its changes in position. The middle or vertical portion of the duodenum is not absolutely fixed, but follows the movements of the ascending colon ; and in distension is pushed to the left of the middle line, assuming its original position when the colon is emptied.


The pancreas is divided obliquely, so that a small portion of the head remains on the left side and a considerably larger portion on the right. These relations correspond with the position of the pancreas, as it does not lie exactly horizontally, but passes obliquely downwards from left to right ; consequently the splenic vein, which lies below it, has had its upper surface removed in the section, and the mouths of the veins opening into it are seen.


The vein entering it directly in the middle line of the body is the superior mesenteric ; and at their junction the portal vein commences. This position is so constant that vertical sections in the middle line would expose a large portion of it (Plate I and II). The portion of the pancreas lying behind the vein is the so-called lesser pancreas.


The position of the pancreas at the level of the first lumbar vertebra, corresponds with that in Plate I and II ; it is, however, so increased in breadth that it extends downwards to the next vertebra.


Behind the pancreas on the right side is the vena cava, with the left renal vein opening into it, and near it on the left side the abdominal aorta. In front of the latter passes the superior mesenteric artery, in order to gain the root of the mesentery beneath the gland.


The aorta has nearly reached the middle line, where it divides below the third lumbar vertebra into the common iliac arteries. Its distance from the anterior wall of the abdomen is nearly four and a half inches ; whilst the distance in the preceding Plate at the level of the eleventh dorsal vertebra, in the same body, is nearly five inches.


In plate, No. XYI, corresponding with the cartilage between the third and fourth lumbar vertebra, this distance is only three and a half inches ; so that it is clearly evident that the anterior curvature of the lumbar spine brings the vessel nearer the abdominal wall, rendering its compression from the front possible.


The section of the kidneys is such that it cuts the right above its hilus, whilst on the left side it has passed through it. The left kidney lies a little higher than the right a relation which exists in the generality of cases. The length of the kidneys corresponds with the bodies of three and a half vertebras, they extend from the upper border of the twelfth dorsal vertebra to the middle of the third lumbar. As they are in relation with the spleen and liver superiorly, and are bounded posteriorly by the diaphragm and pleural cavity, one would expect that they would be displaced in great pleuritic effusion by the descent of the diaphragm as are the liver and spleen. Enlargements of the liver exert a dislocating effect upon the kidney, as will be shown more exactly in the next plate.


The position of tne kidneys is rather antero-posterior than transverse, the hilus being turned more forwards than inwards. According to Luschka, lines which pass through the hilus corresponding with the greatest breadth of these organs intersect if produced forwards, at an angle of 60 in front of the middle of the first lumbar vertebra a statement which corresponds tolerably with the relations seen of the present plate.



Historic Disclaimer - information about historic embryology pages 
Mark Hill.jpg
Pages where the terms "Historic Textbook" and "Historic Embryology" appear on this site, and sections within pages where this disclaimer appears, indicate that the content and scientific understanding are specific to the time of publication. This means that while some scientific descriptions are still accurate, the terminology and interpretation of the developmental mechanisms reflect the understanding at the time of original publication and those of the preceding periods, these terms and interpretations may not reflect our current scientific understanding.     (More? Embryology History | Historic Embryology Papers)
Braune Plates (1877): 1. Male - Sagittal body | 2. Female - Sagittal body | 3. Obliquely transverse head | 4. Transverse internal ear | 5. Transverse head | 6. Transverse neck | 7. Transverse neck and shoulders | 8. Transverse level first dorsal vertebra | 9. Transverse thorax level of third dorsal vertebra | 10. Transverse level aortic arch and fourth dorsal vertebra | 11. Transverse level of the bulbus aortae and sixth dorsal vertebra | 12. Transverse level of mitral valve and eighth dorsal vertebra | 13. Transverse level of heart apex and ninth dorsal vertebra | 14. Transverse liver stomach spleen at level of eleventh dorsal vertebra | 15. Transverse pancreas and kidneys at level of L1 vertebra | 16. Transverse through transverse colon at level of intervertebral space between L3 L4 vertebra | 17. Transverse pelvis at level of head of thigh bone | 18. Transverse male pelvis | 19. knee and right foot | 20. Transverse thigh | 21. Transverse left thigh | 22. Transverse lower left thigh and knee | 23. Transverse upper and middle left leg | 24. Transverse lower left leg | 25. Male - Frontal thorax | 26. Elbow-joint hand and third finger | 27. Transverse left arm | 28. Transverse left fore-arm | 29. Sagittal female pregnancy | 30. Sagittal female pregnancy | 31. Sagittal female at term

Reference

Braune W. An atlas of topographical anatomy after plane sections of frozen bodies. (1877) Trans. by Edward Bellamy. Philadelphia: Lindsay and Blakiston.


Glossary Links

Glossary: A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z | Numbers | Symbols | Term Link

Cite this page: Hill, M.A. (2019, September 20) Embryology Book - An Atlas of Topographical Anatomy 15. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Book_-_An_Atlas_of_Topographical_Anatomy_15

What Links Here?
© Dr Mark Hill 2019, UNSW Embryology ISBN: 978 0 7334 2609 4 - UNSW CRICOS Provider Code No. 00098G