We examine the gastrointestinal tract of a donkey in dorsal recumbency (on its back) much as one...

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We examine the gastrointestinal tract of a donkey in dorsal recumbency (on its back) much as one might do this in abdominal surgery. For the exposure that we use in this presentation, the incisions are different and, as the specimen is preserved, the midventral abdominal incision is much larger than it would be were we actually performing the surgery. Exploration of the viscera would not be markedly different in a horse. See the presentation, “Equine Abdominal

Transcript of We examine the gastrointestinal tract of a donkey in dorsal recumbency (on its back) much as one...

Page 1: We examine the gastrointestinal tract of a donkey in dorsal recumbency (on its back) much as one might do this in abdominal surgery. For the exposure that.

We examine the gastrointestinal tract of a donkey in dorsal recumbency (on its back) much as one might do this in abdominal surgery. For the exposure that we use in this presentation, the incisions are different and, as the specimen is preserved, the midventral abdominal incision is much larger than it would be were we actually performing the surgery.

Exploration of the viscera would not be markedly different in a horse. See the presentation, “Equine Abdominal Topography”, for review.

Page 2: We examine the gastrointestinal tract of a donkey in dorsal recumbency (on its back) much as one might do this in abdominal surgery. For the exposure that.
Page 3: We examine the gastrointestinal tract of a donkey in dorsal recumbency (on its back) much as one might do this in abdominal surgery. For the exposure that.

R L

1. Cut along long axis.

2. Cut along transverse axis (at level of last rib).

Page 4: We examine the gastrointestinal tract of a donkey in dorsal recumbency (on its back) much as one might do this in abdominal surgery. For the exposure that.

epidermis

dermissubcutaneous c.t.

(superficial fascia)

Page 5: We examine the gastrointestinal tract of a donkey in dorsal recumbency (on its back) much as one might do this in abdominal surgery. For the exposure that.

The skin is made up of two layers, a superficial epithelial layer, the epidermis, which is thin, and the dermis, which is a much thicker layer of connective tissue on which the epidermis rests.

The epidermis is usually pigmented and probably no more than 100 microns thick.The dermis is the deeper layer of the skin, continuous with the underlying subcutaneous tissue (superficial fascia).

Different from the fairly uniform epidermis, the thickness of the dermis is variable and depends on the area of the body. In the case of the abdomen, the dermis is thin ventrally, perhaps two to four millimeters thick on average, and becomes gradually thicker as the dorsal midline is approached.

Page 6: We examine the gastrointestinal tract of a donkey in dorsal recumbency (on its back) much as one might do this in abdominal surgery. For the exposure that.
Page 7: We examine the gastrointestinal tract of a donkey in dorsal recumbency (on its back) much as one might do this in abdominal surgery. For the exposure that.

At the sternal end of your longitudinal incision, make a stab incision through the ventral body wall. Go only about ½” deep.

Ventral body wall.

Page 8: We examine the gastrointestinal tract of a donkey in dorsal recumbency (on its back) much as one might do this in abdominal surgery. For the exposure that.

Use the blunt end of hemostatic forceps to push through the peritoneum to enter the abdominal cavity.

Page 9: We examine the gastrointestinal tract of a donkey in dorsal recumbency (on its back) much as one might do this in abdominal surgery. For the exposure that.

Now put your finger through the hole that you’ve made and lift the abdominal wall away from the viscera.

Page 10: We examine the gastrointestinal tract of a donkey in dorsal recumbency (on its back) much as one might do this in abdominal surgery. For the exposure that.

You’re still not through the peritoneum. You’re looking at the internal lamina of the rectus sheath.

Page 11: We examine the gastrointestinal tract of a donkey in dorsal recumbency (on its back) much as one might do this in abdominal surgery. For the exposure that.

Now you’ve carefully cut through the internal lamina and the peritoneum and you’re looking at abdominal viscera. Lifting the body wall away from the viscera, cut along your longitudinal and transverse incisions to expose the viscera.

Page 12: We examine the gastrointestinal tract of a donkey in dorsal recumbency (on its back) much as one might do this in abdominal surgery. For the exposure that.

Abdominal viscera exposed:

RL

cecum

Left parts of large colon.

Right parts of large colon.

Page 13: We examine the gastrointestinal tract of a donkey in dorsal recumbency (on its back) much as one might do this in abdominal surgery. For the exposure that.

cecu

m

large colon, left parts

large colon, right parts

cecocolic fold

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left ventral colon

right ventral colon

cecu

m

desc/sigmoid colon

jejunum

cecocolic fold

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Lift up on the apex of the cecum to demonstrate the cecocolic fold.

cecocolic fold.

Page 16: We examine the gastrointestinal tract of a donkey in dorsal recumbency (on its back) much as one might do this in abdominal surgery. For the exposure that.

Pull on the apex of the cecum to demonstrate the cecocolic fold. The fold extends from the lateral tenia of the cecum to the right ventral colon.

cecocolic fold

???

Page 17: We examine the gastrointestinal tract of a donkey in dorsal recumbency (on its back) much as one might do this in abdominal surgery. For the exposure that.

Draw the cecum away from the viscera as shown.

cecocolic fold

???

??? must be the right ventral colon.

Page 18: We examine the gastrointestinal tract of a donkey in dorsal recumbency (on its back) much as one might do this in abdominal surgery. For the exposure that.

cecum

ileocecal fold

ileum

jejunum

The cecum is turned back, to the right, to show the ileocecal fold.

Page 19: We examine the gastrointestinal tract of a donkey in dorsal recumbency (on its back) much as one might do this in abdominal surgery. For the exposure that.

The ileocecal fold extends from the dorsal tenia of the cecum to the ileum. As a matter of definition, the ileojejunal junction is where the ileocecal fold ends.

Page 20: We examine the gastrointestinal tract of a donkey in dorsal recumbency (on its back) much as one might do this in abdominal surgery. For the exposure that.

Follow the left parts of the large colon caudally. Note that they curve to the right or enter the pelvic inlet. Find the pelvic flexure and draw it out.

CECUM

RT VENT COL

LT VENT COL

Follow the left parts of the large colon caudally. Note that they curve to the right or enter the pelvic inlet. Find the pelvic flexure and draw it out.

RT VENT COLLEFT VENT COL

CECUM

Page 21: We examine the gastrointestinal tract of a donkey in dorsal recumbency (on its back) much as one might do this in abdominal surgery. For the exposure that.

Follow the left parts of the large colon caudally. Note that they curve to the right or enter the pelvic inlet. Find the pelvic flexure and draw it out.

CECUM

RT VENT COL

LT VENT COL

Page 22: We examine the gastrointestinal tract of a donkey in dorsal recumbency (on its back) much as one might do this in abdominal surgery. For the exposure that.

Pelvic flexure

LT VENT COL

LT DORS COL

Page 23: We examine the gastrointestinal tract of a donkey in dorsal recumbency (on its back) much as one might do this in abdominal surgery. For the exposure that.

left vent colon with haustra

left dors colon no haustra

single tenia, mesentery

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Pelvic flexure and left parts of the large colon drawn to the right with the cecum out of the body cavity.

cecum

coils of jejunum (no teniae)

rt dors col

rt vent col

left parts of large colon

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desc/sigmoidcolon (with teniae)

Page 26: We examine the gastrointestinal tract of a donkey in dorsal recumbency (on its back) much as one might do this in abdominal surgery. For the exposure that.

View from the right side.Pelvic

flexure

cecumCecum, pelvic flexure, left parts, and a little of the right parts of large colon drawn out of abdomen, right view.

pelvic flexure

cecum

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Right Side Left Side

right ventral colon

left ventral colon

cecum

jejunum

sternal flexure diaphragmatic flexure

From: Anatomie des Pferdes, W. Ellenberger, H. Baum; 1897. Verlags- buchhandlung Paul Parey

small colon

Page 28: We examine the gastrointestinal tract of a donkey in dorsal recumbency (on its back) much as one might do this in abdominal surgery. For the exposure that.
Page 29: We examine the gastrointestinal tract of a donkey in dorsal recumbency (on its back) much as one might do this in abdominal surgery. For the exposure that.
Page 30: We examine the gastrointestinal tract of a donkey in dorsal recumbency (on its back) much as one might do this in abdominal surgery. For the exposure that.
Page 31: We examine the gastrointestinal tract of a donkey in dorsal recumbency (on its back) much as one might do this in abdominal surgery. For the exposure that.

Coils of jejunum moved out of the way to show the ileum joining the base of the cecum.

ileocecal junction

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Following the jejunum to the duodenojejunal flexure at the cranial end of the duodenocolic fold.

ascending duodenum

jejunum

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duodenojejunal flexure

transv colon

desc colonascnd

duod

jejunum

Page 34: We examine the gastrointestinal tract of a donkey in dorsal recumbency (on its back) much as one might do this in abdominal surgery. For the exposure that.

coils of small colon leading to the rectum

right dorsal

colon

Page 35: We examine the gastrointestinal tract of a donkey in dorsal recumbency (on its back) much as one might do this in abdominal surgery. For the exposure that.

mesocolon of desc/sigmoid colon

right dorsal colon jejunum

Page 36: We examine the gastrointestinal tract of a donkey in dorsal recumbency (on its back) much as one might do this in abdominal surgery. For the exposure that.

Replace coils of small colon….

Page 37: We examine the gastrointestinal tract of a donkey in dorsal recumbency (on its back) much as one might do this in abdominal surgery. For the exposure that.

Replace coils of jejunum ventral to coils of small colon…

cecum

right ventral colon

right dorsal colon

jejunum

transv colon

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Replace left parts of large colon ventral to jejunal coils…

Page 39: We examine the gastrointestinal tract of a donkey in dorsal recumbency (on its back) much as one might do this in abdominal surgery. For the exposure that.

Replace the cecum.