Saturday, April 16, 2011

Blogation Numero Ocho--El Final!

The gallbladder is a small organ that lies just inferior to the liver in humans. The primary function of the gallbladder is to store and release bile, which is produced by the liver. Bile aids in digestion by breaking down or emulsifying fats present in the chyme in the duodenum. The gallbladder is made up of three parts: the fundus, the body and the neck. The neck of the organ connects posteriorly to the cystic duct, which then connects to the common hepatic duct. The common hepatic duct aids in transporting important secretions from the liver to the small intestines.

A gallstone (seen in figure on left) is a crystalline collection made mostly of cholestrol that lies in one of the ducts of the gallbladder. These stones are far more common in females and the elderly. The stones range in size from a pinhead to a golf ball, and the presence of symptoms often correlates with whether the object grows over time to a point where it mechanically injures or obstructs the gallbladder. A serious medical ramification of gallstones can be acute cholecystitis, where a blockage of the cystic duct by the gallstone can cause accumulation of bile in the gallbladder, followed by subsequent inflammation and enlargement of the organ. The most common treatment for this emergent condition is removal of the gallbladder.

The pelvic girdle is the structure that connects the spinal column to the femurs, and encloses the space known as the pelvic cavity. It has many functions, including: supporting the weight of the skeleton superior to it, providing attachment for the major muscles of the thigh, protection of the pelvic organs (including the reproductive organs), among others. The pelvic girdle is composed of three bones: the right hip bone, left hip bone and the sacrum. The hip bones are formed by the fusion of three bones: the pubis, ischium and ilium. The major joints of the pelvic girdle structure are the sacroiliac (SI) joints and the pubic symphisis.

During crush injuries, the pelvis can be compressed which may fracture the pubic rami. The most common cause of these injuries are from objects falling on the pelvis, or from car accidents in which the person is hit (and crushed) from a side impact. The only exception to this is that a fall is the most common cause of this injury in the elderly population. The main concern with these injuries are when the fracture causes damage to surrounding tissues, blood vessels, organs and/or nerves (seen in illustration on the left). These injuries can turn deadly when the blood major arteries supplying the lower limbs are lacerated, and the person (not realizing a pelvic fracture is a potentially fatal injury) doesn't seek immediate medical attention.

The uterine tubes (previously and more commonly known as the fallopian tubes) help the movement of the oocyte (immature ovum) that has been released from the ovary to find its way to the uterine cavity. This activity occurs once a month during a female's reproductive years (ovulation). These tubes are composed of four parts: the ampulla, infundibulum, isthmus, and uterine part. The Infundibulum has fimbriae (finger-like projections) that help usher the ovum through the tube. The Ampulla is typically where fertilization occurs. The tubes are composed of simple columnar epithelium (most of which are ciliated), and is supplied by the ovarian and tubal branches of the ovarian and ascending uterine arteries.

In 1 out of every 250 pregnancies in North America, a fertilized egg is hindered from passing through the uterine tubes to the uterus (by collections of pus called pyosalpinx), and thus implants in the wall of the uterine tube itself (most commonly in the Ampulla region). If left undiscovered or unattended to, such a pregnancy can have very serious consequences. Once implanted in the uterine wall, the blastocyst can begin it's gestational growth, which will eventually rupture the uterine tube, causing severe bleeding into the pelvic cavity. The result will be a miscarriage for the woman, and could be deadly for her as well if she doesn't receive immediate surgical attention. Surgery can be performed if caught before rupture to remove the ectopic pregnancy in order to save the female from a potentially life-threatening situation.
References
Moore et al. "Clinically Oriented Anatomy" (2010) 6th ed
http://www.gallstones.com/
http://www.nlm.nih.gov/medlineplus/ency/imagepages/9288.htm
http://www.umm.edu/imagepages/8786.htm

1 comment:

  1. Thanks Gav...I owe my ability to do my comments to you...lol...When a gallbladder becomes inflamed the boundaries between the gallbladder and the intestines becomes indistinguishable. This can result in a cholecystoenteric fistula. The most common area of the intestine for this to happen is in the duodenum and the transverse colon. The fistula causes a large gallstone that is unable to pass the cystic duct enter the digestive tract. The gallstone will then enter the ileocecal valve and cause a bowel obstruction.

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