Good day everybody. This is Dr. Sanjeev Sanyal, Professor of the Department Chair. So this is going to be a demonstration of the colon. We have removed the small interesting from here. There's a supine cadaver. I'm standing on the right side. Camera person is also on the right side. So before we start the colon itself, there are a few other points which I need to mention to you. Take a look at this peritoneal space where my hand is moving right now. This is called the right paracolic gutter and similarly on next to the descending colon, this peritoneal space is called the left paracolic gutter and both these paracolic gutters, if there's any abnormal fluid collection, the fluid can drain down into the pelvis, which is here. This is the transverse colon. So therefore the portion of the peritoneal cavity below that is called the infracolic compartment and we have removed the mesocolon from here. The portion of the peritoneal cavity above that is called the supracolic compartment. The fluid, any abnormal collection from their supracolic or infracolonic or both, can track down the paracolic gutters and they can come into the pelvis. So this is one point which I want to let you know. Now let's come to the colon itself. So this is the entire colon that we have excised and we have opened it out. This is the terminal ideal, which we have cut. This is the appendix. This appendix, in this particular cadaver, it was touching this muscle here. This is the iliosoas muscle and therefore we already know that in cases of appendicitis, which is the pelvic appendix, it can irritate the iliosoas muscle and can produce what is known as the hip flexion soas sign, also called the cope sign. And if we passively extend the right hip, the patient will have pain. That's called the copes test. So this particular cadaver, though he has a normal appendix, it could have been a soas sign if he had an inflamed appendix. This structure that we see here, where the ilium is opening, this is the secum. The secum is a unique part of the larger distin, which is 7.5 centimetres wide and 7.5 centimetres long, so it's got equal length and width. This is the ascending colon and you can see it is attached here by means of a peritoneal fold. This is called the right phrenocolic ligament, which is attached to the hepatic flexure of the colon. This is the transverse colon, which we have separated out. There was a transverse mesocolon here, a double fold of peritoneum, which we have removed. Then we have again another fold of peritoneum, which is attaching this portion of the colon here. This is called the left phrenocolic ligament, which attaches the sprenic flexure. And we can see deep down this structure is the spleen, so therefore this is the sprenic flexure. And this spleen can produce an impression on the sprenic flexure that we can see through a colonoscope. And thereafter, this is the descending colon. And then it continues as the sigmoid colon.  That's the reason why this is called the sigmoid colon. And then it continues into the pelvis as the rectum at the level of S2. So this is the full extent of the colon. Now let's come to a few other parts of the colon. Now if you look very carefully, we can see one band of muscle tissue here. We can see only part of it here. This is what is known as tina coli. What is this tina coli? Tina coli are three longitudinal bands of muscle, smooth muscle on the surface of the colon. They are bundled smooth muscle, longitudinal smooth muscle. And they have been given names according to their location in the transverse colon. They have been respectively called tina mesocolica, tina libera, and tina omentalis. We can see a part of the tina coli here. To trace the tina coli further down, we can see this is the tina coli here. This is the tina coli. The unique thing about the tina coli is that all the three bands of tina coli, they merge at the base of the appendix. So this is useful landmark that we can use during surgery to trace the base of the appendix during appendicectomy if we have difficulty in locating the appendix. The next structure which I will draw your attention to are these fatty bundles that we see here. These are called appendices epiploike. There were many appendices epiploike and we have removed many of them. They are attached to the tina coli. These are covered by thin layer of visceral petonium. Rarely they can undergo torsion and get inflamed and that condition is known as epiploike appendigitis. The next thing which I would like to draw your attention to are these small dilatations of the colon. These are called saculations or hostry. What are these saculations or hostry produced by? These are produced by the slight shortening of the tina coli which is a longitudinal smooth muscle. And therefore it produces these dilatations and constrictions, dilatations and constrictions which are called hostry. And this same hostry will produce mucosal semilunar folds inside the lumen of the colon. So these are three landmarks of the colon that I wanted to bring your attention to. The next thing which I will draw your attention to is the vascular supply. So for that, again, take a look at this arcade of arteries which I will draw your attention to. We can see one arcade here and please follow me. We can see that it is going all the way around. It is continuing around. It is going across. It is going across and then it is continuing to the left side and it is continuing down. It will continue into the sigmoid also though we have not dissected out the mucentry of the sigmoid. This is called the marginal artery of drumwood. And from the marginal artery of drumwood we can see numerous straight blood vessels are going to the colon. Ascending colon, they are going to the transverse colon, they are going to the descending colon. So this marginal artery, how is it formed? It is formed by the branches of the superior mercenary artery for the midcut and branches of the inferior mercenary artery for the hindcut. Where exactly is the junction between the midcut and the hindcut? This is the transverse colon as I told you earlier. The junction between the right two thirds and the left one third of the transverse colon is the location of the junction between the midcut and the hindcut. So the hindcut is supplied by the inferior mercenary artery which we have not dissected out. It comes out from the abdominal artery approximately where my finger is located at the level of L3. But we can see the superior mercenary artery and that we have already removed. This is the superior mercenary artery and this is the superior mercenary vein. The superior mercenary artery is the artery of the midcut. This arises from the abdominal artery as an unpaired visceral branch from the level of L1.  This is the third part of the duodenum. And it is giving off numerous branches. These are the geigenergal and the ileal branch. But let's not focus on that. Let's focus on the branches to the colon. We can see this branch here. This is the terminal branch of the superior mercenary artery. This is called the ileocolic artery. And this ileocolic artery it divides into an colic branch or a secret branch and an ileal branch which we have cut here because we have removed the small intestine. Then we have the next artery coming from the superior mercenary that is this one here. This is right colic artery. Then we have this artery here. This is the middle colic artery. And then we have this artery here. This is the left colic artery which comes from the inferior mercenary. What do these colic arteries do? Each of these colic arteries they divide into an ascending branch and a descending branch. And we can see that very clearly here. We can see the right colic is dividing into an descending branch and an ascending branch. The middle colic is dividing into a right and a left. This branch is dividing into an upper and a lower. And similarly, this is dividing into a descending and an ascending. All these ascending and descending branches, right and left branches, they all form an asthmatic arc. And this forms what is known as the marginal artery of Drummer. And from there the blood vessels go and supply the colon. The venous drainage for the midcut is the superior mercenary vein. And this is the superior mercenary vein. The branches we can see the tributaries. The superior mercenary vein will unite with the superior mercenary vein behind the pancreas and form the portal vein. Again, the inferior mercenary vein is located here where my finger is tracing. But we have not yet dissected out peritonium. We shall dissect out and then we will be able to see it. The two parts of the colon which have got miscentry. The transverse colon, this has got the transverse mesocolon which we have removed as I said. And the other is the sigmoid colon. It has got a sigmoid miscentry which is called the meso-sigmoid. The meso-sigmoid, if you see carefully now, it is inverted V-shaped, the root of the meso-sigmoid. This is one limb of the V, this is another limb of the V and this is the apex of the V. And crossing under the apex of the V will be the left ureter. So therefore, when we are doing any sigmoid surgery, we have to be careful not to injure the left ureter. That brings me to a few other clinical correlations. Cancer of the colon is not very uncommon. Especially the descending colon because the fecal matter is in contact for a longer duration. We can also have sigmoid ovulus. Left side descending colon, we can have sigmoid diverticulosis. So any of these conditions may require excision and anastomosis of the colon. For example, we may require to excise the ascending colon. This is called right hemicolectomy. And then we can anastomose the ilium to the transverse colon that is called iliotransverse anastomosis. We may have to do a subtotal colectomy where we have to remove the two flexures and the transverse colon. And then we can do a colocolic anastomosis. We may have to do a left hemicolectomy. And we can do, like for example, in cancer of the sigmoid, we may have to do anterior resection. And then we can do a colorectal anastomosis. Or we can bring out the terminal colon as a colostomy. So these are some of the surgeries that are commonly performed for the various pathologies that afflict the colon. For each of these surgeries, we have to be cognizant of these branches. And we have to know exactly which branch to ligate so as to remove that segment of the colon. So these are some salient points about the surgical aspects of the colon that I want to bring your attention to. That's all for now. Thank you very much for watching Dr. Sanjay Sanyal signing out. Solomon is the camera person. If you have any questions or comments, please put them in the comment section below. Have a nice day. Please like and subscribe.


Hi everyone, my name is Steph, this is Little Bookish Teacher and today I'm here with a review of a recent picture book release Australian Animals from Beach to Bush by Brentos. Earlier this year for the CBC Awards I talked about another book by Brentos which was Australian Animals from Dawn to Dusk and I'm loving this series that they are putting together. One because they have the most beautiful, fun, unique, illustrative style but also because their books are looking at environmental issues. The synopsis for this one says Australia is home to many unique animals, let's see how many we can find. Find humpback whales and coral reefs, seek out Australian sea lions and kelp forests, search for bernos, wombats on mountains and spot saltwater crocodiles in wetlands. This is Australia's native wildlife as you've never seen it before, a dreamy pastel popping meditation on these special animals, their conservation status and what we can do to protect them from a ward-nominated artist Brentos. And also there is a little note on the back that this book supports wires who care for sick and injured Australian wildlife and just as this book suggests it is a bit of a look and find book so the way that it's set up you have a gorgeous detailed picture that features a lot of animals living in a particular location so in this case the coral reefs and then over the side you have a main focus animal and then some other animals that you might be able to find in that space and because this book is also talking about their conservation status there is a little intro at the start of the book that shows A, where Australia is, but also has a colour code for the status of these animals so you have animals of least concern, vulnerable, endangered, critically endangered or extinct and as you're going through the book and you are looking for these animals it does tell you their status underneath. I think this is a really great way to start talking about the conservation status of different animals in Australia particularly because we do have quite a few endangered and critically endangered species as well as many that have already gone extinct. Each section and new location has a different colour theme that is just absolutely gorgeous to look at visually but also one of the most heartbreaking pages for me is the extinct animals page. The colour choice and the decision to put them all together and to really use it as a great starting point for a conversation about how this happened and what we can do to stop more animals from becoming extinct I think is really valuable in this book. I haven't seen it done in quite this way which makes it both accessible for kids but is also a little bit heartbreaking. There is also a section at the back of the book that gives some examples for how we can help to preserve our native wildlife here in Australia and I think that this is just a really great easy way to talk about conservation particularly with younger readers but they're just such a gorgeous book and such a lovely way to talk about conservation and to learn a little bit more about particular animals. It's really worthwhile checking out so I will leave a link to where you can find out more information about this down below. I absolutely loved, loved, loved looking at this book, reading it, hunting for all the animals in the pages. It's great for those kids who love to find pictures within pictures so there's a great appeal there too. In the comments let me know if you have read any of Brentos's work or if you follow him on Instagram I love seeing all of his posts over there so I'll leave that link down below as well. If you want to let me know that you're here but you don't want to leave a comment for free to leave an Australian flag emoji down below otherwise I hope that we're on the world you're staying safe and healthy and I will see you in my next video. Thanks so much for watching. Bye everyone.


Okay, let's jump in. Wow. Wow, that me late one. I remember being in Argentina. So he won the election for the presidency of Argentina. It wasn't even close. He won by 10 percentage points. And which is which is 12 actually, I think 56 to 44, which is pretty amazing. I was in Argentina. I remember last, I think it was last year, earlier this year, last year, maybe it was last fall. I can't remember. Anyway, I was there and we met with a bunch of people who know me and kind of fans and have been working for him and with them and kind of the objectivists and libertarians of Buenos Aires. We actually have an objectivist conference in Buenos Aires and we will again in April. So I think it was earlier this year. Anyway, there was some talk about, yeah, Millie is going to, he's running and, you know, probably doesn't have a chance, but it'll be interesting to watch.  So I got to know a little bit about him from people who know him. He's obviously a character. He's quite a clown, but he's also an economics professor and has a, I think, a deep grounding in Austrian economics. He has read, I think, most of Ayn Rand and has a, you know, a somewhat understanding of Ayn Rand's philosophy. He's also a Christian or somewhat religious, not clear how Christian or, but he is religious. He's definitely religious. And he swears, I mean profusely and he yells and he screams and he jumps up and down and he's incredibly passionate. And I think shockingly, although it's not a shock now after the elections leading up to this, but it's still shocking. He won. And he won by a big margin. And this is a guy who ran on a campaign saying to abolish the Argentinian central bank and replace basically Argentinian peso with a dollar. Great idea.  So you can imagine the dollar will be the official currency, but they will be, he will encourage currency competition.  So, you know, there's a video of him with a list of all the governments and he's, this is what I'm going to do, this ministry, you know, is very theatrical. Anyway, he wants to abolish him. He wants to fire, I think, two-thirds of people who work for the government, privatization on mass scale. I assume this is, you know, he's talked about massive and immediate reductions in regulations and taxes. Argentina has crazy taxes and crazy regulations that distort everything. And it's going to be super interesting. I don't know exactly how it all works out. I don't know exactly what he will do and what he is able to do, given the particular, the particular system of government Argentina has and the culture and the bureaucracy and what, let him get away with and so on. But, and sadly, I don't think this election is a sign that the population in Argentina is dedicated to free markets. I think his election is the ultimate expression of, we've had it. We've had it with you fascists. We've had it with you socialists.   We are done. It is, you know, we're upset and we won't have it. And while I think what was expected of this election was that the conservative kind of the right wing mildly right of center candidate would win. They've had it so much. And there's so many that they're willing to go really radical. And, you know, at least a third of the population is willing to go really radical. And then enough of the people who voted for the right, center right, saying the one thing we don't want is the same old Peronista party that we've had for decades. The one thing we're willing to take a gamble on this guy who we don't completely agree with, just avoid another term of this looting disastrous candidate. The fact that the guy who is running, who is the economy minister in the current government, got 44% is shocking because he has an economy that has been devastated by this government, has been crushed by this government and riddled with corruption, but more importantly with what do you call it inflation 140%. I mean, the Argentine economy has been decimated for decades, but over the last few years it's fallen off a cliff in a way that I don't think anybody expected. And for anybody to vote for the existing economy minister is suicidal and crazy. This election should have been between Millet and the right conservative between two opposition characters, not between the establishment guy. Anyway, so now the question is what can we do? He doesn't, his party doesn't have a majority in the parliament. They, you know, so how does he pass laws? How does he dismantle the central bank, dismantling a central bank in a country the size of Argentina is not simple. I mean, there's a sense of which is simple. You can just do it. And I'm not against that, but it's unlikely that that's how it's done. It's not simple. While these things have happened in places like Panama is on the dollar. Ecuador is on the dollar. It's never happened on an economy the size anywhere close to the size of Argentina. I'm looking forward to seeing the plan. I'm looking forward to seeing it put in place because it'll be super exciting and it's a super step forward. And it's a super increase in the amount of freedom Argentinians will have. They will actually be able to earn income in in a currency that doesn't lose its value 100% of its value well over 100% of its value every year. I see Daniel Daniel is just given, you know, he's contributed on a super chat 5000 Argentinian pesos. Now it was a time where 5000 Argentinian pesos would have made my day and would have got us to our goal. And wow, I mean it was a lot of money. But today with inflation and the devaluation of the Argentinian pesos and this is probably the official rate the unofficial rate. It's a it's half of this is 14 bucks. So 5000 Argentinian pesos is 14 bucks. It you know it's it's actually in the in the real market. It's seven bucks. So that gives you a little flavor of kind of how decrepit the whole thing is. Thank you Daniel. That was Daniel's first super chat. So really, really appreciate that. Anyway, I think it's super exciting. It's it's more than exciting because it's it's it's really interesting because it's going to be interesting. What can a free market president president, he's going to be president as of December 10th do when the country is not really free market, even though it elected him and he has a mandate, you have to say winning by 12 points. What can he actually get away with? What can he do? What will be the backlash from the people who elected him? How much room will they give him to do what he needs to do? All fascinating questions. And in that sense, Argentina is kind of the canary in the coal mine. To what extent can you change dramatically? Not like not even like Reagan and Thatcher much more. To what extent can you change dramatically? Change an economy of a culture in a culture where the people are not. We don't know how aligned the people are with you. And certainly the political class is completely misaligned. And there's no tradition of, you know, solid kind of, you know, change of power, democratic change of power, where who knows what the bureaucrats and the military and who else, what they will do if if if this is pushed too much. But again, he won by 56 to 44. So you got to believe that he will have a significant mandate. My advice to him. And by the way, if anybody knows me, and and he needs some advisors, he needs, I don't know, a secretary of the economy, or I'm sure he's got people in mind. But if he needs anybody kind of to bounce ideas off, I am available. I'd be happy to do it. I would want to find a way to support him and to see if you can put together a kind of a rational program. How quickly you can liberate an economy. To me, all of these are fascinating questions and questions that it would be cool to be involved in doing. I doubt I'm going to get that phone call.  Or he knows people. A lot of people around him certainly know who I am. I am available as a consulting advice, anything like that. And I will be in Argentina in April for a big objectives conference. Now, this is not not to suggest. I mean, the only reason I am supporting Millie is not because it's not because he's an end cap. It's in spite of the fact that he claims to be an end cap. And that's because his program is not a program to institute an awkward capitalism. He's not, he strikes me that he's not a nihilist like so many in the Libertarian Party. He's not a nihilist like so many, not all, but so many end caps in the United States. He is, I don't know if you saw him three days ago at a big demonstration waving the Israeli flag. He's a massive fan of Israel. He's even a fan of the United States where end caps in the United States are not fans of the United States or of Israel. So I'll give him that. He's even in a weird way. A fan of Ben Bernanke at the Federal Reserve, but I'll forgive him that. Yeah, I mean, there are better people out there and he might call himself an end cap. And he is religious and he's anti-abortion although he wants there to be a referendum on abortion, at least not instituted from above the banning of abortions. So anyway, let's see what happens. Maybe my last trip to Argentina is what made this possible. That's delusional, I know, but what the hell? Maybe this next trip will make it even, you know, will help put together a completely rational program for him. Who knows? Maybe one of my people in Argentina can arrange a meeting with me and Millet when I'm out there in, what do you call it, in April. Anyway, I am super excited. Again, I don't know what the outcome is going to be, but I'm super excited to watch the process and to see what happens. One way or the other, we will learn a lot about this. And then the question is, can somebody like Millet with his attitude and his little bit crazy persona, can he get stuff done? We don't know that yet. We have no evidence that he is a doer, other than political doer, podcast doer. But is he a doer? Can he actually go out there and produce? Does he have the people around him who may be businessman, people who've actually achieved things? And will the businessman around him be radical? Will they try to undercut his radicalism and try to force him to compromise? I mean, so many questions, so many questions. And at this point, so few answers. And as time passes now, we will get more and more of those answers. So again, I'm excited because I'm a curious guy and I want to see how this plays out. I'm excited to watch it. One other aspect of this, part of the fun of this is to watch the mainstream media go apoplectic around this. They're comparing Millet to Trump. Yeah, Trump was really a free market guy. There's certain elements of the brashness of the way they speak, although Millet is like 100 times worse in a sense than Trump. But Millet does not come across as a pragmatist. Millet does not come across as a kind of somebody committed to lying, committed to untruth, committed to making up reality. Millet does not come across as the kind of primacy of consciousness that Trump has. He's outspoken and crazy, but he's got ideas. He's got principles. He's got beliefs that are clear, and he will be evaluated based on where he achieves them. Trump had none of that, and certainly his beliefs that Trump had were not aligned with free markets. Now, the one thing maybe they should comment, although I think Millet has a grasp on it versus Trump that doesn't, and that is hatred for the left. But that's it. It's the only thing they have in common.