General Considerations Dynamics of Image Analysis

Normal Anatomic Relationships and Dynamic Principles of Pathways of Spread and Localization of Disease

A basic knowledge of normal anatomic relationships and variants is essential to understanding the effects of pathologic processes. Fundamental considerations include constant anatomic landmarks, variations in positions of structures, relationships maintained and bounded by peritoneal and fascial attachments, distribution of intraperitoneal and extraperitoneal fat providing the contrasting interfaces of organ and viscus contours, and governance of the spread and localization of many diseases by specific anatomic characteristics and general physical laws.

Since abdominal symptoms are commonly nonspecific, there are many clinical instances in which the site of primary disease is not clear originally. Radiologic investigation is often initiated by a study focusing attention on another organ or body system. Abnormal findings peripheral to the anticipated area of interest may therefore be of considerable importance in directing attention immediately to the true primary site of disease. A primary site of disease in the abdomen or pelvis may spread along specific pathways, governed by anatomic and physical factors, to a remote site. In many instances, this discrete locus of dissemination may be anticipated and therefore diagnosed at its earliest stage. Conversely, it is not rare that a patient may first present with disease remote from a clinically occult primary site. An integrated

Fig. 1-1. W.E. Hill's "My Wife and My Mother-in-Law."

Both images are present in the drawing. The viewer first sees either an old woman or a young lady. The old woman's prominent nose in profile is the young woman's chin. This drawing illustrates that perception is determined by the relationships.

Fig. 1-1. W.E. Hill's "My Wife and My Mother-in-Law."

Both images are present in the drawing. The viewer first sees either an old woman or a young lady. The old woman's prominent nose in profile is the young woman's chin. This drawing illustrates that perception is determined by the relationships.

understanding ofthe pathways of spread and localization then reveals the true nature of the condition.

Figure 1-1 illustrates that the image one first sees is determined by the relationship established between individual features. In a similar manner, clinical and radio-

Radiographs Abdominal Vicerq

Fig. 1—2. Abdominal viscera.

The stomach has been removed from the cardia to the pylorus, revealing the lesser sac (omental bursa) and structures on the posterior wall. (This figure also appears in the color insert.)

(From Sobotta, Courtesy of Urban & Schwarzenberg.)

Fig. 1—2. Abdominal viscera.

The stomach has been removed from the cardia to the pylorus, revealing the lesser sac (omental bursa) and structures on the posterior wall. (This figure also appears in the color insert.)

(From Sobotta, Courtesy of Urban & Schwarzenberg.)

Normal Anatomic Relationships and Dynamic Principles of Spread and Localization of Disease • 3

Omental Sac

Fig. 1—3. Retroperitoneum of an adult female. (This figure also appears in the color insert.)

(From Sobotta, Courtesy of Urban and Schwarzenberg.)

Fig. 1—3. Retroperitoneum of an adult female. (This figure also appears in the color insert.)

(From Sobotta, Courtesy of Urban and Schwarzenberg.)

logic diagnosis is based on the extraction of a set of features characteristic of a particular process. Deviation from the normal, however, must be recognized before a lesion can be suspected.

Figures 1-2, 1-3, and 1-4 illustrate a detailed overview of the complex anatomic relationships within the abdomen and pelvis. Critical intimate relationships, crossroads, planes of diminished resistance, and channels of flow as influenced by gravity and subatmospheric pressures provide the key for accurate diagnosis and therapy involving the spread and localization of intraabdominal disease.

Essentials of Human Physiology

Essentials of Human Physiology

This ebook provides an introductory explanation of the workings of the human body, with an effort to draw connections between the body systems and explain their interdependencies. A framework for the book is homeostasis and how the body maintains balance within each system. This is intended as a first introduction to physiology for a college-level course.

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