|Henry Gray (18251861). Anatomy of the Human Body. 1918.|
|the mesentery. This fold, in the majority of cases, is more or less triangular in shape, and as a rule extends along the entire length of the tube. Between its two layers and close to its free margin lies the appendicular artery (Fig. 1073). The canal of the vermiform process is small, extends throughout the whole length of the tube, and communicates with the cecum by an orifice which is placed below and behind the ileocecal opening. It is sometimes guarded by a semilunar valve formed by a fold of mucous membrane, but this is by no means constant.|
Structure.The coats of the vermiform process are the same as those of the intestine: serous, muscular, submucous, and mucous. The serous coat forms a complete investment for the tube, except along the narrow line of attachment of its mesenteriole in its proximal two-thirds. The longitudinal muscular fibers do not form three bands as in the greater part of the large intestine, but invest the whole organ, except at one or two points where both the longitudinal and circular fibers are deficient so that the peritoneal and submucous coats are contiguous over small areas.
| The circular muscle fibers form a much thicker layer than the longitudinal fibers, and are separated from them by a small amount of connective tissue. The submucous coat is well marked, and contains a large number of masses of lymphoid tissue which cause the mucous membrane to bulge into the lumen and so render the latter of small size and irregular shape. The mucous membrane is lined by columnar epithelium and resembles that of the rest of the large intestine, but the intestinal glands are fewer in number (Fig. 1074).|
FIG. 1074 Transverse section of human vermiform process. X 20. (See enlarged image)
The Colic Valve (valvula coli; ileocecal valve) (Fig. 1075).The lower end of the ileum ends by opening into the medial and back part of the large intestine, at the point of junction of the cecum with the colon. The opening is guarded by a valve, consisting of two segments or lips, which project into the lumen of the large intestine. If the intestine has been inflated and dried, the lips are of a semilunar shape. The upper one, nearly horizontal in direction, is attached by its convex border to the line of junction of the ileum with the colon; the lower lip, which is longer and more concave, is attached to the line of junction of the ileum with the cecum. At the ends of the aperture the two segments of the valve coalesce, and are continued as narrow membranous ridges around the canal for a short distance, forming the frenula of the valve. The left or anterior end of the aperture is rounded; the right or posterior is narrow and pointed. In the fresh condition, or in specimens which have been hardened in situ, the lips project as thick cushion-like folds into the lumen of the large gut, while the opening between them may present the appearance of a slit or may be somewhat oval in shape.