Is the backside (inside)of your belly button attached to anything?
Although you can lift the abdominal wall up off of the underlying intestines, and there's free space directly behind, there's still some important anatomy to the bellybutton. There are attachments to the bellybutton from behind the muscle that are inside the layers of the abdominal wall.
The abdominal wall is composed of a bunch of layers of tough "fascia" which is a connective tissue that look like sheets made out of that kind of postal tape where you can see the parallel fibers. In between these layers of connective tissue are layers of muscle. On the flanks, there are three layers of muscle. In the front, there's one layer of muscle sandwiched between 2 layers of connective tissue. These muscles are the rectus abdominis muscles and make the "6 pack" that I no longer have...
In the midline, there is a white line called the "linea alba" (which, oddly enough, translates as "white line"...) which goes up and down the middle between the rectus muscles, and it's only fascia. There is no muscle in the midline. The umblicus is where the skin is tethered down to the linea alba with no intervening fat pad. At the linea alba, there is a circular spot where there's no fascia, but usually it's too small to feel unless you really jam your finger down in there and poke around. If it's big enough to feel, it's probably a bellybutton hernia. People who have bellybutton hernias have only some skin and fat between the intestines and the surface.
The important thing to recognize about the bellybutton is that it USED to be an important connector to the placenta. The umbilicus is a scar where the umbilical cord used to be. The umbilical cord remnants still reside in the abdominal wall just beneath the muscle.
The umbilical cord contained 3 blood vessels, and for short times during development it also contained some other stuff. There were 2 arteries that came off of the iliac arteries on their way to the legs. These umbilical arteries travelled up the inside of the abdominal wall from the groins and then popped out through the umbilicus into the cord. There was also a single vein, called the umbilical vein which came back from the placenta. The umbilical vein brought oxygenated blood back, and after going through the umbilicus, it turned upward and entered into the liver, returning it's oxygenated blood into the baby's system.
In adult life, looking at the inside of the abominal wall, the remnants of these structures are still clearly visible. There are two ridges of tissue that go up to the bellybutton from the iliac arteries. In these ridges, there are some tiny blood vessels that still have flow, although a trivial amount. From the abdominal wall stretching upward and joining with the liver is a curtain of tissue called the falciform ligament. The edge of the falciform ligament has the obliterated remnant of the umbilical vein. It also retains some trivial blood flow.
When I fix a bellybutton hernia, I will invariably trim back the edges of the abdominal wall tissue to something strong enough to hold some stitches, and it will ooze blood at 3 locations. Two of them are on the lower border and represent the former umbilical arteries, the remaining one is at the upper border and represents the former umbilical vein.
In patients with advanced cirrhosis of the liver, the umbilical vein becomes enlarged and it won't just ooze... it will gush blood if cut. In general, I won't do elective operations on people who have really bad livers and this is one of several reasons why.
Location: Heber Valley, Utah....or fishing on a local stream or river.
Posts: 580
Re: Ask the Bellydoc
Quote:
BellyDoc previously said:
....The important thing to recognize about the bellybutton is that it USED to be an important connector to the placenta. The umbilicus is a scar where the umbilical cord used to be. The umbilical cord remnants still reside in the abdominal wall just beneath the muscle......
On a similar topic....what determines whether you have an "innie" or "outie" belly button??....could a parent have a choice for their child?...or is it just how the belly button randomly scars/seals up at the time?
On a similar topic....what determines whether you have an "innie" or "outie" belly button??....could a parent have a choice for their child?...or is it just how the belly button randomly scars/seals up at the time?
Thanks
The umbilical ring typically cinches down after the cord is divided. Some kids are born with a frankly obvious umbilical hernia with a big long tube of squeezable fat or even intestine that you can push down and then feel the edges of the hole in the body wall, beneath. Most kids will actually close these off by age 2, but if it's long and narrow enough that it sags over, then it's described as being "proboscoid" (nose-like) and it's probably NOT going to seal off by itself. My 3 year old had a small umbilical hernia as a newborn and it's basically gone now. The incidence of umbilical hernia is somewhere between 4 and 15%. It's one of the most common abnormalities noted in newborns. The numbers are higher in some ethnic groups and in low birthweight individuals. Hernia tendencies do seem to run in families.
An "outie" is a small umbilical hernia. Hernias either stay the same or get bigger, but other than for those who are under 2 years of age, they don't get smaller. Hernias tend to expand in bursts. They'll be the same for a long time, and then they'll grow... then they'll be the same for a long time, and then maybe grow again. The bigger they are, the harder they are to fix without causing tension on the sutures and increasing the risk of hernia recurrence in the future. The general recommendation is to fix a hernia once you know it's there, unless there are other reasons not to.
I've actually got one, myself, it's an "outie" that's just basically a small umbilical hernia. After being thin like an African marathoner all through college, I got nice and round through medical school and beyond. There's now a little more hydraulic pressure pushing on it from the inside, and my belief is that it will one day start to grow. However, for now, my "outie" isn't getting any bigger and it's not causing me any symptoms.
For now, I have a motivation to leave it alone. My girls love to poke me in the bellybutton and I'm sure it's because it's a nice little round ball that sits right there at eye level. I have no desire to disappoint them. When they tire of poking, I'll reconsider repairs.
....think of drift as the random experiment that makes available variations in species which may or may not turn into selectable factors for evolution.
WOW! What an answer!
So, genetic drift is responsible for an allele which may or may not have an impact on survival or reproduction. If the effect is negative the allele should over time disappear (random genetic drift still?). If the allele has a positive effect the number of individuals with this new allele should increase over time, (now it might be evolution?). So how do we determine which factors are selection factors and which are just drift? Is it the severity of the effect?
Back to the vitamin D... If through drift an individual has an allele which makes it more difficult to produce the required amount of vitamin D the survival rate of that individual in the right or wrong (depending on how you look at it) environment may suffer. Bright , sunny tropics = enough vitamin D. Dark and cloudy north = vitamin D deficiency. To me this looks like evolution, UNLESS, it comes down to the severity of the effect of survival and reproduction. I am nowhere near knowledgable enough on the topic to decide how much the level of vitamin D would have to change to have a negative impact on survival and reproduction much less guess at what genetic factors could cause such a change. BUT... If the vitamin deficiency caused by the allele is not severe enough to impact survival and reproduction then we are back to ramdom drift.
Am I geting closer Doc?
Either way, this is, for me anyway, a great topic. Sorry I took so long to get back here to post!
Jon, do you know anything about the ear/nose/and throat region??? I have an issue that has plagued me for a while and never been able to find a solution.
__________________
Who's excited for Katemcy Wheel-toberfest. I is excited!!!
Jon, do you know anything about the ear/nose/and throat region??? I have an issue that has plagued me for a while and never been able to find a solution.
haha okay here it goes (i just typed this huge response but accidentally closed the page before i hit send, son of a...)
I have had this issue since i can remember. It happens almost all the time when i go wakeboarding or swimming. If i ingest water up my nose, i will get a horrible sinus infection for the night. As in, i will maybe get a couple hours of sleep and i am blowing my nose every 10 minutes or less. Here are some of the things i have noticed about it.
It does not matter how clean or unclean the water is. Lake, shower, pool, saltwater, the slightest bit that goes up my nose causes it. (happens all the time wakeboarding)
The symptoms always appear at 8pm (+/- 1 hr) and always disappear the next day at 11am (+/- 1 hr).
Symptoms are: congestion, sinus pressure which causes bad headache, very runny nose.
The mucus is always clear and thin.
I just noticed this recently, but if i go wakeboarding for a few days, and this happens on the first day, it rarely happens for the next few days.
When i am trying to go to sleep, if i lean on my side, one side of my air way opens and allows me to breathe through my nose barely.
No medicines have EVER been able to help. No sprays, pills, liquids, anything.
I broke my nose pretty badly wakeboarding when i was 15, but neither the symptoms nor the severity changed after. My doctor hasn't been able to diagnose it (a while back) and i haven't seen and ENT about it.
So, any ideas?
__________________
Who's excited for Katemcy Wheel-toberfest. I is excited!!!
haha okay here it goes (i just typed this huge response but accidentally closed the page before i hit send, son of a...)
I have had this issue since i can remember. It happens almost all the time when i go wakeboarding or swimming. If i ingest water up my nose, i will get a horrible sinus infection for the night. As in, i will maybe get a couple hours of sleep and i am blowing my nose every 10 minutes or less. Here are some of the things i have noticed about it.
It does not matter how clean or unclean the water is. Lake, shower, pool, saltwater, the slightest bit that goes up my nose causes it. (happens all the time wakeboarding)
The symptoms always appear at 8pm (+/- 1 hr) and always disappear the next day at 11am (+/- 1 hr).
Symptoms are: congestion, sinus pressure which causes bad headache, very runny nose.
The mucus is always clear and thin.
I just noticed this recently, but if i go wakeboarding for a few days, and this happens on the first day, it rarely happens for the next few days.
When i am trying to go to sleep, if i lean on my side, one side of my air way opens and allows me to breathe through my nose barely.
No medicines have EVER been able to help. No sprays, pills, liquids, anything.
I broke my nose pretty badly wakeboarding when i was 15, but neither the symptoms nor the severity changed after. My doctor hasn't been able to diagnose it (a while back) and i haven't seen and ENT about it.
So, any ideas?
I doubt it's actually a sinus INFECTION because a plugged sinus with bacterial yoghurt growing in it makes you pretty sick... fever, chills, septic shock... that sort of thing. Plus, pus drains out of your nose.
I'm guessing you're dealing with a localized inflammatory change in the lining of your nose due to the water blast. There's actually a very narrow slit that represents the nasal passage and when the mucus membranes swell just a tiny bit, they crash into eachother.
As an experiement, the next time you THINK it's going to happen to you, have some Sudafed on hand. Sudafed is an over the counter agent that probably shouldn't be. It causes all sorts of nifty effects and it's a great starting material if you want to manufacture your own crystal meth. It's no slouch of a stimulant all by itself. It does a powerful job of shrinking mucus membrane swelling by constricting blood vessels. For kicks, wash it down with a large cup of coffee.
If you can relieve the symptoms with Sudafed, then it's probably just swollen membranes... almost like a nasal allergy. That doesn't mean you're allergic, but the end result is the same. Even localized nose trauma causes swelling, but it wouldn't help to take allergy meds after getting your nose drilled out by a jet of water... although you'd sleep well.
The Sudafed will wear off whether it works or not. At that point, you'll probably be more swollen than you started. You'll probably come online immediately and post curses on this thread. I'll tell you "I told you so... but now we know," if it worked, and if it didn't, I'll say "yes, but now we've ruled out nasal passage swelling and we're closer to the truth."
If Sudafed works, I'd wonder about using a cortisol nose spray to quell swelling. Flo-nase is just such a product, but this would be a non-indicated use. The good news, though, is that there wouldn't be a rebound period after it wears off. You'd just have to convince a doctor to write it for you for the wrong reasons. It's for allergy, but it works only on the nose, and not on the rest of the system like allergy pills.
If water actually IS getting into your sinuses, it will show up on a skull X-ray. Skull X-rays are almost completely useless in the modern age of CT scans, but this is one of the few reasons to order one. I would actually do this if you were around... I'd wait till you came in from the water and shoot an image, just to know.
I don't know what to tell you if you're getting water that far into your head. You shouldn't. It's well protected to prevent that, and even if you do, it should self clear through absorption. It would certainly cause swelling, if you did... and in fact my first recommendation would be Sudafed to facilitate drainage.
Linear Mode
