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An anastomosis (, plural anastomoses) is a connection or opening between two things (especially cavities or passages) that are normally diverging or branching, such as between
blood vessel Blood vessels are the structures of the circulatory system that transport blood throughout the human body. These vessels transport blood cells, nutrients, and oxygen to the tissues of the body. They also take waste and carbon dioxide away from ...
s, leaf veins, or streams. Such a connection may be normal (such as the foramen ovale in a fetus's heart) or abnormal (such as the
patent foramen ovale Atrial septal defect (ASD) is a congenital heart defect in which blood flows between the atria (upper chambers) of the heart. Some flow is a normal condition both pre-birth and immediately post-birth via the foramen ovale; however, when this do ...
in an adult's heart); it may be acquired (such as an arteriovenous fistula) or innate (such as the arteriovenous shunt of a metarteriole); and it may be natural (such as the aforementioned examples) or artificial (such as a
surgical anastomosis A surgical anastomosis is a surgical technique used to make a new connection between two body structures that carry fluid, such as blood vessels or bowel. For example, an arterial anastomosis is used in vascular bypass and a colonic anastomosis ...
). The reestablishment of an anastomosis that had become blocked is called a reanastomosis. Anastomoses that are abnormal, whether
congenital A birth defect, also known as a congenital disorder, is an abnormal condition that is present at birth regardless of its cause. Birth defects may result in disabilities that may be physical, intellectual, or developmental. The disabilities c ...
or acquired, are often called
fistula A fistula (plural: fistulas or fistulae ; from Latin ''fistula'', "tube, pipe") in anatomy is an abnormal connection between two hollow spaces (technically, two epithelialized surfaces), such as blood vessels, intestines, or other hollow or ...
s. The term is used in
medicine Medicine is the science and Praxis (process), practice of caring for a patient, managing the diagnosis, prognosis, Preventive medicine, prevention, therapy, treatment, Palliative care, palliation of their injury or disease, and Health promotion ...
,
biology Biology is the scientific study of life. It is a natural science with a broad scope but has several unifying themes that tie it together as a single, coherent field. For instance, all organisms are made up of cells that process hereditar ...
,
mycology Mycology is the branch of biology concerned with the study of fungi, including their genetic and biochemical properties, their taxonomy and their use to humans, including as a source for tinder, traditional medicine, food, and entheogens, a ...
,
geology Geology () is a branch of natural science concerned with Earth and other astronomical objects, the features or rocks of which it is composed, and the processes by which they change over time. Modern geology significantly overlaps all other Ea ...
, and
geography Geography (from Greek: , ''geographia''. Combination of Greek words ‘Geo’ (The Earth) and ‘Graphien’ (to describe), literally "earth description") is a field of science devoted to the study of the lands, features, inhabitants, a ...
.


Etymology

Anastomosis: medical or Modern Latin, from Greek ἀναστόμωσις, anastomosis, "outlet, opening", Gr ana- "up, on, upon", stoma "mouth", "to furnish with a mouth". Thus the ''-stom-'' syllable is cognate with that of ''stoma'' in botany or ''stoma'' in medicine.


Medical anatomy

An anastomosis is the connection of two normally divergent structures. It refers to connections between
blood vessel Blood vessels are the structures of the circulatory system that transport blood throughout the human body. These vessels transport blood cells, nutrients, and oxygen to the tissues of the body. They also take waste and carbon dioxide away from ...
s or between other tubular structures such as loops of
intestine The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The GI tract contains all the major organs of the digestive system, in humans a ...
.


Circulatory

In circulatory anastomoses, many arteries naturally anastomose with each other; for example, the inferior epigastric artery and
superior epigastric artery In human anatomy, the superior epigastric artery is a blood vessel that carries oxygenated blood to the abdominal wall, and upper rectus abdominis muscle. It is a branch of the internal thoracic artery. It enters the rectus sheath to descend u ...
, or the anterior and/or posterior communicating arteries in the
Circle of Willis The circle of Willis (also called Willis' circle, loop of Willis, cerebral arterial circle, and Willis polygon) is a circulatory anastomosis that supplies blood to the brain and surrounding structures in reptiles, birds and mammals, including huma ...
in the brain. The circulatory anastomosis is further divided into arterial and venous anastomosis. Arterial anastomosis includes actual arterial anastomosis (e.g., palmar arch, plantar arch) and potential arterial anastomosis (e.g. coronary arteries and cortical branch of
cerebral arteries The cerebral arteries describe three main pairs of arteries and their branches, which perfuse the cerebrum of the brain. The three main arteries are the: * '' Anterior cerebral artery'' (ACA) * '' Middle cerebral artery'' (MCA) * '' Posterior c ...
). Anastomoses also form alternative routes around
capillary A capillary is a small blood vessel from 5 to 10 micrometres (μm) in diameter. Capillaries are composed of only the tunica intima, consisting of a thin wall of simple squamous endothelial cells. They are the smallest blood vessels in the body: ...
beds in areas that don't need a large blood supply, thus helping regulate systemic blood flow.


Surgical

Surgical anastomosis A surgical anastomosis is a surgical technique used to make a new connection between two body structures that carry fluid, such as blood vessels or bowel. For example, an arterial anastomosis is used in vascular bypass and a colonic anastomosis ...
occurs when segments of
intestine The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The GI tract contains all the major organs of the digestive system, in humans a ...
, blood vessel, or any other structure are connected together surgically (anastomosed). Examples include arterial anastomosis in bypass surgery, intestinal anastomosis after a piece of intestine has been resected,
Roux-en-Y anastomosis In general surgery, a Roux-en-Y anastomosis, or Roux-en-Y, is an end-to-side surgical anastomosis of bowel used to reconstruct the gastrointestinal tract. Typically, it is between stomach and small bowel that is distal (or further down the gas ...
and
ureteroureterostomy Ureteroureterostomy ( "urétero-uréte-róstomy") is end-to-end connection (anastomosis) of the two portions of a transected ureter; also called ureteroureteral anastomosis and van Hook operation (after Weller van Hook, surgeon). __TOC__ Reasons ...
. Surgical anastomosis techniques include Linear Stapled Anastomosis, Hand Sewn Anastomosis, End-to-End Anastomosis (EEA). Anastomosis can be performed by hand or with an anastomosis assist device. Studies have been performed comparing various anastomosis approaches taking into account surgical "time and cost, postoperative anastomotic bleeding, leakage, and stricture".


Pathological

Pathological anastomosis results from trauma or
disease A disease is a particular abnormal condition that negatively affects the structure or function of all or part of an organism, and that is not immediately due to any external injury. Diseases are often known to be medical conditions that a ...
and may involve
vein Veins are blood vessels in humans and most other animals that carry blood towards the heart. Most veins carry deoxygenated blood from the tissues back to the heart; exceptions are the pulmonary and umbilical veins, both of which carry oxygenate ...
s,
arteries An artery (plural arteries) () is a blood vessel in humans and most animals that takes blood away from the heart to one or more parts of the body (tissues, lungs, brain etc.). Most arteries carry oxygenated blood; the two exceptions are the pul ...
, or
intestines The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The GI tract contains all the major organs of the digestive system, in humans ...
. These are usually referred to as
fistula A fistula (plural: fistulas or fistulae ; from Latin ''fistula'', "tube, pipe") in anatomy is an abnormal connection between two hollow spaces (technically, two epithelialized surfaces), such as blood vessels, intestines, or other hollow or ...
s. In the cases of veins or arteries, traumatic fistulas usually occur between artery and vein. Traumatic intestinal fistulas usually occur between two loops of intestine (entero-enteric fistula) or intestine and
skin Skin is the layer of usually soft, flexible outer tissue covering the body of a vertebrate animal, with three main functions: protection, regulation, and sensation. Other cuticle, animal coverings, such as the arthropod exoskeleton, have diffe ...
(enterocutaneous fistula). Portacaval anastomosis, by contrast, is an anastomosis between a vein of the portal circulation and a vein of the
systemic circulation The blood circulatory system is a system of organs that includes the heart, blood vessels, and blood which is circulated throughout the entire body of a human or other vertebrate. It includes the cardiovascular system, or vascular system, tha ...
, which allows blood to bypass the
liver The liver is a major organ only found in vertebrates which performs many essential biological functions such as detoxification of the organism, and the synthesis of proteins and biochemicals necessary for digestion and growth. In humans, it ...
in patients with
portal hypertension Portal hypertension is abnormally increased portal venous pressure – blood pressure in the portal vein and its branches, that drain from most of the intestine to the liver. Portal hypertension is defined as a hepatic venous pressure gradient g ...
, often resulting in
hemorrhoids Hemorrhoids (or haemorrhoids), also known as piles, are vascular structures in the anal canal. In their normal state, they are cushions that help with stool control. They become a disease when swollen or inflamed; the unqualified term '' ...
, esophageal varices, or caput medusae.


Biology


Evolution

In
evolution Evolution is change in the heritable characteristics of biological populations over successive generations. These characteristics are the expressions of genes, which are passed on from parent to offspring during reproduction. Variation ...
, anastomosis is a recombination of evolutionary lineage. Conventional accounts of evolutionary lineage present themselves as the branching out of species into novel forms. Under anastomosis, species might recombine after initial branching out, such as in the case of recent research that shows that ancestral populations along human and chimpanzee lineages may have interbred after an initial branching event. The concept of anastomosis also applies to the theory of
symbiogenesis Symbiogenesis (endosymbiotic theory, or serial endosymbiotic theory,) is the leading evolutionary theory of the origin of eukaryotic cells from prokaryotic organisms. The theory holds that mitochondria, plastids such as chloroplasts, and pos ...
, in which new
species In biology, a species is the basic unit of Taxonomy (biology), classification and a taxonomic rank of an organism, as well as a unit of biodiversity. A species is often defined as the largest group of organisms in which any two individuals of ...
emerge from the formation of novel symbiotic relationships.


Mycology

In
mycology Mycology is the branch of biology concerned with the study of fungi, including their genetic and biochemical properties, their taxonomy and their use to humans, including as a source for tinder, traditional medicine, food, and entheogens, a ...
, anastomosis is the fusion between branches of the same or different
hyphae A hypha (; ) is a long, branching, filamentous structure of a fungus, oomycete, or actinobacterium. In most fungi, hyphae are the main mode of vegetative growth, and are collectively called a mycelium. Structure A hypha consists of one or ...
. Hence the bifurcating fungal hyphae can form true reticulating networks. By sharing materials in the form of dissolved
ions An ion () is an atom or molecule with a net electrical charge. The charge of an electron is considered to be negative by convention and this charge is equal and opposite to the charge of a proton, which is considered to be positive by conve ...
,
hormones A hormone (from the Greek participle , "setting in motion") is a class of signaling molecules in multicellular organisms that are sent to distant organs by complex biological processes to regulate physiology and behavior. Hormones are required fo ...
, and
nucleotides Nucleotides are organic molecules consisting of a nucleoside and a phosphate. They serve as monomeric units of the nucleic acid polymers – deoxyribonucleic acid (DNA) and ribonucleic acid (RNA), both of which are essential biomolecules wi ...
, the fungus maintains bidirectional communication with itself. The fungal network might begin from several origins; several spores (''i.e.'' by means of conidial anastomosis tubes), several points of penetration, each a spreading circumference of absorption and assimilation. Once encountering the tip of another expanding, exploring self, the tips press against each other in pheromonal recognition or by an unknown recognition system, fusing to form a genetic singular clonal colony that can cover hectares called a genet or just microscopical areas. For fungi, anastomosis is also a component of reproduction. In some fungi, two different haploid mating types – if compatible – merge. Somatically, they form a morphologically similar mycelial wave front that continues to grow and explore. The significant difference is that each septated unit is binucleate, containing two unfused nuclei, i.e. one from each parent that eventually undergoes
karyogamy Karyogamy is the final step in the process of fusing together two haploid eukaryotic cells, and refers specifically to the fusion of the two nuclei. Before karyogamy, each haploid cell has one complete copy of the organism's genome. In order for ...
and meiosis to complete the sexual cycle. Also the term "anastomosing" is used for mushroom gills which interlink and separate to form a network.


Botany

The growth of a
strangler fig Strangler fig is the common name for a number of tropical and subtropical plant species in the genus ''Ficus'', including those that are commonly known as banyans. Some of the more well-known species are: * ''Ficus altissima'' * ''Ficus aurea'', ...
around a host tree, with tendrils fusing together to form a mesh, is called anastomosing.


Geology

In
geology Geology () is a branch of natural science concerned with Earth and other astronomical objects, the features or rocks of which it is composed, and the processes by which they change over time. Modern geology significantly overlaps all other Ea ...
, anastomosis refers to
quartz Quartz is a hard, crystalline mineral composed of silica ( silicon dioxide). The atoms are linked in a continuous framework of SiO4 silicon-oxygen tetrahedra, with each oxygen being shared between two tetrahedra, giving an overall chemical ...
(or other)
veins Veins are blood vessels in humans and most other animals that carry blood towards the heart. Most veins carry deoxygenated blood from the tissues back to the heart; exceptions are the pulmonary and umbilical veins, both of which carry oxygenated ...
displaying this property, which is often related to shearing in
metamorphic Metamorphic rocks arise from the transformation of existing rock to new types of rock in a process called metamorphism. The original rock ( protolith) is subjected to temperatures greater than and, often, elevated pressure of or more, cau ...
regions.


Geography

Anastomosing streams consist of multiple channels that divide and reconnect and are separated by semi-permanent banks formed of cohesive material, such that they are unlikely to migrate from one channel position to another. They can be confused with
braided river A braided river, or braided channel, consists of a network of river channels separated by small, often temporary, islands called braid bars or, in English usage, '' aits'' or ''eyots''. Braided streams tend to occur in rivers with high sedime ...
s based on their planforms alone, but braided rivers are much shallower and more dynamic than anastomosing rivers. Some definitions require that an anastomosing river be made up of interconnected channels that enclose floodbasins, again in contrast with braided rivers. Rivers with anastomosed reaches include the
Magdalena River The Magdalena River ( es, Río Magdalena, ; less commonly ) is the main river of Colombia, flowing northward about through the western half of the country. It takes its name from the biblical figure Mary Magdalene. It is navigable through much o ...
in Colombia, the upper Columbia River in
British Columbia British Columbia (commonly abbreviated as BC) is the westernmost Provinces and territories of Canada, province of Canada, situated between the Pacific Ocean and the Rocky Mountains. It has a diverse geography, with rugged landscapes that include ...
, Canada, the
Drumheller Channels Drumheller Channels National Natural Landmark showcases the Drumheller Channels, which are the most significant example in the Columbia Plateau of basalt butte-and-basin Channeled Scablands. This National Natural Landmark is an extensively eroded ...
of the
Channeled Scablands The Channeled Scablands are a relatively barren and soil-free region of interconnected relict and dry flood channels, coulees and cataracts eroded into Palouse loess and the typically flat-lying basalt flows that remain after cataclysmic floods ...
of the state of Washington, USA, and the upper Narew River in
Poland Poland, officially the Republic of Poland, , is a country in Central Europe. Poland is divided into Voivodeships of Poland, sixteen voivodeships and is the fifth most populous member state of the European Union (EU), with over 38 mill ...
. The term
anabranch An anabranch is a section of a river or stream that diverts from the main channel or stem of the watercourse and rejoins the main stem downstream. Local anabranches can be the result of small islands in the watercourse. In larger anabranches, ...
has been used for segments of anastamosing rivers. In cave systems anastomosis is the splitting of cave passages that later reconnect.


References

{{reflist Angiology Digestive system Evolutionary biology Petrology concepts Surgery