A cecal appendix has evolved independently at least twice, and apparently represents yet another example of convergence in morphology between Australian marsupials and placentals in the rest of the world. The diameter of the appendix is 6 mm and more than 6 mm is considered a thickened or inflamed appendix. Although the appendix has apparently been lost by numerous species, it has also been maintained for more than 80 million years in at least one clade. [28], In a 2013 paper, the appendix was found to have evolved at least 32 times (and perhaps as many as 38 times) and to have been lost no more than six times. Dr. Heather F. Smith of Midwestern University and colleagues explained: Recently ... improved understanding of gut immunity has merged with current thinking in biological and medical science, pointing to an apparent function of the mammalian cecal appendix as a safe-house for symbiotic gut microbes, preserving the flora during times of gastrointestinal infection in societies without modern medicine. Humans lose salts and electrolytes as they sweat, and must replace these nutrients to carry electrical charges between cells. These animals consume more cellulose and water, making a larger cecum necessary for effective digestion. [12] Therefore, the notion that the appendix is only vestigial became widely held. Typically, point (skin) pain is not present until the parietal peritoneum is inflamed, as well. More than just a reservoir for liquids, the cecum is responsible for the absorption of salts and electrolytes into the body from liquids. Charles Darwin suggested that the appendix was mainly used for digesting leaves as primates, and evolved to take on a new purpose over the course of evolution. [19][20], The most common diseases of the appendix (in humans) are appendicitis and carcinoid tumors (appendiceal carcinoid). The koala's cecum enables it to host bacteria that specifically help to break down cellulose. This valve of the vermiform appendix is also called Gerlach's valve.[3]. The surgical removal of the appendix is called an appendectomy. The cecum functions differently in various animal species. She primarily writes articles about crafts and home improvement. Current epidemiological data on the cause of death in developed countries collected by the World Health Organization in 2001 show that acute diarrhea is now the fourth leading cause of disease-related death in developing countries (data summarized by The Bill and Melinda Gates Foundation). The longest appendix ever removed was 26 cm long. While the base of the appendix is typically located 2 cm below the ileocecal valve, the tip of the appendix can be variably located—in the pelvis, outside the peritoneum or behind the cecum. In particular, it presents at McBurney's point, 1/3 of the way along a line drawn from the anterior superior iliac spine to the umbilicus. The appendix is also used for the construction of an efferent urinary conduit, in an operation known as the Mitrofanoff procedure,[25] in people with a neurogenic bladder. Human ancestors may have also relied upon this system when they lived on a diet rich in foliage. This pain is typically a dull, poorly localized, visceral pain. In rare cases, adenomas are also present. [23], As the inflammation progresses, the pain begins to localize more clearly to the right lower quadrant, as the peritoneum becomes inflamed. It is typically located on the right side of the body (the same side of the body as the appendix, to which it is joined). The cecum is also responsible for breaking down the cellulose fibers from digesting plant matter. [4][5] Intestinal malrotation may also cause displacement of the appendix to the left side. During digestion, the small intestine absorbs nutrients from solid foods, and passes the solid waste products and liquid into the large intestine for absorption into the body.

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