Welcome to the lab everyone. Today we're going to show you five organs that you could live without, and how the loss or removal of those organs would affect your life. Like how would your day to day routine be without that organ? Would you have certain limitations? Now obviously it's going to depend on the type of organ we're talking about here, so we might as well just jump into this list of organs that you can live without. So, starting our countdown backwards with number five, the spleen. Now, the spleen is an organ in the left upper quadrant of the abdomen. Now, it's going to be a lot cooler to show you on the cadaver rather than show you about where it would be on me. So, let's take a look at that. So, you can see we've opened up the thoracic and the abdominal cavity. Some organs to note here, big old liver right here. And then we've also got… That pink structure underneath there is the stomach and then this tissue here is the diaphragm, your breathing muscle, but sandwiched in between the stomach and the diaphragm is the actual spleen. You can see how it really tucks up underneath there, even tucking up underneath that. lateral aspect of the liver there. And something else to note is the vasculature and the blood vessels going into the spleen as this will play a role in how the spleen functions. Now, the spleen is the largest lymphatic structure in the human body and it has similar functions to lymph nodes, but at a larger scale as you can see here. But how does this thing function? So, the spleen functions as a filter for the blood in a way. It's a very vascular structure and blood is constantly being pumped through it. Again, take a look at that. I'll pull my hand out of the way. And you can see those blood vessels going into the spleen here. Now, one of the things that's going to happen is any potential pathogens like bacteria that are going through the bloodstream will pass through the spleen. And since the spleen acts as a lymphatic organ, it's going to have white blood cells in there. And those white blood cells are going to potentially kill and get rid of any pathogens. Now, that's not the only thing the spleen is going to get rid of. Again, we have blood constantly going through here. and red blood cells are constantly circulating throughout the body. Red blood cells, their main job in life is to carry oxygen, but they have a life of about 120 days, and it's a little bit of a rough life because they're constantly trying to squeeze through tight spaces and small little capillaries to deliver oxygen to tissues, and they get worn out over time. So as that blood with the red blood cells passes through into the splenic tissue there, it will also get rid of those old red blood cells. Now don't worry, we're constantly producing more red blood cells in the bone marrow, so anything we take away in the spleen, we replace in the bone marrow. But what happens if someone has like a traumatic injury to the side of their body or breaks some ribs over here and those rib shards that you could potentially see here and here go in and rupture or puncture the spleen? Remember, very vascular, so a lot of bleeding can take place and in those cases, they might have to do an emergency splenectomy, which is the fancy pants name for. removing the spleen. So now that we know what the spleen does, how would that affect someone's life if they had to pull this structure out or remove it? And now they, besides having a little gap or empty space right there, they would have a little bit more risk of developing blood-borne infections. So a lot of times people who have had splenectomies, if they're going in for a major surgery, the surgeons or the doctors will give them antibiotics prior to the surgery because again, they're a little bit more risk for blood-borne pathogens. Now, as far as the red blood cell issue, luckily there's some other organs like the liver that can take that job on for the spleen and get rid of the old worn out red blood cells if someone doesn't have their spleen. And moving on to number four. reproductive structures like the ovaries. Because let's be honest, who needs to keep making kids all the time? So if we take a look at where the ovaries are on this cadaver, you can see this is the abdominal body wall with the skin removed, your six-pack muscles underneath this white tissue. If I reflect that muscular tissue out of the way, then you get to this fatty apron called the greater omentum. We get to reflect that out of the way. Then we run into the small intestines here. We have to reflect these out of the way. Eventually, we can get down to female reproductive structures and we can see right here, the tip of the probe here is the uterus, but I mentioned the ovaries. So let's pull up this right ovary here. I'll get my hand out of the way. Right in the probe there that I'm pinching there is the right ovary. Now we know that the ovaries release eggs or ova, which is the technical term for eggs. They also secrete hormones such as progesterone and estrogen. However, if we are going to concede. that we can live without ovaries and guys. We also have to concede that we can live without the homologous structure to the ovaries called the testes. So the testes are housed in the scrotal tissue which is down below on this particular cadaver dissection and this is the right side of the groin. So in other words, this is a right testis or testicle. And in this particular cadaver dissection we've cut inside so you can see these cool little strings inside called seminiferous tubules that produce the male version of gametes which we would call. sperm cells as opposed to the eggs or the ovum produced by the ovaries. Now, testosterone is also going to be produced in some of the cells of the testes and that testosterone will eventually leave through some of the blood vessels in this cord that we call the spermatic cord and then it can circulate throughout the body. So, from a reproductive standpoint, if you removed a testes or both testes or ovary or both ovaries, how much would that influence someone's day-to-day routine? From a reproductive standpoint, not so much. However, The hormonal loss, depending on if it's one or two, say it was testicular cancer in one testis versus two, you remove both ovaries in a hysterectomy or one just because it's diseased, that will influence if someone would need to have hormone replacement therapy. And so in certain situations, that could affect somebody's life and their physiology a little bit more from a hormonal balance rather than a reproductive balance. Now, there's one other thing I want to mention here. If you were to remove a testicle. then the scrotal sac would essentially be this little empty pouch down here, and some men might not really appreciate or like that. So they actually make prosthetic testes to replace the testicle that has been removed. Now, obviously, they're not going to do that for ovaries because they're inside the cavity, but if a male were to decide that they wanted the scrotal tissue in the testicle to look like it was at peak function at all times, they may opt for a prosthetic testes. No judgment here. you do what you need to do. And number three. The lungs. You can live without an entire lung. Now this is the left lung, which would sit on the left side of the thoracic cavity. Here is the right lung, trachea, scilatash, don't mind that, that would sit on the right side of the thoracic cavity. And obviously this cadaver still has its lungs there, but I wanted to show you how an individual left lung would look like, as well as an individual right lung. Let me move those out of the way. And you can again see these are deflated, pulled away from the thoracic wall here. But let's imagine. that the right lung was completely infiltrated with cancer. Cancerous right lung, the entirety of that lung. They could remove this whole right lung, and if the left lung were okay, it could still function independently and properly, even if this lung were removed. Now you can imagine the space that would be left here, and let me give you the perspective of how much space would be left in that right side of the thoracic cavity. So here you can see we've got a sagittal cut through a body, or a midline cut. And this is the right side of the body, the right side of the thoracic cavity. That right lung I just showed you was in this cavity. Removed it obviously here. But you can see the entirety and how much space would be left during a procedure called a pneumonectomy. Pneumo just refers to lung, ectomy just refers to excision or surgical removal, which we removed not surgically but in our cadaver lab. So you might think, compared to the previous other two things on the list, that removing an entire lung would have a greater effect on someone's lifestyle. And you'd be right. Pulling a whole right lung out of here is sure to decrease somebody's lung capacity, but by how much? You might think that it would be down by 50% because you're essentially taking almost half the lung tissue away. But what they found as the person has had time to heal, say this left lung still there, they found that it will expand a little bit into the extra spaces into the other cavity. Now, don't get me wrong, it's not going to expand completely and engulf the heart and wrap around and just grow into this other cavity, but it's going to have some extra expansion. and adaptations that they found some people can get up to about 70% of their original lung capacity. That means that people in certain situations can have a relatively normal lifestyle, meaning they can do day-to-day routines, and some people can even exercise with one lung. Now, are they going to be to the same capacity as they were with two lungs and run a marathon to the same rate or the same speed that they would if they had both lungs? No, but they can still have fun, get out, and exercise. and hopefully live a relatively normal life even after they've had a lung removed. Now, number two is probably going to be the least surprising on this list because you've probably known someone or maybe you have even had these removed, and that is the tonsils. But did you know there are three different locations of tonsils? The first one we're going to talk about are the ones that everyone thinks about, and that is the palatine tonsils, the one that you can see in the archway of the back of your throat. And if we take a look on the cadaver here, this is a sagittal cut here, and let's take a look where those would be. This is the uvula, or what I used to call the hangy doodle when I was a little kid. And you can see that little tissue that would create the archway. And the tonsils, specifically those palatine tonsils, would be located right here because they're just located inferior to this tissue that we refer to as the soft palate. But there's some others that I mentioned earlier. There's some called the pharyngeal tonsils, which a lot of people refer to as the adenoids. So if you've ever heard of somebody saying they've got their adenoid removed, that would be these pharyngeal tonsils. Coming back to our cadaver dissection, this region is called the pharynx. And specifically the top part of it is called the nasopharynx because it's behind the... nasal cavity right here that you can see. And the adenoid would be embedded in this tissue or in the posterior aspect of the nasopharynx. Now again, they can remove the adenoid. Just FYI, the adenoid's been known to grow back in some cases. Most of the time it stays gone, but every once in a while they'll have cases where people will have their adenoid regrow. Kind of crazy. But even more crazy, or at least the most surprising location of the tonsil to most of my students, is this last one. And that is... the lingual tonsils. There are tonsils on the back of the tongue here and you can see those little bumps right here where we find the tongue tonsils or the lingual tonsils. Now, what are tonsils? Tonsils are lymphoid tissue or lymphatic tissue packed with white blood cells. These are placed in a really strategic location up in the nasopharynx so anything that comes through the nose might run into the adenoid. Anything that comes through the mouth might get run into the like the lingual tonsils or the palatine tonsils. And it's essentially kind of this first line of defense to try to catch pathogens. And those tonsils have the white blood cells and they try to kill things. However, Some people tend to get a little bit too frequent with their infections, say like strep throat, and they may want to remove those tonsils, specifically again those palatine tonsils. Or some people might have some sleep disturbances where their tonsils are so big that it causes obstruction of airflow and they may remove them in that case. Now out of everything on this list, the removal of tonsils is probably going to be the least invasive or as far as I should say the least. detrimental to someone's lifestyle. And as you know, if you've had your tonsils removed or someone else has had them removed, people do relatively just fine. And number one, the colon, which makes up the majority of the large intestine, but you can remove part of the colon or the whole thing. But let's take a look at how it's oriented in the cadaver here. So you can see here's an abdominal dissection and the majority of the tubing that you're seeing right here is actually the small intestine and not the colon that we're going to talk about. But the small intestine has the greatest freedom of movement but is located in the central and lower part of the abdomen. If I step away from the camera, the large intestine is more fixed. It comes up the right side, transverses across, goes down the left side, and then squiggles out towards this midline to the rectum and the anus. And if we show that on the cadaver, if I shift over the small intestine so we can see the right side a little bit better, here's the beginning of the large intestine which is the cecum, and then the cecum becomes the ascending colon here. and then becomes the transverse colon coming across and then we have to shift the small bowel over here again But the transverse colon continues over the left side and then curves downward. And you can probably see underneath my finger, there's some tubing underneath this tissue here, which we'll talk about in another video. But the descending colon is a little shy, hiding behind that tissue, but then emerges as this curved part, which is the sigmoid colon, and then down to the rectum and the anus. But what does the large intestine do? Well, all the stuff in the large intestine is essentially feces. And so it's propelling and moving fecal matter or feces across there. eventually getting it to the anus and hopefully into the toilet. But what it also does as it's moving the feces through is absorbs the last part of water and salt. So I want you to think about that when we talk about removing part of the colon. Now, the technical term for removing the colon is a colectomy. Again, col refers to colonectomy for excision or surgical removal. And we could remove just a small segment or we could maybe remove the whole left half. And in that case, they'd call it. a left hemicolectomy because hemi means half. You could do a right hemicolectomy. But depending on how much colon is removed will influence the side effects or how that will affect the person's life after the surgery. So let me give you two different scenarios that can kind of give you an idea of what might happen with somebody removing part of their colon. Let's say someone has a diseased part of their colon in the descending colon going into part of the sigmoid, but a relatively small portion. A surgeon may come in and make an incision here. and make an incision there and remove that portion of the colon. Now, assuming that this portion is still healthy or the distal portion or the portion downstream, this portion could then be reattached to the other healthy portion upstream and they could reattach that. Granted, that would shorten the colon a little bit and change its orientation a little bit as well, but the person would have relatively normal, we'll call them bowel habits, because I want you to think about the alternative. What if I had to remove the whole... colon because the whole colon was diseased. Now in that case, if the anus and the rectum is okay, they could come in, take the end of the small intestine where they detached it from the diseased part of the colon, take this and create a pouch and attach it to the rectum and the anus, kind of making it a pseudo-rectum. for the stool or the food eventually to make its way out. And in that case, we're not really talking about food because most of the nutrients have been absorbed. Think about removing the whole colon. How much of a watery stool that would create? People would have essentially chronic watery stools or borderline diarrhea, but there's always trade-offs in medicine. If it's going to save somebody's life and the trade-off is you're going to have watery stools for the rest of your life, that's kind of one of those things we have to weigh in making these types of decisions. And the last thing I have to mention is the colostomy bag. Now, for those of you who have not heard of a colostomy bag, this is a bag that essentially is attached. from the outside of the body. So, they have to make an incision through the abdominal wall and they attach it to the large intestine so the feces dump into the bag rather than continue down into the colon. Now, there'd be two scenarios where we could use this. Let's say the rectum and the anus is salvageable, but the surgeon needs it to heal on its own for a few months, and so the surgeon doesn't want any feces or fecal matter to pass through that while it's healing. So, in that case, say we removed this portion again, they would attach the colostomy bag so the feces could come out, but then this portion would be healing. Say over two to three months the healing takes place, they remove the colostomy bag, this portion of the intestines heals, and then they reattach it and then the feces can flow down in its regular course. But what about the other scenario if the rectum and the anus is not salvageable and has to be totally removed due to, say, like cancer or something? In that case, they'd have to remove the rectum and the anus and then that person would not have a temporary colostomy bag. It would be more of a permanent colostomy bag where feces would have to dump into that bag. Again, it's that pros and cons, saving somebody's life from cancer with the trade-off of having feces go into a colostomy bag. However, I've seen some pretty cool belts where people will have these like belts where the colostomy bag will kind of sit into so they can still play sports. Like I had a lady that we worked on in the OR once where she was A avid tennis player was very concerned about being able to play tennis and she got this belt that could hold her colostomy bag. She was good to go! Thanks for watching all of our YouTube videos everyone and regarding this specific video you just watched, there are definitely more than just five organs you can live without so we'll be doing more videos on that but go ahead and comment below let us know what other things you'd like us to make videos on. Like, subscribe if you feel the need and if you feel like supporting the channel we've got some anatomical artwork available for you guys. Also our snazzy anatomy t-shirts. I know these are shameless plugs but again we appreciate everybody's support and we'll see in the next video.