Caecum and the appendix

Question 1

What is the caecum

Answer 1

Blind intestinal pouch between the ileum and the ascending colon

Question 2

Function of the caecum

Answer 2

Stores chyme

Question 3

Length of the caecum

Answer 3

7.5cm

Question 4

Location of the caecum

Answer 4

In the right iliac fossa
Inferior to the ileoceacal junction
2.5cm away from the inguinal ligament

Question 5

When is the caecum palpable

Answer 5

If distended due to faeces, gas or malignancy

Question 6

Where is the caecum covered with peritoneum

Answer 6

Entirely covered

Question 7

Does the caecum have mesentery

Answer 7

No

Question 8

What binds the caecum to the lateral abdominal wall

Answer 8

Cecal folds of peritoneum

Question 9

What is the appendix

Answer 9

Blind intestinal diverticulum that contains lymphoid tissue

Question 10

Where is the appendix attached

Answer 10

To the posteromedial end of the caecum inferior to the ileoceacal junction

Question 11

What are the most common positions of the appendix

Answer 11

Retrocecal (behind the caecum)
Sub ileal (parallel with terminal ileum)

Question 12

Shape of the mesoappendix

Answer 12

Short

Triangular

Question 13

What is the mesoappendix derived from

Answer 13

Posterior side of the mesentery of the terminal ileum

Question 14

Arterial supply of the caecum

Answer 14

Abdominal aorta -> SMA -> ileocolic artery -> Anterior and posterior cecal arteries

Question 15

Arterial supply of the appendix

Answer 15

Abdominal aorta -> SMA -> ileocolic -> appendicular

Question 16

Venous drainage of the caecum

Answer 16

Ileocolic vein which drains into the SMV

Question 17

Venous drainage of the appendix

Answer 17

Appendicular vein which drains into the ileocolic vein

Question 18

Innervation of the caecum and appendix

Answer 18

Ileocolic branch of the superior mesenteric plexus

Question 19

What does lymph from the caecum and appendix drain into

Answer 19

Upper and lower ileocolic lymph nodes via intermediate mesenteric nodes (many intermediate nodes from caecum, 1 intermediate node from appendix)

Question 20

Where are the ileocolic lymph nodes

Answer 20

Surrounding the ileocolic artery

Question 21

What is appendicitis

Answer 21

Acute inflammation of the appendix

Question 22

Common cause of appendicitis in young people

Answer 22

Increase in lymphoid tissue size which occludes the lumen

Question 23

Common cause of appendicitis in 30+ people

Answer 23

Blockage in the appendix with faecal matter

Question 24

Why does the appendix increase in size in appendicitis

Answer 24

It cannot drain

Question 25

How does the pain in appendicitis change

Answer 25

Stretching if the visceral peritoneum causes vague pain in the umbilical region
As the appendix swells it irritates the parietal peritoneum causing severe pain in the right lower quadrant

Question 26

Treatment for appendicitis

Answer 26

Appendectomy

Question 27

What can appendicitis lead to if not removed

Answer 27

Peritonitis as the appendix becomes necrotic and ruptures