Gross Anatomy Of The Large Intestine Flashcards
The large intestine is made up of
Cecum
Appendix
Ascending colon
Transverse colon
Descending colon
Sigmoid colon
Rectum
Anal canal
Introduction(Large intestine) ➢It frames the small intestine
on how many sides
➢Extends from the —— valve to the ——
➢About ——m long & ——cm wide
➢Divided into 4 main sections ——, ——, —— & ——
Introduction(Large intestine) ➢It frames the small intestine
on 3 sides
➢Extends from the ileocecal valve to the anus
➢About 1.5m long & 6.5cm wide
➢Divided into 4 main sections Caecum, colon, rectum & anal canal
Surface Anatomy
➢It starts in the ——- region of the pelvis, just at or below the right waist
➢It enters the ——- region to end as the ——
Surface Anatomy
➢It starts in the right iliac region of the pelvis, just at or below the right waist
➢It enters the lower hypogastric region to end as the anal canal
General features
The large intestine exhibits three features not seen elsewhere
• ——-, ——-, and ———.
General features
The large intestine exhibits three features not seen elsewhere
• Teniae coli, haustra, and epiploic appendages.
N.B: except for its terminal end
Blood supply
➢The different parts of the L.I are supply by the branches of ——— or ———
✓branches of the SMA that supplies the L.I: ——, —— & ——Artery
✓branches of the IFA that supplies the L.I:——- & —— artery
N.B: large intestine is drain by the —-
The sup. mesenteric & inf. mesenteric veins empties into the ———vein
Blood supply
➢The different parts of the L.I are supply by the branches of sup. mesenteric or inf. mesenteric artery
✓SMA: right colic, ileocolic & middle Artery
✓IFA: left colic & sigmoid artery
N.B: large intestine is drain by the accompanying vein
The sup. mesenteric & inf. mesenteric veins empties into the Hepatic portal vein
Innervations
The ——- & ——- plexus innervates the LI based on their embryonic origin
*———. plexus:
Midgut-derivatives
*——- plexus:
Hindgut derivatives
N.B: parasympathetic innervation via the ——— nerves & sympathetic innervation via the —— nerves
Innervations
The sup. & inf. mesenteric plexus innervates the LI based on their embryonic origin
*Sup. Mesenteric. plexus:
Midgut-derivatives
*Inf. Mesenteric plexus:
Hindgut derivatives
N.B: parasympathetic innervation via the pelvic splanchnic nerves & sympathetic innervation via the lumbar splanchnic nerves
Innervation of the large intestine
Midgut derivatives:
Sympathetic:—— plexus by —— nerve
Parasympathetic:——- nerve
Hind gut derivatives:
Sympathetic: ——- plexus by —— nerve
Parasympathetic:———- nerve
Midgut
Sympathetic: superior mesenteric plexus by lesser splanchnic nerve
Parasympathetic: vagus nerve
Hindgut
Sympathetic: inferior mesenteric plexus by lumber splanchnic nerve
Parasympathetic: pelvic splanchnic nerves S2,S3,S4
Lymphatic drainage
4 set of lymph nodes, which are:
Lymphatic drainage
4 set of lymph nodes
✓Epicolic ✓Paracolic ✓Intermediate ✓Terminal
Subdivision of the large intestine
• The large intestine has the following subdivisions: cecum, appendix, colon, rectum, & anal canal.
• The saclike cecum (“blind pouch”) ✓Lies below the ——— valve in the
——- fossa,
✓Measurement: —— by ——cm
✓The first part of the large intestine.
✓Attached to its posteromedial surface is the blind, wormlike ——- that contains masses of lymphoid tissue.
Subdivision of the large intestine
• The large intestine has the following subdivisions: cecum, appendix, colon, rectum, & anal canal.
• The saclike cecum (“blind pouch”) ✓Lies below the ileocecal valve in the
right iliac fossa,
✓Measurement: 6 by 7.5cm
✓The first part of the large intestine.
✓Attached to its posteromedial surface is the blind, wormlike vermiform appendix that contains masses of lymphoid tissue.
Vermiform
appendix
✓A narrow worm-like diverticulum
✓About —cm below the ileocaecal junction
✓Appendix varies from — to —-cm (AV of—cm).
✓Typical width is all about —-mm.
Vermiform
appendix
✓A narrow worm-like diverticulum
✓About 2 cm below the ileocaecal junction
✓Appendix varies from 2 to 20 cm (AV of 9 cm).
✓Typical width is all about 5 mm.
✓There are changes in the diameter of lumen with age
COLON
• The colon has several distinct regions.
✓The ascending colon (——cm), it travels up the right side of the abdominal cavity to the level of the right kidney it makes a right-angle turn-the ——, or —- flexure-before traveling across the abdominal cavity as the ——- colon.
✓The transverse colon(—cm) is directly anterior to the spleen, it bends acutely at the ——(or——) flexure & descend to the left side of the posterior abdominal wall as the ——- colon.
✓Inferiorly, it enters the pelvis, where it becomes the — - shaped —— colon.
COLON
• The colon has several distinct regions.
✓The ascending colon (12.5 cm), it travels up the right side of the abdominal cavity to the level of the right kidney it makes a right-angle turn-the right colic, or hepatic flexure-before traveling across the abdominal cavity as the transverse colon.
✓The transverse colon(50cm) is directly anterior to the spleen, it bends acutely at the left colic (splenic) flexure & descend to the left side of the posterior abdominal wall as the descending colon.
✓Inferiorly, it enters the pelvis, where it becomes the S- shaped sigmoid colon.
COLON
• The colon is retroperitoneal, except for its —— and —— parts.
COLON
• The colon is retroperitoneal, except for its transverse and sigmoid parts.
COLON
• These parts( transverse and sigmoid) are intraperitoneal and anchored to the posterior abdominal wall by mesentery sheets called ——
• It has an inverted —-shaped connection/ root.
COLON
• The colon is retroperitoneal, except for its transverse and sigmoid parts.
• These parts are intraperitoneal and anchored to the posterior abdominal wall by mesentery sheets called mesocolons
• It has an inverted V shaped connection/ root.
The tenia coli is shorter than the length of the large intestine, this exerts a pull on the large intestine making folds called
Haustrations
Which valve guards the appendicular orifice in the cecum
Valve of gerlach
Blood supply of the cecum
Anterior and posterior cecal branches of the ileocolic artery
Lymphatic drainage and venous drainage of the cecum
Lymphatic- drain into the superior mesenteric nodes
Venous- veins follow the artery
The base of the appendix is attached to the ——— surface of the cecum
Posteromedial
Is the appendix a retroperitoneal or intraperitoneal organ
Intraperitoneal
The appendix is connected to the mesentery of the small intestine by the ——
Mesoappendix
Does the appendix have tenia coli and haustrations?
No
Is the base of the appendix fixed?
Yes
The different position of the appendix and the location in relation to the clock and the percentage in people
- Retrocolic/postcecal- 12o’clock-65.28%
- Splenic(Preileal(1%)/postileal(0.4%))- 2o’clock
- Promonteric-3o’clock-<1%
- Pelvic-4o’clock-31.01%
- Subcecal/inguinal/midinguinal-6o’clock-2%
- Paracolic-11o’clock-2%
—— point is the point of maximum tenderness and also the point of incision in appendectomy
Mcburney’s point
Mc Burney’s point lies at the junction of ——two third and——one third of the spinoumbilical line from the —— to ——
Medial
Lateral
Asis
Umbilicus
The base of the appendix lies— cm below the point of intersection of —— and ——- planes
Transtubercular and right lateral
Blood supply of the appendix
Appendicular artery, a branch of the ileocolic artery
Nerve supply of the appendix
From T10 causing referred pain in the umbilicus
Ascending colon is supplied by which branch of the SMA
Right colic artery
Transverse colon is supplied by which branch of the SMA
Middle colic artery
Descending colon is supplied by which branch of the IMA
Left colic artery
Sigmoid colon is supplied by which branch of the IMA
Sigmoid artery
Acute appendicitis of retrocecal appendix results in positive—— test.pain on the extension of ——-
Positive psoas test
Flexed hip
A pelvic appendix, when inflamed may mimic ——- and result in positive——- sign due to irritation of obturator internus
Ovary inflammation
Obturator
Descending colon is —- cm long
25 cm
Anatomical relations of the following structures both anterior and posterior:
Cecum:
Ascending colon:
Transverse colon:
Descending colon:
Sigmoid colon:
- Cecum:
-Anterior: AAW, greater omentum, small intestine
-Posterior: psoas major muscle, iliacus muscle, femoral nerve btw the two muscles - Ascending colon:
-Anterior: AAW, greater omentum, small intestine
-Posterior: iliacus muscle, iliac crest, quadratus lumborum( separated by 2 nerves:iliohypogastric,ilioinguinal), right kidney - Transverse colon
-Anterior:AAW, greater omentum, lesser omentum, lesser omentum,liver above the hepatic flexure, spleen above the splenic flexure
-Posterior: second part of the duodenum, head of pancreas, small intestine(jejunum and ileum),left kidney - Descending colon:
-Anterior: AAW, greater omentum, small intestine
-Posterior: Left kidney, Quadratuslumborum, 2 nerves: (Iliohypogastric nerve and Ilioinguinal nerve), Iliac crest, Iliacus muscle, Lateral cutaneous nerve of the thigh, Femoral nerve, Left psoas and External iliac vessels - Sigmoid colon:
Anterior: Urinary bladder, Uterus and upper vagina ( females only)
Posterior: rectum, sacrum, ileum
• ———-: is a medical condition in which multiple sac- like protrusions called diverticula develop along the colon
• ——— disease: is a chronic inflammatory bowel disease of unknown etiology which can affect any part of the alimentary tract, but most often the terminal ileum and colon
• ———: is an inflammation of the appendix
• Diverticulosis: is a medical condition in which multiple sac- like protrusions called diverticula develop along the colon
• Crohn’s disease: is a chronic inflammatory bowel disease of unknown etiology which can affect any part of the alimentary tract, but most often the terminal ileum and colon
• Appendicitis: is an inflammation of the appendix
