Gross Anatomy Of The Large Intestine

Question 1

The large intestine is made up of

Answer 1

Cecum
Appendix
Ascending colon
Transverse colon
Descending colon
Sigmoid colon
Rectum
Anal canal

Question 2

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 ——, ——, —— & ——

Answer 2

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

Question 3

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 ——

Answer 3

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

Question 4

General features
The large intestine exhibits three features not seen elsewhere
• ——-, ——-, and ———.

Answer 4

General features
The large intestine exhibits three features not seen elsewhere
• Teniae coli, haustra, and epiploic appendages.
N.B: except for its terminal end

Question 5

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

Answer 5

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

Question 6

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

Answer 6

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

Question 7

Innervation of the large intestine
Midgut derivatives:
Sympathetic:—— plexus by —— nerve
Parasympathetic:——- nerve
Hind gut derivatives:
Sympathetic: ——- plexus by —— nerve
Parasympathetic:———- nerve

Answer 7

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

Question 8

Lymphatic drainage
4 set of lymph nodes, which are:

Answer 8

Lymphatic drainage
4 set of lymph nodes
✓Epicolic ✓Paracolic ✓Intermediate ✓Terminal

Question 9

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.

Answer 9

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.

Question 10

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.

Answer 10

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

Question 11

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.

Answer 11

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.

Question 12

COLON
• The colon is retroperitoneal, except for its —— and —— parts.

Answer 12

COLON
• The colon is retroperitoneal, except for its transverse and sigmoid parts.

Question 13

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.

Answer 13

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.

Question 14

The tenia coli is shorter than the length of the large intestine, this exerts a pull on the large intestine making folds called

Answer 14

Haustrations

Question 15

Which valve guards the appendicular orifice in the cecum

Answer 15

Valve of gerlach

Question 16

Blood supply of the cecum

Answer 16

Anterior and posterior cecal branches of the ileocolic artery

Question 17

Lymphatic drainage and venous drainage of the cecum

Answer 17

Lymphatic- drain into the superior mesenteric nodes
Venous- veins follow the artery

Question 18

The base of the appendix is attached to the ——— surface of the cecum

Answer 18

Posteromedial

Question 19

Is the appendix a retroperitoneal or intraperitoneal organ

Answer 19

Intraperitoneal

Question 20

The appendix is connected to the mesentery of the small intestine by the ——

Answer 20

Mesoappendix

Question 21

Does the appendix have tenia coli and haustrations?

Answer 21

No

Question 22

Is the base of the appendix fixed?

Answer 22

Yes

Question 23

The different position of the appendix and the location in relation to the clock and the percentage in people

Answer 23

1. Retrocolic/postcecal- 12o’clock-65.28%
2. Splenic(Preileal(1%)/postileal(0.4%))- 2o’clock
3. Promonteric-3o’clock-<1%
4. Pelvic-4o’clock-31.01%
5. Subcecal/inguinal/midinguinal-6o’clock-2%
6. Paracolic-11o’clock-2%

Question 24

—— point is the point of maximum tenderness and also the point of incision in appendectomy

Answer 24

Mcburney’s point

Question 25

Mc Burney’s point lies at the junction of ——two third and——one third of the spinoumbilical line from the —— to ——

Answer 25

Medial
Lateral
Asis
Umbilicus

Question 26

The base of the appendix lies— cm below the point of intersection of —— and ——- planes

Answer 26

Transtubercular and right lateral

Question 27

Blood supply of the appendix

Answer 27

Appendicular artery, a branch of the ileocolic artery

Question 28

Nerve supply of the appendix

Answer 28

From T10 causing referred pain in the umbilicus

Question 29

Ascending colon is supplied by which branch of the SMA

Answer 29

Right colic artery

Question 30

Transverse colon is supplied by which branch of the SMA

Answer 30

Middle colic artery

Question 31

Descending colon is supplied by which branch of the IMA

Answer 31

Left colic artery

Question 32

Sigmoid colon is supplied by which branch of the IMA

Answer 32

Sigmoid artery

Question 33

Acute appendicitis of retrocecal appendix results in positive—— test.pain on the extension of ——-

Answer 33

Positive psoas test
Flexed hip

Question 34

A pelvic appendix, when inflamed may mimic ——- and result in positive——- sign due to irritation of obturator internus

Answer 34

Ovary inflammation
Obturator

Question 35

Descending colon is —- cm long

Answer 35

25 cm

Question 36

Anatomical relations of the following structures both anterior and posterior:
Cecum:
Ascending colon:
Transverse colon:
Descending colon:
Sigmoid colon:

Answer 36

1. Cecum:
   -Anterior: AAW, greater omentum, small intestine
   -Posterior: psoas major muscle, iliacus muscle, femoral nerve btw the two muscles
2. Ascending colon:
   -Anterior: AAW, greater omentum, small intestine
   -Posterior: iliacus muscle, iliac crest, quadratus lumborum( separated by 2 nerves:iliohypogastric,ilioinguinal), right kidney
3. 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
4. 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
5. Sigmoid colon:
   Anterior: Urinary bladder, Uterus and upper vagina ( females only)
   Posterior: rectum, sacrum, ileum

Question 37

• ———-: 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

Answer 37

• 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