L11 Caecum, Appendix and Colon

Question 1

Most likely spot for obstruction of the colon?

Answer 1

Sigmoid Colon

Question 2

What does the Superior Mesenteric Artery Supply?

Answer 2

*Caecum
*Appendix
*Ascending colon
*Transverse colon (2/3)

Question 3

What does the Inferior Mesenteric Artery Supply?

Answer 3

• Transverse colon (1/3)
• Descending colon
• Sigmoid colon
• Rectum & anal canal

Question 4

Sign of Colon Cancer?

Answer 4

Apple-Core Sign

Question 5

Widest part of the Colon

Answer 5

Cecum

Question 6

Venous Drainage of the Colon?

Answer 6

Question 7

Innervation of the Ascending and Transverse Colon?

Answer 7

SYMPATHETIC + PARASYMPATHETIC
via superior mesenteric plexus from posterior vagal trunk and lower thoracic splanchnic

Question 8

Innervation of the Descending and Sigmoid Colon?

Answer 8

SYMPATHETIC
Via superior/inferior mesenteric and superior hypogastric plexuses from thoracic and lumbar splanchnics

PARASYMPATHETIC
Via inferior hypogastric plexuses from S2-S4 pelvic splanchnics

Question 9

Answer 9

Question 10

What opposes during colonic peristalsis, particularly mass movements?

Answer 10

Ileocaecal Junction

Question 11

Vermiform blind ending diverticulum arising most frequently from posteromedial aspect of caecum?

Base Location?

Answer 11

Apendix

Base location: McBurney’s point

Question 12

Relationships of the Cecum?

Answer 12

Anterior: anterior abdominal wall and loops of small interesting

Posterior: Iliopsoas, lateral femoral cutaneous nerve

Posteromedial: Femoral nerve and external iliac vessels

Question 13

Relationships of the Ascending Colon?

Answer 13

Retroperitoneal

Anterior : Small Intestine

Posterior : Iliacus, quadratus lumborum & lower pole of right kidney

Question 14

Blood Supply/Venous Drainage of Ascending Colon?

Answer 14

SMA (ileocolic and right colic arteries)
SMV (ileocolic and right colic veins)

Question 15

Relationships of the Transverse Colon?

Answer 15

Intraperitoneal

Anterior: Liver & GB, stomach, spleen, greater omentum

Posterior: Small intestine (D2), & pancreas

Question 16

The transverse colon travels _______peritoneally from the __________ flexure to __________flexure attaching to the ___________ ligament

Answer 16

The transverse colon travels INTRAperitoneally from the right colic (hepatic) flexure to the left colic (splenic) flexure attaching to the phrenicocolic ligament

Question 17

The Ascending colon travels _______peritoneally from the _________________ending at _______________ flexure. It has a paracolic gutter leading to _________________

Answer 17

The Ascending colon travels RETROperitoneally from right hypochondrium ending at right colic/hepatic flexure. It has a paracolic gutter leading to subphrenic space

Question 18

Relationships of the Descending Colon?

Answer 18

Retroperitoneal

Anterior: Small intestine

Posterior: Diaphragm, left kidney, quadratus lumborum and iliacus

Question 19

What marks the midgut/hindgut watershed?

Answer 19

Left colic flexure (Transverse/Descending Colon transition)

Question 20

Sigmoid colon begins above the ______travels _______peritoneally to _______ sacral segment.

It is ______ -shaped with long mesentery tapering towards rectum (_______________)

Answer 20

Sigmoid colon begins above the pelvic inlet travels intraperitoneally to 3rd sacral segment.

It is S-shaped variable length with long mesentery tapering towards rectum (sigmoid mesocolon)