Large Intestine

Question 1

Talk briefly about Teniae coli (their arrangement-Numnber)

Answer 1

3 longitudinal muscle bands.
They are arranged one
anterior & two posterior in ascending and descending colon
In transverse colon they are two anterior & one posterior

Question 2

Teniae coli are absent in?

Answer 2

appendix & rectum

Question 3

Appendices epiploicae or omental appendices are absent in?

Answer 3

absent in caecum, appendix & rectum

Question 4

Define ceacum, length, location

Answer 4

It is a blind-ended sac, 3 inches long, situated in right iliac fossa

Question 5

Vermiform appendix is attached to the ceacum to its?

Answer 5

posteromedial surface

Question 6

Ileocecal orifice is provided with …?

Answer 6

two lips, which forms its ileocecal valve

Question 7

Blood Supply Of The Cecum (Mention their branches)

Answer 7

▪ Arteries: Anterior & posterior cecal arteries form ileocolic artery (branch of superior mesenteric artery)
▪ Veins: Drain into superior mesenteric vein
▪ Lymph drainage: Superior mesenteric nodes
▪ Nerve Supply: from superior mesenteric plexus

Question 8

Describe the Vermiform appendix structure, where does it lie, length

Answer 8

It is a narrow, worm-like muscular tube containing a large amount of lymphoid tissue, lies in the right iliac fossa

Question 9

Vermifrom appendix base opens in the

Answer 9

posteromedial surface of cecum about 1 inch below ileocecal junction

Question 10

Does the Vermifrom appendix have a peritoneum covering it?

Answer 10

It has a complete peritoneal covering (mesoappendix) that contains appendicular vessels, nerves, lymphatics & lymph nodes

Question 11

Blood supply of the appendix

Answer 11

▪ Arteries: appendicular artery (branch of ileocolic artery)
▪ Veins: appendicular vein drains into ileocolic vein
▪ Lymphatics: Superior mesenteric nodes

Question 12

What are the Common Positions Of Appendix in order

Answer 12

1. Retrocecal position (65%): it lies behind cecum.
2. Pelvic position (31%): descending down into pelvis.
3. Subcecal position (2%): projecting just below cecum.
4. Pre-ileal position (1.5%): in front Subcecal of the terminal part of ileum.
5. Retro-ileal position (0.5%): behind the terminal part of ileum

Question 13

Describe the Surface anatomy of the appendix

Answer 13

The base of the appendix is situated at (McBurney’s point) the point of junction of the lateral 1/3 & medial 2/3 between the right anterior superior iliac spine with the umbilicus

Question 14

McBurney’s point is known to be

Answer 14

It’s the point of maximum tenderness in acute
appendicitis

Question 15

Pain of the appendicitis may be referred to the? why?

Answer 15

umbilicus as they are supplied by the same T10

Question 16

What might be injured during the appendectomy

Answer 16

Iliohypogastric & Ilioinguinal nerves

Question 17

Ascending colon lies in? Extends from where to where?

Answer 17

It lies in right lumbar region and extends upward from the ileocecal valve to inferior surface of right lobe of liver, where it turns to the left, forming right colic flexure

Question 18

Ascending colon length

Answer 18

15 cm long

Question 19

Is the ascending colon covered by peritoneum?

Answer 19

It is covered by peritoneum from the front and sides only

Question 20

Blood supply of the ascending colon

Answer 20

1- Arteries: ileocolic & right colic branches of superior mesenteric artery
2- Veins: ileocolic & right colic veins drain into superior mesenteric vein
3- Lymph Drainage: Superior mesenteric lymph nodes
4- Nerve Supply: Superior mesenteric plexus

Question 21

Transverse colon passes from which regions, length

Answer 21

right hypochondriac region into left hypochondriac region, 50 cm long

Question 22

Transverse colon extends from where to where?

Answer 22

Extends from right colic flexure below the liver to left colic flexure below the spleen

Question 23

Describe the left colic flexure and right colic flexure position

Answer 23

The left colic flexure is higher (L1) and more posterior than the right colic flexure (L2)

Question 24

What is the Transverse mesocolon

Answer 24

suspends the transverse colon from the anterior border of pancreas

Question 25

Blood supply of the Transverse Colon

Answer 25

Arteries:
1. Right 2/3: mainly by middle colic artery (superior mesenteric artery)
2. Left 1/3: by left colic artery (inferior mesenteric artery)
▪ Veins: Superior and inferior mesenteric artery
▪ Lymph drainage: Right 2/3 into superior mesenteric nodes; left 1/3 into inferior mesenteric nodes.
▪ Nerve supply: right 2/3 by superior mesenteric plexus; left 1/3 through inferior mesenteric plexus.

Question 26

Descending colon extends from … to …

Answer 26

extends downward from left colic flexure, to pelvic brim, where it becomes continuous with sigmoid colon

Question 27

Length of Descending colon

Answer 27

25 cm long

Question 28

Is the Descending colon retroperitoneal or intraperitoneal

Answer 28

Peritoneum covers its front & sides for that it’s retro

Question 29

Descending colon blood supply

Answer 29

1. Arteries: left colic and sigmoid branches of inferior mesenteric artery
2. Veins: drain into inferior mesenteric vein.
3. Lymph drainage: inferior mesenteric nodes
4. Nerve supply: from inferior mesenteric plexus

Question 30

Sigmoid colon lies in? How many cm long is it? Describe it’s shape? Is it intra or retro peritoneal

Answer 30

It lies in the left iliac fossa & pelvic cavity
About 40-50 cm long
It is S-shaped & completely surrounded by peritoneum

Question 31

Sigmoid colon becomes continuous with?

Answer 31

continuous with the rectum at the level of S3
vertebra

Question 32

Sigmoid colon peritoneum shape and name?

Answer 32

Sigmoid colon has a fan shaped fold of peritoneum, known as sigmoid mesocolon

Question 33

Sigmoid colon blood supply

Answer 33

1. Arteries: Sigmoid branches of the inferior mesenteric artery
2. Veins: Drains into sigmoid veins then to the inferior mesenteric vein.
3. Lymph drainage: Drains into the inferior mesenteric lymph nodes
4. Nerve supply: From the Inferior hypogastric plexus