large intestine

Question 1

where does the large intestine begin? (inferior most part)

Answer 1

from the caecum

Question 2

what follows from the caecum? (all the parts)

Answer 2

ascending colon, transverse colon, descending colon, sigmoid colon, rectum

Question 3

what is the flow of the ascending colon?

Answer 3

from the caecum to the right lobe of the liver

Question 4

where is the appendix located?

Answer 4

the mcburney point

Question 5

how does the ileum and appendix connect?

Answer 5

the mesoappendix

Question 6

what is contained in the mesoappendix?

Answer 6

the appendical vessels

Question 7

what are the arteries of the appendix and caecum?

Answer 7

the superior mesentery artery that branches into the
1. anterior cecal branch of the ileocolic artery
2. posterior cecal branch of the ileocolic artery
3. appendicular artery of the ileocolic artery

Question 8

what are the venous drainages of the ascending colon?

Answer 8

the right colic vein and the iliocolic vein

Question 9

where does the ascending colon end?

Answer 9

the hepatic/right colic flexure

Question 10

what are the peritoneal pouches in the large intestine?

Answer 10

the omental appendices

Question 11

what is located anteriorly to the ascending colon?

Answer 11

SIGMA
1. small intestine
2. greater omentum
3. anterior abdominal wall

Question 12

what is located posteriorly to the ascending colon?

Answer 12

1. iliohypogastric and ilioinguinal nerves
2. the right kidney
3. the iliacus and quadratus lumborum

Question 13

what is the flow of transverse colon?

Answer 13

from the hepatic flexure to the splenic flexure

Question 14

what is the vascularization of the ascending colon?

Answer 14

branches of the superior mesentery artery:
1. anterior cecal branch of the ileocolic artery
2. posterior cecal branch of the ileocolic artery
3. right colic artery of the superior mesentery artery
4. colic branch of the ileocolic artery

Question 15

what is the vascularization of the transverse colon?

Answer 15

branches of the SMA and IMA
1. middle colic artery
2. left colic artery (from IMA)

Question 16

what is the venous drainage of the transverse colon?

Answer 16

it drains to the
1. middle colic vein
2. left colic vein

Question 17

what is the splenic flexure and how does it differ from the hepatic flexure?

Answer 17

it is located more posteriorly and it is more acute

Question 18

what is the flow of the descending colon?

Answer 18

from the splenic flexure to the descending colon-sigmoid junction

Question 19

what is the vascularization of the descending colon?

Answer 19

1. the left colic artery
2. the superior sigmoid artery

Question 20

what is located anteriorly to the descending colon?

Answer 20

1. the small intestine
2. the greater omentum
3. the anterior abdominal wall

Question 21

what is located posteriorly to the descending colon?

Answer 21

1. the left kidney
2. the ilioinguinal and iliohypogastric nerve
3. the iliacus and the quadratis lumborum

Question 22

what is located anteriorly to the transverse colon?

Answer 22

1. the greater omentum
2. the anterior abdominal wall

Question 23

what is located posteriorly to the transverse colon

Answer 23

1. duodenum
2. jejunum
3. ileum
4. the head of the pancreas

Question 24

where is the caecum located?

Answer 24

in the true pelvis

Question 25

how is the sigmoid colon formed?

Answer 25

medial protrusion of the descending colon

Question 26

what is on the anterior of the sigmoid colon?

Answer 26

the ureter, urethra, upper vagina (for women)

Question 27

what is on the posterior of the sigmoid colon?

Answer 27

the rectum, ileum, and sacrum

Question 28

what is the rectum formed by?

Answer 28

the taenia coli

Question 29

where does the rectum begin?

Answer 29

from the S3

Question 30

is the rectum retroperitoneal or intraperitoneal?

Answer 30

retroperitoneal

Question 31

what are the muscle fibers of the taenia coli?

Answer 31

1. taenia libera
2. taenia mesocolic
3. taenia omental

Question 32

what is the marginal artery? what is it also called?

Answer 32

the anastomosis of the superior and inferior mesentery artery

Question 33

what are the lymphatics of the large intestine?

Answer 33

ascending and transversal: superior mesentery lymph nodes

descending and sigmoid:
inferior mesentery lymph nodes

Question 34

where do the secondary lymph nodes eventually drain to?

Answer 34

the cisterna chyli

Question 35

what are the innervations of the midgut?

Answer 35

the superior mesenteric plexus

Question 36

what are the innervations of the hindgut?

Answer 36

the inferior mesenteric plexus (the sympathetic lumbar splanchnic nerve and the parasympathetic sacral splanchnic nerve)

Question 37

what is the vascularization of the rectum?

Answer 37

1. superior rectal artery
2. middle rectal artery (internal iliac artery)
3. inferior rectal artery (internal pudendal artery)

Question 38

what causes appendicitis?

Answer 38

obstruction from fecal matter and enlargement of lymph

Question 39

how does appendicitis break the wall of the appendix?

Answer 39

by necrotizing it, the walls may break and perforate to other areas

Question 40

how would you explain the colic and focal pain caused by early and late appendicitis?

Answer 40

colic pain is caused by visceral sympathetic nerve of T10 that causes colic (diffusive) pain on the periumbilical region

focal pain results from perforation of inflammation to the parietal peritoneum of the iliac fossa that is innervated by the respective somatic nerve

Question 41

what may arise as complications of appendicitis?

Answer 41

transmural inflammation (it spreads all over the bowel’s wall)

peritonitis

phlegmon

necrotizing fasciitis