Surgical Recall - Ch. 48 Colon and Rectum

Question 1

Identify the arterial blood supply to the colon:

Answer 1

1. Ileocolic a.
2. R. colic a.
3. SMA
4. Middle colic a.
5. IMA
6. L. colic a.
7. Sigmoidal a.
8. Superior hemorrhoidal a. (superior rectal)
9. Middle hemorrhoidal a.
10. Inferior hemorrhoidal a.
11. Marginal artery of Drummond
12. Meandering artery of Gonzalez

Question 2

What are the white lines of Toldt?

Answer 2

Lateral peritoneal reflections of the ascending and descending colon

Question 3

What parts of the GI tract do not have a serosa?

Answer 3

Esophagus, middle, and distal rectum

Question 4

What are the major anatomic differences between the colon and the small bowel?

Answer 4

Colon has taeniae coli, haustra, and appendices (fat appendages), whereas the small intestine is smooth

Question 5

What is the blood supply to the rectum:

Proximal?

Middle?

Distal?

What is the venous drainage of the rectum:

Proximal?

Middle?

Distal?

Answer 5

Blood Supply:

• Proximal
  
  • Superior hemorrhoidal (or superior rectal) from IMA
• Middle
  
  • Middle hemorrhoidal (or middle rectal) from the hypogastric (internal iliac)
• Distal
  
  • Inferior hemorrhoidal (or inferior rectal) from pudendal a. (a branch of the hypogastric a.)

Venous Drainage:

• Proximal
  
  • Via IMV to splenic vein, then to portal vein
• Middle
  
  • Via iliac vein to IVC
• Distal
  
  • Via iliac vein to IVC