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Anatomy: Abdomen VIII - Large Intestine Part 2

Anatomy and Physiology17 CardsCreated about 2 months ago

This deck covers key concepts related to the anatomy of the large intestine, including the sigmoid mesocolon, colitis, diverticulosis, and the structure and function of the large intestine.

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Root of sigmoid mesocolon:

inverted v-shaped attachment - medially, superiorly along external iliac vessels - medially, inferiorly from bifurcation of common iliac vessels to anterior aspect of sacrum
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Key Terms

Term
Definition
Root of sigmoid mesocolon:
inverted v-shaped attachment - medially, superiorly along external iliac vessels - medially, inferiorly from bifurcation of common iliac vessels to an...
Which branches of the IMA anastomose to form the marginal artery?
Superior branch of most superior sigmoid artery + descending branch of left colic artery
What is the only organ that is both retroperitoneal & subperitoneal?
Rectum
Colitis
Chronic inflammation (ulcerative colitis, Crohn’s disease) - colectomy may be performed (terminal ileum, colon, rectum, anal canal removed) = ileostom...
Diverticulosis
Multiple false diverticula along intestine - 60% in sigmoid colon (fibres change direction here) - Middle Aged + elderly - colonic diverticula = not t...
Diverticulosis
Most commonly on mesenteric side of 2 nonmesenteric teniae coli - nutrient arteries perforate muscle coat to reach submucosa - diverticula can get inf...
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Anatomy: Abdomen VIII - Large Intestine Part 2
TermDefinition
Root of sigmoid mesocolon:
inverted v-shaped attachment - medially, superiorly along external iliac vessels - medially, inferiorly from bifurcation of common iliac vessels to anterior aspect of sacrum
Which branches of the IMA anastomose to form the marginal artery?
Superior branch of most superior sigmoid artery + descending branch of left colic artery
What is the only organ that is both retroperitoneal & subperitoneal?
Rectum
Colitis
Chronic inflammation (ulcerative colitis, Crohn’s disease) - colectomy may be performed (terminal ileum, colon, rectum, anal canal removed) = ileostomy
Diverticulosis
Multiple false diverticula along intestine - 60% in sigmoid colon (fibres change direction here) - Middle Aged + elderly - colonic diverticula = not true diverticula b/c protrusions = mucosa only, not entire colon wall
Diverticulosis
Most commonly on mesenteric side of 2 nonmesenteric teniae coli - nutrient arteries perforate muscle coat to reach submucosa - diverticula can get infected/rupture = diverticulitis; can erode nutrient arteries = hemorrhage
main functions of LARGE INTESTINE
water is absorbed from indigestible residues of liquid chyme

large intestine consists of:

cecum

appendix

ascending colon

transverse colon

descending colon

sigmoid colon

rectum

anal canal

The large intestine can be distinguished from the small intestine by:

1. Omental appendices: small, fatty, omentum-like projections

2. Haustra: sacculations of the wall of the colon between teniae

  1. A much greater caliber (internal diameter)

4. Three teniae coli:

  • Mesocolic = transverse + sigmoid mesocolons attach

  • Omental = omental appendices attach

  • Free (libera) = neither mesocolons nor omental appendices attach

TENIAE COLI

thickened bands of smooth muscle (most of longitudinal coat)

  • begin: base of appendix; thick longitudinal layer of the appendix splits to form three bands

  • run the length of the large intestine

  • end: merge at rectosigmoid junction into a continuous longitudinal layer around rectum

  • teniae are shorter than intestine = colon becomes sacculated between teniae = haustra

CECUM

1st part of large intestine; continuous with ascending colon

  • blind intestinal pouch (7.5 cm in length/breadth)

  • right lower quadrant (lies in iliac fossa inferior to junction of terminal ileum + cecum)

  • usually lies within 2.5 cm of inguinal ligament

  • almost entirely enveloped by peritoneum

  • can be lifted freely; has no mesentery (can be displaced)

  • may be bound to lateral ab. wall by one or more cecal folds of peritoneum

terminal ileum enters the cecum obliquely and partly invaginates into it. What does this form?

  • ileocolic lips (superior and inferior) at the ileal orifice, which form the ileal papilla

  • folds meet laterally = ridges = "frenula of the valve"

  • when cecum is distended or contracts, frenula tighten = closing the valve to prevent reflux from the cecum into ileum

ileal orifice

  • circular muscle is poorly developed around the orifice; valve is unlikely to have any sphincteric action that controls passage of intestinal contents from ileum into cecum

  • probably does prevent reflux from the cecum into the ileum

  • orifice is usually closed by tonic contraction = appears as the ileal papilla on the cecal side

APPENDIX

(vermiform appendix)

  • blind intestinal diverticulum (6-10 cm in length); contains masses of lymphoid tissue

  • arises from posteromedial aspect of cecum inferior to the ileocecal junction

  • has a short triangular mesentery, mesoappendix; derived from posterior side of mesentery of terminal ileum

  • mesoappendix attaches to cecum + proximal part of appendix

ileocolic artery & ileocolic vein

ileocolic artery:

  • terminal branch of superior mesenteric artery

  • supplies cecum

  • branch = appendicular artery; supplies appendix

ileocolic vein:

  • tributary of superior mesenteric vein

  • drains blood from cecum & appendix

The lymphatic vessels from the cecum and appendix pass to which lymph nodes?

  • lymph nodes in mesoappendix

  • ileocolic lymph nodes that lie along ileocolic artery

*Efferent lymphatic vessels pass to superior mesenteric lymph nodes

The nerve supply to the cecum and appendix derives from…

sympathetic and parasympathetic nerves from the superior mesenteric plexus

  • sympathetic origin = lower thoracic spinal cord

  • parasympathetic = derive from vagus nerves

Afferent nerve fibers from appendix accompany sympathetic nerves to T10 segment of spinal cord