Large Intestine

Question 1

Vermiform appendix has a role in

Answer 1

Immunity

Question 2

Omental Apendices

Answer 2

Fat filled bags of visceral Peritoneum

Question 3

Primary functions of Large intestine are

Answer 3

Fluid absorbtion

mucus secretion

Question 4

Taenia Coli

Answer 4

3 bands of outer longitudinal layer of muscularis externa

1. mesocolic
2. omental
3. free

Question 5

Haustra

Answer 5

Outwardly bulging pockets from the walls of large gut

Question 6

Plica semilunares

Answer 6

Cresentric folds projecting into the lumen of Colon

Question 7

Location of Cecum

Answer 7

Right iliac fossa above lateral inguinal ligament

Question 8

Relations of Cecum

Answer 8

Anteriorly-Ant abdominal wall, coils of small intestine
Posteriorly- psoas major, iliacus, femoral Nerve, appendix
Medially-Distal ileum

Question 9

Recesses of cecum

Answer 9

1. Paracecal- common site of abcess collection in appendicitis
2. Superior ileoceal
3. Inferior ileoceal
4. Retrocecal

Question 10

Blood supply of cecum

Answer 10

Anterior and posterior ceal arteries (ileocolic)

Anterior posterior cecal veins >poral vein

Question 11

Nerve supply of Cecum

Answer 11

T11-L1

Question 12

Location of appendix

Answer 12

Narrow blind ended tube below ileoceal oriface in right iliac fossa

Question 13

Common location of Appendix

Answer 13

Retrocecal-11oclock (64%)

Subileal-3oclock (36%)

Question 14

Blood supply of appendix

Answer 14

Appendicular artery (ileocolic)

Appendicular,Ileocolic, superior mesentric vein> Portal vein

Question 15

Nerve supply of appendix

Answer 15

SNS- T9 + T10 via celiac plexus

PSNS-Vagus

Question 16

Referred pain of appendix is felt at

Answer 16

Umblicus cuz T10

with increasing inlfammation>Right iliac fossa since it spreads to parietal peirtoneum

Question 17

Histologic differences in Appendix

Answer 17

Lumen is very narrow and irregular
No villi
Submucosa is filled with lymohoid masses (abdominal tonsils)

Question 18

Mcburneys point

Answer 18

Site of maximum tenderness in appendicits

Lies at junction of lateral 1/3 and medial 2/3 of line joining umblicus to a right anterior superior iliac spine

Question 19

Features of Appendicits

Answer 19

1. Hyperaesthisia at right iliac fossa
2. tenderness at Mcburneys point
3. Muscle guard and rebound tenderness over appendix
4. Pain when thigh is flexed and medially rotated

Question 20

Rreasons for appendicits

Answer 20

Presence of lymphatic follicles
Appendicular artery is an end artery
Small lumen
Gaps in muscularis externa

Question 21

Appendicular dyspepsia

Answer 21

• Spread of infected lymph to Subpyloric nodes

- history of acute appendicits

Question 22

Relations of Ascending colon

Answer 22

Anteriorly- Greater omentum, ant abdominal wall, coils of small intestine
Posteriorly- iliacus, quadratus lamborum, transversus abdominis
lateral cutaneous, ilioinguinal and iliohypogastric nerves

Question 23

Blood suppl of ascending colon

Answer 23

ilieocolic and right colic artery

Question 24

Relations of Transverse colon

Answer 24

Anteriorly- Greater omentum, anterior abdominal wall

posteriorly- 2nd part of duodenum, coils of ileum and jejenum

Question 25

Blood supply of Right 2/3rd of T. colon

Answer 25

Middle colic (superior mesentric)

Question 26

Blood supply of left 1/3rd of T.colon

Answer 26

Ascending branch of left colic / marginal

Question 27

Descending Colon relations

Answer 27

Anteriorly-coils of small intestine

Posteriorly-left kidney, iliac crest, muscles, nerves

Question 28

Relations of signmoid colon

Answer 28

Anteriorly- bladder uterus
Posteriorly- Ureter, piriformis, sacral plexus
Superiorly-rectum
left-iliac vessels

Question 29

Blood supply of Sigmoid colon

Answer 29

Superior rectal artery