Trans - Colon, Rectum, Anus Flashcards by UPCM 2018

normal frequency of defecation

3x per day to once in 3 days

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odor of stool and flatus due to:

sulfur containing compounds in gut flora

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gastrocolic reflex: definition

movement of the colon due to stretching of the stomach and byproducts of digestion in the small intestine

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irritable bowel syndrome is caused by:

heightened visceral sensitivity causing exaggerated gastrocolic reflex

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the foregut is composed of:

GI tract from esophagus to small intestine proximal to bile duct
liver
pancreas
bile ducts

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the midgut is composed of:

GI tract from small intestine distal to bile duct to proximal transverse colon
appendix

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the hindgut is composed of:

GI tract from distal transverse colon to rectum

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the large intestine is ___ in length

around 5ft

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T/F: the diameter of the lumen of the colon gradually increases from the cecum to the sigmoid

F, the diameter of the colon decreases as it proceeds distally

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incomplete outer longitudinal muscle layer of the colon

taenia coli

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areas where the taenia coli converge

appendix

2. rectosigmoid junction (until anus)

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enumerate the 3 taenia coli and their attachments

mesocolic - transverse and sigmoid mesocolon
omental - appendices epiploicae
free - no attachments

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outpocketings of colon wall between taenia coli

haustrae

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difference of haustrae from plicae circulares

plicae circulares encircle the whole circumference of the lumen, haustrae do not

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small fatty omentum-like projectuions distributed near the area of the taenia coli along the colon wall

appendices epiploicae

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functions of the colon

absorption of water and electrolytes

2. propulsion and storage of unabsorbed fecal waste

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location of cecum

right lower quadrant

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T/F: the cecum is almost entirely covered by peritoneum and is suspended by a mesentery

F, it has no mesentery

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entrance of the ileum into the cecum

ileocecal valve

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T/F: the ileocecal valve is a true sphincter

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importance of appendix in embryo

part of the immune system (GALT)

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appendix is most commonly located

retrocecally

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the mesentery of the appendix is the:

mesoappendix

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McBurney’s point

historically a common basis for locating the appendix on a diagonal incision

1/3 of the way along the oblique line joining the ASIS and the umbilicus

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since the position of the appendix is variable, surgeons now prefer to make an incision on the:

point of maximal tenderness

T/F: the ascending colon is intraperitoneal

F, it is retroperitoneal

T/F: the ascending colon has no mesentery

innervation of ascending colon

vagus

longest part of the colon

transverse colon

T/F: the transverse colon is intraperitoneal

T/F: the transverse colon has no mesentery

mesentery of the transverse colon

mesocolon

T/F: the descending colon is retroperitoneal

T/F: the sigmoid colon is retroperitoneal

part of the colon most prone to volvulus

sigmoid colon due to triangular mesentery

site at which the sigmoid colon becomes the rectum

rectosigmoid junction

branches of the superior mesenteric artery

1. middle colic artery 2. right colic artery 3. ileocolic artery

blood supply of transverse colon

middle colic artery

blood supply of ascending colon

right colic artery | ileocolic artery

anastomosis of arteries of ascending and descending colon

marginal artery of Drummond

T/F: the inferior mesenteric artery and the superior mesenteric artery can be cut and the bowels still survive

T, but the small intestine will die as a result of cutting the superior mesenteric artery

anastomosis between middle and left colic artery

arc of Riolan / meandering mesenteric artery

area of poor blood supply in the region of the splenic flexure

point of Griffith

blood supply of descending colon

left colic arteries

blood supply of sigmoid colon

sigmoid arteries

lymph drainage of colon and proximal rectum

paraaortic lymph nodes

lymph drainage of colon and distal rectum

internal iliac and superficial inguinal nerves

sympathetic innervation of colon

lower thoracic and upper lumbar segments of spinal cord superior mesenteric plexus, inferior mesenteric plexus, hypogastric plexus

parasympathetic innervation of colon

1. vagus nerves - ascending colon up to splenic flexure | 2. sacral nerves - descending colon and sigmoid colon

plexus that controls colonic motility

Auerbach's plexus, submucous plexus, Meissner's plexus

the rectum ends at the

anorectal ring

extraperitoneal rectum covered by:

fascia propria

flexures of the rectum

1. sacral flexure 2. anorectal flexure 3. lateral flexures

mucosal infoldings of the rectum

valves of Houston / transverse rectal folds

space where fecal matter is stored until defacation

ampulla of rectum

fossa that provides space for the rectum to distend

pararectal fossae

fascia that divides the retrorectal space into superior and inferior portions

Waldeyer's fascia

fascia that separates prostate and bladder from anterior rectum in males, and is associated with the vagina in females

Denonvillier's fascia

fascia that prevents lateral movement of rectum

lateral stalks

divisions of rectum

1. upper - from sacral promontory to anterior peritoneal reflection 2. middle - from anterior peritoneal reflection to 5-6cm above anal verge 3. lower - from top of anal sphincter to anal verge

autonomic anal sphincter

internal anal sphincter

three loops of external anal sphincter

1. puborectalis 2. superficial anal sphincter 3. subcutaneous portion

parasympathetic stimulation causes the internal anal sphincter to:

relax

sympathetic stimulation causes the internal anal sphincter to:

contract

longitudinal columns within anal canal

columns of Morgagni

line connecting the bases of the columns of Morgagni

dentate line

landmark for the intermuscular border between internal and external anal sphincters

Hilton's white line

line that indicates the junction of the superior and inferior parts of the anal canal (superior part is from hindgut, inferior is from proctodeum)

dentate/pectinate lie

posteriorly and laterally thickened upper portion of the anal canal, pulled by the puborectalis

anorectal ring

anorectal angle when a. normal b. sitting c. squeezing the sphincter

a. 102 b. 119 c. 81

arterial supply of rectum and anus

1. superior rectal artery - from inferior mesenteric 2. middle rectal artery - from internal iliac 3. inferior rectal artery - from internal pudendal

veins that form internal hemorrhoidal plexus

1. superior rectal vein | 2. middle rectal vein

veins that form external hemorrhoidal plexus

inferior rectal vein

difference between internal and external hemorrhoidal plexuses

internal - above dentate line | external - below dentate line

sympathetic innervation of rectum and anus

L1 to L3

parasympathetic innervation of rectum and anus

1. S2 to S4 | 2. nervi erigentes - S3-S4

condition where outpouchings in the colon occur

diverticulosis

condition where a part of the colon has failed to correctly form, and that part is eight blocked or is altogether missing

colonic atresia

twisting of the colon on itself or on the stalk of mesenteric tissue

volvulus

condition where one section of the bowel tunnels into another section

intussusception

acute inflammation of the appendix

appendicitis

enlargement of rectal venous plexus secondary to portal hypertension blockage/increase in portal vein pressure

hemorrhoids

T/F: external hemorrhoids are painless while internal hemorrhoids are painful

F, it is the other way around

the nerve/s involved in internal hemorrhoids

inferior hypogastric plexus

the nerve/s involved in external hemorrhoids

rectal nerve

the vein inflamed in internal hemorrhoids

superior rectal vein

the vein inflamed in external hemorrhoids

inferior rectal vein

grading of hemorrhoids

Grade 1 - hardly seen Grade 2 - bulges then disappears Grade 3 - visible bulges can be pushed inside Grade 4 - cannot be pushed inside

cancer in the proximal colon often causes:

diarrheal symptoms

cancer in the distal colon often causes:

constipation, obstruction

anal warts

condylomas

condition wherein the walls of the rectum protrude through the anus

rectal prolapse

absence of normal anal opening

imperforate anus

surgical removal of appendix

appendectomy

apple core deformity in barium enema indicates:

tumor

process by which a badly damaged esophagus is surgically replaced with the transverse colon

colonic interposition

Trans - Colon, Rectum, Anus Flashcards

(96 cards)