Transcript Appendices epiploic Cecum In the right iliac fossa

In
the
name
of
Allah
Jejunum and
ileum
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Rest of the small intestine
From duodenojejunal flexure
To ileocecal junction
Intraperitoneal
Attached to the posterior
abdominal wall by mesentery
of small intestine
Relations
Anterior abdominal wall
Greater omentum
Posterior abdominal wall
Retroperitoneal structures
Ileum
Jejunum
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In umbilical region of
peritoneal cavity
First 2:5 of small intestine
Diameter 4cm
Mucosal folds are large and
frequent
Thicker wall
More vascular
Redder in life
Arterial arcade less
Aggregated lymphatic follicles
are lesser
Intermesenteric fat less
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In lower part of peritoneal
cavity
Second 3:5 of small intestine
Diameter 3.5 cm
Mucosal folds are small and
few
Thinner wall
Less vascular
Paler in life
Arterial arcade more
Aggregated lymphatic
follicles are more
Intermesenteric fat more
Ileum
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Ileal or Meckel’s diverticulum
Large
intestine
Large intestine
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1.5 m
From caecum to anus
Includes;
Cecum and appendix
Ascending colon
Transverse colon
Descending colon
Sigmoid colon
Rectum
Anal canal
Large
intestine
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Differs from small intestine in
the:
More fixed in position
Greater caliber
Taeniae coli
Sacculation (haustration)
Appendices epiploic
Cecum
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In the right iliac fossa
6.5*7.5 cm
Related posteriorly to the
iliacus & psoas mm
lateral cutaneous N of thigh
femoral nerve
Related anteriorly to the:
ant. Abdominal wall
Small intestine
Greater omentum
Caecum
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Intraperitoneal
sup. & inf. Ileucecal and
retrocecal recesses
ileocecal valve
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Sup & inf. Lip and
frenulum
Posteromedial of cecum
At the level of
transetubercular and
midclavicular lines
Vermiform appendix
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In the right iliac fossa
McBurney’s point
2 cm below the ileocecal
junction
Length 2-20cm average 9cm
Intraperitoneal
Position
Retrocecal & retrocolic 64%
Pelvic 30%
Subcecal 2.5%
pre and postileal 1.5%
Ascending
colon
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15 cm from cecum to hepatic
flexure
Covered in front and sides by
peritoneum
Taeniae coli ant., med. & lat.
Relation
Posteriorly
Quadratus and iliacus
Lateral cutaneous N of thigh
Iliohypogastric
Ilio-inguinal
Ascending
colon
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Relations
anteriorly
Small intestine
Ant. Abdominal wall
Greater omentum
Right or hepatic
flexure
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Turns down and forward
Kidney posterior
Liver anterosuperior and
lateral
Duodenum medial
Gall bladder anteromedial
Transverse
colon
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50 cm, from hepatic to
splenic flexures
From Rt. Lumbar
To Lt. hypochondrium
Intraperitoneal and
attached to the post.
abdominal wall by meso.
Taeniae
Transverse
colon
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Relations
anterior
Omentum
Ant. abdominal wall
posterior
Pancreas
2nd part of duodenum
Lt. colic
flexure
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Higher than right
relations
Spleen
Pancreas
Lt. kidney
Phrenicocolic
Descending colon
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25 cm
from splenic flexure to pelvic brim
Two parts
Covered anterioly by peritineum
Descending
colon
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Relations:
Anterior same as the right
Posterior:
Kidney
Subcostal nerve
Iliohypogastric
Ilioinguinal
Lateral cutaneous N of thigh
Sigmoid colon
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25- 40 cm from pelvic
brim to S3
Has meso.
Lateral limb
Medial limb in front of
sacrum
Intersigmoid recess
Sigmoid colon
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Relations
Posterior
Rectum
Sacrum
Ureter
Anterior
Uterus
bladder
Rectum
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10-15 cm
From S3
To tip of coccyx continuous
as the anal canal
Piercing pelvic diaphragm
Passing downward following
the curve of sacrum
Deviate to the left and turns
right
Rectal ampulla
Anorectal angle
Rectum
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Peritonial covering
Muscular coat
Transverse fold
Rectum
Relations:
Posteriorly;
- Sacrum
- Coccyx
- Piriformis
- Coccygeus
- Lavator ani
- Sacral plexus
- Sympathetic chain
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Rectum
Relations
Anteriorly
In male
- Sigmoid colon
- Ileum
- Bladder
- Vas deferens
- Seminal vesicle
- prostate
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Rectum
Relations
Anteriorly
In female
- Sigmoid colon
- Ileum
- Rectouterine
(Douglas) pouch
- Uterus
- Vagina
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Small and large intestine
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Artery
Superior mesenteric (small
& large)
Inferior mesenteric (large)
Internal iliac (rectum &
anal canal)
Vein
Superior mesenteric (small
& large)
Inferior mesenteric (large)
Internal iliac (same as
artery)
Anal canal
4-5 cm
 From the rectal ampulla
 To the anus
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Posteriorly
- Anococcygeal body
Anteriorly
Male
- Perineal body
- Urogenital diaphragm
- Urethra
- Bulb of penis
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Anal canal
Female
- Perineal body
- Urogenital diaphragm
- Vagina
Laterally
- Ischiorectal fossae
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Anal canal
Upper half
Derived from endoderm
Anal culumns
Anal valves
Anal sinuses
- Autonomic nerve
- Sensitive to stretch
- Artery and vein from and to
inferior mesenteric
Anal canal
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Lower half
Derived from ectoderm
Has no anal columns
Somatic nerve, inferior rectal
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Sensitive to pain,
temperature, touch, pressure
Art. And vein from and to
internal iliac
Pectinate line
Anal canal
Muscle coat
- Internal sphincter
(smooth muscle)
- External sphincter
Subcutaneous
Superficial
Deep
- Puborectalis
- Anorectal ring
Puborectalis + internal
sphincter + deep part of
ext. sphincter
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innervation
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Autonomic
Somatic
Inferior rectal
Rectum and anal canal
Blood supply
Arteries:
- Superior rectal
- Middle rectal
- Inferior rectal
Veins:
- Superior rectal
- Middle rectal
- Inferior rectal
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