Cecum •Is blind end pouch •Location :-in the right iliac fossa…below the

level of junction with ileum.•Length:-6cm.•Cecum is intraperitoneal part..coz it is covered

completely with peritoneum.**what are the peritoneal folds in cecum?1)sup.ileocecal fold.2)inf.ileocecal fold.3)Retrocecal fold.

No mesentry is present

Taienia colli:-three flat bands of longitudinalmuscles that are

restricted.•Note:- the taenia colli convergeon the appendix

& provide for its complete muscular coat.•Note :- cecum often is distended with gas ..can

be papated in ant.abdominal wall.

•Note:-there are two lips in the large intestine that called ileocecal valve.

Relations-:

•Note:-always ant..relation has coils of small intestine.

•1)ant:-coils of small intestine…grater omentum..ant.abdominal wall in right iliac fossa.

•Post:-psoas &iliacus musclethe femoral nerve..lat.cutaneous nerve of thigh.the appendix behind the cecum.

•Medially:-appendix.

Blood supply •Ant & post cecal branches form ileocolic

artery branch from sup.mesenteric artery.

•Veins :-drain in sup mesenteric vein.

•Lymph nodes :-drain in sup.mesenteric lymph nodes.

•Nerve-: السابقات نفس

Ileocecal valve •A rudimentary structure.

•Components:-two horizontal folds of mucous membrane around the orifice of ileum.

•Function:-has a little role or no rple in prevention the reflux of cecum in ileum.

•**gastrin :- is responsible for contraction of muscle tone.

Appendix-:•Is a muscular tube

•Contents :-large amount of lymphoid tissue.•Length:-8-13cm.

•Location :--posteriomedial to cecum .about 2.5cm below the ileocecal junction..in right iliac fossa.

•Note :- it is a complete peritoneal covering.

•Imp:-mesoappendix:- is a short mesentry of appendix by which the appendix attached to

lower layer of mesentry of small intestine .•Fnction:-contains appendicular vessels &

nerves.

Mesoappendix is in the

beginning of

appendix

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Blood supply-:

•Appendicular artery …branch from post.cecal artery..

•Note :-mesoappendix is continuous with the mesentry around the ileum.

•Note :- the fibers responsible for pain in the appendix are from sympathetic …at tenth thoracic segment.

Notes:-imp •The most fixed part of appendix is the

base of it…that is Mcburney’s point. •The line joining the ASIS&umbilicus.•The base lies one third up the line…in

relation to ant.abdominal wall.•The mesoappendix is a mesentry …that

suspend the appendix. •The meso appendix is double layer of

peritoneum.

Ascending colon•Length :-13 cm

•Location :-extends from ccecum to left side to lower part of liver to the right colic flexure to form the transverse colon.in the right loer quadrant.Note :- it is connected to post.abdominal wall.Relation -:

Ant:-the ant.abdominal wall ,greater omentum &coils of small intestine.Post:-the iliacus ,the iliac crest,quadratus lumborum,transversus abdominis,iliohypogastric & ilioinguinal,lower pole of right kidney.

•Blood supply:-right colic artery from sup.mesenteric artery & ileocolic artery.

•Veins :-drain in sup.mesenteric vein.

Descending colon-:

•Length:-25cm.•Location:-in the left upper

&lower quadrant..extends from left colic flexure to pelvic brim

•Note :- it is continuous with sigmoid colon …& CONNECTED TO

POST ABDOMINAL WALL BY PERITONEUM.

•Note :- the ascending & descending colon are retroperitoneal.

•Relation-: •Ant:- same

•Post:lat.border of left kidney,left psoas ,iliac crest,iliacus,quadratus lumborum,ilioinguinal nerve,iliohypogastric nerve,femoral nerve & lat.cutaneus nerve of thigh.

•Blood supply:-left colic artery & sigmoid branch from inf.mesenteric artery

•Veins :- drain in inf.mesenteric vein.•Note :- the left colic flexure is suspended

by phrenicocolic flexure …it is higher than the right.

Transverse colon•Is the longest part of the colon.

Length :-38cmLocation :- occupies the umbilical region.Relation-:

Ant:-ant.abdominal wall (umbilical & hypogastric region)…greater omentumPost:-the second part of duodenum ….pancreas..coils of jejunum & ileum Note :- it is suspended by transverse mesocolon from pancreas

•Blood supply :- 1)proximal 2\3 from sup mesenteric vein by middle colic artery.

• &distalm 1\3 from inf.mesenteric artery.

•Veins:- in sup.mesenteric & inf.mesenteric veins.

•Lymph :-colic nodes…sup.mesenteric lymph nodes..inf mesenteric lymph nodes.

Notes-:

•Transverse mesocolon:- attachment-:•Sup border of transverse colon •Ant.border of pancreas•Post part of greater omentum.

الله • شاء ان تمام