đAnatomy 'āĻ° āĻāĻ¨ā§āĻ¯ āĻĢāĻ°āĻ āĻāĻžāĻ āĻšāĻ˛ā§ Anatomical position.
Anatomical position :
This is the viscera of large intestine with the terminal part of the ileum.
1. Ileo-cecal junction lies postero-medially ; i.e. postero-medial to the caecum on the right side.
2. Left colic flexure is slightly higher than the right colic flexure.
3. Caecum lies higher level than the anal canal.đ
đ Large gut - The large gut extends from the ileocaecal junction to the muco-cutaneous junction of the anal canal (pectinate line). đ
đāĻāĻāĻ¨ length and parts āĻ¨āĻŋā§ā§ āĻāĻžāĻ¨āĻž āĻ¯āĻžāĻ -
It is about 1.5 meters or 6 feet long.
Subdivisions - The large gut consists of four parts -
1. Caecum and appendix
â Caecum is 6 cm long
â Appendix is 2 to 20 cm
2. Colon
â Ascending - 15 cm long
â Transverse - 50 cm long
â Descending - 25 cm long
â Sigmoid - 40 cm long
3. Rectum - 12 cm
4. Anal canal - 3.8 āĻ¸ā§.āĻŽāĻŋ.đ
đđ Functions -
1. It allows absorption of about 500ml of water per day
2. The digestion of cellulose takes place in large gut with the help of putrefaction bacteria
3. Normal flora of large gut synthesize vit B complex and vit K
4. The faeces are usually stored in the descending and sigmoid colon and are voided through the rectum and anal canal.đđ
đđLarge intestine āĻāĻŋāĻ¨ā§āĻ¤ā§ small intestine āĻāĻ° āĻā§ā§ā§ āĻ āĻ¨ā§āĻ āĻā§āĻāĨ¤
āĻāĻā§ large āĻŦāĻ˛āĻžāĻ° āĻāĻžāĻ°āĻ¨ luminal diameter.
Large gut āĻāĻ° storage function āĻāĻ° āĻāĻžāĻ°āĻŖā§ āĻāĻāĻŋāĻ° luminal diameter āĻŦā§ āĻšā§ā§ āĻĨāĻžāĻā§āĨ¤
āĻāĻāĻžāĻ¨ā§ storage function āĻāĻ° āĻāĻžāĻ°āĻŖā§ dialation āĻšā§ āĻ āĻ°ā§āĻĨāĻžā§ lumen dialect āĻšā§āĨ¤ āĻ¤āĻžāĻ large intestine āĻ luminal diameter āĻŦā§ āĻšā§āĨ¤đđ
đŋđŋāĻāĻŦāĻžāĻ° cardinal features of large gut -
āĻāĻāĻ¨ cardinal features āĻŦāĻž characteristic features āĻŦāĻž morphological features āĻāĻ° āĻāĻ¨ā§āĻ¯ āĻāĻ¤ā§āĻ¤āĻ° āĻāĻāĻ āĻšāĻŦā§āĨ¤
Cardinal features :
1. Taeniae coli : Aggregations of the longitudinal muscles of large gut ā§Š āĻāĻž thick bands produce āĻāĻ°ā§āĨ¤ āĻāĻ°āĻžāĻ Taeniae coli.
āĻāĻ taeniae coli vermiform appendix āĻāĻ° rectum āĻ āĻĨāĻžāĻā§ āĻ¨āĻžāĨ¤
Position āĻāĻ° āĻāĻ¨ā§āĻ¯ figure āĻĻā§āĻā§āĻ¨āĨ¤
2. Sacculations or haustrations : taeniae coli āĻ¯ā§āĻāĻžāĻ¨ā§ āĻĨāĻžāĻā§āĨ¤
3. Appendices epiploicae : Ceacum, appendix āĻāĻ° rectum āĻāĻžā§āĻž āĻĒā§āĻ°ā§ large gut āĻ āĻĨāĻžāĻā§āĨ¤
āĻāĻ°ā§ āĻāĻžāĻ˛ā§ āĻāĻžāĻŦā§ āĻŦā§āĻāĻžāĻ¨ā§āĻ° āĻāĻ¨ā§āĻ¯ figure āĻĻā§ā§āĻž āĻšāĻ˛ā§āĨ¤ đŋđŋ
đđ āĻāĻŦāĻžāĻ° taeniae coli āĻ¨āĻŋā§ā§ āĻāĻžāĻ¨āĻž āĻ¯āĻžāĻāĨ¤
â The taeniae coli are three thick bands produced by the aggregations of the longitudinal muscles of the large gut.
The taeniae are absent in the vermiform appendix and in the rectum.
They are -
a) Taenia libera
b) Taenia mesocolica &
c) Taenia omentalis.
Importance of taeniae coli :
1) Caecum āĻāĻ° colon āĻāĻ° haustration produce āĻāĻ°ā§ peristalsis āĻ āĻ¸āĻžāĻšāĻžāĻ¯ā§āĻ¯ āĻāĻ°ā§āĨ¤
2) It serves as a guide for identification of vermiform appendix due to all the taenia coli converge towards the base of the appendix. đđ
đđāĻāĻŦāĻžāĻ° Caecum āĻ¨āĻŋā§ā§ āĻāĻžāĻ¨āĻž āĻ¯āĻžāĻ -
Caecum is a large blind sac, forming the commencement of the large gut.
Types -
1) Foetal type - 2% ; Appendix arises as a straight tube from its apex.
2) Infantile type - 3% ; Appendix is attached to a depressed bottom.
3) Normal or adult type - 90% ; Appendix is situated about 2 cm below the ileo - caecal junction.
4) Exaggerated type - ( 4-5)% ; Appendix is close to the ileo - caecal junction. đđ
đŋđŋVermiform appendix -
It is a narrow worm - like tubular diverticulum arising from the postero - medial wall of the caecum about 2 cm below the ileocaecal junction, and is supposed by a peritoneal fold known as the meso - appendix.
Position āĻāĻ° types āĻ¨āĻŋā§ā§ āĻāĻžāĻ¨āĻž āĻ¯āĻžāĻ -
1. Retro - caecal and retro - colic ( 12 O'clock)
2. Pelvic type ( 4 O'clock)
3. Subcaecal and paracolic ( 11 O'clock)
4. Splenic type ( 2 O'clock)
5. Promontoric type ( 3 O'clock) đŋđŋ
đ Nice to know -
đ Gross features : Shorter and wider
đ Appendices epiploicae : Present
đ Taeniae coli : Present
đ Sacculations : Present
đ Distensibility : More
đ Fixity : Greater part is fixed & immobile
đ Villi : Absent
đ Transverse mucosal folds : Obliterated when longitudinal muscle coat relaxes
đ Goblet cells : Preponderant
đ Crypts of Lieberkuhn : More numerous