LARGE
TESTINE
>
- Introduction
·
Extends
It is about
from the ibocaeal junctiontothe .
anus
smlong
I
·
.
.
Cardinal
>
-
features of Large Investine
1 . Panicole - te ribbon-like bands of the
longitudinal muscle layerof muscular
externa
of colon
.
.
2
Appendices epiploicace- ·
These small bags
are
of
fa
Peritoneum led with
·
fat fr
· scattered all over
except Appendix,
caccum
& colon
·
3 Sacculations Chaustrations) - ·
series of dilation
of walls of cac
e
D CAECUM :
·
Location - right iliae
fora
Communications with ileum withappenden
·
- 1 :
2 :
S
with
ascending
3 .
.
colon
· Dimensions - La 6m
1 -7 3 cm
·
It is intraperitoneal organ
·
>
-
Types :
Conical (febal) - Appendin attached to Apers
1 .
2 Intermediate > Equal right and left cacal pounches
·
-
.
3
Ampullary - >
Right accal Pouch larger than left .
4 .
Exaggerated -
>
Large Right carcal pounch Absent left carcal ,
Pouch L
>
- Visual :
relations
①
·
Anterior - Antabd aorta O coils of ilum
,
·
Posterior - D Right proas major and ilcus muscle
② Right and femoral neme
genitofemoral
Latual waneous neve of thigh
Right gonadal vessels
⑤ Right external iliae avery
⑥ Appendin
Suprior Ascending colon
·
>
-
Inferiorly-
>
Inquiral ligament ileum
·
Medially - Terminal part of
>
- Blood
supply /Lymphonies (Newe↓ supply :
↓
coal branches iloceal
sup Sympatheticfibers-T-L
- -
=
oflocal muchberic ->
Parasympathic fibers - Vagus nerve
artery nodes
-
Drain into
itocaecal
vein
=>
ANATOMY ICAL
① Typhilites -
inflammation of .
carcum
① Carcal volvulus -· twisting of caccum
usually occurs in
persistent mentry of
·
and
carcum
ascending .
colon
2
APPENDIX
>
-
Interaction :
6-10cm
↑
·
Diameter - Imm
·
Parts -> Bar (find toacum)
Bodyp
·
Appendicular Orifice - I cm below
.
ilocaral orifice
Guarded by value
of Gerlach.
·
>
- Positions :
m
I . Paracolic -> appenden passes upward
(2 % to the right of
ascending .
colon
11 o'clock
position.
Retrocolic
2 .
>
- Appendin passes upward behind the carcum and
(65 .
28 %)
Ascending colon
12 clock position.
Appendin pass upward I
Splenic
medially
·
3 -
anterior to the terminal part of me
It may pass
(Pre-ihal-1 .
zo'clock position
)
0% or Posterior (post-ital-0 .
)
4 %
% Promonteric Appendin pares
-
horizontally to
left
the
.
(1 %) towards the sacral
promontory.
30'clock position
5 Pelvic Appendin descend downwards and
.
>
-
medially
(31 .
)
01 %
It cross the pelvic heim to enter true pelnis
Yo'clock position
.
6 Passes
Midinguinal or Subcaeal - appendin lies below the caccum
,
(2 %)
verticallytoward
downwards
points
Go'clock position
midiginal point
#
Burney's Point 1 . It is the site
appendicitis &
of manimum
-
underes in
I
-
Junction
C .
The point lies
-
at the
of lateral
-
Yed a
and mide
23rd of live joining
-
the right
--
AsIs tumbilicus
o M
>Relations :
-
Neo appendin
·
Intsaperitoneal Attachment >
- -
Imme
·ts
of Mesoappendi : 1 .
Appendicular vessels
2 -
Autonomic neves
.
3
Lymphatic vessels from Appendin
%
Lymph nodes
.
Blood supply /lymphatis/nen
>
-
-
supply
1 .
Appendicular ilocolic I ·
Sympatheticfibses > Ta To -
,
vessels nodes
2 .
Parasympathetic - Vagus mine
,
=>ALEOMY
.
Appendicitis -I :
Inflammation of Appendi
2 .
Symptoms - ·
Right lowerAd Pain
. nausea
, vomiting fewer
3
Initially pain
may felt around the Umbilicus
·
that laber localize to right iliac forsa
· examination :
denical
burney point
I . Tenderness at me
2 ·
Proas Test : In Reterocolic position of Appendiatis
may
·
isitate the Right psoas major muscle
forced extention
of right thigh induces pain
·
in
Right iliacorsa
.
3
wator Lest : 1 .
In pelnic position Appendicities may irritate
,
the obturator interus muscle
2. Flexion and medial rotation
of Right
induce
thigh pain in lower abdomen.
n
Rousingsign : 1 Papation of left iliae region induces
.
.
pain in
right iliac region
2 Appendicitis
·
dyspepsia : 1 : chronic
appendicitis
Produces
dypespeia scrembling
duodenu
C .
One to
passage of divas of stomach &
bladder
infected lymph to or
gall
the
subpyloric nodes
which coun initation of Pylon.
s
