{"id":1645,"date":"2020-08-14T11:39:17","date_gmt":"2020-08-14T11:39:17","guid":{"rendered":"https:\/\/meddists.com\/learn\/pre-clinical\/anatomy\/abdomen-and-pelvis\/organs-and-systems\/digestive-tract\/large-intestine\/"},"modified":"2022-03-12T11:54:26","modified_gmt":"2022-03-12T09:54:26","slug":"large-intestine","status":"publish","type":"page","link":"https:\/\/meddists.com\/learn\/pre-clinical\/anatomy\/abdomen-and-pelvis\/organs-and-systems\/digestive-tract\/large-intestine\/","title":{"rendered":"Large Intestine"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\"><div class=\"intro\">The large intestine is the part of the intestines where water and electrolytes are being absorbed, and the final stool or feces are produced and stored temporarily until defecation.<\/div><\/p>\n\n\n\n<figure class=\"wp-block-image\" id=\"attachment_15711\"><a href=\"https:\/\/meddists.com\/wp-content\/uploads\/2018\/08\/large-intestine.png\" target=\"_blank\" title=\"Large Intestine\"><img decoding=\"async\" src=\"https:\/\/meddists.com\/wp-content\/uploads\/2018\/08\/large-intestine-600x404.png\" alt=\"\" class=\"wp-image-15711\"\/><\/a><figcaption><strong>Large intestine and rectum<\/strong>&nbsp;(Credit: OpenStax,&nbsp;<a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA 4.0<\/a>)<\/figcaption><\/figure>\n\n\n<span class=\"block-heading\" id=\"header_1\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Description<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_1\">\n\n\n<p class=\"wp-block-paragraph\">The large intestine consists of:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Cecum<\/li><li>Vermiform appendix<\/li><li>Ascending colon<\/li><li>Right flexure<\/li><li>Transverse colon<\/li><li>Left flexure<\/li><li>Descending colon<\/li><li>Sigmoid colon<\/li><li>Rectum<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">In this article, we will discuss all of the parts of the large intestine except for the rectum and anal canal (which are covered in&nbsp;<a href=\"https:\/\/meddists.com\/course\/anatomy-abdomen-and-pelvis\/lessons\/rectum\/\">their own article<\/a>).<\/p>\n\n\n<\/span><span class=\"block-heading\" id=\"header_2\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">A touch of embryology<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_2\">\n\n\n<p class=\"wp-block-paragraph\">Before we go on, it would be of great benefit to learn (or review) the precursors of the different parts of the large intestine and rectum, as structures that develop from a common precursor are supplied, drained, and innervated by the same blood vessels and nerves.<\/p>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"pure-table\"><thead><tr><th>Origin<\/th><th>Component<\/th><\/tr><\/thead><tbody><tr><td>Midgut<\/td><td>Cecum and appendix<br>Ascending colon<br>Transverse colon (proximal 2\/3)<\/td><\/tr><tr><td>Hindgut<\/td><td>Transverse colon (distal 1\/3)<br>Descending and sigmoid colon<br>Superior rectum and middle rectum<\/td><\/tr><tr><td>Proctodeum<\/td><td>Inferior rectum<\/td><\/tr><\/tbody><\/table><figcaption><strong>Table 1. Embryological origin of the parts of the colon.<\/strong><\/figcaption><\/figure>\n\n\n<\/span><span class=\"block-heading\" id=\"header_3\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Large vs small intestine<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_3\">\n\n\n<p class=\"wp-block-paragraph\">We can distinguish between the large and small intestine by the appearance of:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>A larger caliber<\/li><li><strong>Omental appendices<\/strong>&nbsp;(fatty omentum like projections)<\/li><li><strong>Teniae coli<\/strong>&nbsp;\u2014 Longitudinal muscle bands, that are named based on what they are attached to:<ul><li>Mesocolic \u2014 Where the mesocolon attaches<\/li><li>Appendicular \u2014 Where the epiploic appendages attach<\/li><li>Free (libra) \u2014 As its name suggests, does not attach to anything<\/li><\/ul><\/li><li><strong>Haustrae<\/strong>&nbsp;\u2014 Sacculations (outpouchings)<\/li><\/ul>\n\n\n\n<figure class=\"wp-block-image\" id=\"attachment_15712\"><a href=\"https:\/\/meddists.com\/wp-content\/uploads\/2018\/08\/large_intestine_segment.png\" target=\"_blank\" title=\"Large Intestine\"><img decoding=\"async\" src=\"https:\/\/meddists.com\/wp-content\/uploads\/2018\/08\/large_intestine_segment-600x376.png\" alt=\"\" class=\"wp-image-15712\"\/><\/a><figcaption><strong>Features of the large intestine<\/strong>&nbsp;(Credit: OpenStax,&nbsp;<a href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA 4.0<\/a>)<\/figcaption><\/figure>\n\n\n<\/span><span class=\"block-heading\" id=\"header_4\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Cecum<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_4\">\n\n\n<p class=\"wp-block-paragraph\">The cecum is the initial part of the large intestine. It is intraperitoneal with a caliber of 7.5cm, lying at the right iliac fossa, 2.5cm deep to the inguinal ligament.&nbsp; It starts at the ileocecal junction, which has a distended part (ampulla) with an orifice guarded by a valve. It continues to the ascending colon superiorly, and vermiform appendix inferiorly. It is<\/p>\n\n\n<\/span><span class=\"block-heading\" id=\"header_5\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Appendix<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_5\">\n\n\n<p class=\"wp-block-paragraph\">The appendix is a 6-10cm, blind diverticulum hanging from the cecum. It contains a mass of lymphoid tissue.<\/p>\n\n\n<\/span><span class=\"block-heading\" id=\"header_6\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Clinical information<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_6\">\n\n\n<p class=\"wp-block-paragraph\">In the case of&nbsp;<strong>appendicitis<\/strong>, pain can be felt in&nbsp;<strong>McBurney\u2019s point,&nbsp;<\/strong>located at the lateral 1\/3 of the line between the anterior superior iliac spine and the umbilicus, designating the approximate location of the base of the appendix.<\/p>\n\n\n\n<figure class=\"wp-block-image\" id=\"attachment_18894\"><a href=\"https:\/\/meddists.com\/wp-content\/uploads\/2018\/08\/mcburneys.png\" target=\"_blank\" title=\"Large Intestine\"><img decoding=\"async\" src=\"https:\/\/meddists.com\/wp-content\/uploads\/2018\/08\/mcburneys-600x375.png\" alt=\"\" class=\"wp-image-18894\"\/><\/a><figcaption><strong>McBurney\u2019s point (1)<\/strong>&nbsp;(Credit: Steven Fruitsmaak, GFD License)<\/figcaption><\/figure>\n\n\n<\/span><span class=\"block-heading\" id=\"header_7\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Colon<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_7\">\n\n\n<p class=\"wp-block-paragraph\">The colon consists of 4 parts \u2013&nbsp;<strong>ascending, transverse, descending,<\/strong>&nbsp;and the&nbsp;<strong>sigmoid.<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>On each side, the meeting points of the ascending and descending colon with the transverse colon make up the&nbsp;<strong>right<\/strong>&nbsp;(<strong>hepatic<\/strong>) and&nbsp;<strong>left<\/strong>&nbsp;(<strong>splenic<\/strong>)&nbsp;<strong>colic flexures<\/strong>.<ul><li>The right colic flexure is located under the 10th rib, and the left is under the 9th rib.<\/li><li>The phrenicocolic ligament attaches the splenic flexure to the diaphragm.<\/li><\/ul><\/li><li>The&nbsp;<strong>paracolic gutters<\/strong>&nbsp;are peritoneal recesses formed to the sides of the ascending and descending colon.<\/li><li>The&nbsp;<strong>ascending colon<\/strong>&nbsp;is secondarily retroperitoneal.<\/li><li>The<strong>&nbsp;transverse colon<\/strong>&nbsp;is intraperitoneal, and it is the longest and most mobile. &nbsp;It usually hangs at the level of the umbilicus (L3), covered by the greater omentum and adhered by the gastrocolic ligament. It attaches to the spleen via the splenocolic ligament.<\/li><li>The<strong>&nbsp;descending colon<\/strong>&nbsp;is secondarily retroperitoneal.<\/li><li>The&nbsp;<strong>sigmoid colon<\/strong>&nbsp;is an S-shaped, intraperitoneal continuation of the descending colon, spanning from the left iliac fossa to the rectosigmoid junction at S3.<\/li><\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_8\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Neurovasculature<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_8\">\n\n\n<p class=\"wp-block-paragraph\">The neurovasculature is rather straightforward. The parts of the gastrointestinal tracts that develop together are supplied, drained, and innervated by the same blood vessels and nerves, and at this point, it\u2019s extremely useful to know the embryological origins. <\/p>\n\n\n<\/span><span class=\"block-heading\" id=\"header_9\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Midgut<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_9\">\n\n\n<ul class=\"wp-block-list\"><li>Cecum and appendix<\/li><li>Ascending colon<\/li><li>Transverse colon (proximal 2\/3)<\/li><\/ul>\n\n\n\n<figure class=\"wp-block-table is-style-stripes\"><table class=\"pure-table\"><tbody><tr><td><strong>Blood supply<\/strong><\/td><td>Superior mesenteric artery<\/td><\/tr><tr><td><strong>Venous drainage<\/strong><\/td><td>Superior mesenteric vein <\/td><\/tr><tr><td><strong>Innervation<\/strong><\/td><td>Superior mesenteric plexus <\/td><\/tr><tr><td><strong>Lymphatic drainage<\/strong><\/td><td>Superior mesenteric node group (epicolic, paracolic, middle colic, and intermediate colic)<\/td><\/tr><\/tbody><\/table><figcaption><strong>Table 2. Neurovasculature of the midgut<\/strong><\/figcaption><\/figure>\n\n\n<\/span><span class=\"block-heading\" id=\"header_10\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Hindgut<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_10\">\n\n\n<ul class=\"wp-block-list\"><li>Transverse colon (distal 1\/3)<\/li><li>Descending and sigmoid colon<\/li><\/ul>\n\n\n\n<figure class=\"wp-block-table is-style-stripes\"><table class=\"pure-table\"><tbody><tr><td><strong>Blood supply<\/strong><\/td><td>Inferior mesenteric artery<\/td><\/tr><tr><td><strong>Venous drainage<\/strong><\/td><td>Inferior mesenteric vein <\/td><\/tr><tr><td><strong>Innervation<\/strong><\/td><td>Inferior mesenteric plexus <\/td><\/tr><tr><td><strong>Lymphatic drainage<\/strong><\/td><td>Inferior mesenteric node group<\/td><\/tr><\/tbody><\/table><figcaption><strong>Table 3. Neurovasculature of the hindgut<\/strong><\/figcaption><\/figure>\n\n\n<\/span><span class=\"block-heading\" id=\"header_11\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Mesocolon<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_11\">\n\n\n<p class=\"wp-block-paragraph\">The mesocolon is the collective name for the peritoneal folds that attach the large intestine to the posterior abdominal wall.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>It allows movement to a certain degree and engulfs the neurovasculature associated with the large intestine.<\/li><li>The anterior layer of the transverse mesocolon adheres to the posterior layer of the greater omentum.<\/li><li>It can be divided based on the part of the intestine it is attached to:<ul><li>The&nbsp;<strong>mesoappendix<\/strong><\/li><li><strong>Ascending mesocolon<\/strong><\/li><li><strong>Transverse mesocolon<\/strong><\/li><li><strong>Descending mesocolon<\/strong><\/li><li><strong>Sigmoid mesocolon<\/strong><\/li><li><strong>Mesorectum<\/strong><\/li><li>Note that the cecum has no separate mesocolon<\/li><\/ul><\/li><\/ul>\n\n\n\n<figure class=\"wp-block-image size-large is-resized\" id=\"attachment_24009\"><a href=\"https:\/\/meddists.com\/learn\/wp-content\/uploads\/2021\/11\/mesocolon.png\" target=\"_blank\" title=\"Large Intestine\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/meddists.com\/learn\/wp-content\/uploads\/2021\/11\/mesocolon-1024x600.png\" alt=\"\" class=\"wp-image-8445\" width=\"840\" height=\"492\" srcset=\"https:\/\/meddists.com\/learn\/wp-content\/uploads\/2021\/11\/mesocolon-1024x600.png 1024w, https:\/\/meddists.com\/learn\/wp-content\/uploads\/2021\/11\/mesocolon-300x176.png 300w, https:\/\/meddists.com\/learn\/wp-content\/uploads\/2021\/11\/mesocolon-768x450.png 768w, https:\/\/meddists.com\/learn\/wp-content\/uploads\/2021\/11\/mesocolon.png 1441w\" sizes=\"auto, (max-width: 840px) 100vw, 840px\" \/><\/a><figcaption><strong>Figure 4. The large intestines. The small intestines are cut out, showing the mesentery and mesocolon.<\/strong><\/figcaption><\/figure>\n<\/span><div id=\"the_titles\" style=\"display:none;\"><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">Description<\/h3><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">A touch of embryology<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Large vs small intestine<\/h4><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">Cecum<\/h3><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">Appendix<\/h3><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Clinical information<\/h4><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">Colon<\/h3><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">Neurovasculature<\/h3><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Midgut<\/h4><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Hindgut<\/h4><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">Mesocolon<\/h3><\/div>","protected":false},"excerpt":{"rendered":"<p>Description The large intestine consists of: Cecum Vermiform appendix Ascending colon Right flexure Transverse colon Left flexure Descending colon Sigmoid colon Rectum In this article, we will discuss all of the parts of the large intestine except for the rectum and anal canal (which are covered in&nbsp;their own article). A touch of embryology Before we [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":1640,"menu_order":3,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-1645","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Large Intestine &#8211; Meddists<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/meddists.com\/learn\/pre-clinical\/anatomy\/abdomen-and-pelvis\/organs-and-systems\/digestive-tract\/large-intestine\/\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"5 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/meddists.com\\\/learn\\\/pre-clinical\\\/anatomy\\\/abdomen-and-pelvis\\\/organs-and-systems\\\/digestive-tract\\\/large-intestine\\\/\",\"url\":\"https:\\\/\\\/meddists.com\\\/learn\\\/pre-clinical\\\/anatomy\\\/abdomen-and-pelvis\\\/organs-and-systems\\\/digestive-tract\\\/large-intestine\\\/\",\"name\":\"Large Intestine &#8211; 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