Repaso 5.

ANATOMY JEJUNUM, ILEUM & COLON • The lymphatic system of the small intestine regulates
tissue fluid homeostasis, participates in immune
JEJUNUM surveillance, and transports dietary fat and fat soluble
• The jejunum represents the proximal two-fifths. vitamins from the gut lumen.

-Begins at the duodenojejunal flexure. • The jejunum is innervated by parasympathetic and

-Intraperitoneal sympathetic fibers via the superior mesenteric plexus.
-The wall of the jejunum is thicker and its lumen
The visceral sensation of pain arising from the jejunum is
is wider than in ileum
poorly localized and is usually referred to the
periumbilical region
Additionally, the inner mucosal lining of the jejunum is
characterized by numerous prominent folds that circle
the lumen (plicae circulares).

The less prominent arterial arcades and longer vasa recta

(straight arteries) compared with those of the ileum are
a unique characteristic of the jejunum.

ILEUM

• The ileum makes up the distal three fifths of the small

intestine

-mostly in the right lower quadrant.

VASCULATURE
The ileum has thinner walls, fewer and less prominent
• The arterial supply to the jejunum includes jejunal
mucosal folds (plicae circulares), shorter vasa recta,
arteries from the superior mesenteric artery.
more mesenteric fat, and more arterial arcades, has an
• The superior mesenteric vein drains the small intestine, external diameter of about 3 cm, an internal diameter of
caecum, ascending and transverse colons, and parts of about 2.5 cm.
the stomach and greater omentum.

-The ileum terminates at the ileal orifice (ileocecal

junction) where the cecum of the large intestine begins.

LYMPHATIC DRAINAGE & INNERVATION

-At the ileocecal junction, the lamina muscularis of the ***The large intestine has several distinct anatomical
ileum protrudes into the lumen of the cecum forming a characteristics; the omental appendices, teniae coli and
structure called the ileocecal fold. haustra:

-These muscular fibers form a muscular ring within the Omental or epiploic appendages are fat filled pouches
fold called the ileocecal sphincter which controls the of peritoneum that are attached externally to the walls
emptying of ileal content into the large intestine of the large intestine.

Teniae coli are three longitudinal bands of smooth

muscle located underneath the peritoneum that extend
VASCULATURE
along certain sections of the large intestine. Their
The arterial supply to the ileum includes: contractions facilitate the peristaltic action.

• Ileal arteries from the superior mesenteric artery. Haustra are sacculations that occur along the large
intestine, providing it with its characteristic ‘baggy’
• Ileal branch from the ileocolic artery (from the superior aspect.
mesenteric artery)

LARGE INTESTINE: COLON

• The large intestine extends from the distal end of the

ileum to the anus

A distance of approximately 1.5 m in adults.

It absorbs fluids and salts from the gut contents, thus

forming feces, and consists of the cecum, appendix,
colon, rectum, and anal canal

Layers:

-Taenia Libera
-Taenia mesocolica

-Taenia omentalis

VASCULATURE

CECUM

• The cecum is the first part of the large intestine. It is

inferior to the ileocecal opening and in the right iliac
fossa.

The cecum is continuous with the ascending colon at the

entrance of the ileum and is usually in contact with the
anterior abdominal wall.

The appendix is attached to the posteromedial wall of

the cecum, just inferior to the end of the ileum.

APPENDIX

• The APPENDIX is a narrow, hollow, blind ended tube

connected to the cecum.

It has large aggregations of lymphoid tissue in its walls

and is suspended from the terminal ileum by the
mesoappendix, which contains the appendicular vessels.
APENDICITIS

Anal Canal

✓ Begins anorectal ring

✓ Ends at the intersphincteric groove.

✓ Externally, is surrounded by the internal and

RECTUM & ANAL CANAL
• Extending from the sigmoid colon is the rectum.
The rectosigmoid junction is usually described as being
at the level of vertebra SIII or at the end of the sigmoid
mesocolon because the rectum is a retroperitoneal
structure.
external anal sphincter muscles.
The superior half of the anal canal contains a series of
longitudinal ridges called the anal columns (of
Morgagni), which extend from the anorectal junction
superiorly to the anal valves inferiorly.
The anal valves form an irregular line called the dentate
or pectinate line (important anatomic landmark.)

VASCULATURE

The arterial supply to the rectum and anal canal includes:

• The superior rectal artery from the inferior mesenteric

artery.

• The middle rectal artery from the internal iliac artery.

• The inferior rectal artery from the internal pudendal

artery (from the internal iliac artery).