GIHB

Correlation Seminar
Group 21
12081
12082
12083
12084
GRAND TOPIC: COLORECTAL CANCER
OBJECTIVE NO. 1:- Explain the cardinal features of large intestine. Mention
the attachment and relation of sigmoid mesocolon.
Large Intestine
• The large intestine extends from the ileocaecal junction to the anus, a
distance of approximately 1.5 meters.

• The parts of large intestine are:

Caecum
Vermiform Appendix
Colon
Rectum
Anal canal

Fig 1: Gross Anatomy of Large Intestine

Cardinal features of Large Intestine
1. Appendices epiploicae
2. Taenia coli
3. Sacculations or haustrations

Fig 2: Detailed Anatomy of Large Intestine

Appendices epiploicae
• Small pouches of peritoneum filled
with fat and situated along the colon.

• But, absent in the caecum, appendix

and rectum.

• Chiefly appended to the Transverse

and Sigmoid colon.

• Function - Unknown

Fig 3: Appendices epiploicae visualised

Taeniae coli
• There are 3 longitudinal ribbon-like bands of muscle that run along
the length of the large intestine.

• Extent:
o Proximally: Converge at the base of the appendix.

o Distally: Disperse at the terminal part of the sigmoid colon and

integrate with the longitudinal muscle layer of the rectum.
Taeniae coli (Cont’d.)
• Three longitudinal bands named upon
their attachment:
1. Taeniae libera (no attachments)
2. Taeniae mesocolica (attached
to mesocolon)
3. Taeniae omentalis (attached
to Greater omentum)

• Taeniae have rotated positions due

to formation of left and right
colic flexures.
Fig 4: Position of the 3 Taeniae Coli
Taeniae coli (Cont’d.)
Table 1: Position of Taeniae coli along the parts of large intestine

Position in Caecum,
Position in
Taeniae Ascending, Descending
Transverse colon
and Sigmoid colon

Taeniae libera Anterior Inferior

Taeniae mesocolica Posteromedial Posterior (at the site of

attachment of
transverse mesocolon)
Taeniae omentalis Posterolateral Anterosuperior (where
layer 3 & 4 of greater
omentum meet)
Sacculations / Haustrations
• These are series of pouches/
dilatations in the wall of caecum and
colon between the taeniae.

• These are the reason for the

“segmented appearance” of the colon.

Fig 5: Haustrations of the Colon

Sacculations / Haustrations (Cont’d.)
• Formation :

Length of Taeniae < Length of circular muscle coat

Taeniae 1/6th shorter than muscular coat of colon

Responsible for characteristic puckered

appearance of the Large Intestine
Sigmoid mesocolon
Attachments and relations
• Root : Inverted V-shaped attachment
• Apex: Over the left ureter
(at termination of left common iliac
artery)
• Left limb : Along the upper
half of left external iliac artery
• Right limb : Posterior to pelvic wall
(downward and medially from apex
to S3 Vertebrae)
Fig 6: Attachments and relations of
Sigmoid Mesocolon
Sigmoid mesocolon (Cont’d.)

Contents:
• Sigmoid vessels in left limb
• Superior rectal vessels , nerves, lymph nodes and lymphatics in right limb.
Correlation with colorectal cancer
• Common sites: Rectosigmoid junction, Ascending colon.
• Location can influence symptoms, treatment options and prognosis
• Screening: Colonoscopy, Sigmoidoscopy.

Table 2: Prevalence of Colorectal Cancer according to site and age

Sites Common prevalence
Ascending colon Women and older patients
Rectosigmoidal junction Men and younger patients
Transverse or descending colon Less common
References
• Chaurasia, B. D. (2023). Human anatomy: Regional and applied
dissection and clinical Vol. 2 (9th ed.). CBS Publishers & Distributors.
• Gray, H. (2013). Gray’s Anatomy for Students. Arcturus Publishing.
• Moore, K. L., & Dalley, A. F. (2023). Moore's Clinical Anatomy.
Wolters Kluwer.
• Netter, F. H. (2024). Atlas of human anatomy (7th ed.). Elsevier.
• Open Oregon State. (n.d.). 23.6 The small and large intestines. Open
Oregon State. Retrieved June 22, 2024, from
https://open.oregonstate.education/aandp/chapter/23-6-the-small-and-larg
e-intestines/
• Snell, R. S. (2021). Snell's Clinical Anatomy by Regions. LWW.
• Sobotta, J. (2022). Sobotta Atlas of Human Anatomy, Vol. X. Elsevier.
OBJECTIVE NO. 2:- Explain the location, curvatures and peritoneal relations
and valves of rectum.
OBJECTIVE NO. 3:- Explain the arterial supply, venous drainage and lymphatic
drainage of sigmoid colon and rectum.
Sigmoid Colon
1. Arterial Supply

FIG-
2. Venous Drainage FIGURE--

--------
 FIGURE---
3. Lymphatic Drainage
---
Rectum
FIGURE---
1. Arterial Supply
2. Venous Drainage FIGURE--
3. Lymphatic drainage FIGURE---
CORRELATION
FIGURE-COLORECTAL CANCER
REFERENCE
https://www.researchgate.net/publication/324024840/figure/
fig1/AS:608609398444032@1522115196964/A-schematic-
representation-depicting-the-lymphatic-drainage-with-the-
major-lymphatic_Q320.jpg
 OBJECTIVE NO. 4:- Describe the mechanism of defecation. List the factors
influencing fecal continence and explain their contribution in maintaining fecal
continence.
DEFECATION
DEFECATION REFLEX
RECTO-COLIC REFLEX
RECTO-SPHINCTERIC REFLEX
SOMATIC CONTROL
SUPPRESSION OF URGE
ACT OF DEFECATION
CORRELATION
REFERENCES