Med Oradea - Anatomy II - Digestive System - Large Intestine And Rectum
Med Oradea - Anatomy II - Digestive System - Large Intestine and Rectum
- 1.
The large intestine
- A.
Continues the ileum
- B.
Is situated between the ileocecal valve to the rectum region (S4)
- C.
Has 1,6-1,8m and 8-9cm in diameter (the distal part decreases to 3-3,5cm in diameter)
- D.
It presents teniae coli, haustrae coli, and epiploic coli
- E.
Teniae coli are 3 muscular bands that start at the cecum
Correct Answer(s)
A. Continues the ileum
E. Teniae coli are 3 muscular bands that start at the cecumExplanation
The large intestine is between the ileocecal valve to the rectum region, that's true, but it's at the level of S3, not S4. It has 7-8cm in diameter, decreasing to 3-3,5cm in the distal part. It presents teniae coli, haustrae coli, and epiploic *appendages*Rate this question:
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- 2.
Regarding the large intestine:
- A.
One of the teniae coli is free (no insertions) and is called the free taenia
- B.
Haustrae coli are dilations of the intestinal wall delimited from one another by vertical folds, formed from the intestinal wall
- C.
Epiploic appendices are formed by fat and peritoneum, and look like yellow tassels
- D.
The structure is: serous peritoneum, muscular coat, submucous coat, and mucous layer with vessels and nerves
Correct Answer(s)
A. One of the teniae coli is free (no insertions) and is called the free taenia
C. Epiploic appendices are formed by fat and peritoneum, and look like yellow tasselsExplanation
Option B is almost correct- the haustrae are actually delimited from each other by transversal grooves. The rest is OK.
Option D is also nearly correct, but the vessels and nerves are in the submucous. The mucous layer has Lieberkuhn glands and lymphoid formationsRate this question:
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- 3.
Regarding the large intestine:
- A.
The mucous layer has Lieberkuhn glands and lymphoid formations
- B.
The first part is the cecum, and is from the ileocecal valve to the left iliac fossa
- C.
The vermiform appendix is attached to the cecum and usually oriented downwards
- D.
The cecum has relations behind with the peritoneum, iliac fascia, psoas muscle, and branches from the lumbar plexus
Correct Answer(s)
A. The mucous layer has Lieberkuhn glands and lympHoid formations
C. The vermiform appendix is attached to the cecum and usually oriented downwards
D. The cecum has relations behind with the peritoneum, iliac fascia, psoas muscle, and branches from the lumbar plexusExplanation
The cecum is from the ileocelcal valve to the *right* iliac fossa. Think about where appendicitis pain presents itself- on the right, not the left.Rate this question:
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- 4.
Regarding the cecum:
- A.
Medially, it has relations with the ileum
- B.
It has fewer halfstrae, except in the first part
- C.
Vermiform appendix is above the ileocecal valve
- D.
The ileocecal valve is horizontal with an upper and lower labium, united at their ends, so that the small orifice, being oriented towards the cecum, prevents intestinal content from returning to the ileum
- E.
The vermiform appendix is a cylindrical tube with 12-15cm, and can be oriented descending, lateral, medial, or retrocecal
Correct Answer(s)
A. Medially, it has relations with the ileum
D. The ileocecal valve is horizontal with an upper and lower labium, united at their ends, so that the small orifice, being oriented towards the cecum, prevents intestinal content from returning to the ileumExplanation
Option B is wrong- the cecum doesn't have any haustrae
The appendix is below the ileocecal valve (normally) and has approximately 9cm.Rate this question:
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- 5.
The cecum:
- A.
Is vascularized by the ileocolic artery and veins.
- B.
Receives blood from the upper mesenteric artery
- C.
Ileocolic artery divides into anterior and posterior cecal branches, and appendicular artery branches from the upper mesenteric
- D.
Ileocolic veins drain to the hemorrhoidal veins
Correct Answer(s)
A. Is vascularized by the ileocolic artery and veins.
B. Receives blood from the upper mesenteric arteryExplanation
The ileocolic artery has several branches, including the anterior cecal, posterior cecal, and appendicular
The ileocolic veins drain to the upper mesenteric and from there to the portal veinRate this question:
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- 6.
Innervation of the cecum:
- A.
Is from the upper mesenteric plexus
- B.
The upper mesenteric plexus carries post synaptic parasympathetic fibers from the celiac plexus
- C.
Thoracic splanchnic nerves join the upper mesenteric plexus
- D.
The cecum receives parasympathetic innervation from the vagus nerve
Correct Answer(s)
A. Is from the upper mesenteric plexus
D. The cecum receives parasympathetic innervation from the vagus nerveExplanation
B and C are wrong. The upper mesenteric plexus does receive parasympathetic nerve fibers from the celiac plexus, but the parasympathetic fibers do not synapse there- remember parasympathetics tend to synapse in the walls of the target organ. So they are just passing through the celiac on the way to the upper mesenteric (and from there will synapse in the cecum).
Regarding option C, it's kind of a trick question. The thoracic splanchnic nerves form the celiac plexus, which gives off fibers to the upper mesenteric. Think about the order of formation- the thoracic splanchnics come before the upper mesenteric, so they couldn't "join" the upper mesenteric (because without those nerves the upper mesenteric plexus doesn't exist). By the way, the superior mesenteric plexus does receive a branch from the vagus nerve.Rate this question:
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- 7.
Let's test our concepts. Since the upper mesenteric plexus follows the upper mesenteric artery, what organs does the upper mesenteric plexus innervate? (think about what the upper mesenteric artery supplies)
- A.
Cecum
- B.
Pancreas
- C.
Small intestine
- D.
The source of the upper mesenteric plexus also supplies the duodenum, stomach, and liver
Correct Answer(s)
A. Cecum
B. Pancreas
C. Small intestine
D. The source of the upper mesenteric plexus also supplies the duodenum, stomach, and liverExplanation
It should have been clear from the question that the upper mesenteric plexus supplies whatever the upper mesenteric artery vascularizes. Option D is correct because the celiac plexus innervates all of those organs - and the celiac plexus is the source of the upper mesenteric.Rate this question:
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- 8.
The colon:
- A.
Has a right colic flexure and renal angle
- B.
Presents the transverse mesocolon, which is inclined upwards to the left
- C.
Has an ascending, descending, and transverse part
- D.
Has relations behind with the psoas muscle and the right kidney
- E.
Has relations above with the duodenum, pancreas, and lower surface of the liver
Correct Answer(s)
B. Presents the transverse mesocolon, which is inclined upwards to the left
C. Has an ascending, descending, and transverse part
D. Has relations behind with the psoas muscle and the right kidneyExplanation
The colon has right and left colic flexures, also called the hepatic (right) and splenic (left)
E is tricky. The duodenum and pancreas are behind the transverse colon. The liver is above.Rate this question:
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- 9.
The transverse colon:
- A.
Behind it is the second part of the duodenum
- B.
The transverse mesocolon determines its mobility
- C.
Above is the stomach, with the gastrocolic ligament separating them
- D.
The duodenojejunal flexure is in front
Correct Answer(s)
A. Behind it is the second part of the duodenum
B. The transverse mesocolon determines its mobility
C. Above is the stomach, with the gastrocolic ligament separating themExplanation
D is wrong- the duodenojejunal flexure is belowRate this question:
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- 10.
The descending colon:
- A.
Extends from the left colic flexure to the left iliac crest
- B.
It is shorter than the ascending colon
- C.
It has relations with the small intestine medially and in front
- D.
Behind it is the left kidney and the iliohypogastric and iloinguinal nerves
Correct Answer(s)
A. Extends from the left colic flexure to the left iliac crest
C. It has relations with the small intestine medially and in front
D. Behind it is the left kidney and the iliohypogastric and iloinguinal nervesExplanation
Think about the angle of the transverse colon- it's inclined upwards to the left. So the descending colon logically is longer than the ascending and B must be wrong.Rate this question:
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- 11.
The sigmoid colon:
- A.
Extends from the iliac crest to the rectum at the level of S4
- B.
Is also called the ileo-pelvin colon
- C.
Its haustrae aren't well represented and it has only 2 teniae
- D.
It has 4 divisions
Correct Answer(s)
B. Is also called the ileo-pelvin colon
C. Its haustrae aren't well represented and it has only 2 teniaeExplanation
A is wrong - the rectum is at S3
The sigmoid has 4 divisions: fixed (iliac colon), mobile, and rectosigmoidean. The 2nd and 3rd parts form the pelvin colonRate this question:
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- 12.
The sigmoid colon:
- A.
Its 3rd part is the pelvin colon
- B.
The first part is mobile, the second part is fixed
- C.
The first part, iliac colon, is situated between the lliac crest and the internal border of the psoas muscle
- D.
The last part is rectosigmoid
Correct Answer(s)
C. The first part, iliac colon, is situated between the lliac crest and the internal border of the psoas muscle
D. The last part is rectosigmoidExplanation
A is incorrect - the 2nd and 3rd parts together are the pelvin colon
B is incorrect - the first part is fixed, the 2nd part is mobileRate this question:
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- 13.
The sigmoid colon:
- A.
The iliac part has relations behind with the iliac muscle, genital vessels, iliac vessels, and uterus
- B.
The bladder is in front of the pelvin part and the uterus is behind it
- C.
The right iliac vessels and small intestine are behind the pelvin part
- D.
The iliac part has relations in front with the small intestine and greater omentum
- E.
The uterus is below and in front of the pelvin part, and the douglas excavation is also below
Correct Answer(s)
B. The bladder is in front of the pelvin part and the uterus is behind it
D. The iliac part has relations in front with the small intestine and greater omentum
E. The uterus is below and in front of the pelvin part, and the douglas excavation is also belowExplanation
A is almost correct- the iliac part has relations behind with the iliac muscle, genital vessels, and iliac vessels, but not with the uterus (the uterus is behind the pelvin part)
The small intestine is indeed behind the pelvin part, but it's the left, not the right iliac vessel that is behind it.Rate this question:
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- 14.
Regarding the colon:
- A.
It can be divided by an oblique line into two parts- the right colon formed by the cecum, ascending, and the first 1/3 of the transverse colon; the left by the last 2/3 of the transverse colon, the descending colon, and the sigmoid colon
- B.
The right colon is irrigated by the upper mesenteric artery and the left colon by the lower mesenteric
- C.
The upper mesenteric artery gives off the ileocolic, right colic, and middle colic
- D.
The right colic artery supplies the first 2/3 of the transverse colon, whereas the ileocolic is for the cecum
- E.
The veins accompany the arteries except for the right colic vein
Correct Answer(s)
B. The right colon is irrigated by the upper mesenteric artery and the left colon by the lower mesenteric
C. The upper mesenteric artery gives off the ileocolic, right colic, and middle colic
D. The right colic artery supplies the first 2/3 of the transverse colon, whereas the ileocolic is for the cecum
E. The veins accompany the arteries except for the right colic veinExplanation
A is very nearly correct, but in fact the right colon includes the first 2/3 of the transverse colon. The left colon has only the final 1/3 of the transverseRate this question:
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- 15.
Regarding the colon:
- A.
The left colon is irrigated by the left colic artery and sigmoidean trunk
- B.
The sigmodean trunk branches into the upper, middle, and posterior sigmoidean artery
- C.
The left colic artery has an ascending branch for the last 1/3 of the transverse colon and a descending branch for the descending colon
- D.
Venous drainage for the left colon is to the sigmoidean veins (which accompany the sigmoidean arteries) and the left colic vein (which goes to the lower mesenteric)
Correct Answer(s)
A. The left colon is irrigated by the left colic artery and sigmoidean trunk
C. The left colic artery has an ascending branch for the last 1/3 of the transverse colon and a descending branch for the descending colon
D. Venous drainage for the left colon is to the sigmoidean veins (which accompany the sigmoidean arteries) and the left colic vein (which goes to the lower mesenteric)Explanation
A is correct - the left colic and sigmoidean trunk are branches from the lower mesenteric, which supplies the left colon
B is wrong - the sigmoidean trunk branches into the upper, middle, and *lower* sigmoidean arteriesRate this question:
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- 16.
Innervation of the colon:
- A.
Is from the celiac plexus and the upper and lower mesenteric plexus
- B.
The lower mesenteric plexus surrounds the lower mesenteric artery
- C.
Splanchnic nerves provide parasympathetic innervation
- D.
The celiac plexus is the source of the upper and lower mesenteric plexi
- E.
The vagus provides parasympathetic innervation to the proximal 2/3 of the transverse colon
Correct Answer(s)
A. Is from the celiac plexus and the upper and lower mesenteric plexus
B. The lower mesenteric plexus surrounds the lower mesenteric artery
C. Splanchnic nerves provide parasympathetic innervation
D. The celiac plexus is the source of the upper and lower mesenteric plexi
E. The vagus provides parasympathetic innervation to the proximal 2/3 of the transverse colonExplanation
If you've done some the other quizzes before this one, then you might have thought C was wrong. But in fact the colon receives parasympathetic innervation from both the vagus and pelvic splanchnic nerves (via several nerve plexi). Ordinarily, the splanchnic nerves are sympathetic fibers, however in the case of the colon, it receives part of its innervation from pelvic splanchnic nerves - the pelvic splanchnics are unusual because they are actually parasympathetic nerves. So C is correct.
D is incorrect. The celiac plexus supplies the abdominal aortic plexus which in turn supplies the lower mesenteric plexus. The celiac plexus does supply the upper mesenteric plexus.
The vagus provides parasympathetic innervation to everything before and including the proximal 2/3 of the transverse colon. The distal 1/3 of the transverse colon and everything afterwards receives parasympathetic innervation from the pelvic splanchnic nerves.Rate this question:
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- 17.
Regarding some arteries of the colon:
- A.
The right colic is a branch of the lower mesenteric
- B.
The ileocolic is from the upper mesenteric
- C.
The anterior and posterior cecal arteries are from the right colic artery
- D.
The sigmoid trunk is from the left colic artery
- E.
The right colic supplies the first half of the transverse colon, the left colic the second half
Correct Answer
B. The ileocolic is from the upper mesentericExplanation
The major source of blood supply is from the superior and inferior mesenteric arteries.
The upper mesenteric gives off 3 branches: ileo-colic, right colic, and middle colic. The right colic supplies the first 2/3 of the transverse colon.
Regarding the anterior and posterior cecal arteries, they are from the ileocolic artery, together with the ascending colic, apendicular, and ileal arteries.
The sigmoid trunk is a branch of the lower mesenteric. The left colic is the other branch, and it gives off its own ascending and descending branches (the ascending for the last 1/3 of the transverse colon, and the descending branch of course to the descending colon).
The sigmoidean trunk gives off upper, middle, and lower branchesRate this question:
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- 18.
The rectum:
- A.
It's lower limit is the ano-cutaneous line (where the anal mucous unites with the skin of the perineum)
- B.
Its upper limit is at the end of the sigmoid colon (S3)
- C.
It has a pelvic and perineal part
- D.
The second part is the anal canal, which looks like a curve with the concavity forward
- E.
The first part is the rectal ampoule, which is inside the sacral concavity
Correct Answer(s)
A. It's lower limit is the ano-cutaneous line (where the anal mucous unites with the skin of the perineum)
B. Its upper limit is at the end of the sigmoid colon (S3)
C. It has a pelvic and perineal part
D. The second part is the anal canal, which looks like a curve with the concavity forward
E. The first part is the rectal ampoule, which is inside the sacral concavityExplanation
The rectum has a pelvic and perineal partRate this question:
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- 19.
The rectum:
- A.
The pelvin part is a cylindrical tube, but without the characteristics of the colon
- B.
The muscular fibers of the pelvin part create a uniform layer, unlike the teniae of the colon
- C.
On the external surface of the pelvin part, there are 2-3 transverse grooves that are determined by the Houston valves from the outer surface
- D.
In the perineal part, it is surrounded by the levator ani muscule and sphincters
Correct Answer(s)
A. The pelvin part is a cylindrical tube, but without the characteristics of the colon
B. The muscular fibers of the pelvin part create a uniform layer, unlike the teniae of the colon
D. In the perineal part, it is surrounded by the levator ani muscule and spHinctersExplanation
The Houston valves are on the inner surfaceRate this question:
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- 20.
The rectum:
- A.
The perineal part presents two sagital flexures
- B.
The sacral flexure is the second flexure, with concavity forwards
- C.
The perineal flexure is the second flexure, with concavity backwards
- D.
The pelvin part is called the ampuole
Correct Answer(s)
A. The perineal part presents two sagital flexures
C. The perineal flexure is the second flexure, with concavity backwards
D. The pelvin part is called the ampuoleExplanation
The sacral flexure is the first part - it's concavity is forwards.Rate this question:
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- 21.
The internal configuration of the rectum:
- A.
It's layers are: serous (external) coat, muscular coat, submucous layer, and mucous layer
- B.
In the ampoule, there are 5 transversal folds, called Houston valves
- C.
Valves 1, 3, and 4 are on the left; 2 and 5 are on the right
- D.
The perineal part has longitudinal folds called anal columns
Correct Answer(s)
A. It's layers are: serous (external) coat, muscular coat, submucous layer, and mucous layer
D. The perineal part has longitudinal folds called anal columnsExplanation
There are 3 Houston valves, the first on the left, the second on the right, and the third back on the leftRate this question:
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- 22.
Some relations of the pelvin part of the rectum:
- A.
Douglas pouch is in front, urinary bladder is behind
- B.
In men, the prostate is in front
- C.
The middle sacral artery, sympathetic sacral trunks, and cowper glands are behind
- D.
Levator ani and the pudendal vessels and nerves are behind
Correct Answer
B. In men, the prostate is in frontExplanation
The urinary bladder is in front of the rectum, not behind (in women, it's in front of the vagina/uterus)
C is wrong because the cowper glands are in front of the perineal part, not behind the pelvin part. These glands only exist in men.
D is wrong because the levator ani muscle is behind the perineal part, and the pudendal vessels and nerves are lateral of the pudenal part.Rate this question:
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- 23.
Some relations of the pudendal part of the rectum:
- A.
The bladder and vagina (in women) are in front
- B.
In men, the prostate, urethra, and cowper glands are in front
- C.
Behind is the levator ani muscle
- D.
Pudendal vessels and nerves are lateral
Correct Answer(s)
B. In men, the prostate, urethra, and cowper glands are in front
C. Behind is the levator ani muscle
D. Pudendal vessels and nerves are lateralExplanation
A is wrong- the bladder is in front of the pelvin partRate this question:
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- 24.
Vascularization of the rectum:
- A.
Is from the upper hemorrhoidal artery
- B.
Is from the middle hemorrhoidal artery
- C.
Is from the anterior hemorrhoidal artery
- D.
Is from branches of the internal pudendal, hypogastric, and lower mesenteric arteries
- E.
The middle hemorrhoidal artery is a branch from the internal pudendal artery (a branch of the internal iliac artery)
Correct Answer(s)
A. Is from the upper hemorrhoidal artery
B. Is from the middle hemorrhoidal artery
D. Is from branches of the internal pudendal, hypogastric, and lower mesenteric arteriesExplanation
The rectum is supplied by 3 arteries: upper, middle, and lower hemorrhoidal. The upper is from the lower mesenteric artery, the middle is from the internal iliac (hypogastric) artery, and the lower is from the internal pudendal artery (a branch of the internal iliac)Rate this question:
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- 25.
Regarding venous drainage of the rectum:
- A.
The upper hemorrhoidal vein drains to the inferior mesenteric vein
- B.
The inferior mesenteric vein drains to the splenic vein
- C.
The splenic vein drains to the inferior vena cava
- D.
The drainage is via the upper, middle, and lower hemorrhoidal veins
- E.
The lower hemorrhoidal vein drains to the internal pudendal vein and from there ultimately ends up at the portal system (don't worry about any intermediate veins)
Correct Answer(s)
A. The upper hemorrhoidal vein drains to the inferior mesenteric vein
B. The inferior mesenteric vein drains to the splenic vein
D. The drainage is via the upper, middle, and lower hemorrhoidal veins
E. The lower hemorrhoidal vein drains to the internal pudendal vein and from there ultimately ends up at the portal system (don't worry about any intermediate veins)Explanation
Try not to get confused here. There are 3 veins draining the rectum: upper, middle, and lower hemorrhoidal.
Two of these drain to the caval system, and one drains to the portal system. Let's take a look:
Upper hemorrhoidal -> Inferior mesenteric -> Splenic -> Portal
Middle hemorrhoidal -> internal iliac -> inferior vena cava
Lower hemorrhoidal -> internal pudendal -> internal iliac -> inferior vena cavaRate this question:
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Mar 20, 2023Quiz Edited by
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Jun 03, 2011Quiz Created by
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