LARGE INTESTINE: COLON

Important relations:
Parts: - Transverse colon
1. Caecum Superior: duodenum and beginning part of the
Continuous with jejunum
the ascending colon - Right colic flexure
2. Appendix Also known as the hepatic flexure
See end of note Related to the liver (Antero-superior)
3. Ascending colon Deep to 9th/10th rib
4. Transverse colon - Left colic flexure
5. Descending colon Also known as the splenic flexure
6. Sigmoid colon Related to the spleen (inferior)
7. Rectum - Medial to ascending and descending colon
See separate notes Jejunum and ileum
8. Anal Canal
See separate notes Arterial supply:
- Superior mesenteric artery
Regions: Ileocolic artery
- Right inguinal region caecum and lower ascending colon
- Right flank region Right colic artery
- Umbilical region middle and upper ascending colon
- Left flank region Middle colic artery
- Left inguinal region Upper ascending colon and transverse colon
- Inferior mesenteric artery
Left colic
upper descending colon
Superior sigmoid colon
lower descending colon and sigmoid colon
Superior rectal artery
rectum and sigmoid colon
* Note the marginal artery. It connects the branches
of the middle colic and left colic arteries
Venous drainage:
- Superior mesenteric vein
Ileocolic vein
Caecum and lower ascending colon
Right colic vein
Middle and upper ascending colon
Middle colic vein
Upper ascending colon and transverse colon
- Inferior mesenteric vein
- Hepatic portal vein
Superior mesenteric vein drains directly into it
Inferior mesenteric vein joins with splenic vein
before entering
Lymphatic drainage:
- Superior mesenteric nodes
Paracolic nodes lie directly on the colon
Intermediate colic nodes lie on the arcade arteries
Exception: ileocolic nodes lie on the ileocolic
artery
- Inferior nodes
Paracolic nodes lie directly on the colon
Intermediate colic nodes lie on the arcade arteries
Innervation:
- Fibers from the posterior vagal trunk
Superior mesenteric plexus
Inferior mesenteric plexus
Peritoneal and retroperitoneal structures:
The ascending and descending ports of the colon are
retroperitoneal structures. This means that originally, during
embryological development, it developed as part of the
peritoneum. But early on in the development process they
separated from the peritoneum and fused to the posterior
abdominal wall.
The transverse colon is a peritoneal structure which means it
developed from the peritoneum and remains free from the
posterior abdominal wall.
Ileocaecal orifice:
See notes on small intestine: jejunum and ileum
Vermiform appendix Mucosa and musculature:
- Blind intestinal sac - Taenia coli:
Arises from the posterior medial Thickened bands of smooth muscle
aspect of the caecum Longitudinal muscles
Below the ileocecal junction 3 types:
- Position Omental
Mostly retrocaecal (65%) • Lateral surface of ascending and
Can also be subcaecal (2%), descending colon
ileocaecal (32%) or pelvic (1%) • Anterior surface of transverse colon
- Meso-appendix Free
Has its own mesentery • Anterior surface ascending and
Contain arteries, veins, lymph and nerves descending colon
Triangular shape • Inferior surface of transverse colon
attaches to ileocecal junction, Mesocolonic
ileum, caecum and appendix • Posterior surface of the ascending and
Also has a free border descending colon
- Arterial supply • Superior surface of the transverse
Superior mesenteric artery colon
Ileocolic artery - Haustra:
• Appendicular artery Muscular sacs into which the colon is arranged
- Venous drainage - Omental appendices:
Superior mesenteric vein AKA epiploic appendices
Ileocolic vein Small, fatty projections
- Appendectomy
Surgical removal of the appendix (usually due to
infection)
Palpable point: McBurney’s point
Invisible line from the umbilicus to the ASIS,
point is located 2/3rd of the way down
Mesocolon:
- broad meso-fold of the peritoneal which
connects/attaches the transverse colon to the posterior
abdominal wall.
- Necessary because the transverse colon is a peritoneal
structure.
Carries arteries, veins, lymph nodes and lymph
vessel and nerves

Phrenicocolic ligament:
- Connects the left colic/splenic flexure to the diaphragm

Comparative table:
Characteristic Small intestine Colon
Position Central Peripheral
Type of structure Peritoneal Retroperitoneal
and peritoneal
Contour Even, smooth Sacculated
Muscle Uniform Taenia (bands)
Appendices Absent Present