Caecum and appendix (Dave's notes)

Question 1

The caecum is a ……….. pouch projecting down below the …. ………., ……. in the infant, but the ………… wall ………. the ……….. wall.

Answer 1

blind, ileocolic junction, conical, lateral wall outgrows the medial wall

Question 2

Describe the retrocaecal space

Answer 2

The retrocaecal space may be either shallow or deep, and may have folds

Question 3

Where are the teniae coli located on the caecum?

Answer 3

• One lies anterior
• and two are posterior
• one posteromedial
• and one posterolateral

Question 4

What is the blood supply of the caecum and from whence does it arise? What else of import occurs here?

Answer 4

• from the posterior and anterior caecal vessels which are terminal branches of the ileocolic.
• The appendiceal artery usually arises from the posterior caecal artery

Question 5

Fold between the ileum and appendix is known as the….

Answer 5

ileocaecal recess

Question 6

Where are/may there be further recesses?

Answer 6

• Between the mesoappendix and the floor of the RIF
• And the retrocaecal fossa constitutes a fourth recess

Question 7

Describe the appendix and its length

Answer 7

The appendix is a blind ending tube of 2-25cm in length. Its lumen may obliterate in old age.

Question 8

From whence does the appendix arise?

Answer 8

The appendix arises from the posteromedial wall of the caecum 2cm below the ileocaecal valve. The base is the point of convergence of the teniae coli.

Question 9

What are the most common positions of the appendix? In health?

Answer 9

Retrocaecal and retrocolic. In health- retroileal.

Question 10

Describe the mesoappendix

Answer 10

• The mesoappendix is a triangular fold,
• prolongation of the inferior terminal ileum mesentary

Question 11

Describe the arterial supply, venous drainage, and lymphatics of the appendix

Answer 11

• Arterial supply is from the appendicular artery which arises from the posterior caecal artery. There is no collateral circulation.
• Veins correspond to arterial supply.
• Lymphatic drainage is via the course of the ileocolic artery