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Descending part of the colon. Colon: sections of the intestine, structure and functions of the organ. Diagnosis of colon cancer

Colon- This is the longest section of the large intestine, which includes several parts.

Features of the anatomical location of the intestine in abdominal cavity made it possible to divide it into 4 sections:

  1. Ascending colon.
  2. Transverse colon.
  3. Descending colon.
  4. Sigmoid colon.

The total length of the four parts reaches 1.5 -2 meters.

Ascending colon

The intestine is located to the right of the midline of the abdomen (right flank) in the abdominal cavity. Being a continuation, it rises up to the lower edge of the liver. At this level, it forms the right flexure of the colon (hepatic flexure) and passes into the transverse part. The length of the ascending part is about 15-20 cm. The ascending part is topographically limited at the back by the quadratus dorsi muscle and the right kidney, at the top - by the right lobe of the liver and gallbladder, in front – by the anterior abdominal wall, inwards – by loops. In a small number of people, the intestine has its own mesentery, which ensures its mobility and the development of volvulus of the cecum and colon (in rare cases).

Transverse colon

The ascending and descending sections of the large intestine are connected to each other by the transverse colon. The intestine is located in a horizontal plane, slightly sagging downwards. It originates from the hepatic flexure and reaches the left hypochondrium, forming the splenic flexure (left flexure of the colon). The left flexure is located above the right flexure of the colon. When palpating the abdomen, it can be detected above the navel in the form of a horizontal elastic cord.

The length of the transverse colon varies from 25 cm to 65 cm in an adult. The transverse colon is bounded on the right by the liver, on the left by the stomach and spleen. The pancreas is located behind the intestine, and the loops of the small intestine are adjacent below. The anterior part is covered by the anterior abdominal wall. In the abdominal cavity, it is attached to the walls using the mesentery.

Descending colon

It starts from the left flexure of the colon and descends to the left iliac fossa, turning into. Posterior to the intestine lies the left kidney and the quadratus dorsi muscle. Covered in front and left by the abdominal wall. Right side The descending colon is adjacent to the loops of the small intestine. The length of an adult varies from 10 to 30 cm.

Sigmoid colon

It is located in the left iliac region and forms 2 loops: proximal and distal, which lie on different muscles. The proximal part is supported by the iliacus muscle, and the distal part by the psoas major muscle. The length of the sigmoid colon can be from 15 cm to 50 cm in an adult. Near the intestine there is the left ovary, uterus, and bladder.

Wall structure

Located in the abdominal cavity, throughout the entire length of the wall of the colon are formed by the following layers (membranes):

  • slimy;
  • submucosal;
  • muscular;
  • serous.

The mucous membrane lines the inner surface of the intestine. It contains epithelial cells, between which there are a large number of endocrine glands. The glands bend to form crypts. Each crypt contains goblet cells that produce mucus to facilitate the passage of feces. The surface of the crypts is dotted with cells with a set of villi and enzymes for breaking down substances entering the intestines. The mucous layer also contains blood vessels, clusters of lymphatic plaques (follicles), nerve endings and single muscle fibers. Lymphatic follicles have great importance in the development of immunity in childhood. Protrusions of the mucous wall increase the absorption surface of the intestine several times.

The submucosa is a connective tissue with a high content of nerve fibers, lymphatic follicles, and blood vessels.

The human colon is the main section of the large intestine, which is a continuation of the cecum.

The continuation of the colon is the rectum. The length of the human colon is 1.5 m, diameter is 5-8 cm. At the junction of the colon and cecum, the Busi sphincter is located.

The colon is classified into the following sections: ascending, transverse, descending and sigmoid.

The human ascending colon does not participate in the digestive process, but a large amount of liquid is absorbed into it. The liquid chyme that passes from the small to the colon is converted into harder feces.

The ascending colon is a continuation of the cecum; its posterior part is located on the posterior wall of the abdomen on the right. Its length can be from 12 to 20 cm. A free band of the colon runs along the anterior part, an omental band runs along the posteromedial part, and a mesenteric band runs along the posterolateral part. At the transition to the transverse colon, a right bend of the colon is formed.

The transverse colon originates in the right hypochondrium. Its length is 50 cm. The department has a separate mesentery, which is attached to the mesenteric ribbon transverse colon. The colonic ligament runs along the omental band along the anterior surface, which on its descent passes into the greater omentum, covering the transverse colon in front. The left hepatic flexure of the intestine is located in the left hypochondrium, much higher and deeper than the right splenic flexure, located under the spleen. This can be seen in the photo. During the transition to the descending colon, an acute angle is formed, fixed by the diaphragmatic-colic ligament.

The descending colon is located in the left posterior part of the abdomen. Its length is 22 cm, and its diameter decreases as it approaches the sigmoid colon.

The sigmoid colon is located in the left iliac fossa, moves to the pelvic area and moves into the rectum at the level of the third sacral vertebra. Its average length is 55 cm, but significant individual variations are known. The sigmoid colon has two loops, one located on the iliacus muscle and the other on the psoas major muscle.

The sigmoid colon is surrounded on all sides by peritoneum, forming the mesentery, the length of which decreases from the middle to the ends of the sigmoid colon. The junction of the sigmoid, descending and rectum is fixed by a small mesentery, and the middle part of the organ is mobile.

Diseases

IN modern world the number of patients suffering from inflammation, neoplasms and other pathologies of this organ is increasing significantly, which is associated with the following factors:

  • sedentary lifestyle, overeating, unhealthy diet with a predominance of fatty foods in the diet;
  • prolonged constipation, hypotension, intestinal atony in the elderly;
  • an increase in the level of carcinogens in all parts of the colon, which cannot cope with heavy load harmful components;
  • regular use medications and biologically active additives, the effect of which on the human body has not been thoroughly studied.
  • All pathologies can be divided into the following categories:
  • hereditary and congenital nature;
  • acquired.

According to signs of pathological changes:

  1. inflammatory in nature;
  2. not inflammatory.

Congenital defects of the colon include:

  • Dystopia. The location of the entire colon is localized on the right or left side as a result of embryogenesis disorders.
  • Duplication of part of the large intestine.
  • Stenosis and atresia of the colon. Have a single or multiple character. Accompanied by intestinal obstruction and require surgery.

Hirschsprung's disease

This is a hereditary disease. Main symptoms: constipation and. Constipation is persistent, lasting from several weeks to months and is observed from the birth of a child or from an early age. Flatulence, combined with constipation and complementing the symptoms, does not disappear even after performing enemas. Constipation may alternate with diarrhea lasting several days and leading to exhaustion of the patient. These symptoms appear due to the absence of ganglion cells in part of the intestine of the sigmoid or colon. Due to the constant contraction of damaged areas of the intestine, the areas located above hypertrophy. With further progression of the abnormal area, the passage of intestinal contents is disrupted, which contributes to chronic constipation and flatulence.

Complications of this pathology are intestinal obstruction, intestinal perforation, hemorrhage, enterocolitis.

The disease requires surgical intervention. The aganglionic area and enlarged parts of the intestine are removed.

Nonspecific ulcerative colitis

This is a fairly common chronic pathology. The disease affects the large intestine and is accompanied by the formation of ulcers on the intestinal mucosa, mainly the rectum and colon. The etiology of the disease can be infectious or immunological. Nonspecific ulcerative colitis is divided according to its extent, into total and segmental, as well as according to symptoms: acute form and chronic relapsing. Symptoms in the acute form: diarrhea up to 40 times a day with discharge of blood, pus, mucus that fills the intestines, acute abdominal pain. In the chronic relapsing form, periods of remission are alternating with exacerbations. There is a chronic continuous form in which the pathology is asymptomatic, but steadily progresses.

Common symptoms of UC include anemia, water and electrolyte imbalance, and liver dystrophy. Treatment of the disease is appropriate both conservative and surgical.

Diverticulosis and diverticula

Among the common diseases of the organ are diverticula and diverticulosis. The difference between these pathologies lies in the number of diverticula - sac-like formations of the intestinal wall. The disease, as a rule, is congenital, but if it is acquired, then diverticula are formed as a result of protrusion of the intestinal mucosa through defects in the muscular layer. The cause of these disorders may be inflammation of the intestines, as a result of which the intestinal wall weakens and an increase in pressure in the abdominal region occurs against the background of prolonged constipation. Stool accumulates in diverticula, which provokes an inflammatory process in the intestines. Diverticula are often observed in elderly people. In the absence of inflammation in the diverticula, symptoms of pathology are not observed. IN otherwise, patients experience pain in the abdomen, loose stools, nausea, vomiting, and loss of appetite.

Complications of diverticulitis include cellulitis, paracolytic abscess, peritonitis, intestinal obstruction and malignancy.

Polyps

Diseases of the colon that provoke the occurrence of malignant formations include polyps. They can be single or multiple, have a diameter of 0.5 to 2 cm. They are placed on a wide base or hang into the intestinal lumen. If you have multiple polyps, the risk of colon cancer increases significantly.

The formation can grow outward and not interfere with the passage of feces for a long period of time. With internal growth, a narrowing of the intestinal lumen is observed, which serves as a mechanical barrier to intestinal motor function. Pain occurs when the formation is large and is accompanied by hemorrhage from the affected vessels. Treatment of the disease consists of surgery with the use of cytostatics and radiation therapy.

Cancer

Colon cancer is a relatively benign form of cancer. With timely treatment, the result of therapy will be much better than with stomach cancer. During the course of the disease, all parts are affected almost equally, both left and right, and less commonly, the transverse colon.

The symptoms of the disease are very varied. Among the manifestations of the disease, gastrointestinal disorders, pain in the abdominal area, anemia and intoxication, mucous and bloody discharge in the stool, and intestinal obstruction are observed.

Cancer requires surgery. A wide resection of the affected part and a certain part of the mesentery with regional lymph nodes. In the case of the metastatic stage of the disease, chemotherapy is carried out in addition to surgery.
On early stages the prognosis is favorable and patient survival is 70%.

In cases of advanced cancer, survival rate drops to 20%. Therefore, timely contact with a specialist is simply necessary in order to prevent the likelihood of developing a fatal disease.

Dyskinesia

The disease is associated with the absence of organic changes. The epidemiology of functional disorders is often associated with nervous tension during severe stressful situations. May occur as a result of past infections, sedentary lifestyle life, overeating. In case of disturbances in nervous regulation, two outcomes are possible.

  • Symptoms of hypertension. There is rapid motility, an increase in mucus and fluid secretion. As a result, diarrhea and intestinal spasms are observed.
  • Symptoms of hypotension. Fecal retention occurs and, as a result, prolonged constipation and dull pain in the abdominal area.

Due to the fact that patients do not experience changes in tests and examination of the intestine does not reveal certain disorders, therapy is carried out using neurological means, therapeutic exercises, physiotherapy, folk herbal preparations.

Inflammatory diseases

Ulcerative colitis most often affects the rectum, but can be localized throughout the colon. Epidemiology of the disease in this moment not identified, but there is a predisposition to heredity. Ulcers appear on the mucous membrane. Pain sensations spread to the left side of the abdomen. Blood is released in the stool.

Crohn's disease is a pathology of the colon and rectum that affects the stomach and esophagus. The reasons are unknown. Symptoms: prolonged diarrhea, exhaustion, severe fever, joints and eyes are affected. Severe ulcers form in the intestines, which can form fistulas in the pelvic organs, and the lymph nodes become enlarged.

Appendicitis is an inflammation of the colon caused by blockage of the outlet feces or swelling. The disease is accompanied by pain in the right side of the abdomen, increased body temperature, and vomiting. Requires immediate surgical intervention. Due to the fact that the affected appendix very quickly turns into gangrene, ruptures and leads to peritonitis.

Haemorrhoids

Haemorrhoids - varicose veins veins of the hemorrhoidal plexuses, which is accompanied by such manifestations as hemorrhage, pain, inflammation, prolapse of hemorrhoids. But all these clinical signs do not always appear simultaneously.

The disease develops asymptomatically with the gradual appearance of itching in the anus, in some cases there is a feeling of heaviness and foreign body. With significant expansion, the intestinal lumen narrows and severe pain occurs during defecation. The result is destruction of the veins and severe hemorrhage with prolapse of hemorrhoids.

Treatment of hemorrhoids can be either conservative or surgical. Drug therapy is aimed at eliminating symptoms. A large number of sclerosing drugs are prescribed. Secondary bleeding, inflammation and prolapse of hemorrhoids are a signal for surgical intervention. This method does not give relapses.

The right flexure of the colon is the site of transition of the ascending colon (the initial part of the intestine) into the transverse colon.

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Liver

Right flexure of the colon

4) stomach

5) spleen

345. LEVEL OF THE UPPER AND LOWER LIMITS OF THE LEFT LOCATION

KIDNEY IS

1) lower edge of the XI thoracic vertebra

2) middle of the third lumbar vertebra

Middle of the XI thoracic vertebra

Upper edge of the third lumbar vertebra

5) lower edge of the third lumbar vertebra

346. PARTS OF THE KIDNEY IN WHICH STELLATE VENULES ARE FORMED,

ARE

1) medulla

The most superficial layers of the cortex

3) deep layers of the cortex

Fibrous capsule

5) fat capsule

347. THE FOLLOWING ORGANS ARE ADJUSTED TO THE LEFT KIDNEY

Left flexure of the colon

Pancreas

Loops of jejunum

Spleen

348. THE VESSELS THAT FORM THE MIRACULOUS NETWORK OF THE KIDNEY ARE

Afferent glomerular artery

Capillaries

Efferent glomerular artery

4) interlobular arteries

5) efferent glomerular vein

349. THE LOCATION OF THE NEPHRON IN THE KIDNEY IS

Collapsed part of the cortex

Radial part of the cortex

Renal pyramid

4) renal columns

5) small cups

350. PARTS OF THE URETER ARE

1) renal part

Abdominal part

Pelvic part

Intrawall part

5) diaphragmatic part

351. ADJUSTED TO THE ABDOMINAL PART OF THE URETER

Psoas major muscle

Testicular (or ovarian) artery and vein

3) spleen (left)

4) sigmoid colon

5) quadratus lumborum muscle

352. PELVIC PART OF THE LEFT URETER IN RELATION TO

THE ILIAC BLOOD VESSELS ARE CONTAINED

Anterior to the common iliac artery

2) behind the common iliac artery

Anterior to the common iliac vein

4) behind the common iliac vein

5) behind the external iliac artery

353. PELVIC PART OF THE URETER IN RELATION TO THE INTERNAL

THE GENITAL ORGANS OF WOMEN HAVE THE FOLLOWING POSITION

Behind the ovary

Lateral to the cervix

3) in front of the ovary

Between the anterior wall of the vagina and the bladder

5) anterior to the ovary

354. THE PELVIC PART OF THE URETER HAS A POSITION IN RELATION TO THE INTERNAL GENITAL ORGANS IN MEN

1) medially from the vas deferens

Outward from the vas deferens

Crosses the vas deferens

4) runs parallel to the vas deferens

5) in front of the vas deferens

355. PARTS OF THE BLADDER

Top of the bubble

Bladder neck

Bubble Bottom

Bubble body

5) bubble tail

356. IT IS ATTACHED TO THE POSTER SURFACE OF THE BLADDER IN MEN

Rectum

Seminal vesicles

3) prostate gland

4) sigmoid colon

5) quadratus lumborum muscle

357. ORGANS TO WHICH THE POSTERIOR SURFACE OF THE URINARY IS ADJUSTED

BLADLES IN WOMEN ARE

1) genitourinary diaphragm

2) body of the uterus

Cervix

Vagina

358. THE SIDE COVERED BY THE PERITONEUM OF A FULL URINARY

THE BUBBLE IS

1) tops

Lateral

Rear

Front

359. EXTERNAL OPENING OF THE URETHAL CHANNEL IN WOMEN

LOCATED

1) in front of the clitoris

2) behind the vaginal opening

Anterior to the vaginal opening

Behind the clitoris

5) posterior vaginal vault

360. TO THE PARTS INCLUDED IN THE MALE URINARY

CHANNEL RELATE

Prostatic part

Membranous part

3) cavernous part

Spongy part

5) vesical part

361. TO THE POINTS OF CONTRACTIONS OF THE MALE URETHY CHANNEL

RELATE

Inner hole area urethra

2) area of ​​the bulb of the penis

Urogenital diaphragm area

The area of ​​the external opening of the urethra

5) prostate gland

362. PLACES OF EXTENSIONS OF THE MALE URETHY CANAL

1) area of ​​the genitourinary diaphragm

(flexura colidextra, BNA, PNA; flexura coli hepatica, JNA; syn. hepatic flexure) the place of transition of the ascending colon into the transverse colon.

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