how many colic flexures are there. The one on the right, the right colic flexure is known as the hepatic flexure. how many colic flexures are there

 
 The one on the right, the right colic flexure is known as the hepatic flexurehow many colic flexures are there  This is the American ICD-10-CM version of R10

Persistent and inconsolable crying episodes in an otherwise healthy and well-fed infant characterize infantile colic. The arterial supply to the transverse colon is mostly from the middle colic artery, which is a branch of SMA. Taeniae coli: 3 longitudinal bandsu000b. Owing to gravitational reasons, there is often a characteristic air–fluid interface in the descending colon when the patient is in the left lateral position. Anus. Definition. The transverse colon is one of the four major parts of the colon, extending from the right colic (hepatic) flexure to the left colic (splenic) flexure. The medial aspects of the colic flexures are anterior and likewise reflect abnormality of anterior structures. The transverse colon extends from the hepatic flexure and continues to the left abdomen, where it undergoes a sharp caudal turn at the most inferior aspect of the spleen to become the descending colon. This entails ligation of ileocolic, right colic, and middle colic artery at their respective origin during extended right hemicolectomy, while for transverse colectomy this would mean ligation of the main trunk of middle colic artery. sharp abdominal spasms or cramping. • It ends at the left colic flexure in the left hypochondrial region. 8(14. b. Note that "right" refers to the patient's anatomical right, which may be depicted on the left of a diagram. ileocecal sphincter. Bloating. Sometimes there is relief in symptoms after the infant passes gas or has a bowel movement. True/False: For the PA oblique projection, RAO position, the central ray should be directed 35 to 45 degrees caudally. Lateral projectionintraperitoneal. ভিডিও কলে বিশেষজ্ঞ চিকিৎসকের পরামর্শ নিন. The angles between the neighbouring parts can vary between examined subjects. 006) . chest pain. A right medial paracolic gutter has also been described in cases where the ascending colon has a mesentery; it is limited inferiorly by the ilium and its mesentery. Moore, DVM, PhD. The large colon is divided respectively into left and right and dorsal (upper) and ventral (lower) colons. Splenic flexure syndrome is where gas becomes trapped at the left bend of the colon causing fullness, discomfort and even pain. Generally, transverse colon cancer (TCC) is defined as tumors located between hepatic and splenic flexure[], and is relatively rare, accounting for 10% of all colon cancers[3,4]. For example in biliary colic, which occurs if the stones temporarily obstruct the cystic or common bile duct, patients experience the following signs and symptoms: Intermittent pain in the upper right quadrant or epigastric region. It was a small hooved animal about the size of a dog, and it ate grass. Splenic flexure C. This definition incorporates text from a public domain edition of Gray's. 1 and 3. There are a number of inconsistencies in the description of the bends of the colon down to the anus. Phrenico-colic ligament is a short, double-layered fold of peritoneum that extends laterally, superiorly, and posteriorly from the splenic flexure to blend with the peritoneum lining the inferior surface of the. Which BE projection does not require colic flexures to be included in the image? Lateral projection. After screening of full texts, 33 studies were selected. The "tapered," or "corkscrew," radiographic sign is often seen with. “Many people do assume that after the colic surgery is successfully completed their horse is in the clear,” said Dr. B . Splenic flexure syndrome is where gas becomes trapped at the left bend of the colon causing fullness, discomfort and even pain. There is a nice list in the back of the book "The Handbook of Compliant Mechanisms. 3. cephalic flexure the curve in the mid-brain of the embryo. - pt side down arm at the side and the side up arm on the pillow by head. a. c. The colon in turn can be sectioned into 4 parts which turn at the colic flexures, they are – the ascending colon, then the transverse colon next is the descending colon, and the sigmoid colon. part of the large intestine located between the left and right colic flexures: transverse colon is continuous proximally with the ascending colon at the right colic (hepatic) flexure; it is. Definition of splenic flexure in the Definitions. Bell, R. Moreover, there are six flexures of the mesentery in the gastrointestinal tract. Due to the small capacity, smaller, frequent meals are recommended. The colon is the last part of the guts before the anus (bottom). This chapter includes symptoms, signs, abnormal results of clinical or other investigative. net dictionary. Best answers. “However, during the first 24 to 48 hours after colic surgery, there are. INTRODUCTION. There are three flexures, or U-shaped bends, in the large colon at the sternum, pelvis, and diaphragm. Length: It is about 40-50 cm long. Dehydration is one of the biggest causes of Impaction Colic. To view the redundant S-shaped sigmoid in the AP position, the central ray is directed 30° to 40° cephalad. “However, during the first 24 to 48 hours after colic surgery, there are many factors that have to be closely monitored. This turn is known as the right colic flexure (or hepatic flexure), and marks the start of the transverse colon. For a 5 mm × 5 mm × 10 mm actuator with a stiffness of 131. There must be _____ for current to flow. colic flexure. Therefore, by ensuring that there is no air in the tubing, the risk of instilling air into the colon is avoided. With this in mind, we propose to speak of colic flexures (right colic flexure = RCF = hepatic flexure, flexura coli sinistra; left colic flexure = LCF = splenic flexure, flexura coli dextra; descending-sigmoid flexure = DSF; sigmoid-rectum flexure = SRF) for the colon (colon). However, mesosigmoid is also a mobile structure. (A) 2 only. Which. ascending colon 4. • It starts from the right colic flexure at the right lumbar region and descends down to the umbilical region. Transverse colon. Caudal mesenteric a. Salt aids the body in fluid and temperature regulation. It lies at a higher level than, and on a plane. Rate this question: 13. Mogg, and J. The one on the right, the right colic flexure is also known as the hepatic flexure. The splenic flexure is the bend where the transverse colon and descending colon meet in the upper left part of your abdomen. 13 The Colon Anatomy General Facts Length: approximately 1. The left colonic flexure is also supplied by particular vessels originated from the middle colic and the left colic aa. colic flexure, left the angular junction of the transverse and descending. Tracheotomy is an effective technique used to restore breathing when there is. Chanutin. innermost layer; encircles the lumen of the tract, includes the epithelium; the lamina propria (areolar CT with blood and lymph vessels as well as glands;Moreover, there are too many synonyms, and . decreased. The colic marginal a. 2 kg/m 2. 9 C15. The one on the right, the right colic flexure is also known as the hepatic flexure. Feeding horses small meals often and providing energy through forage can help avoid these issues. Features of colic may include the following: Intense crying that may seem more like screaming or an expression of pain;. 4, 22. net dictionary. Gas is a normal and healthy part of the digestion process. There are a number of inconsistencies in the description of the bends of the colon down to the anus. ) in an attempt to relieve an obstruction by forcing content out. Most horses will have at. The middle colic artery is the most proximal of the colic branches to arise from the superior mesenteric artery (Figure 3). Learn more with this gastroenterology article about large colon displacements in horses written by James N. 1 only. which small bowel series mehtod injects contrast medium through an intestinal tube? True. The junction between the transverse and descending colon is often referred to as the splenic flexure. angles of the right and left colic flexures. The one on the right, the right colic flexure is also known as the hepatic flexure. Owners rank colic as a high priority equine health concern [] and it is a frequent reason for veterinary attendance []. Create flashcards for FREE and quiz yourself with an interactive flipper. There are two colic flexures, or curvatures in the transverse colon. As you can see, the anatomy of the GI tract sets the horse up for potential colic issues. ARTERIES LIGATED : Ileocolic , Right colic artery , Whole middle colic artery. the sigmoid, left colic, and right colic flexures c. It turns downwards as the descending colon, which, like the ascending colon, is retroperitoneal. “We battle many serious endotoxic effects,” continued Dr. It is relatively rare and represent only 1–8% of all colon cancers 2, 3. sharp abdominal spasms or cramping. In the anatomy of the human digestive tract, there are two colic flexures, or curvatures in the transverse colon. It is important to known that trapped gas can occur at both bends of the colon and is therefore referred to as either hepatic flexure syndrome at the right bend or splenic flexure syndrome at the left bend. the sigmoid, right colic, and left colic flexures. True or False. True. The arterial supply to the transverse. 0-C15. The left colic flexure (LCF) and right colic flexure (RCF) are very important endoscopic landmarks used to identify the location of the colonoscope inside the colon. transverse colon 5. - position patient RAO or LPO with midsagittal plane forming an angle of 35 to 40 degrees from the grid device. transverse colon: [TA] the part of the colon between the right and left colic flexures. In the adult horse (500kg) the caecum is about 1 m long and has a capacity of about 30-34 liters. 12. Ten percent is an exceedingly high rate; however, keep in mind that the term “colic” is broadly used to describe various equine stomach ailments. Colic Info . The pontine flexure is located between these two flexures. " Also, there is a way to transform linkages into flexures: the pseudo-rigid body model (PRBM) developed by Larry Howell. c. The one on the right, the right colic flexure is known as the hepatic flexure. anorectal angle. 2. ME EN 7960 – Precision Machine Design – Flexures 12-5 Monolithic Design • May require localized heat treating of the material in the flexure • Applications include flexural couplings, mirror mounts, STM's, and many others • Size is about 20 times the range of motion ME EN 7960 – Precision Machine Design – Flexures 12-6 Clamp DesignAnatomical position. The ascending colon bends abruptly forward and to the left, to the under surface of the right lobe of the liver, on the right of the gall-bladder, where it is lodged in a shallow depression, the colic impression, forming the right colic (hepatic) flexure. Experts say that there are basically two colic flexures in the transverse colon: the right colic flexure—the one that is adjacent to the liver—and the left colic flexure—the one that. The transverse colon including the colic flexures and transverse mesocolon. The flexures are flared out as they enter the brazed joint in a quadrant-type housing, as shown in Fig. Which of the following positions would best demonstrate a double-contrast visualization of the left and right colic flexures? A Left lateral decubitus B AP recumbent C Right lateral decubitus D AP erect. See the full list. Now, it is worth noting that life was not easy for this proto. flexure [flek´sher] a bend or fold. A horse weighing 500kg may take 3400 sweeps and 40 minutes to. 2 and 3. entroclysis. 24. Xu M, et al. 8. Many people do not know that there are several parts of the body that can be possible causes of other illnesses. Figure 3: Venous drainage of the large intestines. Gross anatomy. The hepatic flexure was mobilized in 20%, splenic flexure in 18%, while in 1% of patients both the flexures were mobilized. Colic flexures; Colorectal anatomy (the splenic flexure is labeled at upper right, the hepatic flexure at upper left)Pace CA. left colic flexure. splenic flexure: [ flek´sher ] a bend or fold. Results: Lymphatic drainage at 60 minutes was strongly dominant in the direction of the left colic pedicle (96% of patients), with a median gamma count of 284 (interquartile range, 113-413), versus the left branch of the middle colic count of 31 (interquartile range, 15-49; p < 0. Which of the following is the primary physiological function of the large intestine? water absorption and feces elimination. Rectal examinations are a cornerstone of colic diagnosis, as many large intestinal conditions can be definitively diagnosed by this method alone. Many blood vessels come together at the splenic flexure, so the area is important for blood flow. The transverse colon again takes a right-angled turn just below the spleen (left colic or splenic flexure, which is attached to the diaphragm by the phrenocolic ligament) and becomes the descending (left) colon, which lies vertically in the most lateral left part of the abdominal cavity, occupying the left hypochondrium, left lumbar region,. The one on the right, the right colic flexure is known as the hepatic flexure. There are two colic flexures, or curvatures in the transverse colon. (B) 1 and 2 only. nausea. One of which is the left colic flexure. The right colic artery shows significant anatomical variation; it originates from the superior mesenteric artery in only 10%–15% of patients and more commonly arises from the middle colic artery (Hohenberger et al. hepatic flexure and descending colon. pivot. There are two musculofascial abdominal walls; anterolateral and posterior. The right colic flexure is also known as the hepatic flexure, and the left colic flexure is also known as the splenic flexure. Splenic. constipation. The right colic, or hepatic, flexure unites the ascending and transverse portions, and the transverse and descending parts form the left colic, or splenic, flexure. Colic or cholic ( / ˈkɒlɪk /) [1] is a form of pain that starts and stops abruptly. As the rectum passes in front of the sacrum, it takes a concave shape anteriorly. Left lateral paracolic gutter. Moreover, there are too many synonyms, and . 84. Colic usually peaks around 6 to 8 weeks and then slowly dissipates, disappearing completely around 3 to 4 months of age. The splenic flexure is called that because it’s near your spleen, but sometimes it’s called the left colic flexure because it’s on the left side of your body. b. The atlantoaxial joint between the dens of the axis and the anterior arch of the atlas is a(n) _____ joint. This opening is. The one on the left, the left colic flexure is known as the splenic flexure. Browse Getty Images' premium collection of high-quality, authentic Colic Flexures stock photos, royalty-free images, and pictures. & v. Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified. The left branch forms collaterals with the left colic artery via the marginal artery. but may also occur at the diaphragmatic or sternal flexures, with rotations up to 720 degrees reported. Anteriorly, it usually is in contact with the anterior abdominal wall. ) time for splenic flexure mobilization was 41. 5 m Diameter: ascending colon 7–8cm transverse colon 5 cm descending colon 3–5cm sigmoid colon. The one in front is a shallow colic impression, formed by the hepatic flexure and the one behind is a deeper. 7, and 29. cervical flexure a bend in the neural tube of the embryo at the junction of the brain and spinal cord. ICD-10. Colic usually starts when babies are about 3 weeks old. R10. These spaces have been classified as duodenal recesses. flexures in Fig. This practice is the basis of many digestive issues we see in our equine population. Study with Quizlet and memorize flashcards containing terms like What is the relationship between the midsagittal and midcoronal planes? A Parallel B Perpendicular C 45° D 70°, Aspirated foreign bodies in older children and adults are most likely to lodge in the' A right main bronchus B left main bronchus C esophagus D proximal stomach, Which of the following projections require(s) that the. 1. Anus. A flat and upright abdomen is requested on an acutely ill patient, to demonstrate the presence of air-fluid levels. c. Persistent and inconsolable crying episodes in an otherwise healthy and well-fed infant characterize infantile colic. 1. The large intestine has many changes of direction throughout its length, these are known as ________ and are vulnerable to blockages (colic). What quadrant is the liver located in? How many lobes does the liver have? What organ lies in the duodenal loop? Bile is needed for digestion of _____. Central Ray angulation may be required for. When Does Colic Start? Colic tends to start around 2 to 3 weeks of age. voltage. The angle formed by the two ventral flexures, the cephalic flexure and the cervical flexure together, is a right angle in the ventral direction between the axis of the body and the axis of the brain. at the iliac crest. duodenojejunal junction (Ligament of treitz) A twisting of the intestine on its own mesentery is termed:There are two colic flexures, or curvatures in the transverse colon. Splenic flexure cancer has various lymphatic drainage pathways. Current Flexure. We know we are lead in our ICD 10 manual to code them as part of the transverse colon under the code D12. 1055/b-0034-80024 13 The Colon Anatomy General Facts Length: approximately 1. Much, many, a lot of, lots of : quantifiers - English Grammar Today - a reference to written and spoken English grammar and usage - Cambridge DictionarySome experts believe that colic is the result of an allergy to cow's milk proteins (or lactose intolerance) in formula-fed babies. We searched the PubMed database for studies on the vascular anatomy of the splenic flexure that were published from January 1990 to October 2020. If a horse breaks into a feed room to consume a large amount of grain, contact your. ভিডিও কলে বিশেষজ্ঞ চিকিৎসকের পরামর্শ নিন. Citation, DOI, disclosures and article data. It is the most. A mature horse eats 2-2. Some popular 10-mm long piezoelectric stack actuators used for high-speed nanopositioning stages are shown in Table 1. • It starts from the right colic flexure at the right lumbar region and descends down to the umbilical region. The one on the right, the right colic flexure is known as the hepatic flexure. How many total permanent teeth should an adult have, assuming none have been lost or removed? 32 There are two incisors (2I), one canine (1C), two premolars (2PM) and three molars (3M) for a total of 8 on each side of each jaw. This arrangement entails the food making it round a number of 180 degree bends (known as “flexures”) in the intestine. It is part of the comprehensive lymph system that works to enhance the4. colic flexure; Statements. It was a small hooved animal about the size of a dog, and it ate grass. This is historically based on the fact that anatomists saw the colon in its position in the abdominal cavity down to the pelvis and thus from the “outside” and also described it in this way. “However, during the first 24 to 48 hours after colic surgery, there are many factors that have to be closely monitored. Both colic flexures should be seen in the RAO position radiograph. A pioneering study from Griffith described that the splenic flexure is supplied by terminal branches of the left colic artery in 89% of cases and by the superior mesenteric artery through the middle colic in 11%. the right colic, left colic, and sigmoid flexures d. abdomen. Study Positioning 1 final ch1-3 flashcards. When Does Colic Start? Colic tends to start around 2 to 3 weeks of age. Is hepatic flexure same as splenic flexure? It is the highest point your colon reaches in your body. the ascending and descending limbs of the colic flexures demonstrate some degree of _____ superimposition RAO: the ascending and descending limbs of the right colic flexure are seen with ___________ superimposition when compared to the PA projection Many domesticated horse’s intake is restricted to two meals a day. It ends by dividing into an ascending branch and a descending branch; [1] the terminal branches of the two branches go on to form anastomoses with the middle colic artery , and a sigmoid artery. It’s believed that ten percent of the equine population has contracted colic during its life. Introduction. Below is a list of colic flexures words - that is, words related to colic flexures. (C) 2 and 3 only. The large intestine, also known as the large bowel, is the last part of the gastrointestinal tract and of the digestive system in tetrapods. Kingston. The term "gastro" refers to the:Length of the large intestine? 22 feet; 5 feet. 138. . Here's the ascending colon. See the full list. There was no difference in the incidence of T3/T4 cancers in either group but average nodal harvest was 26 vs. we propose to speak of colic flexures (right. d. 1 Right colic flexure. Impaction colic: The large intestine folds upon itself and. It usually goes away on its own by age 3 to 4 months. Perform AP axial projection with CR 30-40 degrees cephalad. Right dorsal displacement of the colon. 0 references. The proto-horse. both colic flexures should be seen in the RAO position image. The mucosa provides a lubricant, which helps aid in the passage of stool through the colon. Its proximal two-thirds are part of the midgut, whilst the distal third is. This makes it possible for the designer to think of the problem in terms of revolute joints which allows them to use age old design principles with parallelograms and all. left colic flexure 6. Retroflexed views (RVs), attachments, wide‐angle observations, and other tools have therefore been developed to avoid missing blind spots, and there have been many reports on their usefulness. False. The one on the left, the left colic flexure is also known as the splenic flexure. The spleen is an organ located right below the rib cage at the upper left of the. Cecum. The patient must be NPO a minimum of ____ hours before the small bowel series. Where is the urinary bladder located. Infraperitoneal. The right colic a. CR angle and direction for PA Axial. Calcium and phosphorus are the two most important minerals for skeletal development and maintenance. Your colon has two flexures: one on the right side and one on the left. 6. D) length of the sigmoid colon. 5 to 2:1. Figure 5: Schematic of the innervation of the large intestines. Multiply by 4 for a total of 32 adult teeth. K. 0. Cecum, ascending colon, right colic flexure, transverse colon, left colic flexure, descending colon, sigmoid colon, rectum, and anus. What does splenic flexure mean? Information and translations of splenic flexure in the most comprehensive dictionary definitions resource on the web. [2]For better oncological outcomes, extended right hemicolectomy is the preference of many surgeons for a TCC, especially for a right TCC. Subjects. pyloric sphincter. The large colon is divided respectively into left and right and dorsal (upper) and ventral (lower) colons. The diagnosis of this cancer is often late, in an. The large colon of the horse lies on the bottom and somewhat to the left in the abdominal cavity. Large bowel displacement is a fairly common cause of serious colic in horses. Large blind pouch located inferior to. Chanutin. A telescoping, or invagination, of one part of the intestine into another is termed: intussusception. This definition incorporates text from a public domain edition of Gray's. the ascending and descending limbs of the colic flexures demonstrate some degree of _____ superimposition. The large intestine or large bowel is divided into colon and rectum. There have been several flexure designs that have been developed already. The extra movement will mobilize the digestive system. Figure 1: Anatomy of the large intestines, A. Thus, the ileocolic, right colic and middle colic veins accompany the corresponding arteries and drain directly into the superior mesenteric vein, while the left colic and sigmoid veins drain into the inferior mesenteric vein. Rectum. Left colic flexure (or splenic flexure) is the bend in the large intestine in the left upper quadrant of the abdomen as the transverse colon continues as the descending. The central ray is reversed when the patient is PA; that is, the central ray is 30° to 40° caudal with the. All of the tumors were. Located in the lower left abdomen. The one on the right, the right colic flexure is known as the hepatic flexure. Scheduled maintenance: Saturday, September 10 from 11PM to 12AM PDT. 2) The pubic angle is 90 degrees or less in the male. The large intestine comprises the cecum (appendix included), the colon, the rectum and the anal canal. Fatty fish. RAO: the limbs of the left colic flexure demonstrate _____ superimposition and the. The colon has sacculations known as _____. colic flexure, left the angular junction of the transverse and descending colon. Anatomy of the Physical Exam; Chest. d. Belching. In mammals the colon consists of following sections : 1) the ascending colon including the Cecum and Appendix. Windows in Flexures. The cecum is the first part of the large intestine. RAO: the ascending and descending limbs of the right colic flexure are seen with _____ superimposition when compared to the PA projection. Game developer and eternal learner [David Tucker] just posted a project where he’s making linear flexures on a 3D printer. and colic a. ICD-10. This is historically based on the fact that anatomists saw the colon in its position in. In this medical problem, trapped gas builds up in the splenic flexure which is only a location, the area where the transverse colon (which more or less runs "horizontally" in the upper ab from right side of body to left side running below the lowest bilateral rib and the diaphragm) joins the descending colon which is on the left side of the. The phrenicocolic ligament attaches the splenic flexure to the left hemidiaphragm. 7(40. Compare with extended right hemicolectomy, segmental colectomy only includes ligation of the middle colic vessels. 6. After completing its course, the left colic artery divides into its terminal branches; the ascending and descending branch. Caudal mesenteric a. Europe PMC is an archive of life sciences journal literature. Which of the following positions would best demonstrate a double contrast visualization of the left and right colic flexures? 1. “However, during the first 24 to 48 hours after colic surgery, there are many factors that have to be closely monitored. It is noteworthy that the right colic artery is missing in approximately 10% of individuals and that an accessory middle colic artery is present in approximately 1020%. Similar to the right, the left lateral paracolic gutter extends from the left colic (splenic). 829. Hepatic flexure D. Transverse colon. 2, 3 The number of flexures in the LI is usually 9-10, but it may be as high as 19. 8-C15. Colic. The left colic flexure is near the spleen, and hence called the splenic flexure. Cecum B. The length and position of the ascending colon vary greatly; in general, however, the ascending colon lies on the right side and extends approximately 5 cm cranially from the ileocolic orifice to the right colic flexure, where it becomes the. Water is absorbed here and the remaining waste material is stored in the rectum as feces before being removed by defecation. Transverse colon B. 75% of this should be fibre (hay/haylage). 8. In a person’s body, there in lies two flexures associated that are associated with the colon: the. 83) R10. Where and what is the vermiform appendix attached to? Posteromedial Side of the Cecum. The ascending colon bends abruptly forward and to the left, to the under surface of the right lobe of the liver, on the right of the gall-bladder, where it is lodged in a shallow depression, the colic impression, forming the right colic (hepatic) flexure. Circular folds (plicae circulares) = in duodenum and jejunum. Also known as “hepatic flexure,” right colic flexure refers to the junction of the ascending and transverse part of the large bowel that is situated anterior to the lower part of the right kidney and inferior to the right lobe of the liver. 1. 5 m Diameter: ascending colon 7–8cm transverse colon 5 cm descending colon 3–5cm sigmoid colon 3–5cm Significant angles: hepatic flexure (right colic flexure) splenic flexure (left colic flexure) ileocecal valve sigmoid angle Special characteristics: no villi and mucous membrane. Chanutin. part of the large intestine located between the left and right colic flexures: transverse colon is continuous proximally with the ascending colon at the right colic (hepatic) flexure; it is. The _____colic flexure is most superior in the abdomen. The convoluted course of the large. The 2024 edition of ICD-10-CM R10. The pontine flexure is located between these two flexures. This is historically based on the fact that anatomists saw the colon in its position in the abdominal cavity down to the pelvis and thus from the “outside” and also described it in this way. Furthermore, mesorectum assists the attachment of the rectum through. To help separate overlapping loops of. There are many. The one on the left, the left. Soon after its origin it enters the transverse mesocolon, where it. Name the enema tips. Right colic flexure (or hepatic flexure) is used to describe the bend in the colon as the ascending colon continues as the transverse colon. 4. S-shaped. Where is the ascending colon located. After completing its course, the left colic artery divides into its terminal branches; the ascending and descending branch. Figure 4: Lymphatic drainage of the large intestines. Karanjia et al. How many enema tips are there? Three. This entails ligation of ileocolic, right colic, and middle colic artery at their respective origin during extended right hemicolectomy, while for transverse colectomy this would mean ligation of the main trunk of middle colic artery. It is near the liver. d. hepatic flexures and ascending colon 3.