anal canal - neurovascular supply and lymphatics

Question 1

what is the arterial supply above the pectineal line?

Answer 1

Superior rectal artery (branch of inferior mesenteric artery)
Anastomosing branches from the middle rectal artery.

Question 2

what is the arterial supply below the pectineal line?

Answer 2

Inferior rectal artery (branch of the internal pudendal artery)
Anastomosing branches from the middle rectal artery.

Question 3

what is the venous drainage above the pectineal line?

Answer 3

Superior rectal vein

Question 4

what is the venous drainage below the pectineal line?

Answer 4

Inferior rectal vein

Question 5

what does the superior rectal vein empty into?

Answer 5

inferior mesenteric vein

Question 6

what does the inferiro rectal vein empty into?

Answer 6

pudendal vein

Question 7

what is the nerve supply above the pectineal line?

Answer 7

Visceral innervation via the inferior hypogastric plexus.

Sensitive to stretch

Question 8

what is the inferior hypogastric plexus sensitive to?

Answer 8

stretch

Question 9

what is the nerve supply below the pectineal line?

Answer 9

Somatic innervation via the inferior anal nerves

Question 10

what is the inferior anal nerves branches of?

Answer 10

pudendal nerve

Question 11

what is the inferior anal nerves sensitive to?

Answer 11

pain, temperature, touch and pressure

Question 12

what is the lymphatic drainage above the pectineal line?

Answer 12

Internal iliac lymph nodes

Question 13

what is the lymphatic drainage below the pectineal line?

Answer 13

Superficial inguinal lymph nodes

Question 14

what are haemorrhoids?

Answer 14

Haemorrhoids are vascular cushions found within the anal canal of healthy individuals

Question 15

what is it called when haemorrhoids become swollen and distended?

Answer 15

they are referred to as pathological haemorrhoids.

Question 16

what is the function of haemorrhoids?

Answer 16

help with the maintenance faecal continence

Question 17

how are pathological haemorrhoids observed in people?

Answer 17

suffer from constipation, prolonged straining when defecating, or raised intra-abdominal pressure (e.g pregnancy, ascites).

Question 18

which position should patients be in upon examination of anal canal?

Answer 18

the patient in the lithotomy position

Question 19

where are haemorrhoids typically located?

Answer 19

typically located at the 3, 7 and 11 o’clock positions

Question 20

what can pathological haemorrhoids cause?

Answer 20

They can cause bleeding and pain on defecation

Question 21

how can pathological haemorrhoids be managed?

Answer 21

managed conservatively or surgically

depending on severity