Anatomy 4 (lecture 6) Flashcards Preview

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Flashcards in Anatomy 4 (lecture 6) Deck (53)
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1

Purpose of the rectum?

To store faeces until it is appropriate to defecate

2

What type of nerves sense "fullness" of the rectum?

Normal visceral afferent nevre fibres

3

What is required to control the excretion of faeces?

A holding area (the rectum)
Normal visceral afferent nerve fibres
Functioning muscle sphincters
normal cerebral function (to control the appropriate time to defecate
(these can all be affected by a neurological pathology e.g. dementia, MS)

4

What factors, apart from neurological pathology, can affect faecal continence?

Medications
Natural age-related degeneration of nerve innervation of muscle
Consistency of stool

5

What does the pelvic cavity lie between?

Pelvic inlet and pelvic floor

6

What muscle forms the pelvic floor?

Levator ani muscle - forms the musculofascial inferior part of the pelvic cavity

7

Why must there be opening in the pelvic floor?

To permit the distal parts of the alimentary, renal and reproductive tracts to pass from the pelvic cavity into the perineum

8

At what vertebrae level does the sigmoid colon become the rectum?
What is this called?

Anterior to S3
The rectosigmoid junction

9

At what anatomical point does the rectum become the anal canal

Anterior to the tip of the coccyx just prior to passing through the elevator anti muscle

10

What is the anus?

The distal end of the anal canal
The orifice through which faeces pass

11

What out of rectum, anal canal and anus are located in the perineum and what are located in the pelvis?

Rectum = pelvis
Anal canal and anus = perineum

12

What is the rectal ampulla?
What do the walls of this do to accommodate faecal matter?

The dilated part of the rectum where faeces are stored until they are eliminated via the anal canal (lies immediately superior to the elevator ani muscle)
Walls can relax to accommodate faecal matter

13

What covers the superior rectum?

Peritoneum

14

What pouch lies anterior to the superior rectum? - in males and females

Rectouterine pouch (in females)
Rectovesical pouch (in males)

15

In males, what lies anterior to the inferior rectum?

The prostate gland

16

In females, what lies anterior to the inferior/ middle rectum?

Vagina and cervix

17

What is the pouch between the uterus and bladder in females?

Vesicouterine pouch

18

What forms the pelvic diaphragm (aka pelvic floor)? - also most of the roof of the perineum

Mostly the elevator ani muscle along with the fascial coverings

19

What are the 3 smaller muscles that makes up the elevator ani muscle?

Iliococcygeus muscle (ileum to coccyx)
Pubococcygeus (pubic bone to coccyx)
Puborectalis (pubic bone to rectum)
Under voluntary control - skeletal muscle

20

What is the purpose of the elevator ani muscle? (3)

Provides continual support for the pelvic organs (tonically contracted most of the time)
Reflexively contracts further during increase in intra-abdominal pressure e.g. coughing, sneezing
Muscle must relax to allow defecation (and urination) to occur

21

What is the elevator ani muscle supplied by?

"Nerve to levator ani"
A branch of the sacral plexus and pudendal (S2, 3, 4)

22

What is the part of the elevator ani muscle that is particularly important for maintaining faecal continence?
Skeletal/ smooth muscle?

The puborectalis
Skeletal

23

What does contraction of the puborectalis do?

Decreases the anorectal angle (acting like a sphincter)

24

What does the puborectalis do when the rectal ampulla is relaxed and filled with faeces?

voluntarily contracts and helps to maintain continence

25

What is the junction at which the anal canal begins?

The anorectal junction

26

How many anal sphincters are there and what type of muscle supplies each?

2
Internal (smooth muscle)
External (skeletal muscle)
Can control external but not internal

27

What parts of the anal canal is the external and internal anal sphincters found in?

Internal = superior two thirds
External = inferior two thirds (superior part of the external sphincter is containers with the puborectalis muscle)

28

What stimulates/ inhibits contraction of the internal anal sphincter?

Stimulated by sympathetic nerve i.e. sphincter is close
Inhibited by parasympathetic nerve

29

What stimulates the external anal sphincters?

Pudendal nerve

30

Describe the state of the internal anal sphincter in terms of contraction?

Contracted all the rime, relaxes in response to distension of the rectal ampulla