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Gastrointestinal > Faecal Continence > Flashcards

Faecal Continence Flashcards

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1
Q

requirements for control of excretion of faeces

A

a holding area
normal visceral afferent nerve fibres
functioning muscle sphincters
normal cerebral function

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2
Q

describe the holding area for control of excretion of faeces

A

the rectum;

stores faeces until appropriate to defecate

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3
Q

describe the normal visceral afferent nerve fibres for control of excretion of faeces

A

senses fullness of the rectum

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4
Q

describe the functioning muscle sphincters for control of excretion of faeces

A

respond to fullness of the rectum;
appropriately contract, preventing defecation
relax, allowing defecation

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5
Q

describe normal cerebral function for control of excretion of faeces

A

controls appropriate time t defecate

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6
Q

what can affect normal excretion of faeces

A

neurological pathology
medications
degeneration of nerve innervation of muscle (age-related)
consistency of stool (diarrhoea)

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7
Q

neurological pathology affecting normal excretion of faeces

A

dementia
stroke
MS
trauma (spina cord injury)

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8
Q

where is pelvic cavity located

A

within boy pelvis
continuous with abdominal cavity
between pelvic inlet and pelvic floor

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9
Q

what does pelvic cavity contain

A

pelvic organs and supporting tissues

rectum

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10
Q

what do openings in the pelvic floor permit

A

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

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11
Q

where does sigmoid colon become rectum

A

anterior to S3;

rectosigmoid junction

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12
Q

where does rectum become anal canal

A

anterior to tip of coccyx prior to passing through pelvic floor

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13
Q

where is anus located

A

distal end of anal canal

in the perineum

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14
Q

describe the anus

A

the orifice through which faeces pass

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15
Q

where is rectum located

A

in the pelvic

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16
Q

where is anal canal located

A

in the perineum

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17
Q

where does rectal ampulla lie

A

immediately superior to elevator ani muscle

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18
Q

role of the rectum

A

walls can relax - accommodating faecal material

functioning muscles and muscle sphincters required to hold faeces in ampulla until appropriate to defecate

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19
Q

what part of the rectum does the peritoneum cover

A

superior rectum

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20
Q

pouches of peritoneum

A

rectouterine (pouch of Douglas)

rectovesical

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21
Q

anatomical relationship between pouches of peritoneum and rectum

A

pouches lie anterior to superior rectum

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22
Q

anatomical relationship between prostate gland and rectum

A

prostate gland anterior to inferior rectum

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23
Q

anatomical relationship between vagina and cervix and rectum

A

vagina and cervix anterior to inferior/middle rectum

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24
Q

proper name for pelvic floor muscles

A

lavator ani msucles

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25
what do pelvic floor muscles form
forms most of pelvic diaphragm - floor of pelvis and roof of perineum together with fascial coverings
26
what is the pelvic floor made up of
a number of small skeletal muscles; iliococcygeus pubococcygeus puborectalis
27
function of pelvic floor
provides continual support for pelvic organs - tonically contracted most of time
28
further contraction of pelvic floor
increases during an increase in intra-abdominal pressure (e.g. coughing, sneezing)
29
relaxation of pelvic floor
allows defecation and urination
30
nerve supply of pelvic floor
the nerve to levator ani | pudendal
31
describe the nerve of levator ani
branch of sacral plexus
32
describe the pudendal nerve
from S2, 3, 4
33
what is the puborectalis
part of levator ani muscle | skeletal muscle
34
role of puborectalis
maintains faecal continence
35
contraction of puborectalis
decreases anorectal angle- acting like a sphincter | helps maintain continence
36
describe the anal sphincters
2; internal - smooth muscle external - skeletal muscle
37
where is internal anal sphincter located
superior 2/3 of anal canal
38
how is contraction stimulated in internal anal sphincter
sympathetic nerves
39
how is contraction inhibited in internal anal sphincter
parasympathetic nerves - in response to distension of rectal ampulla
40
where is external anal canal sphincter located
inferior 2/3 of anal canal | superior part of sphincter continuous with puborectalis muscle
41
how is contraction stimulated in external anal sphincter
pudendal nerve - in repose to rectal ampulla distension and internal sphincter relaxation
42
where do sympathetic nerve fibres of rectum/anal canal leave the spinal cord
T12-L2
43
course of sympathetic nerve fibres of rectum/anal canal
synapse at inferior mesenteric ganglia | reach rectum via periarterial plexuses around branches of IMA
44
where do visceral afferents of rectum/anal canal leave spinal cord
S2-S4
45
visceral afferents of rectum/anal canal
run with parasympathetics | sense stretch
46
where do parasympathetic nerve fibres of rectum/anal canal leave spinal cord
S2-S4
47
course of parasympathetic nerve fibres of rectum/anal canal
leave spinal cord via splanchnic nerves | synapse in walls of rectum
48
function of parasympathetic nerve fibres of rectum/anal canal
inhibits internal anal sphincter | stimulates peristalsis
49
somatic motor nerve of rectum/anal canal
come from pudendal nerve (S2-S4) and nerve to levator ani (S3-S4)
50
function of somatic motor nerve of rectum/anal canal
contraction of external anal sphincter and puborectalis
51
what is the pudendal nerve a branch of
branch of sacral plexus | S2, S3, S4 anterior rami
52
what does the pudendal nerve supply
supplies external anal sphincter
53
how does pudendal nerve exit pelvis
via greater sciatic foramen
54
how does pudendal nerve enter perineum
via lesser sciatic foramen
55
branches of pudendal nerve
branches to supply structures of perineum
56
how can pudendal nerve/sphincter be damaged
during labour; stretched torn - weakened muscles can cause faecal incontinence
57
what is the pectinate line
marks the junction between the part of the embryo which formed the GI tract (endoderm) and part that formed the skin (ectoderm)
58
arterial supply superior to pectinate line
from inferior mesenteric artery
59
venous drainage superior to pectinate line
to portal venous system (IMV)
60
nerve supply superior to pectinate line
autonomic
61
lymphatic drainage superior to pectinate line
inferior mesenteric nodes (internal iliac nodes)
62
arterial supply inferior to pectinate line
from internal iliac artery
63
venous drainage inferior to pectinate line
to systemic venous system (internal iliac)
64
nerve supply inferior to pectinate line
somatic | pudendal
65
lymphatic drainage inferior to pectinate line
superficial inguinal nodes
66
describe the lymphatics of the pelvis
lie alongside the arteries
67
what do internal iliac lymph nodes drain
inferior pelvic structures
68
what do external iliac lymph nodes drain
lower limb | superior pelvic structures
69
what do common iliac lymph nodes drain
lymph from external and internal iliac nodes then onto lumbar nodes
70
arterial supply of rectum and anal canal
internal iliac artery - degree of anastomoses
71
how do rectal varies form
in relation to portal hypertension | dilation of collateral veins between portal and systemic venous system
72
what are haemorrhoids
prolapses of rectal venous plexuses
73
how do haemorrhoids form
raised pressure (e.g. chronic constipation, training, pregnancy)
74
where are ischionanal fossae found
lie on each side of anal canal (left and right)
75
what are ischioanal fossae filled with
fat and loose connective tissue
76
how do the 2 ischionanal fossae communicate with each other
posteriorly
77
infeciton within ischioanal fossa
ischioanal abscess

Gastrointestinal (71 decks)

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