Anal canal Flashcards

1
Q

Where does the anal canal run from and to

A

From the rectal ampulla to the anus

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2
Q

What does the anal canal run between (Anteroposteriorly)

A

Anococcygeal ligament (posterior) and the perineal body (anterior)

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3
Q

What is the anal canal located within

A

The anal triangle of the perineum

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4
Q

Length of the anal canal

A

4cm

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5
Q

What direction does the anal canal follow

A

Posteroinferior

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6
Q

What surrounds the anal canal and what is there function

A

Internal and external anal sphincters

They maintain faecal continence

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7
Q

Which anal sphincters are voluntary and involuntary muscle

A

External is voluntary

Internal is involuntary

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8
Q

Where is the internal anal sphincter

A

Surrounds the upper 2/3 of the anal canal

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9
Q

Where is the external anal sphincter

A

Surrounds the lower 2/3 of the anal canal

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10
Q

What does the external anal sphincter blend with

A

Puborectalis muscle

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11
Q

What must occur to allow defecation

A

Relaxation of both anal sphincters

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12
Q

What is at the anorectal junction

A

Anorectal ring (muscular ring formed by fusion of the internal anal sphincter, external anal sphincter and puborectalis muscle)

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13
Q

What are anal canals

A

Series of longitudinal ridges in the superior aspect of the mucous membrane

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14
Q

What do anal columns contain

A

Terminal branches of the superior rectal vessels

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15
Q

What joins the anal columns inferiorly

A

Anal valves

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16
Q

What’s superior to the anal valves and what do they contain

A

Anal sinuses which contain glands that secrete mucus

17
Q

When do anal sinuses secrete mucus

A

When compressed by faeces to aid defecation

18
Q

What do the anal valves form

A

The pectinate line

19
Q

Embryological origin above and below the pectinate line

A

Above - hindgut

Below - ectoderm of the proctodeum

20
Q

Epithelial lining above and below the pectinate line

A

Above - columnar

Below - non keratinised stratified squamous which transitions to keratinised (I.e skin) at the inter-sphincteric groove

21
Q

How does the anal canal superior to the pectinate line differ from the anal canal inferior to the pectinate line

A

Blood supply
Innervation
Lymphatic drainage
Embryological origin

22
Q

Arterial supply above the pectinate line

A

Aorta -> IMA -> Superior rectal artery

23
Q

Arterial supply below the pectinate line

A

Aorta -> common iliac -> internal iliac -> internal pudendal -> inferior rectal artery

24
Q

What other artery contributes to supply of the anal canal

A

Middle rectal arteries anastomose with the superior and inferior rectal arteries

25
Venous drainage above and below the pectinate line
Above - superior rectal vein which drains into the IMV | Below - inferior rectal vein which drains into the internal pudendal vein
26
Innervation above and below the pectinate line
Above (visceral) - inferior hypogastric plexus | Below (somatic) - inferior anal nerves which are branches of the pudendal nerve
27
Where is pain above the pectinate line referred to
S2-4 dermatomes
28
What is the anal canal sensitive to above and below the pectinate line
Above - stretch | Below - pain, touch, temperature and pressure
29
What does lymph drain into from above and below the pectinate line
Above - internal iliac lymph nodes | Below - superficial inguinal lymph nodes
30
What are haemorrhoids
Vascular cushions found within the anal canal which help with the maintenance of faecal continence
31
What are pathological haemorrhoids
Swollen or distended haemorrhoids
32
Who are pathological haemorrhoids seen in
People who suffer from: Constipation Prolonged straining when defecating Raised intra-abdominal pressure (pregnancy, ascites)
33
Consequences of pathological haemorrhoids
Bleeding and pain on defecation