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GI > Physiology Of Defecation > Flashcards

Physiology Of Defecation Flashcards

1
Q

Functions of the colon

A

Absorption of water and electrolytes (osmosis)
Excretion of waste (motility)
Production of vitamins/regulation of immune system (microbiome)

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2
Q

Normal colonic transit time

A

24-48 hours

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3
Q

Length of colon in an adult

A

1.5m

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4
Q

What controls passage of stool into caecum from ileum

A

Ileocaecal valve

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5
Q

Parts of colon

A

Caecum
Ascending colon
Transverse colon
Descending colon
Sigmoid colon

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6
Q

What is the name of the bend between ascending and transverse colon

A

Hepatic flexure

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7
Q

Where does majority of absorption of water and electrolytes occur

A

Ascending colon
First part of transverse colon

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8
Q

What is the name of the bend between transverse and descending colon

A

Splenic flexure

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9
Q

Layers of the colonic wall

A

Mucosa
Muscularis mucosae
Submucosa
Muscularis propria
Subserosa
Serosa

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10
Q

histology of colonic mucosa

A

Single layer of columnar epithelium
Goblet cells
Lamina propria- inflammatory cells

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11
Q

Muscularis propria of colon

A

Inner circular muscle (CM)
Auerbach nerve plexus
Longitudinal muscle (LM)

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12
Q

Function of longitudinal muscle in colon muscularis propria

A

Segmental motility

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13
Q

Function of inner circular muscle in colon muscularis propria

A

Mass movement by peristalsis

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14
Q

Which nerve plexus is in the muscularis propria of the colon

A

Auerbach nerve plexus

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15
Q

Haustra

A

saccules in the colon that give it its segmented appearance. Haustral contraction is activated by the presence of chyme and serves to move food slowly to the next haustra, along with mixing the chyme to help with water absorption

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16
Q

Taenia coli

A

three bands of longitudinal smooth muscle on the colon surface

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17
Q

What produces Haustra

A

Longitudinal muscle

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18
Q

Nerve supply to colon

A

Enteric nervous system
Intrinsic
Extrinsic

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19
Q

What are receptors in colon (entry of faeces)

A

Mucosal stretch receptors

20
Q

Extrinsic nervous system

A

Parasympathetic
Sympathetic

21
Q

Intrinsic nervous system of colon

A

Myenteric plexus
Submucosal plexus

22
Q

Which nerve controls defecation

A

Pelvic nerve

23
Q

What stimulates defecation reflex

A

Parasympathetic stimulation

24
Q

Parts of anal sphincter

A

Internal hemorrhoid tissue
Levator ani muscle
Internal anal sphincter
External anal sphincter
External hemorrhoid tissue

25
Q

Pudendal nerve

A

Somatic
Controls external anal sphincter to maintain continence

26
Q

4 phases of defecation

A

Basal
Pre-expulsive
Expulsive
Termination

27
Q

External anal sphincter

A

Circular striated muscle

28
Q

Internal anal sphincter

A

Smooth muscle

29
Q

Levator ani muscle

A

Support anal-rectum
Part of pelvic floor

30
Q

Puborectalis muscle

A

When contracted promotes continence
90 degree angle- bending analysis pathway

31
Q

Basal phase of defecation

A

Colon- segmental contractions (mixing)
Rectum - motor complexes (to keep rectum empty)
Anal sphincter- tonic contraction
Puborectalis- contracted (90 degree anorectal angle)

32
Q

Anorectal angle to maintain continence

A

90 degrees

33
Q

Pre-expulsive phase of defecation

A

Colon- high amplitude propagating contractions
-mass movement of stool 8 times a day
-gastro-colic reflex
Rectum- fills causing distension
-rectal compliance
Anal sphincter- EAS maintains contraction
-reflex relaxation of IAS (RAIR)- for stool sampling
Puborectalis- remains contracted

34
Q

Mass movement of stool per day

A

8 times

35
Q

Stool sampling

A

Reflex relaxation of internal anal sphincter
External anal sphincter maintains contraction
Tests whether stool is solid, liquid, gas

36
Q

Constipation

A

Condition where go to toilet less than 3 times a week

37
Q

Expulsive phase of defecation

A

Rectum contracts
IAS, EAS and PR relaxes
Valsalva manoeuvre/posture aid emptying

38
Q

Sitting posture while defecating

A

Puborectalis muscles chokes rectum to maintain continence

39
Q

Squatting posture when defecating

A

Puborectalis muscle relaxes and straightens pathway to anus

40
Q

Termination phase of defecation

A

Traction loss causes sudden contraction of EAS ( closing reflex)
Valsalva ceases
Change in posture to standing

41
Q

Disorders of defecation - constipation/obstructive defecation

A

Consistency of stool
Bowel motility
Physical blockage to the bowel
Pelvic floor disorders

42
Q

Diagnostic testing for constipation/obstructive defecation

A

Colonic transit study
Defecating proctogram
Anorectal manometry

43
Q

Disorders of defecation - faecal incontinence

A

Consistency of stool or frequency of movements
Diseased bowel mucosa
Reduced rectal capacity
Pelvic floor disorder

44
Q

Diagnostic testing for faecal incontinence

A

Endo-anal ultrasound
Anorectal manometry

45
Q

Anorectal manometry

A

Measures pressure generated by contraction of muscles

GI (12 decks)

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