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The Rectum Flashcards

1
Q

The rectum is…

A

…the most distal segment of the large intestine

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2
Q

The rectum is continuous proximally with ______, and terminates _______.

A

the sigmoid colon, into the anal canal.

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3
Q

Location of the rectum

A

Posterior part of the lesser pelvis, in front of lower three pieces of sacrum and the coccyx

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4
Q

Vertebral location of the rectum

A

It begins at the level of the S3 (as a continuation of the sigmoid colon) & ends by becoming continuous with the anal canal at the anorectal junction.

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5
Q

Macroscopic differences between rectum and colon

A

Absence of tenia coli, haustra, and omental appendices.

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6
Q

Length of the rectum

A

12cm long

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7
Q

Diameter of the rectum

A

4cm in the upper part, same as the sigmoid colon. In the lower part, it is dilated to form the rectal ampulla.

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8
Q

The rectum begins as the continuation of the sigmoid colon on…

A

…the pelvic surface of the third piece of the sacrum.

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9
Q

The rectum first follows the curve of the sacrum and coccyx. True or false?

A

True

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10
Q

Direction of the rectum after curve of sacrum

A

It runs antero-inferiorly to the central perineal tendon lying on the anococcygeal ligament and the parts of the levator ani muscles passing to that ligament.

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11
Q

End direction of the rectum

A

It turns postero-inferiorly as the anal canal, 2-3cm from the tip of the coccyx, and immediately posterior to the central perineal tendon and to the apex of the prostate in the male.

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12
Q

The beginning and the end of the rectum lie in the median plane. True or false?

A

True

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13
Q

Flexure types in the rectum

A

Anteroposterior

Lateral

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14
Q

How many Antero-posterior flexures are in the rectum?

A

Two

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15
Q

What are the anteroposterior flexures of the rectum?

A

The sacral flexure

The perineal flexure

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16
Q

The sacral flexure of the rectum follows…

A

…the concavity of the sacrum and the coccyx. It is dorsal.

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17
Q

The perineal flexure of the rectum is the…

A

…the backward bend at the anorectal junction. It is ventral.

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18
Q

Rectum - Intra or Retroperitoneal?

A

Upper third - intraperitoneally
Middle third - retroperitoneally
Lower third - extraperitoneal

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19
Q

How many lateral flexure are there?

A

3

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20
Q

Lateral flexures correspond to or are formed by…

A

…the transverse rectal folds

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21
Q

Direction of the the upper lateral curve of the rectum.

A

It is convex to the right

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22
Q

Direction of the middle lateral curve

A

It is convex to the left

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23
Q

What is the most prominent lateral rectal fold?

A

The middle

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24
Q

Direction of the lower lateral curve

A

It is convex to the right.

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25
Location of the upper lateral curve of the rectum
S3-S4
26
Location of the middle lateral curve of the rectum
Sacrococcygeal junction
27
Location of the lower lateral curve of the rectum
Tip of the coccyx
28
The distance between the anus and the floor of the recto-vesical/uterine pouch is...
7.5cm in males, 5.5cm in females.
29
The lower one-third of the rectum lies below...
...the rectovesical pouch in males and the rectouterine pouch in females.
30
The rectouterine pouch is also referred to as...
...the pouch of Douglas
31
The anatomical relations of the upper two thirds of the rectum in men
* Rectovesical pouch * Coils of intestine * Sigmoid colon
32
The anterior anatomical relations of the lower one-third of the rectum in women
The lower part of the vagina
33
The anatomical relations of the upper two thirds of the rectum in women
* Rectouterine pouch * Coils of intestine * Sigmoid colon
34
The anterior anatomical relations of the lower one-third of the rectum in men
Prostate | Seminal vesicles
35
In women, the pouch separates the rectum from...
...the uterus and the upper part of the vagina.
36
The rectum is located within the pelvic cavity. True or false?
True
37
Posterior relations of the rectum in male and female
* Bones * Ligament * Muscles * Vessels * Nerves
38
Bones that are posterior relations of the rectum
Lower three pieces of the sacrum | The coccyx
39
Ligaments that are posterior relations of the rectum
Anococcygeal ligament
40
Muscles that are posterior relations of the rectum
Piriformis Coccygeus Levator ani
41
Vessels that are posterior relations of the rectum
Median sacral Superior rectal Lower lateral sacral
42
Nerves that are posterior relations of the rectum
Sacral plexus Sympathetic chain with the ganglion impar Anterior primary rami of S3, S4, S5, Col and the pelvic splanchnic nerves Lymph nodes, lymphatics and fat. SALS
43
The mucous membrane of an empty rectum shows...
...two types of folds, longitudinal and transverse
44
The longitudinal folds of the rectum are transitory. True or false?
True
45
The longitudinal folds present in...
...the lower part of an empty rectum
46
The longitudinal folds are obliterated by..
...distension.
47
Other names for the transverse mucosal folds of the rectum
Horizontal folds, Houston’s valves or Plicae transversales
48
Which of the rectal mucosal folds is permanent and most marked when the rectum is distended?
Transverse
49
The upper transverse fold lies...
...near the upper end of the rectum, and projects from the right or the left wall.
50
The middle transverse fold lies at...
...the upper end of the rectal ampulla, and projects from anterior and right walls. It is the largest and most constant.
51
The lowest transverse fold lies...
2.5cm below the middle fold
52
What distinguishes the lower transverse rectal told from the other two?
It is inconstant and projects from the left wall. Others project from right or left.
53
Houston’s valves are located along the concavity of the lateral curves. True or false?
True
54
How many developmental parts does the rectum have?
2
55
What part of the rectum develops from the hindgut?
The upper part related to the peritoneum; it lies above the middle fold of the rectum.
56
The lower part of the rectum devoid of peritoneum develops from...
...the cloaca. It lies below the middle fold.
57
The rectum is sensitive to distension. True or false?
True
58
Blood supply of the rectum
Superior rectal artery Middle rectal artery Inferior rectal artery
59
The superior rectal artery is the continuation of...
...the inferior mesenteric artery at the pelvic brim, medial to the left ureters.
60
The middle rectal arteries arise from...
...the anterior division of the internal iliac artery
61
The middle rectal arteries supply...
...the muscle coats of the lower part of the rectum.
62
The inferior rectal artery is a branch of...
...the internal pudental artery in the perineum
63
The median sacral artery supplies...
...the posterior wall of the anorectal junction
64
What are the veins of the rectum?
Superior rectal vein Middle rectal vein Median sacral vein
65
Lymphatics from more than the upper half of the rectum pass..
...along the superior rectal vessels to the inferior mesenteric nodes after passing through the pararectal and sigmoid nodes.
66
Lymphatics from the lower half of the rectum pass...
...along the middle rectal vessels to the internal iliac nodes.
67
For nerves, the rectum is supplied by...
both sympathetic (L1, L2) - inferior hypogastric plexuses + lumbar splanchnic and parasympathetic (S2, S3, S4) - pelvic splanchnic nerves and inferior hypogastric
68
Supports of the rectum
- Pelvic floor formed by levator ani muscle - Fascia of Waldeyer - Lateral ligaments of the rectum - Rectovesical fascia of Denonvilliers - Pelvic peritoneum
69
Examination of the rectum is done through...
Protoscopy Per rectal exam (PR) Digital rectal exam
70
Rectocoele
Protrusion of the mucous membrane and submucosa of the rectum outside the anus. Children, mid-aged women and the elderly are affected.

ANA2 (33 decks)

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