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ANA2 > The Rectum > Flashcards

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
Q

Location of the upper lateral curve of the rectum

A

S3-S4

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26
Q

Location of the middle lateral curve of the rectum

A

Sacrococcygeal junction

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27
Q

Location of the lower lateral curve of the rectum

A

Tip of the coccyx

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28
Q

The distance between the anus and the floor of the recto-vesical/uterine pouch is…

A

7.5cm in males, 5.5cm in females.

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29
Q

The lower one-third of the rectum lies below…

A

…the rectovesical pouch in males and the rectouterine pouch in females.

30
Q

The rectouterine pouch is also referred to as…

A

…the pouch of Douglas

31
Q

The anatomical relations of the upper two thirds of the rectum in men

A
  • Rectovesical pouch
  • Coils of intestine
  • Sigmoid colon
32
Q

The anterior anatomical relations of the lower one-third of the rectum in women

A

The lower part of the vagina

33
Q

The anatomical relations of the upper two thirds of the rectum in women

A
  • Rectouterine pouch
  • Coils of intestine
  • Sigmoid colon
34
Q

The anterior anatomical relations of the lower one-third of the rectum in men

A

Prostate

Seminal vesicles

35
Q

In women, the pouch separates the rectum from…

A

…the uterus and the upper part of the vagina.

36
Q

The rectum is located within the pelvic cavity. True or false?

A

True

37
Q

Posterior relations of the rectum in male and female

A
  • Bones
  • Ligament
  • Muscles
  • Vessels
  • Nerves
38
Q

Bones that are posterior relations of the rectum

A

Lower three pieces of the sacrum

The coccyx

39
Q

Ligaments that are posterior relations of the rectum

A

Anococcygeal ligament

40
Q

Muscles that are posterior relations of the rectum

A

Piriformis
Coccygeus
Levator ani

41
Q

Vessels that are posterior relations of the rectum

A

Median sacral
Superior rectal
Lower lateral sacral

42
Q

Nerves that are posterior relations of the rectum

A

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
Q

The mucous membrane of an empty rectum shows…

A

…two types of folds, longitudinal and transverse

44
Q

The longitudinal folds of the rectum are transitory. True or false?

A

True

45
Q

The longitudinal folds present in…

A

…the lower part of an empty rectum

46
Q

The longitudinal folds are obliterated by..

A

…distension.

47
Q

Other names for the transverse mucosal folds of the rectum

A

Horizontal folds, Houston’s valves or Plicae transversales

48
Q

Which of the rectal mucosal folds is permanent and most marked when the rectum is distended?

A

Transverse

49
Q

The upper transverse fold lies…

A

…near the upper end of the rectum, and projects from the right or the left wall.

50
Q

The middle transverse fold lies at…

A

…the upper end of the rectal ampulla, and projects from anterior and right walls. It is the largest and most constant.

51
Q

The lowest transverse fold lies…

A

2.5cm below the middle fold

52
Q

What distinguishes the lower transverse rectal told from the other two?

A

It is inconstant and projects from the left wall. Others project from right or left.

53
Q

Houston’s valves are located along the concavity of the lateral curves. True or false?

A

True

54
Q

How many developmental parts does the rectum have?

A

2

55
Q

What part of the rectum develops from the hindgut?

A

The upper part related to the peritoneum; it lies above the middle fold of the rectum.

56
Q

The lower part of the rectum devoid of peritoneum develops from…

A

…the cloaca. It lies below the middle fold.

57
Q

The rectum is sensitive to distension. True or false?

A

True

58
Q

Blood supply of the rectum

A

Superior rectal artery
Middle rectal artery
Inferior rectal artery

59
Q

The superior rectal artery is the continuation of…

A

…the inferior mesenteric artery at the pelvic brim, medial to the left ureters.

60
Q

The middle rectal arteries arise from…

A

…the anterior division of the internal iliac artery

61
Q

The middle rectal arteries supply…

A

…the muscle coats of the lower part of the rectum.

62
Q

The inferior rectal artery is a branch of…

A

…the internal pudental artery in the perineum

63
Q

The median sacral artery supplies…

A

…the posterior wall of the anorectal junction

64
Q

What are the veins of the rectum?

A

Superior rectal vein
Middle rectal vein
Median sacral vein

65
Q

Lymphatics from more than the upper half of the rectum pass..

A

…along the superior rectal vessels to the inferior mesenteric nodes after passing through the pararectal and sigmoid nodes.

66
Q

Lymphatics from the lower half of the rectum pass…

A

…along the middle rectal vessels to the internal iliac nodes.

67
Q

For nerves, the rectum is supplied by…

A

both sympathetic (L1, L2) - inferior hypogastric plexuses + lumbar splanchnic and

parasympathetic (S2, S3, S4) - pelvic splanchnic nerves and inferior hypogastric

68
Q

Supports of the rectum

A
  • Pelvic floor formed by levator ani muscle
  • Fascia of Waldeyer
  • Lateral ligaments of the rectum
  • Rectovesical fascia of Denonvilliers
  • Pelvic peritoneum
69
Q

Examination of the rectum is done through…

A

Protoscopy
Per rectal exam (PR)
Digital rectal exam

70
Q

Rectocoele

A

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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