wk 4 8 - anatomy - faecal continence - distal GI

Question 1

number of lateral folds in rectum

Answer 1

3

Question 2

what can be palpated in a female rectal exam

Answer 2

cervix

Question 3

likely area for ascites to collect in females/males

Answer 3

rectouterine pouch (pouch of douglas) 
rectovesical in males

Question 4

3 parts of hip bone

Answer 4

pubic
iisheum
ileum

Question 5

muscle which forms most of pelvic diaphragm (with fascial coverings), name 3 parts

Answer 5

levator ani

puborectalis (most important) (surrounds pubic)
pubococcygeus
iliococcygeus

Question 6

importance of levator ani muscle

Answer 6

prevents organs being pushed inferiorly and fall out (during cough,sneezing)

Question 7

2 nerves supply the levator ani

Answer 7

Pudenal S2,3,4 (keeps guts off floor)

nerve levator ani (s3,4) (branch of sacral plexus)

Question 8

contraction of puborectalis has what effect on rectum

Answer 8

relaxes the anorectal angel, acting as a sphincter and allowing foecal continence

Question 9

internal anal sphincter

Answer 9

thickening of 3 muscle layers of colon

Question 10

external anal sphincter

Answer 10

solid disc of muscle

Question 11

t/f internal anal sphincter is smooth muscle

Answer 11

true

external - skeletal

Question 12

where is internal anal sphincter located in anal canal

Answer 12

superior 2/3

Question 13

t/f contraction of internal inhibits parasympa

Answer 13

true

internal - contracted all the time, relaxes in response to distension of rectal ampulla

Question 14

what stimulates contraction of external anal sphincter

Answer 14

pudendal nerve

Question 15

what controls the structures found in perineum? in pelvis? what separates the 2

Answer 15

perineum - somatic motor and sensory (body wall)

pelvis - sympa,para,visceral afferent (body cavity)

lavter ani - above = pelvis, below = perineum

Question 16

where are parasympa fibres for rectum from

Answer 16

S2-4 (visceral afferents also in S2-4) (hindgut)

Question 17

t/f sympa fibres from T12-L2

Answer 17

true

Question 18

somatic motor from

Answer 18

S2,3,4 (pudenal nerve - keeps guts off the floor)

Question 19

outline parthay of pudendal nerve to external anal sphincter

Answer 19

branch of sacral plexus -S2,3,4 nterior rami
exits pelvis via greater sciatic foramen
enters perineum via lesser sciatic foramen
supplies structures of perineum

Question 20

during labour which muscle is likely to tear

Answer 20

puborectalis

pudendal nerve may also be damaged

Question 21

pectinate line

Answer 21

marks junction between part of embryo which formed GI tract
above = endoderm
below = ectoderm (outer lining of embryo)

Question 22

t/f lesions above pectinate line will be more painful than below

Answer 22

false - feel less localised

Question 23

nerves supplying above pectinate line

Answer 23

autonomic

below = somatic, pudendal

Question 24

t/f lymphatics follow the veins in body

Answer 24

false

follows arteries

Question 25

difference in rectal varices and haemorrhoids

Answer 25

varices - portal hypertension, dilation of veins

haemorrhoids - prolapses of rectl venous plexuses (rapid pressure - constipation, straining, pregnancy)

check blood pressure to differentiate

Question 26

internal or external haemorrhoid - which one would be more painful

Answer 26

external (requires anaesthetic)