ANATOMY RECTUM &ANAL

CANAL
Length-12

cm

ANATOMY/CURVATURES
Lateral

curvatures-3
A P curves-2

INTERIOR OF RECTUM
HOUSTON VALVES
1ST-S3vertebra,lt / rt
2nd-(lt)
3rd-most imp & constant
(rt)S5 vertebra
4th-(lt)
Functions
Support wt of faeces

RELATIONS OF RECTUM
Peritoneal
Ant/post/lat

Post relations

Artery supply
SRA-rt-ant

lt
MRAIRAOTHERS-

& post

VENOUS DRAINAGE
importance

Lymphatic drainage

NERVE SUPPLY
SYMP-sup

hypogastric
plexus(L1,L2)
Parasymp-pelvic
splanchnic n.

Anal canal anatomy

Anatomical-

dentate line-anal verge

Surgical-

anorectal jn-anal verge

Anorectal ring
-puborectalis
-deep ext
sphincter
-conj long
muscle
-int
sphincter
Helps for continence
Anorectal angle (80-90
degrees) between rectum
and anal canal (maintained
by continuous tonic activity
of the puborectalis muscle)

muscles

PUBORECTALIS -continence

-supplied by somatic nerves

-funct ii ext anal shincters
Ext anal sphincters-vol muscle
-supplied by pudendal n.
-deep,sup,subcut
Int anal sphincters-invol muscle
-supplied by autonomic n
Long muscle-

Int structure
Dentate

line
White line of hiltons
Column of morgagni
Anal valve
Anal sinus

Importance of dentate line

Development-upper>endodermal cloaca
-lower>ecto proctodeum
Artery-upper>sup rectal art
-lower>inf rectal art
Venous-upper>sup rectal vein
-lower>inf rectal vein
Lymph-upper>int iliac
lower>sup inguinal nodes
Nerve-upper>autonomic
-lower>somatic

HILTONS LINE
Represented

by anal intersphincteric groove

At the lower end of int sphincter m.
Bluish pink area above &black skin below

Physiology of continence

Resting Tone
depends on INTERNALSPHINCTER
High pressure zone prevents stool
leakage (like LES for reflux)
Squeeze pressure (when stool presents distally)
contraction of EXTERNAL SPHINCTER +
PUBORECTALIS
prevents stool from leaking out of vault
once in the proximal anal canal