Anatomy and Function of the Normal Rectum and Anus

Alexander M. Holschneider, Helga Fritsch, and Philipp Holschneider

Contents

7.1

Introduction . . . 143

7.2

Comparative Anatomy . . . 143

7.3

The Anal Canal . . . 143

7.3.1

Epithelial Lining . . . 144

7.3.1.1

Epithelium Caudal to the Pectinate Line . . . 144

7.3.1.2

Epithelium Cranial to the Valves . . . 144

7.3.2

Sphincter Anatomy . . . 144

7.3.2.1

The Internal Sphincter . . . 144

7.3.2.2

The External Sphincter . . . 144

7.3.2.3

The Pelvic Diaphragm . . . 146

7.3.2.4

The Muscular Diaphragm . . . 146

7.3.2.S

The Suspending Mechanism . . . 146

7.4

The Striated Muscle Complex . . . 147

7.S

The Nerve Supply of the Normal

Rectum and Sphincters . . . 147

7.S.1

Parasympathetic Nerves . . . 147

7.S.2

Sympathetic Nerves . . . 150

7.S.3

Nerves to the Levator Ani Muscles

and the External Sphincter . . . 150

7.6

Rectal and Anal Sensation and Control . . . 150

7.6.1

Intrinsic Sensory Receptors

of the Anal Canal . . . 151

7.6.2

Extrinsic Sensory Receptors . . . 151

7.7

Continence . . . 152

7.7.1

Electric Properties of the Mechanism

of Defecation . . . 152

7.7.2

Pharmacologic Properties of the

Mechanism of Defecation . . . 152

7.7.3

Puborectalis Muscle:

Reflex Contractions . . . 155

7.7.4

Adaptation Reaction . . . 156

7.7.S

Feeling of Fullness . . . 156

7.7.6

The Anorectal Angle . . . 156

7.7.7

Corpus Cavernosum Recti . . . 157

7.7.8

The Rectum . . . 158

7.7.9

Mechanism of Defecation . . . 158

References . . . 159

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