Chetwood  first used the gluteus maximus muscle to support the rectum; further reports were made by Shoemaker , Bistrom , Prochiantz , Hentz , Skef et al. , and Holschneider  (Fig. 31.15). Skef et al. stated that the muscle "normally functions as an accessory muscle of anal continence" . The coccygeal fibers of the gluteus are wrapped around the anal canal with its intact neu-romuscular bundle. The pull is direct and sling-like. Shoemaker  reported that six out of six patients became continent, but there have been only isolated reports since then (Fig. 31.16). Kucukaydin et al. recently presented 5 patients with gluteus maximus transplant who in the follow-up period showed no continence problems.
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This ebook provides an introductory explanation of the workings of the human body, with an effort to draw connections between the body systems and explain their interdependencies. A framework for the book is homeostasis and how the body maintains balance within each system. This is intended as a first introduction to physiology for a college-level course.