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Anal canal | |
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Details | |
Precursor | Hindgut, proctodeum |
Artery | Superior rectal artery (above pectinate line) and inferior rectal artery (below line) |
Vein | Superior rectal vein (above pectinate line) and Inferior rectal vein (below line) |
Nerve | Autonomic inferior hypogastric plexus (above pectinate line) and somatic inferior rectal nerves (below line) |
Lymph | Superficial inguinal lymph node (below pectinate line) and internal iliac lymph nodes (above line) |
Identifiers | |
Latin | canalis analis |
MeSH | D001003 |
TA98 | A05.7.05.001 |
TA2 | 3009 |
FMA | 15703 |
Anatomical terminology |
The anal canal is the part that connects the rectum to the anus, located below the level of the pelvic diaphragm. [1] It is located within the anal triangle of the perineum, between the right and left ischioanal fossa. As the final functional segment of the bowel, it functions to regulate release of excrement by two muscular sphincter complexes. The anus is the aperture at the terminal portion of the anal canal.
In humans, the anal canal is approximately 2.5 to 4 cm (0.98 to 1.57 in) long, from the anorectal junction to the anus. [2] [3] [4] It is directed downwards and backwards. It is surrounded by inner involuntary and outer voluntary sphincters which keep the lumen closed in the form of an anteroposterior slit.
The canal is differentiated from the rectum by a transition along the internal surface from endodermal to skin-like ectodermal tissue.
The anal canal is traditionally divided into two segments, upper and lower, separated by the pectinate line (also known as the dentate line):
The anal verge refers to the distal end of the anal canal, a transitional zone between the epithelium of the anal canal and the perianal skin. It should not be confused with the pectinate line between the upper and lower zones within the anal canal.
The anal gland secretes lymphal discharge and built-up fecal matter from the colon lining. In some animals this gland expungement can be done routinely every 24–36 months to prevent infection and fistula formation.
The external anal sphincter muscle is the voluntary muscle that surrounds and adheres to the anus at the lower margin of the anal canal. This muscle is in a state of tonic contraction, but during defecation, it relaxes to allow the release of feces.
Movement of the feces is also controlled by the involuntarily controlled internal anal sphincter, which is an extension of the circular muscle surrounding the anal canal. It relaxes to expel feces from the rectum and anal canal.
The perineum in placental mammals is the space between the anus and the genitals. The human perineum is between the anus and scrotum in the male or between the anus and vulva in the female. The perineum is the region of the body between the pubic symphysis and the coccyx, including the perineal body and surrounding structures. The perineal raphe is visible and pronounced to varying degrees.
The pudendal nerve is the main nerve of the perineum. It is a mixed nerve and also conveys sympathetic autonomic fibers. It carries sensation from the external genitalia of both sexes and the skin around the anus and perineum, as well as the motor supply to various pelvic muscles, including the male or female external urethral sphincter and the external anal sphincter.
Fecal incontinence (FI), or in some forms, encopresis, is a lack of control over defecation, leading to involuntary loss of bowel contents — including flatus (gas), liquid stool elements and mucus, or solid feces. FI is a sign or a symptom, not a diagnosis. Incontinence can result from different causes and might occur with either constipation or diarrhea. Continence is maintained by several interrelated factors, including the anal sampling mechanism, and incontinence usually results from a deficiency of multiple mechanisms. The most common causes are thought to be immediate or delayed damage from childbirth, complications from prior anorectal surgery, altered bowel habits. An estimated 2.2% of community-dwelling adults are affected. However, reported prevalence figures vary. A prevalence of 8.39% among non-institutionalized U.S adults between 2005 and 2010 has been reported, and among institutionalized elders figures come close to 50%.
The levator ani is a broad, thin muscle group, situated on either side of the pelvis. It is formed from three muscle components: the pubococcygeus, the iliococcygeus, and the puborectalis.
Articles related to anatomy include:
The internal anal sphincter, IAS, or sphincter ani internus is a ring of smooth muscle that surrounds about 2.5–4.0 cm of the anal canal. It is about 5 mm thick, and is formed by an aggregation of the smooth (involuntary) circular muscle fibers of the rectum. It terminates distally about 6 mm from the anal orifice.
The middle rectal artery is an artery in the pelvis that supplies blood to the rectum.
The inferior rectal artery is an artery that supplies blood to the lower third of the anal canal below the pectinate line.
The ischioanal fossa is the fat-filled wedge-shaped space located lateral to the anal canal and inferior to the pelvic diaphragm. It is somewhat prismatic in shape, with its base directed to the surface of the perineum and its apex at the line of meeting of the obturator and anal fasciae.
The rectal venous plexus is the venous plexus surrounding the rectum. It consists of an internal and an external rectal plexus. It is drained by the superior, middle, and inferior rectal veins. It forms a portosystemic (portocaval) anastomosis. This allows rectally administered medications to bypass first pass metabolism.
The superior rectal artery is an artery that descends into the pelvis to supply blood to the rectum.
The inferior rectal nerves usually branch from the pudendal nerve but occasionally arises directly from the sacral plexus; they cross the ischiorectal fossa along with the inferior rectal artery and veins, toward the anal canal and the lower end of the rectum, and is distributed to the sphincter ani externus and to the integument (skin) around the anus.
The anal triangle is the posterior part of the perineum. It contains the anus in mammals.
The pelvic fasciae are the fascia of the pelvis and can be divided into:
The pectinate line is a line which divides the upper two-thirds and lower third of the anal canal. Developmentally, this line represents the hindgut-proctodeum junction.
The following outline is provided as an overview of and topical guide to human anatomy:
The anocutaneous line, also called the Hilton white line or intersphincteric groove, is a boundary in the anal canal.
The rectum is the final straight portion of the large intestine in humans and some other mammals, and the gut in others. The adult human rectum is about 12 centimetres (4.7 in) long, and begins at the rectosigmoid junction at the level of the third sacral vertebra or the sacral promontory depending upon what definition is used. Its diameter is similar to that of the sigmoid colon at its commencement, but it is dilated near its termination, forming the rectal ampulla. It terminates at the level of the anorectal ring or the dentate line, again depending upon which definition is used. In humans, the rectum is followed by the anal canal, which is about 4 centimetres (1.6 in) long, before the gastrointestinal tract terminates at the anal verge. The word rectum comes from the Latin rēctumintestīnum, meaning straight intestine.
In humans, the anus is the external opening of the rectum located inside the intergluteal cleft. Two sphincters control the exit of feces from the body during an act of defecation, which is the primary function of the anus. These are the internal anal sphincter and the external anal sphincter, which are circular muscles that normally maintain constriction of the orifice and which relax as required by normal physiological functioning. The inner sphincter is involuntary and the outer is voluntary. Above the anus is the perineum, which is also located beneath the vulva or scrotum.
Rectal discharge is intermittent or continuous expression of liquid from the anus. Normal rectal mucus is needed for proper excretion of waste. Otherwise, this is closely related to types of fecal incontinence but the term rectal discharge does not necessarily imply degrees of incontinence. Types of fecal incontinence that produce a liquid leakage could be thought of as a type of rectal discharge.