Surgery I, II - lecture

Anatomy and fysiology of anorectum

-          the rectum with the anal canal forms the last section of the colon. It is located in the small pelvis. It is 12-16 cm long and about 4 cm wide. The filled rectum is triple-laterally curved (anteroposterior view), and double-axial curved anteroposteriorly (lateral view). The lateral curvature is due to a sharper carving on the right side of the rectum. In the middle of its length, at the point of the Kohlrausch's fold, at the base of which is the thickened circular muscle, against this carving the rectum curves to the left, above and below it to the right

Anteroposterior double curvature:

  1. flexura sacralis – in the cranial three-quarters of the length of the rectum parallel to the curvature of the sacrum and the skeleton (convexity backwards);
  2. flexura perinealis – at the beginning, the last fifth to a quarter of the length, bending the rectum at and below the tip of the coccyx backwards towards the anal opening (rectum convexity forward);

Two main parts:

  1. ampulla recti (rectum in a narrower sense) - cranial part, length 10-12 cm, in the range of flexura sacralis, perineal flexure passes into:
  2. canalis analis – length 2.5-3.8 cm, narrower, differs in the longitudinal orientation of the mucosal folds.


Vascular supply

Ø   a. mesenterica inferior

Ø  a. rectalis superior

Ø  a. haemorrhoidales

Ø  v. mesenterica inferior➡️ v.portae

Ø  v. rectalis➡️  v.portae i VCI

  

Muscles of pelvic floor

Ø  levator ani

Ø  m. coccygeus

Ø  m. Piriformis

Ø  fascia perinea profunda

Ø  m. transversus perinei superf.

Ø  m. ischiocavernosus

Ø  m. sphincter ani externus



Frank H. Netter, Netterův anatomický atlas člověka. 2005


For more detailed information see anatomy and histology, physiology, review the defecation reflex.