ANATOMY OF RECTUM AND ANAL CANAL

ANATOMY OF RECTUM AND ANAL CANAL

Structural Components

1. Rectum: the terminal part of the large intestine, about 12 cm long and 6 cm in diameter
2. Anal canal: 4 cm long and 3.5 cm in diameter
3. Pectinate line (dentate line): demarcation between rectum and anal canal
4. Anal valves: 3-5 pairs of longitudinal folds in the anal canal
5. Anal columns: small mucosal projections between anal valves
6. Crypts of Lieberkühn: glandular structures in the rectal mucosa

Vascular Supply

1. Superior rectal artery: branches from the inferior mesenteric artery
2. Middle rectal artery: branches from the internal iliac artery
3. Inferior rectal artery: branches from the internal iliac artery
4. Anorectal venous plexus: drains into the inferior rectal veins and internal iliac veins

Lymphatic Drainage

1. Superior rectal lymph nodes: in the mesorectum
2. Middle rectal lymph nodes: in the pelvic fascia
3. Inferior rectal lymph nodes: in the ischiorectal fossa

Anatomical Relations

1. Rectum: posterior to the sacrum and coccyx
2. Anal canal: anterior to the coccyx and perineal body
3. Inferior rectal vessels: pass through the ischiorectal fossa
4. Anal sphincters: external and internal sphincters

Methods of Rectal Examination

1. Digital rectal examination (DRE)
2. Proctoscopy
3. Anoscopy
4. Rectal endoscopy

Digital Rectal Examination (DRE)

1. The examiner inserts a gloved finger into the rectum
2. The rectal wall and anal sphincters are palpated
3. The examination is useful for detecting rectal tumors, foreign bodies, and anal fissures

Proctoscopy

1. A proctoscope is inserted into the rectum
2. The rectal mucosa is visualized using a light source
3. The examination is useful for detecting rectal tumors, hemorrhoids, and anal fissures

Anoscopy

1. An anoscope is inserted into the anal canal
2. The anal canal and rectal mucosa are visualized using a light source
3. The examination is useful for detecting anal fissures, hemorrhoids, and rectal tumors

Proctoscopic Examination of Rectum and Anal Canal

1. The patient is prepared with enemas and sedation
2. The proctoscope is inserted into the rectum
3. The rectal mucosa is visualized and biopsied if necessary
4. The examination is useful for detecting rectal tumors, hemorrhoids, and anal fissures

Indications and Contraindications of Proctoscopy

1. Indications: rectal bleeding, anorectal pain, rectal tumor
2. Contraindications: rectal stricture, rectal fistula, anal fissure

Homoeopathic Therapeutics for Common Ano-rectal Conditions

1. Haemorrhoids: Aesculus, Collinsonia, Hamamelis
2. Anal fissures: Calendula, Lachesis, Ratanhia
3. Rectal prolapse: Aloe, Calcarea, Graphites
4. Rectal tumors: Calcarea, Causticum, Phosphorus