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STRUCTURE OF RECTUM

(latin rectus-straight)

Sigmoid to anal canal

Lies against lower 3 sacral vertebrae & coccyx, median

sacral vessels

Inferior sympathetic trunk & sacral plexus

FUNCTION OF RECTUM

The rectum intestinum acts as a temporary storage site for feces. As the
rectal walls expand due to the materials filling it from within, stretch
receptors from thenervous system located in the rectal walls stimulate the
desire todefecate. If the urge is not acted upon, the material in the rectum
is often returned to thecolon where more water is absorbed. If defecation is
delayed for a prolonged period,constipationand hardened feces results.

When the rectum becomes full, the increase in intrarectal pressure forces
the walls of theanal canalapart, allowing the fecal matter to enter the
canal. The rectum shortens as material is forced into the anal canal
andperistaltic wavespropel the feces out of the rectum. The internal and
externalsphincter allow the feces to be passed by muscles pulling the anus
up over the exiting feces.

INNERVATION OF RECTUM

Emptying of the rectum is analogous to emptying of the

bladder in many respects

Filling of the rectum activates stretch receptors in the rectal

wall, which transmit impulses by the way of the inferior
hypogastric plexus to segments S2 through S4 of the sacral
spinal cord.

Afferent impulses then ascend the spinal cord to higher

control centers, which are probably located in the pintine
reticular formation and the cerebral cortex.

Rectal peristalsis is induced parasympathetic activation

from segments S2 through S4, which also induces
relaxation of internal sphincter.

The sympathetic nervous system inhibits peristalsis.

The external sphincter consists of striated muscle and is

under voluntary control

Rectal emptying is mainly accomplished voluntarily by

abdominal pressing

Below pelvic pain line

Sympathetic lumbar spinal cord via lumbar splanchnic

nerves

Parasympathetic S2- S4 spinal cord level via pelvic

splanchnic veins

Pain afferents through parasympathetic to S2 S4

RECTAL DISORDERS

Fecal Retention: Transection of the spinal cord above the

lumbosacral centers for defecation leads to fecal retention.
Interruption of the afferent arm of those reflex pathway fro
defecation deprives higher centers of information about the
filling state of the rectum, while interruption of descending
motor fibres impairs voluntary abdominal pressing.
Sphincter closure is often inadequate because of spastic
weakness

Fecal Incontinence: Lesions of the sacral spinal cord (S2-S4)

abolish the anal reflex and produce fecal incontinence. If the
stool is watery, involuntary loss of stool occurs.