RECTUM

Features ofLarge Intestine

1) Taenia Coli
2) Sacculation Not present in Rectum & Anal Canal.
3) Appendices Epiploicae

in
+

front of 3 sacral vertebrae

->
12 cm
long
Diameters In upper part -
4cm
Most dialated
*
part -

Ampulla
Direction
Upper 1/3: Downwards & Backwards
Middle Vertically downward
Lower 13. Downward & Forward

Saggital Section

:
=-- -
-

*
↑
C3 Y -
-
R
e ctovesicular

-
Pouch

Rituch
53

>
Anacoccygeal Raphe
Rectovesicular Fascia (Fascia ofDenonvilliers) Value ofHouston

Value ofHouston

CURVATURES
Anteroposterior Curvature Lateral Curvatures
Value ofHouston
1 2

AnalAnal
Columns
Sinus

Dentalhe
·

Sacral Curvature

dusorectalists,
Pecten

I
aut
due to concavity of
White Line

Sacrum & Coccyx At 33-Sy

*
Upper lateral curvature

>Middle lateral curvature

At
Sacrococcygeal joint
Perinealcurateene Ayralayera'

R L
PERITONEAL RELATIONS
PERITONEAL COVERING

tr.
WIII -

Upper -> Anteriorly& on sides also

Middle
->Anteriorly

"cower y -> No peritoneum

VISCERAL RELATIONS

ANTERIOR RELATIONS

In Male In Females
Upper Part -
Rectovesicular Pouch -

Rectouterine Pouch
with coils ofjejunum Coils
-

ofjejunum
-
Heum -
Heum
·

Sigmoid Colon -

Sigmoid Colon

Lower Part -
Base ofbladder
-

Lower part ofVagina

Terminal Wreter
Rectovaginal fascia
-
-

Seminal Vesicles
-

Ampulla ofVas deferen

~
Prostrate land
-

Rectovesicular Fascia
ofDenonvilliers

POSTERIOR RELATIONS -
both of & I

>Median Sacral Artery 1)Lower 3 Sacral Vertebrae

·asI
2) Coccyx
3)
Piriformis
4) Coccygeus
am an anin ani

6) Sympathetic chain
7)
langlion impar
8) Median Sacral Vessels
9) Superior Rectal & (only front of
in 53)
10) FASCIA OFWALDEYER

>langlion impar
<
 INTERIOR OF RECTUM
Mucosal Folds

I I

TEMPORARY PERMANENT
CHOUSTON's VALVE)
Longitudinal folds visible

dialated rectur
in
AtReato-Sigmoidal junction

(
↑

Ist Transverse Fold

lateral curvature
. IVO Fold Opposite
to
Right

X
-
Ind Transverse Fold
"
III -
- -

=>
-
-
IVth Fold -

in
-
c
- t
And Transverse Fold"
IIa Fold A
*

Largest& mostconstant ~Ith Transverse Fold

TRANSVERSESECTION ↓
to Lower lateral curvature
·
Opposite to Middle lateral Opposite
curvature

ARTERIAL SUPPLY
Median Sacral A

SBA

Mesentric A
·
Superior Rectal Artery -

Inferior EIA

·
Middle Rectal Artery -

Anterior division ofInternal Gliac Artery Ire

·

Inferior Rectal Artery -

Internal Pudendal
·
Median Sacral Artery -

Aorta IRA

-evable
IMA

> Chief ofRetur

Muscles in upper part
Entire mucous membrane

-
94A

superficia

Pelvic
Diaphragm
L

= -
-
- =

⑳
IRA -
· Pudendal Canal

Internal Pudendal

VENOUS DRAINAGE

m
b.V"
External
m

Venous Plexus
->

->
·IRV
noriore
Internal Pudendal Vein
Caval System
 LYMPHATIC DRAINAGE

Upper 12. Inferior Mesentric nodes

Lower >
Internal Iliac Nodes

SUPPORTS
1)PELVIC DIAPHRAGM -
Puborectalis muscle
a) Fascia ofWALDEYER
> SRA & SRV

[mta Nodes"
"

3) Lateral
ligamentofRectum - Made
of Condensation ofPelvic Fascia

this
> -
MRA
& MRV are
reaching return
through ligament.

4) Retrovesicular fascia of Denonvilliers

5) Fat in Aschiorectal fossa
6) Perineal Body

CLINICAL
RECTAL PROLAPSE
1) Incomplete Prolapse (Mucous Prolapse)
Rectal mucosa
protude through Anus.
-

d't straining during defecation

excessive

2)
Complete Prolapse (Procidential
Rectal mucosa
protude through Anus.
to
-

d't damage primary supports