Anourethral Reflex. Description of a Reflex and Its Clinical Significance: Preliminary Study
Total Page:16
File Type:pdf, Size:1020Kb
Load more
Recommended publications
-
The Anatomy of the Rectum and Anal Canal
BASIC SCIENCE identify the rectosigmoid junction with confidence at operation. The anatomy of the rectum The rectosigmoid junction usually lies approximately 6 cm below the level of the sacral promontory. Approached from the distal and anal canal end, however, as when performing a rigid or flexible sigmoid- oscopy, the rectosigmoid junction is seen to be 14e18 cm from Vishy Mahadevan the anal verge, and 18 cm is usually taken as the measurement for audit purposes. The rectum in the adult measures 10e14 cm in length. Abstract Diseases of the rectum and anal canal, both benign and malignant, Relationship of the peritoneum to the rectum account for a very large part of colorectal surgical practice in the UK. Unlike the transverse colon and sigmoid colon, the rectum lacks This article emphasizes the surgically-relevant aspects of the anatomy a mesentery (Figure 1). The posterior aspect of the rectum is thus of the rectum and anal canal. entirely free of a peritoneal covering. In this respect the rectum resembles the ascending and descending segments of the colon, Keywords Anal cushions; inferior hypogastric plexus; internal and and all of these segments may be therefore be spoken of as external anal sphincters; lymphatic drainage of rectum and anal canal; retroperitoneal. The precise relationship of the peritoneum to the mesorectum; perineum; rectal blood supply rectum is as follows: the upper third of the rectum is covered by peritoneum on its anterior and lateral surfaces; the middle third of the rectum is covered by peritoneum only on its anterior 1 The rectum is the direct continuation of the sigmoid colon and surface while the lower third of the rectum is below the level of commences in front of the body of the third sacral vertebra. -
Fecal Incontinence/Anal Incontinence
Fecal Incontinence/Anal Incontinence What are Fecal incontinence/ Anal Incontinence? Fecal incontinence is inability to control solid or liquid stool. Anal incontinence is the inability to control gas and mucous in addition to the inability to control stool. The symptoms range from mild release of gas to a complete loss of control. It is a common problem affecting 1 out of 13 women under the age of 60 and 1 out of 7 women over the age of 60. Men can also be have this condition. Anal incontinence is a distressing condition that can interfere with the ability to work, do daily activities and enjoy social events. Even though anal incontinence is a common condition, people are uncomfortable discussing this problem with family, friends, or doctors. They often suffer in silence, not knowing that help is available. Normal anatomy The anal sphincters and puborectalis are the primary muscles responsible for continence. There are two sphincters: the internal anal sphincter, and the external anal sphincter. The internal sphincter is responsible for 85% of the resting muscle tone and is involuntary. This means, that you do not have control over this muscle. The external sphincter is responsible for 15% of your muscle tone and is voluntary, meaning you have control over it. Squeezing the puborectalis muscle and external anal sphincter together closes the anal canal. Squeezing these muscles can help prevent leakage. Puborectalis Muscle Internal Sphincter External Sphincter Michigan Bowel Control Program - 1 - Causes There are many causes of anal incontinence. They include: Injury or weakness of the sphincter muscles. Injury or weakening of one of both of the sphincter muscles is the most common cause of anal incontinence. -
ANAL CLEANSING: Lack of Materials Contributes to Disease, Shame, Confusion Questions
ANAL CLEANSING: Lack of materials contributes to disease, shame, confusion Questions Without proper materials for anal cleansing, students desires to wipe and to wash their hands after wiping. and their classmates are at increased risk of acquiring “Sometimes there is feces left on you and your hands diarrheal diseases through hand contamination. The and, say, you have bought doughnuts and shared lack of such materials at schools is a concern. Further- them with someone and then he will eat your dirt… more, latrines can be quickly filled if inadequate mate- and then he is sick and then you feel bad,” said a rials (such as rocks or corncobs) are used by students. grade 7 male from Kamunda. To better understand how anal cleansing can be ef- fectively communicated, SWASH+ researchers wanted Perceived personal risk of disease or illness was men- to know three things: tioned near the end of discussions as a reason to • How do students feel about anal cleansing? clean properly. Cholera was the illness mentioned first, • What materials are best for anal cleansing? and, followed by dysentery, typhoid and nyach (a term for • How much do students know about this area? any STI excluding HIV/AIDS). Emotional factors that motivate students to wipe in- Research clude a desire to avoid shame due to soiled clothing or smelliness. Students also mentioned that ineffective Since 2007, the SWASH+ program has been conduct- cleansing inhibits concentration. “When you smell, you ing research in rural Nyanza Province, Kenya, to assess cannot focus in class,” said a grade 7 female from the impact, sustainability, and scalability of a school- Bunde. -
Vocabulario De Morfoloxía, Anatomía E Citoloxía Veterinaria
Vocabulario de Morfoloxía, anatomía e citoloxía veterinaria (galego-español-inglés) Servizo de Normalización Lingüística Universidade de Santiago de Compostela COLECCIÓN VOCABULARIOS TEMÁTICOS N.º 4 SERVIZO DE NORMALIZACIÓN LINGÜÍSTICA Vocabulario de Morfoloxía, anatomía e citoloxía veterinaria (galego-español-inglés) 2008 UNIVERSIDADE DE SANTIAGO DE COMPOSTELA VOCABULARIO de morfoloxía, anatomía e citoloxía veterinaria : (galego-español- inglés) / coordinador Xusto A. Rodríguez Río, Servizo de Normalización Lingüística ; autores Matilde Lombardero Fernández ... [et al.]. – Santiago de Compostela : Universidade de Santiago de Compostela, Servizo de Publicacións e Intercambio Científico, 2008. – 369 p. ; 21 cm. – (Vocabularios temáticos ; 4). - D.L. C 2458-2008. – ISBN 978-84-9887-018-3 1.Medicina �������������������������������������������������������������������������veterinaria-Diccionarios�������������������������������������������������. 2.Galego (Lingua)-Glosarios, vocabularios, etc. políglotas. I.Lombardero Fernández, Matilde. II.Rodríguez Rio, Xusto A. coord. III. Universidade de Santiago de Compostela. Servizo de Normalización Lingüística, coord. IV.Universidade de Santiago de Compostela. Servizo de Publicacións e Intercambio Científico, ed. V.Serie. 591.4(038)=699=60=20 Coordinador Xusto A. Rodríguez Río (Área de Terminoloxía. Servizo de Normalización Lingüística. Universidade de Santiago de Compostela) Autoras/res Matilde Lombardero Fernández (doutora en Veterinaria e profesora do Departamento de Anatomía e Produción Animal. -
48 Anal Canal
Anal Canal The rectum is a relatively straight continuation of the colon about 12 cm in length. Three internal transverse rectal valves (of Houston) occur in the distal rectum. Infoldings of the submucosa and the inner circular layer of the muscularis externa form these permanent sickle- shaped structures. The valves function in the separation of flatus from the developing fecal mass. The mucosa of the first part of the rectum is similar to that of the colon except that the intestinal glands are slightly longer and the lining epithelium is composed primarily of goblet cells. The distal 2 to 3 cm of the rectum forms the anal canal, which ends at the anus. Immediately proximal to the pectinate line, the intestinal glands become shorter and then disappear. At the pectinate line, the simple columnar intestinal epithelium makes an abrupt transition to noncornified stratified squamous epithelium. After a short transition, the noncornified stratified squamous epithelium becomes continuous with the keratinized stratified squamous epithelium of the skin at the level of the external anal sphincter. Beneath the epithelium of this region are simple tubular apocrine sweat glands, the circumanal glands. Proximal to the pectinate line, the mucosa of the anal canal forms large longitudinal folds called rectal columns (of Morgagni). The distal ends of the rectal columns are united by transverse mucosal folds, the anal valves. The recess above each valve forms a small anal sinus. It is at the level of the anal valves that the muscularis mucosae becomes discontinuous and then disappears. The submucosa of the anal canal contains numerous veins that form a large hemorrhoidal plexus. -
DOCTORAL THESIS Carrying Queerness Queerness, Performance
DOCTORAL THESIS Carrying Queerness Queerness, Performance and the Archive Hunt, Raymond Justin Award date: 2013 General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights. • Users may download and print one copy of any publication from the public portal for the purpose of private study or research. • You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal ? Take down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. Download date: 01. Oct. 2021 Carrying Queerness: Queerness, Performance and the Archive by Raymond Justin Hunt, BA, MA A thesis submitted in partial fulfilment of the requirements for the degree of PhD Department of Drama, Theatre and Performance University of Roehampton 2013 ABSTRACT This dissertation responds to the archival turn in critical theory by examining a relation between queerness, performance and the archive. In it I explore institutional archives and the metaphors of the archive as it operates in the academy, while focusing particularly on the way in which queerness may come to be archived. Throughout I use the analytic of performance. This work builds on and extends from crucial work in Queer studies, Performance Studies and Archival Studies. -
Ano-Vesical Reflex: Role in Inducing Micturition in Paraplegic Patients
Paraplegia 32 (1994) 104-107 © 1994 International Medical Society of Paraplegia Ano-vesical reflex: role in inducing micturition in paraplegic patients A Shafik MD Professor and Chairman, Department of Surgery and Research, Faculty of Medicine, Cairo University, Cairo, Egypt. The reflex relationship between the anal canal and the urinary bladder was investigated in 14 normal volunteers and in seven patients with spinal cord injury of more than 2 years duration. The latter induced urination by dilating the anal canal with the finger. The vesical pressure was measured by a balloon-tipped catheter introduced into the urinary bladder which was filled with 100 ml saline. The anal canal was inflated with a balloon catheter filled with 2 ml air; inflation was increased in increments of 2 ml up to 10 ml. The vesical pressure in response to both slow and rapid anal distension was recorded. The external and internal anal sphincters were blocked separately and the test was repeated. Rapid anal inflation elevated the vesical pressure. The greater the anal inflation, the higher the vesical pressure. Slow anal distension induced insignificant vesical pressure changes (p > 0.05). Rapid anal distension with internal sphincter block induced insignificant vesical pressure changes (p > 0.05) while the vesical pressure showed a significant increase with external sphincter block. In paraplegic subjects, the vesical pressure increased on rapid anal distension with 6 ml air but did not further increase with greater distension. Vesical pressure increase was recorded after external sphincter block but there was an insignificant change after internal sphincter paralysis. The aforementioned results were reproducible. -
Technology Review of Urine-Diverting Dry Toilets (Uddts) Overview of Design, Operation, Management and Costs
Technology Review of Urine-diverting dry toilets (UDDTs) Overview of design, operation, management and costs As a federally owned enterprise, we support the German Government in achieving its objectives in the field of international cooperation for sustainable development. Published by: Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH Registered offices Bonn and Eschborn, Germany T +49 228 44 60-0 (Bonn) T +49 61 96 79-0 (Eschborn) Friedrich-Ebert-Allee 40 53113 Bonn, Germany T +49 228 44 60-0 F +49 228 44 60-17 66 Dag-Hammarskjöld-Weg 1-5 65760 Eschborn, Germany T +49 61 96 79-0 F +49 61 96 79-11 15 E [email protected] I www.giz.de Name of sector project: SV Nachhaltige Sanitärversorgung / Sustainable Sanitation Program Authors: Christian Rieck (GIZ), Dr. Elisabeth von Münch (Ostella), Dr. Heike Hoffmann (AKUT Peru) Editor: Christian Rieck (GIZ) Acknowledgements: We thank all reviewers who have provided substantial inputs namely Chris Buckley, Paul Calvert, Chris Canaday, Linus Dagerskog, Madeleine Fogde, Robert Gensch, Florian Klingel, Elke Müllegger, Charles Niwagaba, Lukas Ulrich, Claudia Wendland and Martina Winker, Trevor Surridge and Anthony Guadagni. We also received useful feedback from David Crosweller, Antoine Delepière, Abdoulaye Fall, Teddy Gounden, Richard Holden, Kamara Innocent, Peter Morgan, Andrea Pain, James Raude, Elmer Sayre, Dorothee Spuhler, Kim Andersson and Moses Wakala. The SuSanA discussion forum was also a source of inspiration: http://forum.susana.org/forum/categories/34-urine-diversion-systems- -
Progress Report Anal Continence
Gut: first published as 10.1136/gut.12.10.844 on 1 October 1971. Downloaded from Gut, 1971, 12, 844-852 Progress report Anal continence Anal continence depends on an adaptable barrier formed at the ano-rectal junction and in the anal canal by a combination of forces. These are due in part to the configuration of the region and in part to the action of muscles. The forces are activated in response to sensory information obtained from the rectum and the anal canal. In order to understand some of the concepts of the mechanism of anal continence, some of the features of the anatomy and physiology of the region will be discussed. Anatomy (Fig. 1) The lumen of the rectum terminates at the pelvic floor and is continued, downwards and posteriorly, as the anal canal, passing through the levator ani muscle sheet and surrounded by the internal and external anal sphincters. The anal canal is 2.5 to 5 cm in length and 3 cm in diameter when distended. The axis of the rectum forms almost a right angle (average 820) with the axis of the anal canal. It has been established by radiological studies that the anal canal is an antero-posterior slit in the resting state.' The former concept of http://gut.bmj.com/ the anal canal being surrounded successively craniocaudally by the internal anal sphincter and then the external anal sphincter has been replaced by the knowledge that the two muscles overlap to a considerable extent with the external sphincter wrapped round the internal sphincter2'3. -
15-1040-Junu Oh-Neuronal.Key
Neuronal Control of the Bladder Seung-June Oh, MD Department of urology, Seoul National University Hospital Seoul National University College of Medicine Contents Relevant end organs and nervous system Reflex pathways Implication in the sacral neuromodulation Urinary bladder ! body: detrusor ! trigone and bladder neck Urethral sphincters B Preprostatic S Smooth M. Sphincter Passive Prostatic S Skeletal M. Sphincter P Prostatic SS P-M Striated Sphincter Membraneous SS Periurethral Striated M. Pubococcygeous Spinal cord ! S2–S4 spinal cord ! primary parasympathetic micturition center ! bladder and distal urethral sphincter ! T11-L2 spinal cord ! sympathetic outflow ! bladder and proximal urethral sphincter Peripheral innervation ! The lower urinary tract is innervated by 3 principal sets of peripheral nerves: ! parasympathetic -pelvic n. ! sympathetic-hypogastric n. ! somatic nervous systems –pudendal n. ! Parasympathetic and sympathetic nervous systems form pelvic plexus at the lateral side of the rectum before reaching bladder and sphincter Sympathetic & parasympathetic systems ! Sympathetic pathways ! originate from the T11-L2 (sympathetic nucleus; intermediolateral column of gray matter) ! inhibiting the bladder body and excite the bladder base and proximal urethral sphincter ! Parasympathetic nerves ! emerge from the S2-4 (parasympathetic nucleus; intermediolateral column of gray matter) ! exciting the bladder and relax the urethra Sacral somatic system !emerge from the S2-4 (Onuf’s nucleus; ventral horn) !form pudendal nerve, providing -
Clinical and Functional Anatomy of the Urethral Sphincter
Review Article International Neurourology Journal Int Neurourol J 2012;16:102-106 http://dx.doi.org/10.5213/inj.2012.16.3.102 pISSN 2093-4777 · eISSN 2093-6931 INJ Clinical and Functional Anatomy of the Urethral Sphincter Junyang Jung, Hyo Kwang Ahn, Youngbuhm Huh Department of Anatomy, Kyung Hee University School of Medicine, Seoul, Korea Continence and micturition involve urethral closure. Especially, insufficient strength of the pelvic floor muscles including the urethral sphincter muscles causes urinary incontinence (UI). Thus, it is most important to understand the main mechanism causing UI and the relationship of UI with the urethral sphincter. Functionally and anatomically, the urethral sphincter is made up of the internal and the external sphincter. We highlight the basic and clinical anatomy of the internal and the external sphinc- ter and their clinical meaning. Understanding these relationships may provide a novel view in identifying the main mechanism causing UI and surgical techniques for UI. Keywords: Urethral sphincters; Pudendal nerve; Autonomic nervous system; Urinary incontinence; Urination INTRODUCTION tomical damage to the ligaments, facial support, and pelvic floor musculature, including the levator ani [8]. The pudendal nerve The urethral sphincter is crucial for the maintenance of urinary innervating the EUS is susceptible to injury during vaginal birth continence [1,2]. The urethral sphincter refers to one of the fol- because it travels between the sacrospinous and sacrotuberous lowing muscles [3]: 1) the internal urethral sphincter (IUS), ligaments [9]. In this article, we discuss the basic and clinical which consists of smooth muscle and is continuous with the anatomy of the urethral sphincter and the relationship between detrusor muscle and under involuntary control, and 2) the ex- the urethral sphincter and UI. -
Sanitation Options
MIT OpenCourseWare http://ocw.mit.edu 11.479J / 1.851J Water and Sanitation Infrastructure in Developing Countries Spring 2007 For information about citing these materials or our Terms of Use, visit: http://ocw.mit.edu/terms. On-site Sanitation Brian Robinson and Susan Murcott Week 12 - MIT 11.479J / 1.851J Water and Sanitation Infrastructure in Developing Countries Mass. Institute of Technology May 8, 2007 On-site Sanitation • Sanitation ladder: options in sanitation • Ecological Sanitation • Case Study: Ecosan in Kenya Improved sanitation • connection to a public sewer • connection to septic system • pour-flush latrine • simple pit latrine • ventilated improved pit latrine The excreta disposal system is considered “adequate” if it is private or shared (but not public) and if it hygienically separates human excreta from human contact. "Not improved“ = service or bucket latrines (where excreta are manually removed), public latrines, latrines with an open pit. Sanitation “Ladder” Technology Hygiene 1. Open defecation, “flying toilet” 2. “Cathole” burial 3. Pit latrine 4. VIP 5. EcoSan 6. Pour-flush 7. Water-sealed toilets + neighborhood wastewater collection 8. Water-sealed toilets + neighborhood wastewater collection + treatment 1. No Poop sanitation *S. Murcott (T.P.) 2. “Cathole” burial Sanitation “Ladder” Technology Hygiene 1. Open defecation, “flying toilet” 2. “Cathole” burial 3. Pit latrine 4. VIP On-site sanitation 5. EcoSan 6. Pour-flush 7. Water-sealed toilets + neighborhood wastewater collection 8. Water-sealed toilets + neighborhood wastewater collection + treatment 3. Pit latrine – with pit Drainage? 3. Pit Latrine, No Pit 4. Ventilated Fly screen improved Air (ventilation) pit latrine (VIP) Vent pipe Seat cover A dry latrine system, with a screened vent pipe Pedestal to trap flies and often Pit collar Cover slab (May be extended to with double pits to base of pit in poor allow use on a ground conditions) permanent rotating basis.