Normal tonic anal sphincter

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About video

The external anal sphincter measures about 8 to 10 cm in length, from its anterior to its posterior extremity, and is about 2. Studies using manometry report a decrease in both resting pressure (based on the tonic activity of the internal anal sphincter) and squeezing pressure (exerted by the phasic activity of the external anal sphincter). 18, 118 pudendal nerve terminal motor latencies are normal in these patients, confirming the absence of a neurogenic lesion. The internal anal sphincter, ias, (or sphincter ani internus) is a ring of smooth muscle that surrounds about 2. 0 cm of the anal canal its inferior border is in contact with, but quite separate from, the external anal sphincter. It is about 5 mm thick, and is formed by an aggregation of the involuntary circular fibers of the rectum. This sphincter system contains three muscular loops that surround the anal canal. The external anal sphincter is innervated by the inferior hemorrhoidal branch of the pudendal nerve. Continuous tonic activity of the external anal sphincter and pelvic floor muscles has been recorded at rest and during sleep, which helps maintain fecal continence. Low spinal anaesthesia has little effect on anal canal resting pressure, suggesting that there is negligible tonic parasympathetic discharge to the internal anal sphincter. 5 we are not aware of any convincing data that enable malouf and kamm to make the unreferenced statement that there is normal extrinsic parasympathetic excitatory sic drive to the internal anal sphincter. Dual-sphincter disease is implicated when both resting and squeeze pressures are abnormal, and neither finding is absolutely specific in an individual patient. Pudendal nerve terminal motor latency can be determined from the time taken for a digitally delivered pudendal nerve stimulus to elicit anal sphincter contraction. The internal anal sphincter is in a state of tonic contraction as the rectum distends, to a certain volume, there is reflex relaxation of the internal anal sphincter and followed by a contraction of the external anal sphincter.

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