rectum

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"Rectal" redirects here. For the route of administration, see Rectal (medicine).

For the conic sections see Latus rectum or Semi-latus rectum

Rectum
Anatomy of the anus and rectum
Posterior aspect of rectum exposed by removing lower part of sacrum and coccyx
Gray's	subject #249 1183
Artery	superior rectal artery (first two-thirds of rectum), middle rectal artery (last third of rectum)
Vein	superior rectal veins, middle rectal veins
Nerve	inferior anal nerves, inferior mesenteric ganglia[1]
Lymph	inferior mesenteric lymph nodes, pararectal lymph nodes, internal iliac lymph nodes, Deep inguinal lymph nodes
Precursor	Hindgut
MeSH	Rectum

The rectum (from the Latin rectum intestinum, meaning straight intestine) is the final straight portion of the large intestine in some mammals, and the gut in others, terminating in the anus. The human rectum is about 12 centimetres (4.7 in) long.^[2] Its caliber is similar to that of the sigmoid colon at its commencement, but it is dilated near its termination, forming the rectal ampulla.

Role in human defecation

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 the nervous system located in the rectal walls stimulate the desire to defecate. If the urge is not acted upon, the material in the rectum is often returned to the colon where more water is absorbed. If defecation is delayed for a prolonged period, constipation and hardened feces results.^{[citation needed]}

When the rectum becomes full, the increase in intrarectal pressure forces the walls of the anal canal apart, allowing the fecal matter to enter the canal. The rectum shortens as material is forced into the anal canal and peristaltic waves propel the feces out of the rectum. The internal and external sphincter allow the feces to be passed by muscles pulling the anus up over the exiting feces.

Supports of rectum

• Pelvic floor formed by levator ani muscles.
• Fascia of Waldeyer
• Lateral ligaments of rectum which are formed by the condensation of pelvic fascia
• Rectovesical fascia of Denonvillers, which extends from rectum behind to the seminal vesicles and prostate in front.
• Pelvic peritoneum
• Perineal body

Medical procedures

For the diagnosis of certain ailments, a rectal exam may be done.

Suppositories may be inserted into the rectum as a route of administration for medicine.

The endoscopic procedures colonoscopy and sigmoidoscopy are performed to diagnose diseases such as cancer.

Digital Rectal Stimulation, the insertion of one finger into the rectum, is used to induce peristalsis in patients whose own peristaltic reflex is inadequate to fully empty the rectum.

Manual Evacuation is the use of a gloved finger to evacuate faeces from the rectum, and is utilised primarily in acute constipation and also the long-term management of neurogenic bowel, seen most frequently in people with a spinal cord injury or multiple sclerosis.

Rectum

Temperature taking

related article: rectal thermometry

Body temperature can also be taken in the rectum. Rectal temperature can be taken by inserting a medical thermometer not more than 25 mm (1 inch) into the rectum via the anus. A mercury thermometer should be inserted for 3 to 5 minutes; a digital thermometer should remain inserted until it beeps. Due to recent concerns related to mercury poisoning, the use of mercury thermometers is outlawed.^[where?] Normal rectal temperature generally ranges from 36 to 38 °C (97.6 to 100.4 °F) and is about 0.5 °C (1 °F) above oral (mouth) temperature and about 1 °C (2 °F) above axilla (armpit) temperature.^{[citation needed]}

Pediatricians recommend that parents take infants' and toddlers' temperature in the rectum for two reasons:

1. Rectal temperature is the closest to core body temperature and in young children, accuracy is critical.
2. Younger children are unable to cooperate when having their temperature taken by mouth (oral), which is recommended for children ages 6 and above as well as adults.

In recent years, the introduction of tympanic (ear) thermometers and changing attitudes on privacy and modesty have led some parents and doctors to discontinue taking rectal temperatures.^{[citation needed]}

Sexual stimulation

Due to the proximity of the anterior wall of the rectum to the vagina in females or to the prostate in males and the shared nerves thereof, rectal stimulation or penetration can result in sexual arousal. For further information on this aspect, see anal sex.

Additional images

Median sagittal section of male pelvis, showing arrangement of fasciæ   Arteries of the pelvis   Median sagittal section of male pelvis   Median sagittal section of female pelvis   Sagittal section of the lower part of a female trunk, right segment   Blood vessels of the rectum and anus   Organs of the female reproductive system   Cross-section microscopic shot of the rectal wall   Section of mucous membrane of human rectum (60×)   Dog Rectum cross-section (40×)   Dog Rectum cross-section (400×)

See also

• Gastrointestinal tract
• Murphy drip
• Pectinate line
• Rectal prolapse

References

• Henry Gray: Anatomy of the human body (Bartleby.com; Great Books Online)
• Eldra P. Solomon - Richard R. Schmidt - Peter J. Adragna : Human anatomy & physiology ed. 2nd 1990 (Sunders College Publishing, Philadelphia) ISBN 0-03-011914-6

External links

• Blue Histology
• Cross section at UV pembody/body15a
• Cross section at UV pelvis/pelvis-e12-15
• SUNY Anatomy Image 7808
• SUNY Labs 43:11-0101

v t e Routes of administration / Dosage forms Oral Digestive tract (enteral) Solids Pill Tablet Capsule Time release technology Osmotic controlled release capsule (OROS) Liquids Solution Softgel Suspension Emulsion Syrup Elixir Tincture Hydrogel Buccal / Sublabial / Sublingual Solids Orally Disintegrating Tablet (ODT) Film Lollipop Lozenges Chewing gum Liquids Mouthwash Toothpaste Ointment Oral spray Respiratory tract Solids Smoking device Dry Powder Inhaler (DPI) Liquids pressurized Metered Dose Inhaler (pMDI) Nebulizer Vaporizer Gas Oxygen mask Oxygen concentrator Anaesthetic machine Relative analgesia machine Ophthalmic / Otologic / Nasal Nasal spray Ear drops Eye drops Ointment Hydrogel Nanosphere suspension Mucoadhesive microdisc (microsphere tablet) Urogenital Ointment Pessary (vaginal suppository) Vaginal ring Vaginal douche Intrauterine device (IUD) Extra-amniotic infusion Intravesical infusion Rectal (enteral) Ointment Suppository Enema Solution Hydrogel Murphy drip Nutrient enema Dermal Ointment Liniment Paste Film Hydrogel Liposomes Transfersome vesicles Cream Lotion Lip balm Medicated shampoo Dermal patch Transdermal patch Transdermal spray Jet injector Injection / Infusion (into tissue/blood) Skin Intradermal Subcutaneous Transdermal implant Organs Intracavernous Intravitreal Intra-articular or intrasynovial injection Transscleral Central nervous system Intracerebral Intrathecal Epidural Circulatory / Musculoskeletal Intravenous Intracardiac Intramuscular Intraosseous Intraperitoneal Nanocell injection Additional explanation: Mucous membranes are used by the human body to absorb the dosage for all routes of administration, except for "Dermal" and "Injection/Infusion". Administration routes can also be grouped as Topical (local effect) or Systemic (defined as Enteral = Digestive tract/Rectal, or Parenteral = All other routes).