HTHSCI 1DT3 Lecture 12: anatomy sur-62-69
26 Dec 2020
School
Department
Course
Professor
Document Summary
Anal cushion: mass of spongy vascular tissue. Positioned @ 3, 7 and 11 o"clock. Where the three major arteries that feed the vascular plexuses enter the anal canal. Gravity, straining engorgement and enlargement of anal cushions. Hard stool disrupts connective tissue around cushions. Cushions protrude and can be damaged by hard stool. Haemorrhoids arise above dentate line not painful. May be gripped by anal sphincter thrombosis. 2nd: prolapse on defecation but spontaneously reduce. 3rd: prolapse on defecation but require digital reduction. On paper, on stool, may drip into pan. Rigid sig to identify higher rectal pathology. Injection c sclerosant (5% phenol in almond oil) Excision of piles + ligation of vascular pedicles. Bed rest c elevated foot of bed. Tear of squamous epithelial lining in lower anal canal. Mostly trauma 2o to the passage of hard stool. Spasm of internal anal sphincter contributes to pain and ischaemia + poor healing. Rarer causes, often multiple lateral fissures.
