Rectum

"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
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 cm long. 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.

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.

Temperature taking

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. 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.

Many 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.

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

External links

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

Routes of administration / Dosage forms Oral Digestive tract (enteral) Solids Pill · Tablet · Capsule · Osmotic controlled release capsule (OROS) · Softgel Liquids Solution · 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 Ocular / 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 vesicals · 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 · 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).