General Surgery Lecture on Benign Ano-Rectal Conditions

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What is the name of the muscular junction between the rectum and anal canal that can be felt with the finger?

Pelvic diaphragm

Anal verge

Anorectal ring (correct)

Anal sphincter

What is the anatomical landmark that separates the columnar epithelium and autonomic nerves (above) from the squamous epithelium and spinal nerves (below)?

Anorectal ring

Dentate line (correct)

Anal verge

Anal canal

Which muscle is a continuation of the circular muscle coat of the rectum and is an involuntary muscle?

Pelvic diaphragm

Internal sphincter (correct)

External sphincter

Longitudinal muscle coat

What is the venous drainage system above the dentate line?

Portal venous system Signup and view all the answers

What is the venous drainage system below the dentate line?

Systemic venous system Signup and view all the answers

What type of muscle is the external sphincter composed of?

Voluntary (somatic) muscle Signup and view all the answers

What is the typical location of engorged veins in patients with hemorrhoids?

3, 7, 11 o'clock positions Signup and view all the answers

What is the characteristic of 1st degree hemorrhoids?

They bleed but do not prolapse through the anus Signup and view all the answers

Which of the following is a recommended treatment for 2nd degree hemorrhoids?

Rubber band ligation, photocoagulation, or hemorrhoidectomy Signup and view all the answers

What is the typical location of an anal fissure?

Primarily in the posterior midline, with 10% in the anterior midline Signup and view all the answers

What is the key distinguishing feature of 4th degree hemorrhoids?

They are permanently prolapsed and cannot be manually reduced Signup and view all the answers

What is a potential cause of an anal fissure that is not located at the midline?

Inflammatory bowel disease (IBD) Signup and view all the answers

Which of the following arteries supply the anal canal?

Superior, middle, and inferior hemorrhoidal arteries Signup and view all the answers

Where do the superior and middle hemorrhoidal veins drain?

Into the portal system via the inferior mesenteric vein Signup and view all the answers

What is the distinction between internal and external hemorrhoids?

Internal hemorrhoids are above the dentate line and part of the portal circulation, while external hemorrhoids are below the dentate line and part of the systemic circulation Signup and view all the answers

Which of the following is NOT a risk factor for hemorrhoids?

Hypotension Signup and view all the answers

What is a common clinical feature of internal hemorrhoids?

Painless rectal bleeding Signup and view all the answers

Where does the lymph from the lower half of the anal canal drain?

Into the superficial and deep inguinal lymph nodes on each side Signup and view all the answers

What is the purpose of topical nitroglycerine in the treatment of anorectal conditions?

To promote healing by increasing local blood flow Signup and view all the answers

What is the objective of surgery in treating anorectal conditions?

To relieve sphincter spasm and increase blood flow Signup and view all the answers

Which bacterium is commonly involved in causing anorectal abscesses?

E. coli Signup and view all the answers

What is the treatment for an anorectal abscess?

Incision and drainage Signup and view all the answers

What is the etiology of a fistula-in-ano?

Various causes including perirectal abscesses and iatrogenic factors Signup and view all the answers

According to Goodsall's Rule, where is the internal opening of a fistula likely to be if the external opening is at 11 o'clock position?

2 o'clock Signup and view all the answers