[Using dissection of the internal anal sphincter with its hypertrophy in children]

Evaluating the rectum and anus plays a crucial role in conducting a thorough physical examination of the gastrointestinal system. Although it may be uncomfortable and often embarrassing for the patient, it holds immense diagnostic value, particularly in detecting gastrointestinal diseases and abnormalities. This guide will explain how to perform this assessment using inspection and palpation methods.
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...

The muscles of the pelvic floor and perineum are crucial for supporting the pelvic organs, controlling continence, and aiding in sexual function, childbirth, and core stability. They are typically divided into the superficial perineal layer and the deep pelvic floor layer.
Perineal Layer
The perineum is a diamond-shaped area below the pelvic diaphragm, divided into an anterior urogenital triangle that contains the external genitals and a posterior anal triangle housing the anus. The urogenital...

The large intestine is divided into three main regions: the cecum, colon, and rectum. Extending from the ileocecal valve to the anus, it frames the small intestine on three sides.
The ileocecal sphincter, a mucous membrane fold, guards the opening from the ileum to the large intestine. This valve permits material from the small intestine to pass into the large intestine. Attached to the ileocecal valve is the cecum. This small pouch, approximately 6 cm long, has a twisted, coiled tube known as...

The large intestine, a vital component of the gastrointestinal tract, is structured with four main layers: the mucosa, submucosa, muscularis, and serosa. Each layer performs a distinct role in facilitating the smooth functioning of the large intestine.
The innermost mucosa layer comprises simple columnar epithelium, lamina propria, and muscularis mucosae. This layer is primarily populated with absorptive cells, tasked with water absorption, and goblet cells, responsible for secreting mucus to...

Urination, or micturition involves the coordination of the bladder's detrusor muscle and two sphincters to ensure controlled bladder emptying.
The process begins with bladder filling, where the bladder wall stretches as urine accumulates. This stretching activates the urine storage reflex, mediated by the sacral spinal segments and the pontine storage center. Efferent sympathetic impulses stimulate the detrusor muscle to relax and the internal urethral sphincter to contract, facilitating urine...

After spending 3 to 10 hours in the large intestine, chyme loses a lot of water and becomes feces, the final product of digestion. Feces consist of undigested dietary fiber such as cellulose, mucus, sloughed-off epithelial cells, and microbes. The descending and sigmoid colon stores feces and uses haustral contractions to dry it out but retains enough water to give it a semi-solid texture.
The mass peristalsis then pushes the feces into the rectum, which stretches the rectal walls to activate...