The puborectalis is a muscle of the pelvic floor, a part of the levator ani muscle group. It plays an important role in ensuring faecal continence. To understand its anatomy and function better, it is helpful to look at its attachments, actions, innervation and blood supply.
The puborectalis muscle originates from the posterior surface of the pubis. It is shaped like a U, forming a sling around the anal canal, and attaching to the pubis on the contralateral side.
Tonically, the puborectalis muscle works to bend the anal canal anteriorly. This results in the creation of the anorectal angle, which is significant in the maintenance of faecal continence. Furthermore, this muscle is voluntarily inhibited during defecation.
The nerve to levator ani and the pudendal nerve are the two nerves that innervate the puborectalis.
The puborectalis is supplied by three different arteries: the inferior gluteal, the inferior vesical and the pudendal arteries.
Faecal continence is the body's ability to control the release of stool from the rectum. It is a complex process, and the puborectalis muscle plays a vital role in achieving this. The rectum is the final segment of the large intestine and is used to store stool before it is passed out of the body. It is located in the pelvis and is connected to the anus. The puborectalis muscle surrounds the rectum and when it is tonically contracted, it creates the anorectal angle. This angle is important in faecal continence, as it helps to close off the rectum and prevents stool from passing through. Furthermore, it facilitates the relaxation of the muscles surrounding the anus, in order to allow for the passage of stool during defecation.
A weakened or atrophied puborectalis muscle can lead to a range of clinical conditions, including faecal incontinence, anal prolapse, and constipation. When the muscle is weakened, it results in difficulty controlling the passage of stool, causing faecal incontinence. Moreover, when the muscle is not strong enough to hold up the rectum, it can lead to the rectum slipping down, resulting in anal prolapse. Additionally, a weakened puborectalis muscle can lead to constipation, as the rectum is unable to store stool properly when the muscle is not functioning properly.
The first step for treating puborectalis dysfunction is for patients to work with a doctor to diagnose the underlying cause. Treatment may involve simple lifestyle changes, such as increasing fiber intake, drinking more fluids, and increasing physical activity. In more severe cases, medications or surgery may be recommended. Additionally, physical therapy can be used to strengthen the puborectalis muscle and improve its functioning.
The puborectalis is a muscle of the pelvic floor that is involved in maintaining faecal continence. It plays a major role in this process, as it creates the anorectal angle and facilitates the relaxation of the muscles surrounding the anus during defecation. When the puborectalis muscle is weakened, it can lead to a range of clinical conditions, including faecal incontinence, anal prolapse, and constipation. Treatment may involve lifestyle modifications, medications, or surgery, as well as physical therapy for strengthening the muscle. It is important for patients to work with a doctor to diagnose and properly treat puborectalis dysfunction.
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