Hemorrhoids
A. External hemorrhoids are covered by squamous epithelium
B. Innervated by branches of the pudendal nerve.
C. External hemorrhoids can occur circumferentially under the anoderm
D. External hemorrhoids are drained via the superior rectal vein into the inferior vena cava.
ANSWER
D.External hemorrhoids are drained via the superior rectal vein into the inferior vena cava.
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– Internal hemorrhoids drain through the superior rectal vein into the portal system.
– External hemorrhoids drain through the inferior rectal vein into the inferior vena cava.
A. Denonvilliers’ fascia
B. Treitz’s muscle
C. Waldeyer fascia
D. Presacral fascia
ANSWER
B. Treitz’s muscle
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Treitz’s muscle consists of 2 distinct parts:
1. Anal submucosal muscle, whose fibers subside submucosally between the sinusoids, fixes the cushions to the “floor” of the hemorrhoids (i.e., to the internal anal sphincter),
2.Mucosal suspensory ligament (Park’s ligament) penetrates the internal sphincter and fixes the sinusoids to the conjoined longitudinal muscle.
A. Denonvilliers’ fascia
B. Treitz’s muscle
C. Waldeyer fascia
D. Presacral fascia
ANSWER
B. Treitz’s muscle
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Treitz’s muscle consists of 2 distinct parts:
1. Anal submucosal muscle, whose fibers subside submucosally between the sinusoids, fixes the cushions to the “floor” of the hemorrhoids (i.e., to the internal anal sphincter),
2.Mucosal suspensory ligament (Park’s ligament) penetrates the internal sphincter and fixes the sinusoids to the conjoined longitudinal muscle.
A. Denonvilliers’ fascia
B. Treitz’s muscle
C. Waldeyer fascia
D. Rectal visceral fascia
ANSWER
D. Rectal visceral fascia
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Rectal visceral fascia extends along the pelvic cavity in the ventro-dorsal direction, forming a continuous “hammock-like” sheath, enveloping the rectum.
A. Dentate line
B. Treitz’s muscle
C. Hilton white line
D. Parks Ligament
ANSWER
A. Dentate line
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Pectinate line (dentate line) is a line which divides the upper two-thirds and lower third of the anal canal. Developmentally, this line represents the hindgut-proctodeum junction.
Above Pectinate line – internal hemorrhoids (not painful)
Below Pectinate line – external hemorrhoids (painful)
A. not painful
B. Supplied by superior rectal artery
C. origin from endoderm
D. Supplied by inferior rectal nerves
ANSWER
D. Supplied by inferior rectal nerves
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Internal hemorrhoids – Nerves supply – inferior hypogastric plexus
External hemorrhoids – Nerves supply – inferior rectal nerves
In-Shorts
Collateral vessels within the inferior hemorrhoidal plexus are located below the anorectal line and are termed external hemorrhoids.
– External hemorrhoids are covered by squamous epithelium
– Innervated by cutaneous nerves which are branches of the pudendal nerve.
– External hemorrhoids can occur circumferentially under the anoderm and can occur in any location.
– External hemorrhoids are drained via the inferior rectal vein into the inferior vena cava.
Pectinate line (dentate line) is a line which divides the upper two-thirds and lower third of the anal canal. Developmentally, this line represents the hindgut-proctodeum junction.
