Yuniarti

The anal canal is the terminal part

of the large intestine and of the
entire digestive canal. It extends
from the superior aspect of the
pelvic diaphragm to the anus

The canal (2.5-3.5 cm long)

begins where the rectal ampulla
narrows at the level of the U-
shaped sling formed by the
puborectalis muscle
The anal canal, surrounded by internal and external anal sphincters

The internal anal sphincter is an involuntary sphincter surrounding the superior two thirds of the anal canal

The external anal sphincter is a large voluntary sphincter that forms a broad band on each side of the inferior
two thirds of the anal canal

Internally, the superior half of the

mucous membrane of the anal canal
is characterized by a series of
longitudinal ridges called anal
columns. These columns contain the
terminal branches of the superior
rectal artery and vein.

The inferior ends of the anal columns

are joined by anal valves. Superior to
the valves are small recesses called
anal sinuses.

The inferior comb-shaped limit of the

anal valves forms an irregular line, the
pectinate line, that indicates the
junction of the superior part of the
anal canal
The anal canal superior to the
pectinate line differs from the part
inferior to the pectinate line in its
arterial supply, innervation, and
venous and lymphatic drainage

The superior rectal artery supplies

the anal canal superior to the
pectinate.

The two inferior rectal arteries

supply the anal canal inferior to
the pectinate line as well as the
surrounding muscles and perianal.

The middle rectal arteries assist

with the blood supply to the anal
canal by forming anastomoses
with the superior and inferior
rectal arteries.
The internal rectal venous plexus drains in both directions from the level of the pectinate line

Superior to the pectinate line, the internal rectal plexus drains chiefly into the superior rectal vein

Inferior to the pectinate line, the internal rectal plexus drains into the inferior rectal veins (tributaries of the
caval venous system) around the margin of the external anal sphincter.

The middle rectal veins (tributaries of the

internal iliac veins) mainly drain the
muscularis externa of the ampulla and
form anastomoses with the superior and
inferior rectal veins.
Superior to the pectinate
line, the lymphatic vessels
drain deeply into the internal
iliac lymph nodes and
through them into the
common iliac and lumbar
lymph nodes

Inferior to the pectinate line,

the lymphatic vessels drain
superficially into the
superficial inguinal lymph
nodes,
superior to the pectinate line is visceral
innervation from the inferior
hypogastric plexus, involving
sympathetic, parasympathetic, and
visceral afferent fibers
inferior to the pectinate line is somatic
innervation derived from the inferior anal
(rectal) nerves, branches of the pudendal
nerve..