Anatomy & Physiology

of Anal canal

Dr. Nadan Kandel

BAMS, M.D. Kayachikitsa

Department of Kayachikitsa
Naradevi Ayurved Hospital
Kathmandu, Nepal
 Guda location
• It is located into the lower part of the trunk in
the shroni(the pelvic cavity)
• The shroni consisits of five bones
• Among which four bones are near vagina and
anal canal, anteriorly two pubic and laterally t
wo bones of pelvis, fifth is sacral bone.
 Guda /Anal canal
• It commences from terminal end of sthoolantra
(the larger intestine) and open outside the body
as anal orifice in mid perineum.
• It is one of the marma (the vital point of the bod
y)
• Any accidental injury on this region may cause i
mmediate death.
• According to the charak Samhita guda consist of t
wo parts – the Uttar Guda (the upper anal canal)
and Adhar Guda (the lower anal canal)
• He as not mentioned any demonstrable line divid
ing the uttar and adhar Guda. (ch.sh. 7/9)
• The renowned commenter of charak Samhita , ch
akrapani datta described the uttar guda as reserv
oir of the faeces and adhar guda as discharger ou
t of the faeces.
• According to Sushruta the entire length of guda i
s five and half angula.
• According to Sushruta commenter Dalhan the an
gula measurement means maximum with of the
pulp of individual thumb or thumb impression.
• According to Sushruta the guda consists of three
vali (the semicircular folds of anorectal mucosa)
the pravahani , visarjani and samvarani.
• The total lenth of guda or vali becomes 4-1/2 an
gula
 Physiology of Guda
• According to Sushruta the function of guda is t
o expel out the faeces and flatus.
• According to the Chakrapani datta , the Uttar
–guda (extra-peritoneal part of rectum) act as
reservoir of faeces and the adhar-guda (anal c
anal below anorectal ring ) discharges the faec
es and flatus.
 Anal canal
• Developmentally arises from endodermal cloac
a and ectodermal proctodeum.
• terminal part of the large intestine.
• begins at the ano-rectal junction where rectal a
mpulla suddenly becomes narrow, and the junct
ion is situated about 2to 3cm in front and slightl
y below the tip of the coccyx.
• below the level of pelvic diaphragm & lies in an
al triangle.
• 3.8cm long, it extends from the anorectal junct
ion to the anus.
Relations
• Anteriorly- related to perineal body, membr
anous urethra, bulb of penis, lower end of th
e vagina.
• Posteriorly- related anococcygeal ligament,
tip of the coccyx
• Laterally-ischiorectal fossae
Interior of the anal canal:
• 3 parts :
• upper part(15mm)- lined by mucous membrane, & endodermal in
origin, mucous membrane shows 6 to 10 vertical folds, these fol
ds are- anal columns of Morgagni.
• lower ends of the anal columns are united to each other by short
semilunar folds of mucous membrane, these folds- anal valves.
• Above each valve there is a depression in the mucosa known as
- anal sinus.
• Anal glands- floor of the sinuses receives ducts of tubular anal g
lands, which ramify in the submucous coat of the anal canal and
sometimes penetrate the internal sphincter muscle. These gland
s are occasionally infected and act as source of anal fistula.
• anal valves together form a transverse line that runs all round th
e anal canal- pectinate line.
• Middle part of anal canal (15mm)
• transitional zone or pecten- lined by mucous membran
e.
• The mucosa has a bluish appearance because of a d
ense venous plexus that lies beneath.
• lower limit of the pecten- has a whitish appearance w
hite line or Hilton’s line, interval between the subcuta
neous part of external anal sphincter & the lower borde
r of internal anal sphincter.

• Lower cutaneous part

• 8mm long & lined by true skin containing sweat & se
baceous glands.
Anal Canal & its clinical anatomy
• Musculature of the anal canal:
1.Internal anal sphincter- involuntary in nature, formed by the t
hickened circular muscle coat of this part of the gut.

2. External anal sphincter- voluntary control & has three parts:

subcutaneous ,superficial and deep parts.
• subcutaneous part lies below the level of internal sphincter a
nd surrounds the lower part of the anal canal.
• superficial part is elliptical in shape and arises from the term
inal segment of the coccyx and anococcygeal ligament, the fi
bres surround the lower part of the internal sphincter and ar
e inserted into the perineal body.
• deep part surrounds the upper part of the internal sphincter
and is fused with the puborectalis
Anorectal ring:
• muscular ring present at the anorectal junction.
• formed by the fusion of the puborectalis, deep external
sphincter and the internal sphincter.
• Arterial supply:
• the part of the anal canal above the Pectinate line- supe
rior rectal artery
• the part below the pectinate line -inferior rectal artery.
• Venous drainage:
• internal rectal venous plexus drains into superior rectal v
ein
• lower part of the external rectal venous plexus & inferior
rectal vein- internal pudendal vein
• the middle part - middle rectal vein into the i
nternal iliac vein.

• upper part-the superior rectal vein into the inf

erior mesenteric vein.

• anal vein are arranged radially around the a

nal margin & communicate with the internal r
ectal plexus and with the inferior rectal vein.
Lymphatic drainage and nerve supply:
1. lymph vessels
• above the pectinate line- drain into the internal iliac n
odes.
• part below the pectinate line drain into superficial ing
uinal nodes.
2. nerve supply:
• above pectinate line, the anal canal- autonomic nerve
s (inferior hypogastric plexus and pelvic splanchnic).
• Below pectinate line- somatic (inferior rectal )nerves.
• external sphincter - by inferior rectal nerve & by bran
ch of the fourth sacral nerve.
 Physiological aspect
• Functions
1. Absorptive function- water, electrolytes, organi
c substances like glucose, alcohol, drugs like
anaesthetic agents, sedatives and steroids.
2. Formation of feces- after absorption of nutrien
ts, water and other substances, the unwanted
substances in the large intestine form feces a
nd excreted out.
3. Excretory function-it excretes heavy metals lik
e mercury, lead, bismuth and arsenic through f
eces.
4. Secretory function- it secretes mucin and i
norganic substances like chlorides and bicar
bonates.
5. Synthetic function- bacterial flora of large i
ntestine synthesis folic acid, vitamin B12 an
d vitamin K.