Weakened or absent anal reflexes

Introduction Attenuation or disappearance of anal reflex indicates bilateral bilateral pyramidal or cauda equina damage. The afferent nerve is the pudendal nerve. The central nucleus of the posterior horn of the medullary 4 to 5 and the anterior horn of the same segment, the efferent nerve is The genital nerve. The external anal sphincter undergoes bilateral perineal innervation. When one side of the pyramidal tract is damaged or the peripheral nerve is damaged, the anal reflex still exists. When the bilateral pyramidal tract is damaged or the cauda equina is damaged, the anal reflex disappears.

Cause

The cauda equina nerve damage is more common in clinical practice, mostly due to various congenital or acquired causes of absolute or relative narrowing of the lumbar spinal canal, which compresses the cauda equina and produces a series of neurological dysfunction. The cauda equina is damaged, and the anal perineum and lower limbs have abnormal sensation and burning pain. In severe cases, dysfunction may occur.

an examination

Related inspection

Anal reflex anus examination anus examination rectal-anal motor function measurement

symptom:

When the cauda equina nerve root is damaged, it can manifest as various symptoms of nerve damage below the waist 2 . When the horsetail is damaged, the boundary of the sensory disorder is clear. The upper anterior border is the groin, and the posterior is the horizontal line at the upper end of the humerus. Below this, all the hips, perineum and lower limbs have sensory disturbances, accompanied by spontaneous pain (electrical pain) and abnormal perineum. Feeling and radiating to the lower extremities, often painful feelings are delayed. The height and extent of the horsetail damage may vary, and the upper and lower boundaries may be different.

an examination:

The examiner uses a cotton swab to gently stroke or use a pin to gently puncture the perineal skin around the anus of the patient. When normal, the anus is contracted immediately. If the above reaction is slow or does not occur, the anal reflex is weakened or disappeared.

Differential diagnosis

Identification:

1, anal relaxation: anal relaxation, contraction of the anal canal sphincter and anorectal ring contraction is not obvious and completely disappeared, if caused by injury, the anus can be scarred and scar tissue, incomplete incontinence when the diagnosis can be sphincter and sphincter contraction The force is weakened. Common in anal incontinence.

2, fecal incontinence: due to anal or nerve damage, can not control the phenomenon of feces and gas discharge. Also known as defecation incontinence or anal incontinence. Those who can't control dry stools and loose stools, say complete incontinence; those who can control dry stools, can't control loose stools and gas, say incomplete incontinence. Defecation is a complex and coordinated reflex action that is performed under the dual control of the visceral autonomic and cerebral central nervous system. Fecal incontinence can occur with resection of the lower rectum, obstruction of nerve reflexes, and loss of anal sphincter tension. The elderly can cause anal incontinence due to atrophy of the anal sphincter. Temporary fecal incontinence can also occur when you are suddenly shocked.

3, anal sphincter rupture: anal external sphincter rupture caused by a variety of factors, strong mechanical impact of the anus trauma, can lead to the rupture of the external anal sphincter, in addition, accidental surgery can also lead to the fracture of the external anal sphincter, making Fecal incontinence.

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