Rectal supply

fascial layers

  • Upper 1/3 peritoneum to front and sides
  • Middle 1/3 peritoneum to front only
  • Lower 1/3 devoid of peritoneum

arterial ss

Branches of inferior mesenteric and internal iliac
superior/middle/inferior rectal artery (go figure)

venous drainagae

rectal veins
empty into portal venous system
one of the sites of portosystemic anastomosis

innervation

sympathetic innervation

  • lumbar splanchnic nerves L1-3
  • pass via superior and inferior hypogastric plexuses

parasympathetic innervation

S2-4 via the pelvic splanchnic nerves and inferior hypogastric plexuses

sensory

pain transmission follows parasympathetic fibres S2-4

lymphatic drainage

Upper rectum → pararectal lymph nodes → inferior mesenteric nodes
Below dentate line → superficial inguinal nodes
Lower part of rectum → internal iliac

lymphatic drainage rectum passmed.png