1. encopresis: a disorder characterized by repeated stool evacuation in
inappropri- ate places in children over the age of four
primary: children who never reached continence
secondary: children who reached continence for at least a year and are
now relapsed
2. sympathetic nervous system role: *involuntary*
When the rectum is empty, the SNS inhibits the contraction of the
rectal wall, and contracts the internal anal sphincter (IAS) to prevent
leakage
3. parasympathetic nervous system role: when the rectum is filled post
mass transit, it stretches and the PNS sends information to the CNS to
coordinate bowel elimination. The rectum then contracts in conjunction
,with the ENS and the IAS relaxes. Feces then moves down the anal
canal to the external anal sphincter (EAS)
4. enteric nervous system: The intrinsic nervous system within the bowel
wall. This system responds to a variety of stimuli and generates
peristalsis
5.rectoanal inhibitory reflex: the involuntary relaxation of the IAS when
the rectum is stretched that allows feces to move down anal canal
6. sampling reflex: when rectal contents contact Anoderm (receptors at
distal anal canal) for differentiation
allows squamous epithelium below the Denate Line with sensory
receptors that differentiate between solid, liquid, gaseous rectal
contents
7. anal wink: with cotton swab, swipe at 5 and 7 o'clock on the
buttocks with the patient in the modified lithotomy position
,a focused physical exam that assesses prostate and pelvic muscle
control and verifies function of pudendal nerve
8. bulbocavernosus reflex: in modified lithotomy position, squeeze penis
glans to verify external anal sphincter wink or flick the clitoris in
females
a focused physical exam that assesses prostate and pelvic muscle
control and verifies function of pudendal nerve
9. 5 factors that promote continence: 1: colonic transit, stool volume, and
consis- tency
2: sensory awareness
3: sphincter competence
4: rectal compliance and
capacity 5: extrinsic factors
, 10.secretory diarrhea: The absorptive capacity of the bowel is
overwhelmed by the volume of water and electrolytes that are
secreted into it
11.osmotic (absorptive) diarrhea: inadequate or reduced absorption of the
bowel
12.functional (motility) diarrhea: Increased motility results in decreased
contact time of the stool with the lumen and intestinal mucosa
13.external anal sphincter: composed of smooth muscle that maintains
sphincter tone (contraction) and striated muscle that permits voluntary
control/contractility
14.parasympathetic nervous system: part of the autonomic nervous
system that acts to promote colonic peristalsis and motility activity
15.sympathetic nervous system: part of the autonomic nervous system
that acts to reduce intestinal motility and secretions
16.soluble fiber: foods that contain soluble fiber have the ability to
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