WEB WOC Continence Care (Answered) Complete
Verified Solution
encopresis
a disorder characterized by repeated stool evacuation in inappropriate 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
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
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)
enteric nervous system
The intrinsic nervous system within the bowel wall. This system responds to a variety of
stimuli and generates peristalsis
rectoanal inhibitory reflex
the involuntary relaxation of the IAS when the rectum is stretched that allows feces to
move down anal canal
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
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
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
5 factors that promote continence
1: colonic transit, stool volume, and consistency
2: sensory awareness
, 3: sphincter competence
4: rectal compliance and capacity
5: extrinsic factors
secretory diarrhea
The absorptive capacity of the bowel is overwhelmed by the volume of water and
electrolytes that are secreted into it
osmotic (absorptive) diarrhea
inadequate or reduced absorption of the bowel
functional (motility) diarrhea
Increased motility results in decreased contact time of the stool with the lumen and
intestinal mucosa
external anal sphincter
composed of smooth muscle that maintains sphincter tone (contraction) and striated
muscle that permits voluntary control/contractility
parasympathetic nervous system
part of the autonomic nervous system that acts to promote colonic peristalsis and
motility activity
sympathetic nervous system
part of the autonomic nervous system that acts to reduce intestinal motility and
secretions
soluble fiber
foods that contain soluble fiber have the ability to absorb and retain water
*use to help resolve diarrhea
insoluble fiber
foods that contain insoluble fiber add bulk to the stool and do not absorb water
*use to help resolve constipation
irritable bowel syndrome
cause is unknown but thought to be multifactorial including: multifactorial: visceral
hypersensitivity, enhanced GI permeability known as "leaky gut", altered composition of
the GI microbiota, low-grade inflammation, altered immune response, autonomic
nervous system dysfunction, altered bile acid metabolism, and psychological distress
IBS s/s
Abdominal pain, bloating and distention, feelings of incomplete emptying, changes in
stool frequency and consistency, pain relieved by defecation, Abdominal pain
associated with eating and intraluminal stimulation such as gas, constipation and/or
diarrhea
obstructed defecation syndrome
disorders that are characterized by the inability to eliminate normally, even when the
stool is an ideal form/consistency. May be the result of muscle/sphincter control issues
or mechanical obstacles
pelvic floor dyssynergia
most common cause of obstructed defecation syndrome
results from the inability to coordinate pelvic floor and sphincter relaxation and
Verified Solution
encopresis
a disorder characterized by repeated stool evacuation in inappropriate 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
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
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)
enteric nervous system
The intrinsic nervous system within the bowel wall. This system responds to a variety of
stimuli and generates peristalsis
rectoanal inhibitory reflex
the involuntary relaxation of the IAS when the rectum is stretched that allows feces to
move down anal canal
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
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
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
5 factors that promote continence
1: colonic transit, stool volume, and consistency
2: sensory awareness
, 3: sphincter competence
4: rectal compliance and capacity
5: extrinsic factors
secretory diarrhea
The absorptive capacity of the bowel is overwhelmed by the volume of water and
electrolytes that are secreted into it
osmotic (absorptive) diarrhea
inadequate or reduced absorption of the bowel
functional (motility) diarrhea
Increased motility results in decreased contact time of the stool with the lumen and
intestinal mucosa
external anal sphincter
composed of smooth muscle that maintains sphincter tone (contraction) and striated
muscle that permits voluntary control/contractility
parasympathetic nervous system
part of the autonomic nervous system that acts to promote colonic peristalsis and
motility activity
sympathetic nervous system
part of the autonomic nervous system that acts to reduce intestinal motility and
secretions
soluble fiber
foods that contain soluble fiber have the ability to absorb and retain water
*use to help resolve diarrhea
insoluble fiber
foods that contain insoluble fiber add bulk to the stool and do not absorb water
*use to help resolve constipation
irritable bowel syndrome
cause is unknown but thought to be multifactorial including: multifactorial: visceral
hypersensitivity, enhanced GI permeability known as "leaky gut", altered composition of
the GI microbiota, low-grade inflammation, altered immune response, autonomic
nervous system dysfunction, altered bile acid metabolism, and psychological distress
IBS s/s
Abdominal pain, bloating and distention, feelings of incomplete emptying, changes in
stool frequency and consistency, pain relieved by defecation, Abdominal pain
associated with eating and intraluminal stimulation such as gas, constipation and/or
diarrhea
obstructed defecation syndrome
disorders that are characterized by the inability to eliminate normally, even when the
stool is an ideal form/consistency. May be the result of muscle/sphincter control issues
or mechanical obstacles
pelvic floor dyssynergia
most common cause of obstructed defecation syndrome
results from the inability to coordinate pelvic floor and sphincter relaxation and
