WEB WOC CONTINENCE CARE
QUESTIONS & SOLUTIONS(RATED
A+)
encopresis - ANSWERa 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 - ANSWER*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 - ANSWERwhen 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 - ANSWERThe intrinsic nervous system within the bowel wall.
This system responds to a variety of stimuli and generates peristalsis
rectoanal inhibitory reflex - ANSWERthe involuntary relaxation of the IAS when the
rectum is stretched that allows feces to move down anal canal
sampling reflex - ANSWERwhen 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 - ANSWERwith 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 - ANSWERin 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 - ANSWER1: colonic transit, stool volume, and
consistency
2: sensory awareness
3: sphincter competence
4: rectal compliance and capacity
5: extrinsic factors
secretory diarrhea - ANSWERThe absorptive capacity of the bowel is overwhelmed by
the volume of water and electrolytes that are secreted into it
osmotic (absorptive) diarrhea - ANSWERinadequate or reduced absorption of the bowel
functional (motility) diarrhea - ANSWERIncreased motility results in decreased contact
time of the stool with the lumen and intestinal mucosa
external anal sphincter - ANSWERcomposed of smooth muscle that maintains sphincter
tone (contraction) and striated muscle that permits voluntary control/contractility
parasympathetic nervous system - ANSWERpart of the autonomic nervous system that
acts to promote colonic peristalsis and motility activity
sympathetic nervous system - ANSWERpart of the autonomic nervous system that acts
to reduce intestinal motility and secretions
soluble fiber - ANSWERfoods that contain soluble fiber have the ability to absorb and
retain water
*use to help resolve diarrhea
insoluble fiber - ANSWERfoods that contain insoluble fiber add bulk to the stool and do
not absorb water
*use to help resolve constipation
irritable bowel syndrome - ANSWERcause 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 - ANSWERAbdominal 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
QUESTIONS & SOLUTIONS(RATED
A+)
encopresis - ANSWERa 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 - ANSWER*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 - ANSWERwhen 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 - ANSWERThe intrinsic nervous system within the bowel wall.
This system responds to a variety of stimuli and generates peristalsis
rectoanal inhibitory reflex - ANSWERthe involuntary relaxation of the IAS when the
rectum is stretched that allows feces to move down anal canal
sampling reflex - ANSWERwhen 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 - ANSWERwith 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 - ANSWERin 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 - ANSWER1: colonic transit, stool volume, and
consistency
2: sensory awareness
3: sphincter competence
4: rectal compliance and capacity
5: extrinsic factors
secretory diarrhea - ANSWERThe absorptive capacity of the bowel is overwhelmed by
the volume of water and electrolytes that are secreted into it
osmotic (absorptive) diarrhea - ANSWERinadequate or reduced absorption of the bowel
functional (motility) diarrhea - ANSWERIncreased motility results in decreased contact
time of the stool with the lumen and intestinal mucosa
external anal sphincter - ANSWERcomposed of smooth muscle that maintains sphincter
tone (contraction) and striated muscle that permits voluntary control/contractility
parasympathetic nervous system - ANSWERpart of the autonomic nervous system that
acts to promote colonic peristalsis and motility activity
sympathetic nervous system - ANSWERpart of the autonomic nervous system that acts
to reduce intestinal motility and secretions
soluble fiber - ANSWERfoods that contain soluble fiber have the ability to absorb and
retain water
*use to help resolve diarrhea
insoluble fiber - ANSWERfoods that contain insoluble fiber add bulk to the stool and do
not absorb water
*use to help resolve constipation
irritable bowel syndrome - ANSWERcause 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 - ANSWERAbdominal 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
