WEB WOC Continence Care 2024/2025| graded A+
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
,WEB WOC Continence Care 2024/2025| graded A+
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
, WEB WOC Continence Care 2024/2025| graded A+
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
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
,WEB WOC Continence Care 2024/2025| graded A+
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
, WEB WOC Continence Care 2024/2025| graded A+
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
