A 21-year-old woman was evaluated in the office for fecal retention. The patient fell from a 5-meter building 6 months ago, and she suffered from multiple fractures. She is now undergoing physical therapy for rehabilitation after the hospitalization. During the last six months, the patient had severe constipation. The family reports multiple episodes of fecal incontinence. Examinations show stool retention in the distal colon. Anal examination shows decreased tone. Injury at which of the following structures would explain this patient's presentation?

Question

Quizplus · Accepted Answer

Eductional Objective: The sacral spinal cord corresponds to the voluntary innervation of the anal sphincter via the pudendal nerve. Additionally, it provides the parasympathetic innervation to the distal colon stimulating peristalsis. Sacral spinal cord injuries lead to distal colon retention and fecal incontinence due to external anal sphincter dysfunction.

A 21-Year-Old Woman Was Evaluated in the Office for Fecal