A patient presents to the emergency complaining of fever, chills, and a painful mass adjacent to his anus. On examination, a tender, fluctuant mass is palpated. Purulent material is noted through the skin and the diagnosis of ischioanal abscess is made. The patient is taken to the operation theatre, and incision and drainage of the abscess is performed. During the procedure, the extent of the lesion is underestimated, and the inferior rectal nerve is damaged. This nerve is a direct branch of which of the following nerves?
A patient presents to the emergency complaining of fever, chills, and a painful mass adjacent to his anus. On examination, a tender, fluctuant mass is palpated. Purulent material is noted through the skin and the diagnosis of ischioanal abscess is made. The patient is taken to the operation theatre, and incision and drainage of the abscess is performed. During the procedure, the extent of the lesion is underestimated, and the inferior rectal nerve is damaged. This nerve is a direct branch of which of the following nerves?
π‘ Explanation
**Core Concept**
The inferior rectal nerve is a branch of the pudendal nerve, which provides sensory and motor innervation to the perineal region. This nerve is responsible for controlling the external anal sphincter and providing sensation to the skin around the anus.
**Why the Correct Answer is Right**
The pudendal nerve arises from the S2, S3, and S4 nerve roots of the sacral plexus. It enters the pelvis through the greater sciatic foramen and then passes through the lesser sciatic foramen to enter the ischioanal fossa. The inferior rectal nerve is a direct branch of the pudendal nerve that supplies the external anal sphincter and the skin around the anus. Damage to this nerve can result in loss of anal sphincter tone and decreased sensation in the perianal region.
**Why Each Wrong Option is Incorrect**
**Option A:** The sciatic nerve is a major nerve that arises from the L4, L5, S1, S2, and S3 nerve roots and provides motor innervation to the lower limb. It is not directly related to the inferior rectal nerve.
**Option B:** The ilioinguinal nerve arises from the L1 and L2 nerve roots and provides sensory innervation to the skin of the upper medial thigh and the inguinal region. It is not directly related to the inferior rectal nerve.
**Option C:** The obturator nerve arises from the L2, L3, and L4 nerve roots and provides motor innervation to the adductor muscles of the thigh. It is not directly related to the inferior rectal nerve.
**Clinical Pearl / High-Yield Fact**
The inferior rectal nerve is at risk during surgeries involving the ischioanal fossa, such as incision and drainage of an ischioanal abscess. Damage to this nerve can result in significant complications, including fecal incontinence and decreased sensation in the perianal region.
**Correct Answer: C. Pudendal nerve. Pudendal nerve.**
β Correct Answer: C. Pudendal nerve
π€ Share this MCQ
Share Card Preview
π 1080x1080 square card β fills the full width in WhatsApp and Telegram