Posted by lae2 on October 14, 2021 at 14:51:15:
In Reply to: Question about ACR posted by Alexis S. on October 14, 2021 at 13:34:28:
: Hi Dr. Evey! A few of us were wondering what the difference between the anococcygeal raphe and the anococcygeal ligament are. If you could clear this up for us that would be great!
Oooooh. Its key to know the difference or the anorectal sling mechanics does not make sense. The anococcygeal raphe is the intertendon from the pelvic diaphragm (excluding puborectalis) extending from the anal aperture to the coccyx. The anococcygeal ligament (body) extend from the coccyx to the external anal sphincter near the anus. The puborectalis passes between the raphe and the ligament. Thus, the proximal and distal anal canal is tethered to the coccyx. The puborectalis is not. Hence, the functional sphincter and the sling.