External anal sphincter

The external anal sphincter (sphincter ani externus) is a short oval tube of skeletal muscle surrounding the inferior portion of the anal canal and is distally adherent to the skin around the margin of the anus and the external anal sphincter is far more substantial than the internal anal sphincter. It is one of the three structures in the anal sphincter complex but while the internal anal sphincter and the conjoint longitudinal muscle are considered parts of the anal canal wall, the external anal sphincter is actually a part of the pelvic floor (perineal) muscles.

Origin: skin and fascia surrounding the anus

Insertion: perineal body and anococygeal ligament

Nerve: Inferior anal branch of pudendal nerve (S2-S4)

Action: keep the anal canal and anus closed, aids in the expulsion of the feces, and support pelvic floor

Artery: Inferior rectal arteries

Description:

The external anal sphincter (sphincter ani externus) is a flat plane of muscular fibers, elliptical in shape and intimately adherent to the integument surrounding the margin of the anus. It measures about 8 to 10 cm. in length, from its anterior to its posterior extremity, and is about 2.5 cm. broad opposite the anus.

It consists of two strata, superficial and deep:

• The superficial, constituting the main portion of the muscle, arises from a narrow tendinous band, the anococcygeal raphé, which stretches from the tip of the coccyx to the posterior margin of the anus; it forms two flattened planes of muscular tissue, which encircle the anus and meet in front to be inserted into the central tendinous point of the perineum, joining with the Transversus perinaei superficialis, the Levator ani, and the Bulbocavernosus.

• The deeper part forms a complete sphincter to the anal canal. Its fibers surround the canal, closely applied to the Sphincter ani internus, and in front blend with the other muscles at the central point of the perineum. In a considerable proportion of cases the fibers decussate in front of the anus, and are continuous with the Transversi perinaei superficiales. Posteriorly, they are not attached to the coccyx, but are continuous with those of the opposite side behind the anal canal. The upper edge of the muscle is ill-defined, since fibers are given off from it to join the Levator ani.

The action of this muscle is peculiar:

• (1) It is, like other muscles, always in a state of tonic contraction, and having no antagonistic muscle it keeps the anal canal and orifice closed.

• (2) It can be put into a condition of greater contraction under the influence of the will, so as more firmly to occlude the anal aperture, in expiratory efforts unconnected with defecation.

• (3) Taking its fixed point at the coccyx, it helps to fix the central point of the perineum, so that the Bulbocavernosus may act from this fixed point.