mani
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an infant is investigated for contipation, shows increased tone of int anal sphinctor. furthur studies show massive dilatation of rectum proximal to it. The defect would have resulted frfom abnormal development f which of the following:
surface ectoderm
mesoderm
neural crest
neuroectoderm
endoderm
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| MLF
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Hirschsprungs disease = due to failure of migration of neural crest cells, resulting in lack of enteric nervous plexus. So the answer should be neural crest.
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| edgardny
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This is somewhat similar to Achalasia. The lower esophageal sphinter is unable to relax, there is dismotility of the esophagus, food can't enter the stomach. Bird beak appearance. Both Dx with Barium swallow radiograph.
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| mani
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why should there be increased tone of int anal sphintor?
in hirschprung, there is an aganglionic segmnet that is collapsed and bowel proximal to it is dilated
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| edgardny
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Sorry I didn't try to compare the tone of the sphinters rather I try to emphasize on the lack of innervation in the segments in both diseases, but the tones definitely differentiates these dxs
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| zaidsuror
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TO ANSWER MANI,THE INCREASE TO TONE IS BECAUSE THE SMOOTH MUSCLE IS AUTONOMOS AND THEROLE OF THEINNERVATIONIS TO MODULATE THE DEPOLARIZATION SO IN ITS ABSENCE T REMAINS IN A STATE OF CONTRACTION.
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