Anatomy and Physiology

An understanding of the normal anatomy and physiology of the perianal area and anal canal is important for the reliable description and interpretation of the medical findings after allegations of anal penetrative acts. Unfortunately, varying definitions have resulted in considerable confusion, such that there is no consensus among forensic practitioners about the nomenclature that should be used in describing injuries to this area. Therefore, a brief overview of the relevant information is given in the remaining Subheadings, together with references to more substantive texts.

The anus refers not to an actual anatomical structure but to the external opening of the anal canal. The skin that immediately surrounds the anus is variously referred to as the anal verge or anal margin (173). Because the anal canal can evert and invert as the anal sphincters and pelvic floor muscles relax and contract, the anal verge/margin is not a fixed, identifiable landmark.

10.4.2. Perianal Area

The perianal area is a poorly defined, approximately circular area that includes the folds of skin encircling the anus. It is covered by skin that is often hyperpigmented when compared with the skin on the buttocks, although this varies with age and ethnicity (174).

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