I have 12))) + 6 holes in my ears)
but in general 8)
There are many in Vilnius and especially in Klaipeda. In Kaunas, the least. There are many half-breeds in Lithuania. There was a fashion to marry girls from Russia to improve the breed)))
Poles in Lithuania are like Russians in Latvia.
I study law ... not one teacher speaks Russian either at lectures, or just one on one ...
It can be completely different diametrically opposed reasons.
If we start from the "usual", then usually it is illiteracy, incorrect use of words, the same slang and lack of thought design, which the two previous speakers have already mentioned.
Or, for example, ignorance of the language (foreign or native).
If you look from the other side, then the reason may be specifically in the difference between these people, namely, in education, intelligence level, erudition, traditions, nationality, worldview, life experience and other things that distinguish us from others, i.e. . specific general (holistic) misunderstanding.
In this case, people do not understand each other, not because one of them is an idiot, and the other is a sage, but because they think absolutely differently and there can be no "correct" in this case - there are different things, and this must be taken into account .
In Russian, because I have such knowledge of Latvian that even the most nationally preoccupied Latvian will beg and start persuading me to speak Russian.
like zys? http://www.dafont.com/bullet-holz.font
So these are fonts.
download, drag the file to Local Disk C - Windows - Fonts and upload fsh.
Let's talk about the anus from a scientific point of view. There are many surprises waiting for you. Jokes aside, our digestive tract is a well-designed system for absorbing all the nutrients we need. And what we do not need is collected in compact piles, which we dispose of in a socially acceptable way.
And you know what else science tells us about the anus? Gives a biological rationale for why some like to be underneath. Well, besides, the ass is just beautiful. And since our buns suit us this way and perform such an important function, let's take a closer look at them. Our article outlines everything that everyone who has a butt should know about.
If you learn to control the muscles of the anus, you will ejaculate longer and better
We ejaculate at the expense of the same muscles that help hold gases - these are the muscles of the pelvic floor. You can feel their work if you try to stop urination in the middle of the process or if you try not to fart. And you can train these muscles with the help of Kegel exercises. Keep in mind: to pump the muscles of the pelvic floor, you can not connect the buttocks, abs and hips to the work. You need to focus only on themselves.
The average person defecates once a day
But for someone it happens once every three weeks, and for someone - several times a day. Proctologist Patricia Raymond (on YouTube as Butt Meddler) says that all this is very individual. So if you do not suffer from constipation or diarrhea, then poop as poop.
The rectum can protrude from the anus
It's called rectal prolapse, or simply rectal prolapse, and it looks ugly. It's so tubular in appearance, a bit like a jam roll.
This can happen if you push very hard on the toilet. And sometimes - from sneezing, coughing or just walking. This is treated with surgery, but sometimes it’s enough just to add more fiber to the diet.
There's Scientific Proof Why Some Gays And Bis Like To Be Bottom
Scientists believe that specific biological factors have been discovered that are responsible for what role homosexual men prefer in sex. In other words, whether you are an asset or a liability is inherent in nature. According to scientists, left-handers, those who have older brothers, and those who have not met gender norms since childhood are prone to a passive role.
Say thanks to the scientists at the University of Toronto at Mississauga, who believe that "non-handedness" is the most important factor. So they write! Quote: "Among homosexuals, deviance from gender norms correlates with roles in anal sex."
Asshole
Hemorrhoids are a disease of the veins that feed the rectum. They can bleed without any pain. However, if they fall out, pain and itching may occur. This happens when you push too hard on the toilet.
What to do with external nodes? Keep clean, wipe with baby wipes. But if there are a lot of them, it can be very painful, and then there are two ways: wait until it goes away on its own, or go to the proctologist and treat it - perhaps surgically.
The proctologist can get to the bottom of the tumor of the rectum
An examination by a proctologist goes like this: you are asked to lie on your side, the doctor puts on a glove, applies lubricant and puts his finger inside. Next, he examines the rectum with a finger for everything that should not be there: bleeding, abscesses, and so on. Such an examination quickly shows whether there is cancer or not, and if it is, then more studies are assigned.
Tell me more about proctology? Or is it already enough?
We see that it is not enough. So, on the Butt Meddler channel there is song, where everything about colonoscopy is popularly told (in accordance with US medical protocols, but they correspond to the recommendations and practices of domestic doctors - approx. translator). The song sings: "if you don't want the cancer, scopin" is the answer" ("if you don't want cancer, then get examined like this"), and in the chorus - a request to look in the back door.
Botox for the anus is a reality
Want to get skinny like a virgin again? At your service laser rejuvenation of the anus is a cosmetic operation, after which it becomes tighter. Designed for fecal incontinence, but everyone can use it.
If you squeeze the sphincter, you fart louder
When you try to hold back the winds so as not to violate decorum, the sound only gets louder. Loud winds are the result of aerophagy, the swallowing of air that occurs when drinking soda, drinking through a straw, or chewing gum. Swallowed air is looking for an exit. And finds it with a loud sound, but no smell. It's air and nothing more. It's just that if you swallow a lot of it, it should quickly come out. It's like puffing out your cheeks and expelling air through your mouth. So if you really want to fart, and before that you swallowed air - relax: there will most likely be no smell.
If your gas smells like something is dead, it's because that's how it is.
This happens when the body has not processed everything. Partially digested food - be it fats or carbohydrates - descends from the stomach into the intestines, where bacteria decompose it, releasing smelly gases. Fortunately, there are usually not very many of them. It is better to let such winds go alone.
Alas, there is a catch: since the amount of gas is scanty, it is difficult to feel it in advance and take measures to ensure that it is not released. So if there is a sudden smell nearby, this is most likely a surprise not only for others, but also for the source itself.
When rimming, you also need to protect yourself
Use plastic wrap or a cut condom to avoid catching dysentery through fecal contact or hepatitis A and B.
Dysentery is a very unpleasant thing, with bloody diarrhoea, pain in the abdomen and a constant urge to go to the toilet, even with an empty bowel. For prevention, it is necessary not only to protect yourself, but also to observe hygiene.
The bigger the butt, the smarter the person
According to a joint study by researchers from the University of Pittsburgh and the University of California at Santa Barbara, the larger a woman's buttocks, the better her performance in cognitive tests.
Owners of impressive pop and hips consistently take precedence over less curvaceous ladies. The scientific explanation for this is that omega-3 essential fatty acids accumulate in the thighs and buttocks, which stimulate brain development. Such a supply of nutrients is especially important for women during pregnancy. As the study showed, the children of women with big butts are also smarter than other children.
Translation: Caterina Baburina
ANUS [canalis analis(PNA) anus; syn.: anal canal, anal canal] - the distal segment of the rectum, ending with the anus.
Anatomy
The length of 3. p. ranges from 1.5 to 5 cm, on average it is 3 cm. Anterior to the anal canal in men is the cavernous bulb of the urethra (see), in women - the lower part of the posterior wall of the vagina.
2-2.2 cm above the anus, on the mucous membrane of the anal canal, there are from 14 to 6 vertical parallel elevations - the anal (anal) columns of Morgagni (columnae anales). The groove between each two pillars is closed from below by a fold - the anal (anal) valve (valvula analis), which forms a blind pocket. These grooves and pockets (Fig. 1) together form the anal (anal) sinuses - crypts (sinus anales) with a depth of 0.2 to 0.8 cm. At the base of the anal columns there are triangular protrusions of the mucous membrane - anal papillae - papillae. A clearly visible, somewhat protruding zigzag line from the anal flaps (folds) is called the anorectal, dentate or comb line (linea pectinata) and is the boundary between the glandular epithelium of the rectal ampulla and the stratified squamous epithelium of the anal canal, devoid of hair and sweat glands. At the edge of the anus, the stratified epithelium gradually passes into the epidermis of the skin. The comb line is the place where, during embryogenesis, the ectodermal skin protrusion connected with the endodermal hindgut, and the anal folds are the remains of the germinal membrane that existed between them.
The muscular membrane of 3. p. consists of internal (m. sphincter ani int.) and external (t. sphincter ani ext.) sphincters 3. p. ). The external sphincter, which, unlike the internal one, is arbitrary, consists of three portions - subcutaneous, superficial and deep. Through all three portions of the external sphincter, they pass from top to bottom and attach to the skin the fibers of the muscle that lifts 3. p. and pubic-rectal (m. puborectalis). M. levator ani strengthens the pelvic floor, holding the organs located in it. With an arbitrary contraction of the middle part of this muscle (m. pubococcygeus), 3. p. and the skin surrounding it are drawn in and up. Normally, the tone of the sphincter 3. p. in men, when measured with a spring sphincterometer (see), is on average 600 g, its maximum strength, i.e., volitional contraction, is 900 g. In women, respectively, 520 and 775 g. Both sphincters , especially external, play a major role in the retention of feces and intestinal gases. From the submucosa of the anal canal in the region of the anus, thin bundles of smooth muscle fibers diverge radially, which are attached to the skin surrounding this opening - the muscle wrinkling the skin 3. p. (m. corrugator cutis ani). This muscle turns inside the mucous membrane of the lower end of the anal canal after the end of the act of defecation (see Defecation).
The walls of the anal canal are innervated by the branches of the pudendal nerve (n. pudendi), which accompany the lower rectal arteries.
blood supply the anal canal is carried out by the lower rectal arteries (aa. rectales inf.), which are branches of the internal genital arteries (aa. pudendi int.). The branches of the lower rectal arteries anastomose with the branches of the upper and middle rectal arteries (aa. rectales sup. et med.).
The veins of the anal canal form the submucosal and subcutaneous plexuses. The submucosal venous plexus is located in the region of the lower ends of the anal columns in the form of a ring and is a collection of cavernous veins that form nodules - cavernous bodies (see Hemorrhoids). The subcutaneous plexus is located in the region of the external sphincter. The outflow of blood is carried out through the lower rectal veins (vv. Rectales inf.), Passing along with the arteries of the same name. The branches of the inferior rectal veins anastomose with the branches of the middle and superior rectal veins.
Lymph drainage from a rich network of limf, capillaries - skin 3. p. and limf, vessels of the mucous membrane of the anal canal is carried out to limf, nodes of the inguinal region and to the lateral sacral limf, nodes.
Pathology
Malformations are included in the group of anorectal anomalies and in the existing classifications are considered among the malformations of the rectum (see Rectum), since they have a single embryogenesis with them and are often combined. However, there are isolated malformations 3. p. - atresia, stenosis, ectopia. Unlike the most pronounced malformations of the rectum, which are formed on the 4-6th week. embryonic development, they occur later - on the 6-12th week.
Atresia(absence of the anus, covered anus, atresia ani, anus imperphoratus) is 8-10% of anorectal anomalies. It occurs due to the complete preservation of the anal membrane or the fusion of hypertrophied genital folds over a perforated membrane. In the latter case, the anal canal remains passable and may have a more or less wide fistulous tract that opens along the perineal suture in any of its places up to the frenulum of the penis. A wedge, a picture of an atresia 3. the item depends on an anatomic option of an anomaly. With complete atresia (without a fistula - Fig. 2) after 10-12 hours. after birth, the baby begins to push hard, but the meconium does not go away. At the same time, symptoms of intestinal obstruction arise and progress: bloating, vomiting of stomach contents, and then with an admixture of meconium, Toxicosis and exsicosis increase. In advanced cases, the disease is complicated by aspiration pneumonia, intestinal perforation, peritonitis, and the newborn dies. In the presence of a fistula, the symptoms are smoothed out, and if the fistula is wide enough, no intestinal obstruction is observed and the child can physically develop normally.
For timely recognition of atresia, examination of the perineum at the time of birth is necessary. Conduct a differential diagnosis in terms of clarifying "low" or "high" atresia.
At an atresia 3. the item operational treatment is shown. Complete atresia according to vital indications is corrected as a matter of urgency by the method of perineal proctoplasty (see Rectum, operations).
In cases where there is a thin film covering the intestinal lumen, a cruciform incision or an oval incision is sufficient; the need for mobilization of the intestine and suturing does not arise. In the presence of a fistula located close to the natural location of the anus, in some cases in newborns it is enough to make a careful expansion of the fistulous opening with a surgical clamp and the discharge of meconium becomes satisfactory. If this fails, as well as in older children, anoplasty is indicated (Fig. 4).
The results of surgical treatment are quite satisfactory.
Stenosis(congenital narrowing 3. p., stenosis ani) is 5-8% of anorectal anomalies. The mechanism of occurrence is similar to atresia, but the anal membrane is not completely preserved, but partially. The narrowing is localized most often in the region of the comb line of the anal ring, varying significantly in severity.
With stenosis 3. p. a wedge, symptoms in the neonatal period and the first months of life are often absent, because liquid feces freely pass through the narrowed opening, but with sharp degrees of stenosis, constipation is observed in a child from the first days of life. In any case, with the introduction of complementary foods, constipation becomes more and more persistent, defecation is accompanied by strong straining and screaming. Feces come out in the form of a ribbon or a narrow cylinder. Further the volume of a stomach progressively increases, hron, a fecal intoxication accrues.
The diagnosis is established by examination of the perineum and digital rectal examination. In some cases, stenosis must be differentiated from Hirschsprung's disease (see Megacolon).
With stenosis 3. p., treatment begins with bougienage, using Hegar's dilators or special bougie. 1-2 sessions are carried out daily, gradually increasing the diameter of the bougie. The bougie lubricated with vaseline oil is inserted through the narrowed opening and left for 10-15 minutes. It is advisable to combine bougienage with diathermy of the anal region or electrophoresis with a solution of novocaine, potassium iodide. Tangible results are observed after 1-2 months. systematic treatment. The effect is better, the earlier bougienage is started.
In cases not amenable to treatment with bougienage, surgical treatment is indicated. With a loose and narrow narrowing ring, they are limited to a longitudinal dissection of the site of stenosis, followed by suturing the wound in the transverse direction. With a sharp degree of stenosis, when there is a dense wide scar, the most acceptable is the intrasphincter excision of the stenosing ring from the side of the perineum, followed by suturing the edge of the intestine to the edge of the skin incision.
The results of treatment are quite satisfactory.
ectopia(ectopia ani) is observed in 3-5% of cases of anorectal anomalies. Occurs when the urorectal septum is insufficiency in the sagittal plane, as a result of which the perineum remains underdeveloped and there is no secondary migration of the anus to its usual place.
There are perineal and vestibular ectopia. In the first case, the anus opens closer to the root of the scrotum in boys or the posterior commissure of the labia in girls (Fig. 3), while maintaining a skin bridge between the opening and the genital fissure. In the second case, in girls, the skin bridge is absent and the mucous membrane of the vestibule of the vagina passes into the mucous membrane of the anus.
With ectopia, there are no functional disorders. The contraction of the external sphincter surrounding the anus is well expressed, and digital rectal examination determines good patency of the anus and a pronounced tone of the closing apparatus. All of these signs are important distinguishing features of ectopia from fistulous forms of rectal atresia, which are characterized by functional abnormalities and extrasphincter location on the perineum of the fistulous opening. In some patients with ectopia 3. p., no treatment is required, for example, in boys, as well as in girls with perineal ectopia. With vestibular ectopia, it is necessary to correct the anomaly surgically, because the future woman expects significant deviations from the norm: there are cases of sexual intercourse through an ectopic anus; in addition, the close proximity of 3. p. and the genital slit contributes to infection of the genital and urinary tract. The operation is performed after 1 year of the child's life. It consists in moving the abnormally located anal opening to the usual place (Fig. 5). The functional results of surgical treatment are quite satisfactory.
Damage may be due to various reasons. Relatively often there is a rupture of the sphincter and anal canal during childbirth. They are easily eliminated if stitches are applied immediately after childbirth. Domestic and professional injuries 3. p. can occur when the crotch falls on protruding or sharp objects: stakes, pipes, protruding parts of tools and instruments, etc. Injuries 3. p. can also occur if the klister tip, thermometer, etc. breaks. n. Masturbation can also cause damage to 3. n. Damage to 3. items is sometimes observed by foreign bodies introduced into the anal canal while drunk or with a criminal intent (bottles, sticks, etc.).
The isolated gunshot wounds 3. items meet seldom (see. Rectum, damages).
Among the injuries of 3. p., one should distinguish: a) soft tissue injuries with damage to the skin ring and mucous membrane of 3. p. without damage to the sphincter; b) wounds of the area 3. p. with damage to the sphincter; c) detachment of the rectum.
In the first case, the wounds are usually in the form of a gutter with a small defect in the skin and mucous membrane. The depth of the wound is insignificant, and it does not reach the sphincter.
The severity of damage to the second group depends on the amount of destruction. The open wound surface is constantly infected with feces, which leads to the development of purulent complications.
The detachment of the rectum is usually diagnosed without difficulty, because when viewed instead of the sphincter and mucous membrane of 3. p., fatty tissue soaked in blood and feces is visible.
All injuries of 3. items require, as a rule, urgent surgical intervention - removal of a foreign body, wound treatment, intestinal fistula, etc.; at a later date, reconstructive surgery is necessary.
Functional disorders. Various organic and functional diseases and damages of area 3. and. can lead to insufficiency of its closing function. This insufficiency is divided into three degrees: inadequate retention of gases (I degree), involuntary release of liquid stools or incontinence of enema water (II degree), incontinence of solid feces (III degree). At insufficiency of the I degree good effect gives to lay down. sphincter gymnastics, general hardening of the body, prevention of diarrhea.
At the expressed forms of insufficiency of function 3. the item (II and III degree) apply a sphincteroplasty. Most often, suturing of the sphincter 3. p. according to Lockhart-Mummery (reef sutures on the posterior semicircle of the sphincter), resection of the cicatricially modified sphincter with suturing of its ends, and also, according to individual indications, plastic surgery - the formation of an artificial sphincter from the thin muscle of the thigh (method Faerman) or from the gluteus maximus muscles, plastic surgery using a fascial tape from the thigh aponeurosis (Vreden method). At the expressed deformations 3. the item with sharp disturbance of its function plastic operations are made after temporary assignment of a calla by imposing of a preliminary colostomy.
Diseases. The most common acquired diseases of 3. p. include hemorrhoids, cryptitis, papillitis, sphincteritis (anusitis, anitis), fissure 3. p. and paraproctitis.
Haemorrhoids- a common disease, which is based on hyperplasia of the cavernous veins and bodies of the submucosa of the distal rectum and 3. p.; arises under the influence of various factors, requires conservative and, if necessary, surgical treatment (see Hemorrhoids).
Cryptite- acute, subacute or hron, inflammation of the morganian sinuses associated with damage to the sinuses and the excretory ducts of the anal glands that open in them with dense and sharp inclusions of feces, followed by infection. Complaints with cryptitis come down to a burning sensation and a foreign body in 3. p., tenesmus.
With a digital examination, pain and swelling of the inflamed anal sinus is determined, and with anoscopy, its hyperemia. In cases where the inflammatory process has captured all the sinuses, a digital examination determines the compaction along the entire scallop line - “pectenosis”. Treatment is conservative (see Proctitis, treatment), with unsuccessful treatment, excision of the sinus is indicated. Cryptitis is often combined with papillitis and takes hron, a course characterized by anal itching, pain, spasm of the sphincter 3. p. An abscess formed in the anal sinus region can open on its own into the lumen of 3. p., which leads to the formation of an incomplete internal fistula, or outward, perforating the muscular wall of the rectum and penetrating into the adrectal tissue; in the latter case, purulent paraproctitis develops (see Paraproctitis).
Papillitis- inflammation, and sometimes subsequent hypertrophy of the anal papillae due to their constant traumatization with feces, especially with constipation, anal fissure, hemorrhoids, paraproctitis. It is necessary to distinguish hypertrophied anal papillae from anal fibrous polyps, which is most often possible only with gistol, the study of remote formations. Symptoms of papillitis - anal itching, pain in area 3, p. External examination and digital examination of the rectum are determined by enlarged and painful papillae, maceration of the perianal skin, sometimes ulceration of the top of the papilla. The treatment is conservative (see Proctitis, treatment), with unsuccessful treatment, an operation is indicated - removal of the papilla.
Fissure of the anus located in 90% of cases on the back (coccygeal) wall of the anal canal. Symptoms - severe pain after defecation (from several minutes to 2-3 hours), slight bleeding during stool, spasm of the sphincter 3. p. -rogo almost always has a hypertrophied area ("sentinel tubercle"). An acute fissure in most cases is amenable to conservative treatment - a sparing diet, laxatives, oil microclysters, suppositories. Simple stretching of the sphincter 3. p. according to Recamier, proposed in 1828, is not used due to trauma and insufficient therapeutic effect. At hron, a crack good results are given by novocaine and alcohol blockades. A more radical operation is the excision of a fissure within the healthy mucosa (Fig. 6) and the removal of sphincter spasm by injecting long-acting anesthetics.
Fistulas of the anus most often arise on the basis of acute paraproctitis (see Paraproctitis) and very rarely due to intestinal tuberculosis, actinomycosis of the rectum. The main difference between banal fistulas 3. p. and specific ones is that with banal fistulas, the internal opening of the fistula is located at the level of the scallop line in one of the anal sinuses. In relation to the muscles of the anal canal, fistulas are divided into simple - low level (intrasphincteric), transsphincteric and complex - high level (extrasphincteric).
Diagnosis of fistulas 3. p. is based on an external examination, digital examination, probing, a test with dyes (methylene blue) and fistulography.
Surgical treatment. With simple fistulas, Gabriel's operation is most effective - excision of the anterior wall of the fistula with a triangular flap into the lumen of the rectum along with the internal opening of the fistula. With a cross-sphincteric location of the fistulous tract, excision of the fistula into the intestinal lumen is indicated with suturing the bottom of the wound (without skin) with catgut sutures. With high extrasphincteric fistulas, the fistulous tract on the perineum is excised and the internal opening of the fistula is eliminated either with the help of a silk ligature, or with a plastic skin-mucosal flap, or by dosed sphincterotomy Operations for complex fistulas 3. p. and sphincter function.
Itching of the anus idiopathic, suigen arises out of association with concomitant common (diabetes) or proctol. (proctitis, hemorrhoids, etc.) diseases; aggravated at night and in heat, often deprives patients of their ability to work. Treatment consists in the appointment of a sparing diet and microclysters with collargol (25-30 instillations per course of treatment at night, after a cleansing enema); inside enteroseptol 0.5 g 2-3 times a day. Mandatory sanitation of the skin, a thorough toilet after defecation. In persistent cases (only with dry forms of itching) - intradermal injections of the perianal region with 0.2% methylene blue in 0.5% solution of novocaine. With unsuccessful treatment, operations are possible (although not very effective) - the intersection of cutaneous nerves, etc. General strengthening therapy and sometimes a psychiatrist's consultation are necessary.
warts- warty growths 3. p., associated with irritation of the perianal skin of the perineum with proctosigmoiditis of viral etiology. The course is long, it is necessary to exclude syphilis and gonorrhea. Treatment first, as in anal itching, and then removal of genital warts, better by cryodestruction (see Cryotherapy).
Tumors- benign (polyp, fibroma, nevus) and malignant (adenocarcinoma, squamous cell carcinoma, sarcoma, pigmented and non-pigmented melanoma). The polyp and fibroma are subject to transanal removal. With cancer and melanoma, complex treatment is indicated, as with similar tumors of the rectum (see Rectum, tumors).
Bibliography: Aminev A. M. Guide to proctology, vol. 1-3, Kuibyshev, 1965-1973; Braytsev V. R. Diseases of the rectum, M., 1952;
Lenyushkin A. I. Proctology of childhood, M., 1976, bibliogr.;
Duhamel J. Anal fistulae in childhood, Amer. J. Proctol., v. 26, p. 40, 1975, bibliogr.; G o 1 i g h e r J. C. Surgery of the anus, rectum and colon, L., 1975, bibliogr.; Mandache F. Die Chirurgie des Rektums, B., 1974; Stephens F. D. a. Smith E. D. Ano-rectal malformations in children, Chicago, 1971.
V. D. Fedorov; A. I. Lyonyushkin (det. hir.).
