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Because the wording sucks. It's a confusing way to word the question. I too was confused what direct tributaries was referring to and chose Inferior mesenteric because I suck and also because this question sucks.
Really its asking where are the hemorrhoids? They are on/from the superior rectals even though those veins feed to Inferior mesenteric.
Why could this not be dysuria?
I think that you are thinking about urinary incontinence. If we damage the pudendal nerve S2-S4, you can exhibit urinary and fecal incontinence since this nerve innervates both the urethral and the external anal sphincters. However since the pelvic splanchnic nerves also have roots that originate in S2-S4 a patient with pudendal nerve damage will also have impotence since these control the erection reflex. He wouldn't have dysuria which is painful urination. Most likely caused by a urethral infection or a blockade of the urinary tract. He would have urinary incontinence. I hope this helps.
Superior rectal comes from the inferior mesenteric vein which comes from the splenic vein --> portal veins
Thus, this dude had cirrhosis so it would "back-up" into the superior rectal vein.
FA 2018: p360
Superior rectal not superior mesenteric. Took me a minute
ugh am i ever gonna get these right EVER
why not the inferior mesenteric, since the superior rectal drains there
@titanesxvi think it is because question says direct which is why superior rectal
thomasburton, so are they asking what vessels do internal hemorrhoids directly drain into? The order is Superior rectal vein--> Inferior mesenteric vein--> portal vein.
Yes exactly, so they do eventually reach IMV but not 'directly'