Anus, Recutm, Prostate From Mosby

Front 1

Hesitancy in urination accompanied by decreased force and caliber of stream, dribbling, incomplete emptying of bladder, frequency, urgency, nocturia, and dysuria. On rectal examination, the prostate feels smooth, rubbery, symmetric, and enlarged.

Back 1

Benign Prostatic Hypertrophy

Front 2

On rectal examination a hard, irregular nodule is palpable. Prostate feels asymmetric, and the median sulcus is obliterated.

Back 2

Prostatic Carcinoma

Front 3

mnemonic for BPH?

Back 3

NUTS: Nocturia, Urine dribbles, Tried to void but can't, Small stream

Front 4

Child complains of intense itching of the perianal area. The perianal area is irriteated from scratching. Child is extremely irritable at night.

Back 4

Enterobiasis (roundworm, pinworm)

Front 5

How would you obtain an enterobiasis specimen for microscopic exam?

Back 5

press sticky side of cellulose tape against perianal folds and then press tape on glass slide

Front 6

Lack of passage of stool within first 48 hours of life. Nerve studies show no abnormalities.

Back 6

imperforate anus

Front 7

On rectal exam, an elderly patient has a pink doughnut rosette protruding from anus

Back 7

prolapse

Front 8

Rectal polapse in children is associated with ____?

Back 8

Cystic fibrosis

Front 9

Hard nodular shelf at the tip of the examining finger during a rectal exam?

Back 9

intraperitoneal metastases

Front 10

Sessile polypoid mass with nodular raised edges and areas of ulceration. Consistency is stony with an irregular contour.

Back 10

rectal carcinoma

Front 11

Patient presents with rectal bleeding. Rectal exam reveals soft pedunculated (or sessile) nodules.

Back 11

polyps

Front 12

Varicose Veins that originate below the anorectal line

Back 12

external hemorrhoids

Front 13

Itching and bleeding with defecation in an adult.

Back 13

external hemorrhoids

Front 14

Blue shiny masses at the anus

Back 14

external hemorrhoids

Front 15

Varicose veins that originate above the anorectal line

Back 15

internal hmeorrhoids

Front 16

Patient complains of anal burning/itching that intereres with sleep (adult)

Back 16

Pruritus ani (probably fungal)

Front 17

Patient complains of pain, itching, and rectal bleeding after passage of large hard stools

Back 17

anorectal fissure

Front 18

Caused by drainage of a perianal or perirectal abscess. It is an inflammatory tract that runs from the anus or rectum and oens onto the surfaceof the perianal skin

Back 18

anorectal fistula

Front 19

Painful and tender anus or rectum. Patient has a fever. Patient has an area of swelling and erythema of the anus both internally and externally.

Back 19

perianal and preirectal abscesses

Front 20

Anal cancers are considered a type of _______ cancer

Back 20

skin

Front 21

The majority of anal cancers are _____, which are associated with _______

Back 21

squamous cell carcinomas, HPV.

Front 22

About 15% of anal cancers are _____, which originate from ______

Back 22

adenocarcinomas, glands near the anus.

Front 23

Which congenital anomaly is usually first diagnosed in young adults although they are a congenital anomaly. Located in the midline, superficial to the coccyx and lower sacrum, it is seen as a dimple with a sinus tract opening?

Back 23

Pilonida Cysts

Front 24

Anal canal s approximately how long?

Back 24

2.5 - 4 cm long

Front 25

Internal ring of smooth muscle muscle is under _____ control

Back 25

involuntary autonomic

Front 26

Defecation is controlled by ?

Back 26

striated external sphincter

Front 27

Lower half of anal canal is supplied with ___ nerves making it _____ to painful stimuli

Back 27

somatic, sensitive

Front 28

Anal canal is lined by columns of mucosal tissue also called ___ ____ _____

Back 28

columns of Morgagni

Front 29

Inflammation of anal crypts can result in what?

Back 29

fistula or fissure formation

Front 30

From wheredo internal hemorrhids result?

Back 30

dilation of anastomosing veins crossing the columns of Morgagni

Front 31

anastomosing veins crossing the columns of mucosal tissue form a ring called ______

Back 31

zona hemorrhoidalis

Front 32

The lower segment of the anal canal contains a venous plexus that drains into the ____ __ __

Back 32

inferior rectal veins

Front 33

dilation of which plexus results in external hemorrhoids?

Back 33

plexus that drains to inferior rectal veins

Front 34

Rectum is approximately _____ cm long

Back 34

12

Front 35

3 semilunar transverse folds in rectal wall

Back 35

Houston valves

Front 36

Dimensions of prostate gland

Back 36

4 x 3 x 2 cm

Front 37

Part of prostate accessible by digital rectal exam

Back 37

posterior surface (right and left lateral lobes)

Front 38

Which lobe of the prostate is composed of glandular tissure and is not palpable on exam

Back 38

median lobe

Front 39

Anal opening develops by what week gestation?

Back 39

8 weeks

Front 40

First meconium is ordinarily passed within first ?

Back 40

24 - 48 hrs

Front 41

Gastrocolic reflex?

Back 41

pass stool after feeding

Front 42

Which sphincters are under involuntary reflexive control at birth?

Back 42

both internal and external

Front 43

when do children achieve control of external anal sphincter?

Back 43

18 - 24 months

Front 44

Prostate remains undeveloped until?

Back 44

puberty

Front 45

What changes lead to constipation in the pregnant female?

Back 45

Dietary habits and hormonal changes that decrease GI tract tone and motility.

Front 46

What predisposeds pregnant women to hemorrhoids?

Back 46

Dietary habits and hormonal changes that decrease GI tract tone and motility. Increased pressure in veins below the enlarged uterus and increased blood flow.

Front 47

What causes stool retention in older adults?

Back 47

degeneration of afferent neurons in the rectal wall

Front 48

Loss of internal sphincter tone in the older adult may lead to _____

Back 48

incontinence

Front 49

What structures of the prostate gland atrophy with age?

Back 49

fibromuscular

Front 50

What part of the prostate gland hypertrophies with age?

Back 50

glandular part

Front 51

Fungal infection of perianal area is more common in adults with _____

Back 51

diabetes

Front 52

In children perianal irritation is more commonly caused by ____

Back 52

pinworms

Front 53

When discussing location in rectum or anus: 12 o'clock refers to the ______ _______

Back 53

ventral midline

Front 54

When discussing location in the rectum or anus: 6 o'clock refers to the ____ ______

Back 54

dorsal midline

Front 55

Upon initial insertion of the examining finger into the anal sphincter the patient may feel urgency for ____

Back 55

a bowel movement

Front 56

An extremely tight anal sphincter results from what?

Back 56

scarring, spasticity caused by fissure, inflammation, or anxiety

Front 57

Examing finger can palpate a distance of about ____ to ___ into the rectum

Back 57

6 - 10 cm

Front 58

Rectal walls should feel ____ ____ and ______

Back 58

smooth, even, and uninteruppted

Front 59

Bidigital palbpation is particulary useful for detecting a _____

Back 59

perianal abscess

Front 60

Prostate gland should feel like a ___________, firm, smooth, and slightly moveable

Back 60

pencil eraser

Front 61

a healthy prostate has a diameter of _____ with less than ____ protrusion

Back 61

4 cm, 1 cm

Front 62

A rubbery or boggy consistency of the prostate may indicate what?

Back 62

BPH

Front 63

Stony hard nodularity of the prostate gland my indicate what?

Back 63

carcinoma

Front 64

Grade I prostate enlargement?

Back 64

1 - 2 cm

Front 65

Grade II prostate enlargement?

Back 65

2 - 3 cm

Front 66

Grade III prostate enlargement?

Back 66

3 - 4 cm

Front 67

Gade IV prostate enlargement?

Back 67

more than 4 cm

Front 68

A uterus in what position maybe palpable through rectal examination

Back 68

retroverted or retroflexed

Front 69

Which female structure is palpable through the anterior rectal wall?

Back 69

cervix

Front 70

Peritoneal metastases maybe felt as nodules just above what structure in males?

Back 70

prostate

Front 71

Very light or tan stools may indicate what?

Back 71

obstructive jaundice

Front 72

Tarry black stool should make you suspect what?

Back 72

upper gi tract bleeding

Front 73

Shrunken buttocks in an infant or child suggest?

Back 73

chronic debilitating disease

Front 74

Asymmetric creases of buttocks in a child may indicate what?

Back 74

congenital dislocation of the hips

Front 75

Small flat flaps of skin around the rectum (condylomas) of an infant may indicate infection with what?

Back 75

syphilis

Front 76

How would you examine patency of the anus in a newborn?

Back 76

use lubicated catheter, shtick no more than 1 cm into rectum. Patency is usually confirmed by passage of meconium

Front 77

Sinuses, tufts of hair, and dimpling in the pilonidal area may indicate:

Back 77

lower spinal deformities

Front 78

If there is no evidence of stool in the new born suspect?

Back 78

Rectal atresia, Hirschsprung disease, or cystic fibrosis

Front 79

When performing a digital rectal exam on a newborn which finger should you use?

Back 79

pinky

Front 80

A lax anal sphincter in a newborn may indicate what?

Back 80

Lesion of the peripheral spinal nerves or spinal cord. Shigella infection. Previous fecal impaction.

Front 81

A consistently empty rectum in the presence of constipation is a clue to the diagnosis of what?

Back 81

Hirschsprung disease.

Front 82

A palpable prostate in a preadolescent boy suggest?

Back 82

precocious puberty or some virilizing disease.

Front 83

Why may the stool of apregnant woman be dark green or black?

Back 83

consumption of iron preparations.

Front 84

Hemerrhoids are an expected variation in ______ pregnancy

Back 84

late

Front 85

Prostate in older males may have a ___ _____ _____ feel to it

Back 85

rubbery, smooth, symmetric

Front 86

Greenish-black, viscous, contains occult blood; stool is sterile

Back 86

Newborn meconium 1st stool

Front 87

Transitional: thin, slimy, brown to green

Back 87

3 to 6 day old infant's stool

Front 88

Mushy, loose, golden yellow; frequency varies fom after each feeding to every few days; nonirritating to skin

Back 88

Stool from a breast fed infant

Front 89

Light yellow, characteristic odor, irritating to skin

Back 89

Stool from a formula fed infant