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34 Cards in this Set
- Front
- Back
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The anal canal is liberally supplied by ... sensory nerves
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somatic
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The anal canal is demarcated from the rectum superiorly by a serrated line, the ... junction (often called the ... or ... line).
This junction also marks a transition from skin to ... membrane and somatic to ... nerve supplies. |
anorectal
pectinate or dentate mucous visceral |
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look at slide 4
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ok
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What can you feel against the anterior rectal wall in the male? in the female?
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prostate gland
uterine cervix |
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The prostate gland is rounded, heart shaped, and normally ... cm long. Only what 2 structures are palpable?
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2.5 cm
lateral lobes and median sulcus |
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look at slide 6 – 8
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ok
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Lower ... Questions
-Is there any change in the pattern of bowel function? -Any change in size or caliber of the stool? -Any diarrhea or constipation? -What is the stool color? -Any obvious blood or mucus in the stool? -Is there any pain on defecation? -Any itching? -Any extreme tenderness in the anus or rectum? -Any purulent discharge or bleeding? -Any history of anal warts, ulcerations, or fissures? -Any involvement in anal intercourse? |
GI
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External Hemorrhoids (Thrombosed): dilated hemorrhoidal veins that originate ... the pectinate line and are covered with skin. Seldom produce pain unless ... (must be opened and drained).
picture on slide 12 |
below
thrombosed |
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Internal Hemorrhoids (...): enlargements of normal vascular cushions located ... the pectinate line (in this position not usually palpable). May cause bright-red bleeding with defecation.
picture on slide 13 |
Prolapsed
above |
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...: with straining, rectal mucosa (with or without its muscular wall) may prolapse through the anus appearing as a doughnut or rosette of red tissue. Often seen in the elderly.
picture on slide 14 |
Prolapse of the Rectum
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Anal Fissure: very ... oval ulceration of the anal canal most commonly found in the ... midline. May be associated with a “...” skin tag just below it. Emphasis on painful.
picture on slide 15 |
painful
posterior sentinel |
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...: inflammatory tract or tube that opens at one end into the anus or rectum and at the other end onto the skin. Usually antedated by an .... Think about these in ppl who are immunocompromised (especially ...)
picture on slide 16 |
Anorectal Fistula
abscess diabetics |
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Cancer of the Rectum: ... carcinoma of the rectum makes routine rectal examination important for adults.
picture on slide 17 |
Asymptomatic
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...: widespread peritoneal metastases from any source may develop in the area of the peritoneal reflection anterior to the rectum.
picture on slide 18 |
Rectal Shelf
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Lower ... Questions (for men)
-Is there any difficulty starting the urine stream or holding back urine? -Is urine flow weak? -Is there frequent urination, especially at night? -Any pain or burning upon urination or ejaculation? -Is there any blood in the urine or semen? -Any pain or stiffness in the lower back, hips, or upper thighs? -Any discomfort or heaviness at the base of the penis with associated malaise, fever, or chills? The last 3 questions, if positive, usually suggest ... |
GU
prostate cancer |
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Normal Prostate: rounded, pear-shaped structure ~... cm long. The ... can be felt between the two lateral lobes. Only the ... surface of the prostate is palpable.
(should feel like a contracted thenar eminence) picture on slide 21 |
2.5
median sulcus posterior |
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...: an acute, febrile condition caused by bacterial infection. The gland is very tender, swollen, firm, and warm. EXAMINE GENTLY!!
picture on slide 22 |
Prostatitis
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Benign Prostatic ... (BPH):
Starts in the ... decade of life. Affected gland usually symmetrically enlarged, smooth, and firm. Median sulcus may be obliterated. BPH may restrict urinary flow, causing symptoms, yet not be palpable. picture on slide 23 |
HYPERPLASIA
3rd |
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... of the Prostate: suggested by areas of hardness in the gland (knuckle-like consistency). Hard areas of the prostate are not always malignant; they may also result form prostatic ... and chronic ....
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Cancer
stones inflammation |
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... cancer is the leading cancer diagnosed in men in the United States, and the first leading cause of death.
... cancer is the second leading cause of death in the United States, and the third most common cancer. |
Prostate
Colorectal |
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When inspecting the sacrococcygeal and perianal areas, specifically look for ... (see slide #36)
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pilonidal cysts
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When examining the anus and rectum, consider ... in selected pts (gives us a lot of info that the external visual exam does not)
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anoscopy
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If severe tenderness prevents entry and internal examination, suspect a ..., such as an ..., that might explain the tenderness
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lesion
anal fissure |
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The Male Patient:
-The normal prostate is rubbery and nontender. -If possible, extend your finger above the prostate to the region of the ... and .... Note any nodules or tenderness. -Remember to note the color of any fecal matter on the glove, and test it for .... |
seminal vesicles and the peritoneal cavity
occult blood |
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The Female Patient:
-The anorectal area is usually examined ... the female genitalia, while the woman is in the ... position. -If only the anorectal area requires examination, the ...-lying position is satisfactory. -Use the same techniques for examination that are used for men. |
after
lithotomy side |
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...: fairly common, probably congenital, abnormality located in the midline superficial to the coccyx or the lower sacrum. Generally asymptomatic, but may be complicated by ....
picture on slide 36 |
Pilonidal Cyst and Sinus
abscess |
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Female Urethral Catheterization:
1. position 2. clean the ... 3. lubricate the ... 4. gently insert the ... 5. ***Advance catheter ... *** 6. inflate ... w/ recommended volume pictures slides 37 – 41 |
meatus
catheter catheter well into the bladder balloon |
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Male Urethral Catheterization:
1. clean the ... and ... 2. instill ... and/or ... (usually supplied w/ cath set) 3. gently insert catheter -The ... Catheter (J-1): may be necessary in a male patient with a large prostate that makes standard catheterization difficult. *... tips are angulated and firm.* 4. Inflate balloon w/ recommended volume when catheter is well ... bladder pictures slides 42-46 |
meatus and glans
lubricant and/or local anesthetic Coude Tip Coude within |
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... - An abnormal constriction of the foreskin that prevents it from being drawn back to uncover the glans penis.
slides 47-53 |
Phimosis
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... - Retraction and constriction, especially of the prepuce behind the glans penis. This is an emergency!
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paraphimosis
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Paraphimosis is frequently ..., occurring during catheterization or physical examination. If the retracted foreskin is somewhat tight, it functions as a tourniquet, causing the glans to swell, both blocking the foreskin from returning to its normal position and worsening the constriction. It should be regarded as an ..., because constriction leads quickly to vascular compromise and .... Firm circumferential compression of the glans with the hand may relieve edema sufficiently to allow the foreskin to be restored to its normal position. If this is ineffective, a dorsal slit performed using a local anesthetic relieves the condition temporarily. ... is then performed when edema has resolved.
slides 54-63 |
iatrogenic
emergency necrosis Circumcision |
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Attention to ... penile nerves for regional anesthesia
picture on slide 64 |
dorsal
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... is an inflammation of the glans penis. In ... (inflammation of the glans and prepuce), the glans (tip) of the penis becomes irritated and inflamed as a result of bacterial or fungal infection, irritation from chemicals in clothing, or an unknown cause.
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Balanitis
balanoposthitis |
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Zipper entrapment:
slides 68 - 71 |
ok
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