anus and bowel

Question 1

anal canal

Answer 1

outlet of the gastro-intestinal tract, and it is about 3.8 cm long in adults.
It is lined with modified skin (which has no hair or sebaceous glands) that merges with rectal mucosa at the anorectal junction.

Question 2

sphincters

Answer 2

internal sphincter is under involuntary control by the autonomic nervous system

external sphincter surrounds the internal sphincter and has a small section overriding the tip of the internal sphincter at the opening.

It is under voluntary control

Question 3

intersphincteric groove

Answer 3

separates the internal and external sphincters and is palpable.

Question 4

Peritoneal Reflection in males

Answer 4

The peritoneum covers only the upper two-thirds of the rectum.

In males, the anterior part of the peritoneum reflects down to within 7.5 cm of the anal opening, forming the rectovesical pouch and then covers the bladder.

Question 5

Peritoneal Reflection in females

Answer 5

In females, this area is termed the rectouterine pouch, and it extends down to within 5.5 cm of the anal opening.

Question 6

male puberty

Answer 6

prostate gland undergoes a very rapid increase to more than twice its prepubertal size.

During early adulthood, its size remains fairly constant.

The prostate gland commonly starts to enlarge during the middle adult years. This enlargement, benign prostatic hypertrophy is present in 10% of men by 40 years of age and increases with age.

Question 7

Colorectal cancer

Answer 7

second most common cancer, accounting for 13% of all cancers in Canada

1 in 14 Canadian men and 1 in 16 Canadian women during their lifetime.

there were large differences among provinces, and individuals in lower-income groups were less likely to be screened than those in the highest income group,

Question 8

Risk factors for developing CRC

Answer 8

being of older age, particularly >50 years;

having a family history of CRC, having familial adenomatous polyposis or hereditary nonpolyposis colon cancer;

having inflammatory bowel disease;

eating a diet high in red and processed meats;

consuming alcohol; smoking;

being physically inactive; being obese

Question 9

Diarrhea

Answer 9

occurs with gastroenteritis, colitis, and irritable bowel syndrome.

Question 10

melena

Answer 10

Black or bloody stools

Question 11

Steatorrhea

Answer 11

excessive fat in the stool, as occurs in malabsorption of fat.

Question 12

Pruritus

Answer 12

(itching) can be caused by hemorrhoids.

Question 13

Encopresis

Answer 13

persistent passing of stools into clothing by a child older than age 4 years, at which age continence would be expected.

Question 14

Subjective Data

Answer 14

1. Usual bowel routine
2. Change in bowel habits
3. Rectal bleeding, blood in the stool
4. Medications
5. Rectal conditions
6. Family history
7. Self-care behaviours

Question 15

Examine the male patient

Answer 15

left lateral decubitus or standing position.

Instruct the standing male patient to point his toes together; this relaxes the regional muscles, making it easier to spread the buttocks.

Question 16

Place the female patient

Answer 16

lithotomy position if you are examining genitalia as well; use the left lateral decubitus position for examination of the rectal area alone.

Question 17

Help the patient relax and retain a sense of control by using these measures:

Answer 17

• Ensure privacy.
• Explain each step in the examination before you perform it.
• Use a gentle, firm touch and gradual movements.
• Communicate throughout the examination. Maintain a dialogue to share information.