Anus, Rectum, And Prostate

Question 1

How long is the rectum?

Answer 1

12cm long
*anorectal junction
*rectal ampulla (stores feces)
*houston valves

Question 2

How long is the anal canal?

Answer 2

2.5cm to 4cm long
*internal sphincter (cannot control)
*external sphincter (controls feces expulsion)

Question 3

What are the columns of Morgagni? (Anal canal)

Answer 3

1. Vertical folds in mucosa

Question 4

What are Zona hemorrhodialis (anal canal)

Answer 4

Contains rectal venous plexus
*from anal valves to anus

Question 5

Where does the gastrointestinal tract terminate?

Answer 5

1. In a short segment, the anal canal

Question 6

What holds the anal canal in a closed position

Answer 6

1. The voluntary external anal sphincter
2. The involuntary internal anal sphincter

Question 7

Where does the angle of the anal canal lie?

Answer 7

1. On a line roughly between the anus and umbilicus

Question 8

What nerves supply the anal canal?

Answer 8

1. Somatic sensory nerves

Question 9

What is the anorectal junction (pectinate or dentate line)

Answer 9

The boundary between somatic and visceral nerve supplies

Question 10

How large is a normal prostate and what are the components?

Answer 10

4 X 3 X 2
*median sulcus (feel the back side of the prostate through the front of the rectum)
*three lobes
*alveoli

Question 11

Where does the prostate gland lie?

Answer 11

1. Against the anterior rectal wall
   *rounded, heart-shaped, and normally 2.5 cm long

Question 12

What are the palpable lobes of the prostate gland?

Answer 12

1. Lateral
2. Median sulcus

Question 13

When can infants and children control their external anal sphincter?

Answer 13

By 18 to 24 months
*bc the nervous system is still developing
*prostate is undeveloped until puberty

Question 14

What can lead or be components of anal discomfort?

Answer 14

1. Relation to position and defecation
2. Straining at stool
3. Blood and mucus
4. Interference with ADLs and sleep

Question 15

What does red blood and black blood mean in blood (where is the blood coming from)

Answer 15

Red
*lower (distal)
Black
*upper GI (stomach bleeds, stomach cancer)

Question 16

What can an enlarged prostate do to urine output?

Answer 16

1. Will clamp down on the urethra
2. Have an un-steady stream

Question 17

What is an episiotomy or fourth degree laceration?

Answer 17

1. 4th degree
   *vaginal tear to rectum
2. Episiotomy
   *trying to prevent 4th laceration
   *controlling the direction of the tear
   *cutting the perineum

Question 18

What is the leading cancer diagnosed in men in the US?

Answer 18

Prostate cancer
*3rd leading cause of death

Question 19

What are the primary risk factors for prostate cancer?

Answer 19

1. Age
2. Ethnicity
3. Family history
   *maybe an association between dietary fat and risk of prostate cancer

Question 20

What ages to screen for prostate cancer?

Answer 20

1. 55 - 69
   *discuss PSA screening
   *dont screen 70 and above

Question 21

Are prostate exams usually painful?

Answer 21

No
*if painful you’re doing it wrong or something is there like a mass

Question 22

What are the different ways to position the patient for the prostate exam?

Answer 22

1. May stand, leaning forward with upper body resting across the examining table and hips flexed
2. Patient may lie on his left side with his buttocks close to the edge of the exam table
   *flex the patients hips and knees especially top leg

Question 23

What is occult blood

Answer 23

Blood present that you cant see

Question 24

What is the difference between a fissure and fistula

Answer 24

1. Fissure (crack)
2. Fistula (hole)
   *can be found with frequent UTIs

Question 25

What walls of the rectum will you be able to feel

Answer 25

1. Lateral and posterior

Question 26

What does a normal prostate feel like

Answer 26

Rubbery and nontender

Question 27

What is the treatment for a hemorrhoid

Answer 27

1. Fiber
2. Sits bath
3. Scalpel make an X incision so the clot can drain