Anus, rectum, and prostate Flashcards
What in the health history is essential to ask regarding anus, rectum, and prostate?
change in bowel habits, blood in stool, pain w/ defecation, rectal bleeding or tenderness, anal warts or fissures, weak urinary stream, changes in urinary habits, dysuria, hematuria
What should you ask about any changes in bowel habits?
size or caliber of stools, diarrhea, constipation, color of stools, mucus presence
If someone says yes to rectal bleeding, what else should you ask about?
family history of colonic polyps, cancer, IBD
What can pencil-thin stools indicate?
colon cancer
What can blood in stool indicate?
polyps, hemorrhoids, GI bleeding, or carcinoma
What can mucus in stool indicate?
villous adenomas, intestinal infections, IBD, IBS
What are some unhealthy stools?
yellow, green, quickly sinking or floating, pebble, loose, mucus, pencil-thin, pale, undigested, bright red, black
If someone has pain with defecation, what should you ask?
itching, extreme tenderness in rectum or anus, presence of mucopurulent discharge, ulcers, repetitive anal intercourse, insertion of foreign body in rectum
What’s the inflammation of the lining of the rectum with symptoms like anorectal pain, tenesmus, discharge and/or bleeding?
proctitis
What could proctitis be caused by?
IBD, STIs, trauma from receptive anal intercourse, bacterial infections, radiation therapy
What are anal fissures?
small tear in lining of the anus, commonly from passing large or hard stools and constipation and straining
Or… chrohn’s disease/IBD, anal cancer, HIV, TB, syphilis
What are anal warts?
HPV or secondary syphilis, ask about any history!
If a patient has anal foreign bodies, what do you need to ask?
why it’s there, consent, ask about batteries, designed for internal use, what kind of object?
If a patient has a weak urinary stream, what should you ask about?
- urinary intermittency
- weak or strong flow of urine
- blood in urine
- frequency
- retention
- sudden onset of similar symptoms
What does a sudden onset of urinary frequency, urgency, dysuria, perineal & low back pain, malaise, fever, or chills?
possible acute prostatitis
When are symptoms with urinary issues particularly indicative of BPH?
men > 70 yrs
What helps diagnose BPH?
american urological association symptom score
What can blood in the urine be caused by?
BPH, urolithiasis, nephrolithiasis, UTIs, prostate, bladder or kidney cancer
What are key components of anorectal and prostate exams?
- properly position patient (side = preferred)
- inspect sacrococcygeal and perianal areas
- look for lesions, ulcers, inflammation, rash, excoriations
- inspect anus (lesions, mass, skin breakdown)
- perform digitial
How should you position a patient for a rectal exam?
ask patient to lie on left side w hips and knees partially flexed, drape appropriately
