Anus/Rectum/Prostate

Question 1

internal sphincter

Answer 1

under involuntary control by the autonomic nervous system

Question 2

external sphincter

Answer 2

surrounds the internal sphincter, under voluntary control

Question 3

prostate

Answer 3

2 cm behind symphysis pubis
Surrounds bladder neck and urethra
Secretes thin, milky alkaline fluid that helps sperm viability

Question 4

sigmoid colon

Answer 4

S-shaped course in pelvic cavity from iliac flexure of descending colon and ends at rectum
40 cm long

Question 5

gastrocolic reflex

Answer 5

After eating- wave of peristalsis, voiding shortly after eating

Question 6

control of sphincter

Answer 6

not achieved until 1.5-2 years

Question 7

male puberty

Answer 7

prostate gland- rapid increase to greater than twice its prepubertal size

Question 8

Who is more at risk for prostate cancer?

Answer 8

African Americans and men whose first-degree relatives relatives had prostate cancer

Starts younger in African Americans and grows faster than other racial/ethnic groups

Question 9

risk for prostate cancer

Answer 9

Men who have three or more family members with prostate cancer is about ten times

Question 10

How is prostate cancer detected?

Answer 10

prostatic specific antigen (PSA)
and/or
digital rectal exam (DRE)

Question 11

hemorrhoid

Answer 11

Flabby skin sac, thromboses hemorrhoid is shiny and blue

Question 12

fistula

Answer 12

small, round opening in anal area

Question 13

black, tarry stool with malodor

Answer 13

upper GI bleeding

Question 14

black, non-tarry stool

Answer 14

may be due to ingesting iron or bismuth preparation

Question 15

gray, tan stool

Answer 15

absence of bile pigment

Question 16

pale, yellow, greasy stool

Answer 16

increased fat content, Steatorrhea

Question 17

dyschezia

Answer 17

pain due to local condition (hemorrhoid, fissure) and constipation

Question 18

early detection for cancer

Answer 18

DRE performed annually after age 50

fecal occult blood test annually after age 50

sigmoidoscopy every 5 years or colonoscopy every 10 years after age 50 (45 for African Americans)

information about PSA blood test annually for men older than 50 years or African American men beginning at age 45 years

Question 19

encopresis

Answer 19

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

Question 20

colorectal cancer

Answer 20

20% higher for African Americans

Question 21

Rome III criteria for constipation

Answer 21

3 or less stools per week
straining
lumpy or hard stools
incomplete evacuation

Question 22

risks for constipation

Answer 22

older age
women
inactivity
low calorie or low fiber diet
low income/educational level

Question 23

pilonidal cyst

Answer 23

located in the midline over the coccyx or lower sacrum. Opens as a dimple with visible tuft of hair and possibly an erythematous halo. Advanced- palpable sinus tract.
First diagnosed between 15-30 years.

Question 24

anorectal fistula

Answer 24

Chronically inflamed GI tract (Crohn disease, local irrigation) creates an abnormal passage from inner anus or rectum out to skin surrounding anus, may result from local abscess.

The red, raised tract opening may drain serosanguineous or purulent matter when pressure is applied.

May heal with warm bath, high-fiber and analgesics.

Question 25

rectal prolapse

Answer 25

rectal mucous membrane protrudes through the anus, appearing as a most red doughnut with radiating lines. Complete prolapse includes the anal sphincter.

Caused by weakened pelvic floor muscles or following Valsalva maneuver and requires surgery.

Question 26

pruritus ani

Answer 26

Intense perianal itching caused by pinworm infection, hemorrhoids, anal fissure, dermatitis, chronic diarrhea, poor hygiene, perfumes/dyes, systemic diseases such as DM or inflammatory bowel disease.

Question 27

abscess

Answer 27

cavity of pus usually extending from anal crypt

characterized by persistent throbbing rectal pain

appears red, hot, swollen, indurated and tender

must be drained before it worsens or develops sepsis

Question 28

rectal polyp

Answer 28

a protruding growth from the rectal mucous membrane that is fairly common

can be pedunculated or sessile

colonoscopy/biopsy are needed to screen for malignant growth

removal has been shown to prevent deaths from colorectal cancer

Question 29

carcinoma

Answer 29

asymptomatic

the important of a DRE

cauliflower shape, fixed and stone-hard

Question 30

things to note when checking prostate gland

Answer 30

Size- 2.5-4 cm wide, should not protrude more than 1 cm into the rectum

Shape- heart shape, with palpable central groove

Surface- smooth

Consistency- elastic, rubbery

Mobility- slightly moveable

Sensitivity- nontender to palpation