Anus, Rectum, Prostate (Exam 3)

Question 1

Anal canal

Answer 1

outlet of the GI tract

Question 2

Sphincters

Answer 2

2 concentric layers of muscle surrounding anal canal

Question 3

Intersphinteric groove

Answer 3

separates the internal and external sphincters

PALPABLE

Question 4

Rectum

Answer 4

distal portion of large intestine

Question 5

Valves of Houston

Answer 5

3 semilunar transverse folds

Question 6

Prostate

Answer 6

in front of anterior wall of rectum and 2cm behind symphysis pubis surrounding the bladder neck and urethra

SECRETES A THIN, MILKY, ALKALINE FLUID THAT SUPPORTS SPERM

Question 7

Subjective Data

Answer 7

S/S (bowel routine, changes in bowel habits, rectal bleeding or blood in stool)
Medications (laxatives, stool softeners, iron)
Rectal conditions (pruritis, hemorrhoids, fissure, fistula)
Family history (prostate cancer)
PCC (high fiber diet, most recent exam)

Question 8

Benign Prostatic Hyperplasia (BPH)

Answer 8

prostate gland starts to enlarge during middle adulthood; BPH present in 80% of men over 60

IMBALANCE BETWEEN CELL PROLIFERATION AND APOPTOSIS

prostatic growth constricts urethra and causes obstruction, impedes urine output like clamp on a garden hose

Question 9

Prostate Cancer

Answer 9

MOST FREQUENTLY DIAGNOSED CANCER IN MEN, SLOW GROWING

increasing age, family history (brother or father), AA and African Caribbean men, obesity, smoking

PSA SCREENING

Question 10

Prostate-Specific Antigen (PSA)

Answer 10

small protein made by prostate gland

blood tested annually and followed for rise in PSA; rising PSA means gland is active which can also occur with noncancerous growth, infection like prostatitis, and ejaculation, NOT JUST CANCER

Question 11

PSA Screening

Answer 11

screening is effective in detecting early prostate cancer, not always accurate

FURTHER TESTING FOR RISING PSA INCLUDE RADIOLOGIC IMAGING AND BIOPSY can be costly and slightly painful, can lead to worry waiting for results

WITH PSA SCREENING, 5-10 YR SURVIVAL RATES ARE CLOSE TO 100%-98%

Question 12

Colorectal cancer (CRC)

Answer 12

3RD MOST COMMON CAUSE OF CANCER DEATH IN THE US; COLONOSCOPY RECOMMENDED AT AGE 45

CANCER STAGE AT DIAGNOSIS IS MOST SIGNIFICANT FACTOR IN CRC PROGNOSIS

has a precursor lesion in bowel lining-adenomatous colon polyps, which are protrusions into the lumen of the bowel

Question 13

CRC Risk factors

Answer 13

highest to lowest risk: blacks, native americans, whites, hispanics, AAPI

older age
hereditary Lynch syndrome
history of chronic IBS (ulcerative colitis or crohns)
type 2 diabetes

MODIFIABLE RISK FACTORS ARE MORE THAN HALF OF CASES AND DEATHS
smoking
risky diet (high in processed or red meat, low in calcium, low in fruits and veggies, low in whole grains)
heavy drinking
obesity
physical inactivity

CAN BE REDUCED BY ACCESS TO SCREENINGS, HEALTH TEACHING, AND GOOD DIET

Question 14

Testing stool for occult blood

Answer 14

liquid based/dry slide cards

Question 15

Hemorrhoids

Answer 15

common, flabby papules are a varicose vein

Question 16

External hemorrhoid

Answer 16

below anorectal junction covered by anal skin

Question 17

Internal hemorrhoid

Answer 17

above anorectal junction covered by mucous membrane

Question 18

Fissure

Answer 18

painful longitudinal tear in superficial mucosa at anal margin

pain with passing stool is described as passing shards of glass and may have bright red color

caused by trauma, ischemia, elevated anal pressure

Question 19

Fecal impaction

Answer 19

complete colon blockage by hard, desiccated immovable stool which presents as constipation or overflow incontinence

Question 20

Rectal prolapse

Answer 20

complete rectal mucous membrane protrudes through anus, appearing as a moist red doughnut with radiating lines

Question 21

Bright red stool color

Answer 21

rectal bleeding

Question 22

Black tarry stool color

Answer 22

with distinct malodor means upper GI bleeding with blood partially digested

Question 23

Occult bleeding in stool

Answer 23

cancer of the colon