Chapter 15-anus, rectum, prostate Flashcards
prostate
3 lobes of the prostate surround the urethra. . two lateral lobes lie against the anterior rectal wall, palpable as a rounded heart shaped structure approx 2.5 cm long. 4x2x3
median sulcus
two lateral lobes separated by median sulcus
exam
inspect for lumps, ulcers, inflammation, rashes, excoriations
examine anus and rectum
note: shincter tone, tenderness, induration, irregularities or nodules
pilonidal cyst
abnormality in the midline superficial to the coccyx or lower sacrum. look for an opening to sinus tract. may form abscess
external hemorrhoids
dilated hemorrhoidal veins-local pain with defecation and sitting.
internal hemorrhoids
enlargements of the normal vascular cushions located above the pectinate line
prolapse rectum
on straining for a bm, the rectal mucosa w or w/o muscular wall may prolapse through the anus appearing as a doughnut or rosette of red tissue.
anal fissure
painful oval ulceration of the anal canal, found most commonly in the midline posteriorly. may be a swollen sentinel skin tag just below it. gentle seperation of the anal margins may reveal the lower edge of the fissure
anorectal fissure
inflammatory tract or tube that opens at one end into the anus or rectum and at the other end onto the skin surface or into another viscus.
rectal shelf
widespread peritoneal metastases from any source may develop in the area of the peritoneal reflection anterior to the rectum. firm to hard nodular rectal shelf may be palpable withthe tip of the finger.
prostatitis
presents with fever and urinary tract symptoms such as frequency, urgency, dysuria, incomplete voiding, lower back pain. gland feel tender, swollen, boggy, warm
Prostate lobes
Anterior lobe part of transitional zone. 10-20% of cancers and BPH in this lobe
Posterior lobe peripheral zones 70-80% of cancers
Lateral lobes spans all zones
Median is central surrounds ejaculatory ducts. 2.5 % of cancers although these are invasive
