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Anus, Rectum

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Infant passes stools by reflex until 1 - 2 yrs. Wave of ... Place pad of index finger gently against anal verge should feel anus tighten then relax ... – PowerPoint PPT presentation

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Title: Anus, Rectum


1
Anus, Rectum Prostate Assessment
  • Week 9

2
Structures of the Anus Rectum
3
Anatomy of the Prostate Gland and Seminal Vesicles
4
Anatomy of the Female Internal Genitalia
5
A P Dev. Considerations
  • Infant passes stools by reflex until 1½ - 2 yrs  
  • Wave of peristalsis called gastrocolic reflex
  • At puberty prostate ? rapidly ?2x previous size
  • Prostate starts to enlarge during middle adult
    years Benign Prostatic Hypertrophy present in
    110 males at age 40 ?s with age
  • Thought its due to hormonal imbalance leading to
    growth of benign adenomas, which gradually
    obstruct urethra urine output.

6
Transcultural Considerations
  • Prostate cancer more common in North America
    northwestern Europe, is rare in Central South
    America, Africa Asia
  • Incidence rates 50 higher in Black-Americans
    than other racial groups
  • Mortality rates 2x higher for blacks than whites
  • Black-Americans highest incidence rates in world
    cause unknown inherited predisposition could
    account for 5 10 of prostate cancers dietary
    fat may also be factor.

7
Subjective Data Collection
  • Usual bowel routine
  • Change in bowel habits
  • Rectal bleeding, blood in the stool
  • black or tarry stool called MELENA blood from
    higher in GI tract
  • Rectal conditions
  • Family history
  • Self-care behaviours
  • Medications.

8
Objective DataThe Physical Exam
Anus, Rectum, and Prostate
  • Preparation
  • Position
  • Equipment needed
  • Penlight
  • Lubricating jelly
  • Glove
  • Guaiac test container

Slide 25-5
9
Inspection
  • Perform rectal exam on all adults, particularly
    those in middle late years
  • Position male (L) side or standing, female in
    lithotomy then move to (L) side drape
    appropriately
  • Inspect perianal area
  • Inspect sacrococcygeal area
  • Ask client to perform Valsalva maneuver nothing
    should protrude
  • Use clock face to describe location of lesion
    around anus

10
Palpation
  • Place pad of index finger gently against anal
    verge should feel anus tighten then relax
  • Flex tip of finger slowly insert into anal
    canal in direction of umbilicus
  • Rotate examining finger to palpate entire
    muscular ring - examine sphincter muscle tone
  • Use thumb forefinger to palpate perianal tissue
    assess for swelling tenderness, assess
    bulbourethral glands
  • Insert finger further to examine rectal wall -
    normally feels smooth with no nodularity .

11
11
Palpation of the Anus Rectum
12
Developmental Considerations of Aging Adult
  • When aging person performs valsalva may note
    relaxation of perianal musculature decreased
    sphincter control
  • Exam same as previously described.

13
Abnormal FindingsAnus and Perianal Region
Anus, Rectum, and Prostate
  • Pilonidal cyst or sinus
  • Hemorrhoids

Slide 25-9
14
Abnormal Findings Pilonidal Sinus Hemorrhoids
15
Abnormal FindingsRectum
Anus, Rectum, and Prostate
  • Rectal polyp
  • Fecal impaction

Slide 25-10
16
Polyps Impaction
17
THE END
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