Title: Anus, Rectum
1Anus, Rectum Prostate Assessment
2Structures of the Anus Rectum
3Anatomy of the Prostate Gland and Seminal Vesicles
4Anatomy of the Female Internal Genitalia
5A 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.
6Transcultural 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.
7Subjective 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.
8Objective DataThe Physical Exam
Anus, Rectum, and Prostate
- Preparation
- Position
- Equipment needed
- Penlight
- Lubricating jelly
- Glove
- Guaiac test container
Slide 25-5
9Inspection
- 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
10Palpation
- 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
11Palpation of the Anus Rectum
12Developmental Considerations of Aging Adult
- When aging person performs valsalva may note
relaxation of perianal musculature decreased
sphincter control - Exam same as previously described.
13Abnormal FindingsAnus and Perianal Region
Anus, Rectum, and Prostate
- Pilonidal cyst or sinus
- Hemorrhoids
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14 Abnormal Findings Pilonidal Sinus Hemorrhoids
15Abnormal FindingsRectum
Anus, Rectum, and Prostate
- Rectal polyp
- Fecal impaction
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16Polyps Impaction
17THE END