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Copyright 2002, Delmar, A division of Thomson Learning
Chapter 22
Anus, Rectum, and Prostate
Copyright 2002, Delmar, A division of Thomson Learning
Competencies Identify anatomic landmarks of the
rectum and the prostate gland. Describe the characteristics of the
most common rectal and prostatic chief complaints.
Perform inspection and palpation of the anus, rectum, and prostate on an adult.
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Copyright 2002, Delmar, A division of Thomson Learning
Competencies Explain the pathophysiologic
rationale for abnormal findings. Document assessment findings. Describe the changes that occur
in the rectum and the prostate with the aging process.
Copyright 2002, Delmar, A division of Thomson Learning
Assessment to Include Male
Anus, rectum, prostate Female
Anus, rectum
Copyright 2002, Delmar, A division of Thomson Learning
Health History Age
Young adult Middle-aged adult Older adult
Sex Female Male
Race
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Common Chief Complaints Rectal bleeding Rectal pain Anal incontinence Constipation Diarrhea Pruritis Palpable mass
Copyright 2002, Delmar, A division of Thomson Learning
Characteristics of Chief Complaint Quality Quantity Associated manifestations Aggravating factors Alleviating factors Timing
Copyright 2002, Delmar, A division of Thomson Learning
Past Health History Medical history
Anorectal specific Systemic
Surgical history Anorectal specific Prostate
Medications
(continues)
Copyright 2002, Delmar, A division of Thomson Learning
Past Health History Communicable diseases Allergies Injuries/accidents Childhood illnesses
Anal stenosis Hirschsprung’s disease
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Copyright 2002, Delmar, A division of Thomson Learning
Past Health History Family history
Rectal polyps Rectal cancer Pilonidal cyst Prostate cancer
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Copyright 2002, Delmar, A division of Thomson Learning
Past Health History Social history
Substance use Sexual practices Work environment Hobbies/leisure Stress
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Copyright 2002, Delmar, A division of Thomson Learning
Past Health History Health maintenance
Sleep Diet Exercise Safety devices Health checkups
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Assessment Special equipment General approach
Minimize apprehension Privacy Comfort
Patient position Left lateral decubitus Standing Knee-chest
Copyright 2002, Delmar, A division of Thomson Learning
Inspection Assess the following areas for
lesions, swelling, inflammation, tenderness, color, appearance Perineum Sacrococcygeal area Anal mucosa
Copyright 2002, Delmar, A division of Thomson Learning
Palpation Anus and rectum
Assess for masses, anal sphincter, nodules
Prostate Bidigital exam Assess for tenderness, masses, or
swelling Assess posterior surface for size,
shape, consistency, mobility
Copyright 2002, Delmar, A division of Thomson Learning
Gerontological Variations Decreased muscle elasticity in the
rectum Increased risk for rectal prolapse Bowel function changes Enlarged prostate Increased risk for prostate cancer
Copyright 2002, Delmar, A division of Thomson Learning
Normal Findings Perineum and sacrococcygeal areas
Tissue is smooth, intact, free from tenderness
Anal mucosa Tissue is pigmented, coarse, moist, and
hairless Rectum
Good sphincter tone No excessive pain, tenderness, induration,
or nodules
Copyright 2002, Delmar, A division of Thomson Learning
Common Abnormal Findings Excoriation of the perineal skin Hemorrhoids Anal fissures Anorectal abscess Anorectal fistula
(continues)
Copyright 2002, Delmar, A division of Thomson Learning
Common Abnormal Findings Rectal prolapse Anal incontinence Anal stenosis Internal hemorrhoids Rectal polyps Benign prostatic hypertrophy
(continues)
Copyright 2002, Delmar, A division of Thomson Learning
Common Abnormal Findings Variations in stool color
Bright red stool Black stool Melena Gray, tan Pale yellow, greasy, fatty
Copyright 2002, Delmar, A division of Thomson Learning
Risk Factors for Rectal Cancer Age > 50 Familial history History of adenomatous polyps,
familial polyposis, endometrial or ovarian or breast cancer
Diet low in fiber, high in fat
Copyright 2002, Delmar, A division of Thomson Learning
Risk Factors for Prostate Cancer Age > 50 Family history African American Diet high in fat, oil, sugar High levels of serum testosterone
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