Copyright 2002, Delmar, A division of Thomson Learning Chapter 22 Anus, Rectum, and Prostate.

Copyright 2002, Delmar, A division of Thomson Learning

Chapter 22

Anus, Rectum, and Prostate


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.

(continues)


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.


Assessment to Include Male

Anus, rectum, prostate Female

Anus, rectum


Health History Age

Young adult Middle-aged adult Older adult

Sex Female Male

Race


Common Chief Complaints Rectal bleeding Rectal pain Anal incontinence Constipation Diarrhea Pruritis Palpable mass


Characteristics of Chief Complaint Quality Quantity Associated manifestations Aggravating factors Alleviating factors Timing


Past Health History Medical history

Anorectal specific Systemic

Surgical history Anorectal specific Prostate

Medications

(continues)


Past Health History Communicable diseases Allergies Injuries/accidents Childhood illnesses

Anal stenosis Hirschsprung’s disease

(continues)


Past Health History Family history

Rectal polyps Rectal cancer Pilonidal cyst Prostate cancer

(continues)


Past Health History Social history

Substance use Sexual practices Work environment Hobbies/leisure Stress

(continues)


Past Health History Health maintenance

Sleep Diet Exercise Safety devices Health checkups


Assessment Special equipment General approach

Minimize apprehension Privacy Comfort

Patient position Left lateral decubitus Standing Knee-chest


Inspection Assess the following areas for

lesions, swelling, inflammation, tenderness, color, appearance Perineum Sacrococcygeal area Anal mucosa


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


Gerontological Variations Decreased muscle elasticity in the

rectum Increased risk for rectal prolapse Bowel function changes Enlarged prostate Increased risk for prostate cancer


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


Common Abnormal Findings Excoriation of the perineal skin Hemorrhoids Anal fissures Anorectal abscess Anorectal fistula

(continues)


Common Abnormal Findings Rectal prolapse Anal incontinence Anal stenosis Internal hemorrhoids Rectal polyps Benign prostatic hypertrophy

(continues)


Common Abnormal Findings Variations in stool color

Bright red stool Black stool Melena Gray, tan Pale yellow, greasy, fatty


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


Risk Factors for Prostate Cancer Age > 50 Family history African American Diet high in fat, oil, sugar High levels of serum testosterone

Copyright 2002, Delmar, A division of Thomson Learning Chapter 22 Anus, Rectum, and Prostate.

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