40 Questions
Which of the following is NOT a common indication for a rectal examination?
Nausea and vomiting
What is the length of the anal canal from the anorectal junction to the anal verge?
3 - 5 cm
What is the absolute contraindication for a digital rectal examination?
Lack of consent
In men, what is one of the primary reasons for performing a digital rectal examination?
To screen for suspected prostatic cancer
What is an example of a relative contraindication for a digital rectal examination?
Anorectal mass
What is the significance of routine digital rectal examination according to the article by Manimaran N and Galland RB?
Diagnosis of abdominal pain
During rectal examination, how far should the digit be inserted into the rectum?
Approximately 4 inches
Which artery supplies the rectum and anal canal?
Internal iliac artery
What is the typical location of an anal fissure in the perianal region?
Posterior midline
What position can be chosen for perianal inspection during a digital rectal examination?
Lithotomy position
When assessing stool color, what does black and tarry stool indicate?
Bleeding from upper gastrointestinal tract
What does the Bristol Stool Scale (BSS) characterize?
Stool consistency
What should be performed if there is no gross blood after a rectal examination?
Perform a fecal occult blood test on the residual matter
Where are the columns of Morgani located?
Superior half of the rectum
What does a pale and greasy stool suggest?
Steatorrhea plus upper gastrointestinal bleeding
What should be performed if there is gross blood after withdrawing your finger during a rectal examination?
Perform a fecal occult blood test on the residual matter
What should be done to prompt a Valsalva maneuver during perianal inspection?
Instruct the patient to deeply inhale
What is the approximate length of the anal canal in adults?
3 to 5 cm
Which anatomical structure demarcates the rectosigmoid junction?
Teniae coli
What is the main responsibility of the internal anal sphincter?
Provides continuous anal contraction for anal continence between bowel movements
What is the purpose of using a topical anesthetic during digital rectal examination?
In case the patient has local discomfort
When is anoscopy indicated?
When disease in the anal canal is suspected
What equipment is needed to perform anoscopy?
An anoscope, cotton swabs, tissue paper, and a dedicated light source
What is the main responsibility of the external anal sphincter?
Voluntary control for additional continence
What position can be used for digital rectal examination and anoscopy?
Standing, lithotomy, knee-to-chest, and prone positions
What anatomical structures differ in females and males anterior to the rectum?
Prostate and vagina
What demarcates the anorectal junction?
Puborectalis muscle ring
What is indicated in patients who present with perianal pruritus?
Digital rectal examination
What is the purpose of using two gloves on the dominant hand and one glove on the nondominant hand before beginning the examination?
To prevent contamination of both hands during the examination.
When is a digital rectal examination not needed in a patient with severe anal pain?
If a fissure or a thrombosed external hemorrhoid is clearly visualized.
What is the purpose of asking the patient to bear down during the digital rectal examination?
To relax the anal sphincter and increase patient comfort.
What is the recommended external diameter of an anoscope for most adults?
19 mm
When inserting the anoscope, what maneuver may make the insertion easier for the patient?
Asking the patient to take deep breaths and bear down.
What should be done if any fecal matter is observed during anoscopy?
Remove it with a large swab.
What is recommended to prevent complications such as patient discomfort and perianal abrasions during digital rectal examination and anoscopy?
Use lubricant generously.
What should be documented when identifying lesions observed during the physical examination?
Their anatomical location as anterior, posterior, left, or right.
What should be done if a local anesthetic is not sufficient to alleviate patient discomfort during examination?
Refer for examination under general anesthesia.
What should be noted after fully withdrawing the anoscope from the patient's anal canal?
The presence of any visible blood and fecal matter on the glove.
What is used to remove any fecal matter observed during anoscopy?
A large swab
Which maneuver may help visualize prolapsing hemorrhoids or mucosa in patients whose symptoms suggest prolapse during digital rectal examination?
Valsalva maneuver
Explore references related to digital rectal examination, anoscopy, and abdominal diagnosis from reputable sources such as the New England Journal of Medicine and Textbook of Physical Diagnosis. Gain insights into relevant chapters and resources for comprehensive understanding.
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