CSD 2C | Rectal Examination GI

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Which of the following is NOT a common indication for a rectal examination?

Perianal pruritus

Nausea and vomiting (correct)

Unexplained weight loss

Rectal bleeding

What is the length of the anal canal from the anorectal junction to the anal verge?

10 - 15 cm

3 - 5 cm (correct)

5 - 8 cm

1 - 3 cm

What is the absolute contraindication for a digital rectal examination?

Lack of consent (correct)

Anal strictures

Severe anal pain prompting anesthesia

Recent anal surgery

In men, what is one of the primary reasons for performing a digital rectal examination?

To screen for suspected prostatic cancer Signup and view all the answers

What is an example of a relative contraindication for a digital rectal examination?

Anorectal mass Signup and view all the answers

What is the significance of routine digital rectal examination according to the article by Manimaran N and Galland RB?

Diagnosis of abdominal pain Signup and view all the answers

During rectal examination, how far should the digit be inserted into the rectum?

Approximately 4 inches Signup and view all the answers

Which artery supplies the rectum and anal canal?

Internal iliac artery Signup and view all the answers

What is the typical location of an anal fissure in the perianal region?

Posterior midline Signup and view all the answers

What position can be chosen for perianal inspection during a digital rectal examination?

Lithotomy position Signup and view all the answers

When assessing stool color, what does black and tarry stool indicate?

Bleeding from upper gastrointestinal tract Signup and view all the answers

What does the Bristol Stool Scale (BSS) characterize?

Stool consistency Signup and view all the answers

What should be performed if there is no gross blood after a rectal examination?

Perform a fecal occult blood test on the residual matter Signup and view all the answers

Where are the columns of Morgani located?

Superior half of the rectum Signup and view all the answers

What does a pale and greasy stool suggest?

Steatorrhea plus upper gastrointestinal bleeding Signup and view all the answers

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 Signup and view all the answers

What should be done to prompt a Valsalva maneuver during perianal inspection?

Instruct the patient to deeply inhale Signup and view all the answers

What is the approximate length of the anal canal in adults?

3 to 5 cm Signup and view all the answers

Which anatomical structure demarcates the rectosigmoid junction?

Teniae coli Signup and view all the answers

What is the main responsibility of the internal anal sphincter?

Provides continuous anal contraction for anal continence between bowel movements Signup and view all the answers

What is the purpose of using a topical anesthetic during digital rectal examination?

In case the patient has local discomfort Signup and view all the answers

When is anoscopy indicated?

When disease in the anal canal is suspected Signup and view all the answers

What equipment is needed to perform anoscopy?

An anoscope, cotton swabs, tissue paper, and a dedicated light source Signup and view all the answers

What is the main responsibility of the external anal sphincter?

Voluntary control for additional continence Signup and view all the answers

What position can be used for digital rectal examination and anoscopy?

Standing, lithotomy, knee-to-chest, and prone positions Signup and view all the answers

What anatomical structures differ in females and males anterior to the rectum?

Prostate and vagina Signup and view all the answers

What demarcates the anorectal junction?

Puborectalis muscle ring Signup and view all the answers

What is indicated in patients who present with perianal pruritus?

Digital rectal examination Signup and view all the answers

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. Signup and view all the answers

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. Signup and view all the answers

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. Signup and view all the answers

What is the recommended external diameter of an anoscope for most adults?

19 mm Signup and view all the answers

When inserting the anoscope, what maneuver may make the insertion easier for the patient?

Asking the patient to take deep breaths and bear down. Signup and view all the answers

What should be done if any fecal matter is observed during anoscopy?

Remove it with a large swab. Signup and view all the answers

What is recommended to prevent complications such as patient discomfort and perianal abrasions during digital rectal examination and anoscopy?

Use lubricant generously. Signup and view all the answers

What should be documented when identifying lesions observed during the physical examination?

Their anatomical location as anterior, posterior, left, or right. Signup and view all the answers

What should be done if a local anesthetic is not sufficient to alleviate patient discomfort during examination?

Refer for examination under general anesthesia. Signup and view all the answers

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. Signup and view all the answers

What is used to remove any fecal matter observed during anoscopy?

A large swab Signup and view all the answers

Which maneuver may help visualize prolapsing hemorrhoids or mucosa in patients whose symptoms suggest prolapse during digital rectal examination?

Valsalva maneuver Signup and view all the answers