Male Rectal Exam and Anorectal Pathology

Length of anal canal

2.5-4 cm long.

Innervation of lower half of anal canal

Somatic sensory innervation.

Innervation of upper half of anal canal

Autonomic control.

Length of rectum

12 cm long.

Function of rectal ampulla

Stores flatus and feces.

Prostate location relative to bladder and urethra

At the bladder base, surrounding the urethra.

Prostate surface accessible during DRE

Posterior surface only.

Prostate location relative to rectal wall

Lies against the anterior rectal wall.

Anatomical structure of prostate gland

Three lobes with a median sulcus.

Is the median lobe of the prostate palpable on DRE?

No, it is not palpable.

Patient positions for performing DRE

Knee-to-chest, left lateral flexed, or standing with upper body supported.

System used to describe anal and rectal finding locations

Clock referents.

Clinical significance of reduced sphincter tone

Indicates a potential neurological deficit.

Causes of tight rectal sphincter tone

Scarring, anxiety, or inflammation.

Clinical implication of rectal pain

Always indicative of local disease.

Normal findings of posterior prostate on DRE

Rubbery, nontender, with palpable median sulcus.

Position to palpate rectovaginal wall in female patients

Lithotomy position.

Pathophysiology of pilonidal cyst

Hair penetrating skin in the sacrococcygeal area.

Clinical features of pilonidal cyst

Painful, fluctuant lesion at top of gluteal cleft.

Etiology of anal warts

Human Papillomavirus (HPV).

Appearance of anal warts

Pedunculated lesions along anus and gluteal cleft.

Perianal or perirectal abscess definition

Infection of soft tissue or mucus glands around anal canal.

Microbiology of perianal abscesses

Polymicrobial.

Anorectal fissure definition

Tear in the anal mucosa.

Classic symptoms of anorectal fissure

Pain with bowel movement, constipation, blood on toilet paper.

Anal fistula cause and course

Tunnel from anus/rectum to skin surface, caused by abscess drainage.

Common causes of pruritus ani

Fungal infection in adults, parasites in children.

Location and covering of external hemorrhoids

Below anorectal line, covered by anal skin.

Location and covering of internal hemorrhoids

Above anorectal junction, covered by rectal mucosa.

Typical patient demographic for rectal prolapse

Elderly women.

Most common histological type of anal cancer

Squamous cell carcinoma.

Screening frequency for anal cancer in high-risk patients

Annually.

Origin of anorectal adenocarcinomas

Glands near the anus.

Most common histological type of colorectal cancer

Adenocarcinoma.

DRE findings in acute bacterial prostatitis

Tender, enlarged, and boggy prostate.