Term
1-Change in bowel pattern, especially stools of thin pencil-like caliber, may warn of
2-Blood in the stool may be from
3-mucus may accompany |
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Definition
1-Change in bowel pattern, especially stools of thin pencil-like caliber, may warn of colon cancer.
2-Blood in the stool may be from polyps or cancer, also from gastrointestinal bleeding or local hemorrhoids;
3-mucus may accompany villous adenoma |
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Term
Proctitis if itching, anorectal pain, tenesmus, or discharge or bleeding from infection or rectal abscess. Causes include gonorrhea, chlamydia, lymphogranuloma venereum, receptive anal intercourse, ulcerations of herpes simplex, chancre of primary syphilis. Itching in younger patients may be from pinworms. |
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Definition
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Term
Genital warts from
condylomata lata in
Anal fissures in |
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Definition
Genital warts from human papillomavirus
condylomata lata in secondary syphilis
Anal fissures in proctitis, Crohn's disease |
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Term
| difficulty starting or holding back the urine stream? Is the flow weak? What about frequent urination, especially at night? Or pain or burning as urine is passed? Any blood in the urine or semen or pain with ejaculation? Is there frequent pain or stiffness in the lower back, hips, or upper thighs |
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Definition
| These symptoms suggest urethral obstruction as in benign prostatic hyperplasia (BPH) or prostate cancer, especially in men older than 70 years. The AUA Symptom Index helps quantify BPH severity and need for referral |
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Term
| feeling of discomfort or heaviness in the prostate area at the base of the penis, Any associated malaise, fever, or chills Suggests |
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Definition
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Term
Anal and perianal lesions include-
A linear crack or tear suggests-
if swollen, thickened, fissured perianal skin with excoriations is noted Consider- |
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Definition
Anal and perianal lesions include hemorrhoids, venereal warts, herpes, syphilitic chancre, and carcinoma.
A linear crack or tear suggests anal fissure from large, hard stools, inflammatory bowel disease, or STDs.
if swollen, thickened, fissured perianal skin with excoriations is noted Consider pruritus ani |
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Term
Tender, purulent, reddened mass with fever or chills accompanies an anal abscess.
Abscesses tunneling to the skin surface from the anus or rectum may form a clogged or draining anorectal fistula.
Fistulas may ooze blood, pus, or feculent mucus. |
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Definition
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Term
No perirectal lesions or fissures. External sphincter tone intact. Rectal vault without masses. Prostate smooth and nontender with palpable median sulcus. (Or in a female, uterine cervix nontender.) Stool brown and hemoccult negative.”
OR
“Perirectal area inflamed; no ulcerations, warts, or discharge. Unable to examine external sphincter, rectal vault, or prostate because of spasm of external sphincter and marked inflammation and tenderness of anal canal.”
OR
“No perirectal lesions or fissures. External sphincter tone intact. Rectal vault without masses. Left lateral prostate lobe with 1 × 1 cm firm, hard nodule; right lateral lobe smooth; median sulcus obscured. Stool brown and hemoccult negative.”
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Term
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Definition
| A pilonidal cyst is a fairly common, probably congenital, abnormality located in the midline superficial to the coccyx or the lower sacrum. Look for the opening of a sinus tract. This opening may exhibit a small tuft of hair and be surrounded by a halo of erythema. Although pilonidal cysts are generally asymptomatic, except perhaps for slight drainage, abscess formation and secondary sinus tracts may complicate the picture. |
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Term
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Definition
| External hemorrhoids are dilated hemorrhoidal veins that originate below the pectinate line and are covered with skin. They seldom produce symptoms unless thrombosis occurs. This causes acute local pain that increases with defecation and sitting. A tender, swollen, bluish, ovoid mass is visible at the anal margin. |
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Term
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Definition
| enlargements of the normal vascular cushions located above the pectinate line. Here, they are not usually palpable. Sometimes, especially during defecation, internal hemorrhoids may cause bright-red bleeding. They may also prolapse through the anal canal and appear as reddish, moist, protruding masses, typically located in one or more of the positions illustrated. |
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Definition
| On straining for a bowel movement, the rectal mucosa, with or without its muscular wall, may prolapse through the anus, appearing as a doughnut or rosette of red tissue. A prolapse involving only mucosa is relatively small and shows radiating folds, as illustrated. When the entire bowel wall is involved, the prolapse is larger and covered by concentrically circular folds. |
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Definition
| a very painful oval ulceration of the anal canal, found most commonly in the midline posteriorly, less commonly in the midline anteriorly. Its long axis lies longitudinally. There may be a swollen “sentinel” skin tag just below it. Gentle separation of the anal margins may reveal the lower edge of the fissure. The sphincter is spastic; the examination is painful. Local anesthesia may be required. |
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Term
| An anorectal fistula is an |
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Definition
| inflammatory tract or tube that opens at one end into the anus or rectum and at the other end onto the skin surface (as shown here) or into another viscus. An abscess usually antedates such a fistula. Look for the fistulous opening or openings anywhere in the skin around the anus. |
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Definition
| Polyps of the rectum are fairly common. Variable in size and number, they can develop on a stalk (pedunculated) or lie on the mucosal surface (sessile). They are soft and may be difficult or impossible to feel even when in reach of the examining finger. Proctoscopy and biopsy are needed for differentiation of benign from malignant lesions. |
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Term
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Definition
| Asymptomatic carcinoma of the rectum makes routine rectal examination important for adults. Illustrated here is the firm, nodular, rolled edge of an ulcerated cancer |
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Term
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Definition
| Widespread peritoneal metastases from any source may develop in the area of the peritoneal reflection anterior to the rectum. A firm to hard nodular rectal “shelf” may be just palpable with the tip of the examining finger. In a woman, this shelf of metastatic tissue develops in the rectouterine pouch, behind the cervix and the uterus. |
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Term
Normal Prostate Gland
As palpated through the anterior rectal wall, the normal prostate is a rounded, heart-shaped structure approximately 2.5 cm long.
The median sulcus can be felt between the two lateral lobes.
Only the posterior surface of the prostate is palpable. Anterior lesions, including those that may obstruct the urethra, are not detectable by physical examination. |
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Definition
| As palpated through the anterior rectal wall, the normal prostate is a rounded, heart-shaped structure approximately 2.5 cm long. The median sulcus can be felt between the two lateral lobes. Only the posterior surface of the prostate is palpable. Anterior lesions, including those that may obstruct the urethra, are not detectable by physical examination. |
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Term
Prostatitis
Acute bacterial prostatitis, presents with
The gland feels
More than 80% of infections are caused by
In men younger than 35, consider |
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Definition
.Acute bacterial prostatitis, presents with fever and urinary tract symptoms such as frequency, urgency, dysuria, incomplete voiding, and sometimes low back pain.
The gland feels tender, swollen, “boggy,” and warm. Examine it gently.
More than 80% of infections are caused by gram-negative aerobes such as E. coli, Enterococccus, and Proteus.
In men younger than 35, consider sexual transmission of Neisseria gonorrhea and Chlamydia trachomatis. |
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Term
Chronic bacterial prostatitis is associated with
Men may be asymptomatic or have symptoms of
The prostate gland may feel normal, without tenderness or swelling.
Cultures of prostatic fluid usually show infection with |
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Definition
Chronic bacterial prostatitis is associated with recurrent urinary tract infections, usually from the same organism.
Men may be asymptomatic or have symptoms of dysuria or mild pelvic pain.
The prostate gland may feel normal, without tenderness or swelling.
Cultures of prostatic fluid usually show infection with E. coli. |
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Term
| Benign prostatic hyperplasia |
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Definition
is a nonmalignant enlargement of the prostate gland that increases with age, present in more than 50% of men by 50 years.9 Symptoms arise both from smooth-muscle contraction in the prostate and bladder neck and from compression of the urethra. They may be irritative (urgency, frequency, nocturia), obstructive (decreased stream, incomplete emptying, straining), or both, and are seen in more than one-third of men by 65 years. The affected gland may be normal in size, or may feel symmetrically enlarged, smooth, and firm, though slightly elastic; there may be obliteration of the median sulcus and more notable protrusion into the rectal lumen.
It may be challenging to distinguish these conditions from the more common chronic pelvic pain syndrome, seen in up to 80% of symptomatic men who report obstructive or irritative symptoms on voiding but show no evidence of prostate or urinary tract infection. Physical examination findings are not predictable, but examination is needed to assess any prostate induration or asymmetry suggestive of carcinoma. |
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Term
| Cancer of the prostate is suggested by |
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Definition
| an area of hardness in the gland. A distinct hard nodule that alters the contour of the gland may or may not be palpable. As the cancer enlarges, it feels irregular and may extend beyond the confines of the gland. The median sulcus may be obscured. Hard areas in the prostate are not always malignant. They may also result from prostatic stones, chronic inflammation, and other conditions |
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