Anus, Rectum, and Prostate
A 49-year-old male nurse experiences fecal incontinence after a motor vehicle accident
that left him paralyzed below the waist. He asks his rehabilitation physician about the
control of this function in a person without his injuries. Which of the following is true
regarding the muscle control of the anal sphincter? correct answers The internal anal
sphincter is under involuntary control, whereas the external anal sphincter is under
voluntary control
A 62-year-old male who is undergoing evaluation for possible prostate cancer strongly
declines a rectal examination, stating that, "Some trainee once did that and it hurt
badly." Which of the following is true about the innervation of the anus and rectum that
may explain this patient's experience of discomfort? correct answers The anal canal
has a rich somatosensory innervation, making poorly directed examinations painful in
this area.
A 54-year-old male with a strong family history of breast and prostate cancer presents
to his primary care provider to discuss prostate screening. His father died at age 73
years from prostate cancer that was not detected on routine digital rectal examinations
(DREs), and he would like to minimize his chance of a similar occurrence. Which of the
following is true regarding the anatomy and screening of the prostate by DRE? correct
answers The median lobe of the prostate is located anterior to the urethra and is not
palpable on DRE.
A third-year medical student rotating on the internal medicine service performs a digital
rectal examination (DRE) on a 56-year-old female patient. The patient has been
admitted for suspicion of a myocardial infarction, and confirmation that there is no blood
in the stool is required before anticoagulation can be started. The student reports that
the fecal occult blood test was negative but notes that he palpated a structure through
the anterior rectum that he could not identify. The attending physician confirms normal
anatomy and reviews with the student that the most likely identity of the structure
palpable is which of the following? correct answers Cervix
A 45-year-old female executive reports to her primary care provider that she has
recently experienced a change in the patterns of her bowel movements. She expresses
a great concern as her family history includes a maternal aunt who died of colon cancer
at age 49 years; her mother has had colonoscopies every 3 years with numerous
adenomatous polyps removed. Which of the following historical elements would be the
most concerning for colon cancer in this patient? correct answers Recent onset of
small-caliber stools
A 49-year-old customer service representative presents to his gastroenterologist for
follow-up of his long-standing inflammatory bowel disease (IBD). He was diagnosed
A 49-year-old male nurse experiences fecal incontinence after a motor vehicle accident
that left him paralyzed below the waist. He asks his rehabilitation physician about the
control of this function in a person without his injuries. Which of the following is true
regarding the muscle control of the anal sphincter? correct answers The internal anal
sphincter is under involuntary control, whereas the external anal sphincter is under
voluntary control
A 62-year-old male who is undergoing evaluation for possible prostate cancer strongly
declines a rectal examination, stating that, "Some trainee once did that and it hurt
badly." Which of the following is true about the innervation of the anus and rectum that
may explain this patient's experience of discomfort? correct answers The anal canal
has a rich somatosensory innervation, making poorly directed examinations painful in
this area.
A 54-year-old male with a strong family history of breast and prostate cancer presents
to his primary care provider to discuss prostate screening. His father died at age 73
years from prostate cancer that was not detected on routine digital rectal examinations
(DREs), and he would like to minimize his chance of a similar occurrence. Which of the
following is true regarding the anatomy and screening of the prostate by DRE? correct
answers The median lobe of the prostate is located anterior to the urethra and is not
palpable on DRE.
A third-year medical student rotating on the internal medicine service performs a digital
rectal examination (DRE) on a 56-year-old female patient. The patient has been
admitted for suspicion of a myocardial infarction, and confirmation that there is no blood
in the stool is required before anticoagulation can be started. The student reports that
the fecal occult blood test was negative but notes that he palpated a structure through
the anterior rectum that he could not identify. The attending physician confirms normal
anatomy and reviews with the student that the most likely identity of the structure
palpable is which of the following? correct answers Cervix
A 45-year-old female executive reports to her primary care provider that she has
recently experienced a change in the patterns of her bowel movements. She expresses
a great concern as her family history includes a maternal aunt who died of colon cancer
at age 49 years; her mother has had colonoscopies every 3 years with numerous
adenomatous polyps removed. Which of the following historical elements would be the
most concerning for colon cancer in this patient? correct answers Recent onset of
small-caliber stools
A 49-year-old customer service representative presents to his gastroenterologist for
follow-up of his long-standing inflammatory bowel disease (IBD). He was diagnosed
