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Exam (elaborations)

CONT580 Quiz 1-3 questions with complete solutions

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CONT580 Quiz 1-3 questions with complete solutions

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CONT580 Quiz 1-3 questions with
complete solutions

The internal anal sphincter is:

A-a continuation of the longitudinal muscles

B-Stimulated to contract by rectal filling

C- Reflexively relaxes by rectal filling

D-Under volitional control - correct answer ✔✔C- Reflexively relaxes by rectal filling

The internal sphincter is tonically contracted at all times to prevent leakage.. until the rectum fills the it
automatically relaxes to allow contents to move into contact with the epithelium lining the transition
zone so it can detect gas, liquid stool and hard stool. This is known as the rectoanal inhibitory reflex



The reflex that allows an individual to differentiate among stool , liquid and gas is known as the:

A-gastrocolic reflex

B-Sampling reflex

C-Rectoanal inhibitory reflex

D- wink reflex - correct answer ✔✔B-Sampling reflex



Numerous sensory receptors are located in the upper canal where a small amount of stool is sampled to
identify it as gas, liquid or solid.



During your initial assessment, Mr Gutter complains of loss of gas and occasional liquid stool. You know
this is evidence of what type of fecal incontinence and sphincter problems?

A-Passive incontinence and internal anal sphincter damage

B- Flatus incontinence and internal anal sphincter damage

C-Urge incontinence and external anal sphincter damage

D- Transient incontinence and external anal sphincter damage - correct answer ✔✔B- Flatus
incontinence and internal anal sphincter damage

,Flatus incontinence is defined as leakage of gas and or liquid stool. This occurs in patients who have IAS
damage. Passive fecal incontinence is the leakage of formed and liquid stool as well as gas without
awareness caused by cognitive impairment or someone with sensorimotor dysfunction.



Upon initial assessment of the patient with bowel dysfunction or incontinence, which of the following
findings would initiate a referral for further evaluation?

A- Unintentional weight loss

B- Rectum full of firm stool

C-Severe incontinence associated dermatitis

D- Chronic use of laxatives - correct answer ✔✔A- Unintentional weight loss



RED FLAG bowel symptoms requiring colonoscopy would include unintentional weight loss, recent onset
of constipation, fam hx of colorectal cancer, narrow caliber stools. rectal prolapse, symptoms of bowel
obs, and bloody stools



Bowel motility can be negatively affected by:

A Diabetic autonomic neuropathy and Parkinson's disease

B- Cerebral palsy and melanosis coli

C-Scleroderma and obesity

D- Pregnancy and hyponatremia - correct answer ✔✔A Diabetic autonomic neuropathy and Parkinson's
disease

Diabetic Neuropathy affects the autonomic nervous system therefore parasympathetic and sympathetic
nerves are damaged which in turn negatively affect bowel motility



An essential assessment during the initial outpatient clinic evaluation of a patient experiencing diarrhea
and fecal incontinence is to:

A- Recommend a containment device

B- Request a stool sample to check for microbial imbalances

C-Obtain a 7-14 day bowel and dietary diary

D-Refer to primary care for further evaluation - correct answer ✔✔C-Obtain a 7-14 day bowel and
dietary diary

, During your initial interview, a patient reports his typical stool consistency to be pellet like and hard. This
finding suggests the patient may have:

A- Slow colonic transit

B- Ineffective absorption of fluid by the bowel wall

C-Excessive intake of dietary fiber

D-Ineffective internal sphincter control - correct answer ✔✔A- Slow colonic transit



The longer the stool is in the colon, the more moisture is removed



An 85 yo F with advanced dementia and no history of bowel dysfunction is at risk for fecal incontinence
primarily because dementia will impair:

A- The sampling reflex

B- Her ability to respond to the sensations of rectal fullness

C- The ability of the internal sphincter to relax

D-Colonic transit time - correct answer ✔✔B- Her ability to respond to the sensations of rectal fullness



The First step in developing an effective comprehensive management plan for a 5 yo with retentive
encopresis is to:

A- Conduct radiographic defecography

B-Clean out the gut with daily ducolax tabs

C- Establish rapport with the parents and provide intensive education and counseling

D- Institute extensive dietary modifications - correct answer ✔✔C- Establish rapport with the parents
and provide intensive education and counseling



A 54 yo M reports occasional episodes of difficulty controlling his stool. In the last year he has undergone
pelvic radiation for prostate cancer. Which of the following essential mechanisms for bowel continence is
most likely disrupted:

A- Functioning of the pelvic floor musculature

B- Compliance of the rectum

C- Integrity of neural pathways

D- Quality of IAS - correct answer ✔✔B- Compliance of the rectum

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