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What is the length of the anus, rectum and
sigmoid colon?
- Anus: (2.5-4cm)
- Rectum: ( 12cm)
- Sigmoid colon: ( 40cm)
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What is the function of internal anal sphincter?
Involuntary control- when the rectum fills with stool, the internal sphincter relaxes and results in the urge to defecate.
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What is the function of the external anal sphincter?
Voluntary control of defecation
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What is the definition and cause of
hemorrhoids?
Hemorrhoids- varicose anal veins
They are due to chronic increased venous pressure (constipation/straining with BMs)
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What is meconium?
It is the first stool passed by the newborn that is dark green, and occurs within 24 to 48 hours of birth.
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What is gastro-colic reflex?
It is the reflex causing increased peristalisis/BM after each feeding.
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What is melena, and what causes it?
- It is a dark tarry stool
- Caused from an upper GI bleed (gastric/ duodenal ulcer or cancer)
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What is hematochezia and what causes it?
- Maroon stools
- Lower GI bleed ( or UGI bleed with rapid motility)
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What is BRBPR, and what causes it?
Drips of blood in toilet or on toilet tissue- hemorrhoids, polyps, tumor
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What is steatorrhea, and what causes it?
- Excess fat in stool
- Pancreatic problem, malabsorption
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What is clay colored stools, and what causes it?
Absence of bile pigment- biliary obstruction (liver problem, gallstones)
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What are black stools, and what causes them?
- Melena(dark tarry stool)- upper GI bleed ( gastric/ duodenal ulcer or cancer)
- Iron or Bismuth(or Peptobismo)
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What are some lifestyle factors affecting
constipation?
- Not getting enough fluid, fiber and exercise
- Some medications can cause it too: antidepressants, antihistamines(Diphenhydramine, Benadryl), calcium channel blocker (Verapamil), and Iron
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What are the 3 purposes of rectal exam?
- Assess anorectal area
- Prostate exam in males
- Bimanual recto-vaginal exam in women
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What are the risk factors for colorectal
cancer?
- Age > 50 years old
- Hig fat/ low fiber diet
- Obesity
- Smoking
- Precancerous Intestinal polyps
- Inflammatory Bowel Disease ( Crohns disease, ulcerative colitis)
- Family History of colon cancer, adenomatous polyposis( precancerous polyps)
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What are some health promotion and
screening recommendations that should be done monthly?
- Monthly- genital self exam (GSE) & testicular self exam ( TSE)
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What are some health promotion and
screening recommendations that should be done annually?
- DRE (digital rectal exam- screen for prostate and colon cancer)
- PSA - a nonspecific blood test for prostate caner, will also increase with inflammation and BPH
- Fecal occult blood test (FOBT)- guaiac testing
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What are some health promotion and screening recommendations that should be done every 5 years?
- Routine screening starting at age 50
- Flexible sigmoidoscopy
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What are some health promotion and screening recommendations that should be done every 10 years?
- Routine screening starting at age 50
- Colonoscopy
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What is the purpose of fecal occult
blood (guaiac) testing?
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