Chapter: 20 Anus,Rectum,Prostate 
While you are examining a 1-year-old girl, the mother mentions how eager she is to begin toilet training her child. How should you respond? When is it best to begin toilet training?
What do the rectum and anus form?
Control of the external anal sphincter is gradually achieved at what age?
Differentiate between internal and external hemorrhoids.
You are observing an examiner take the history of a 70-year-old man as part of the musculoskeletal examination. You notice that the examiner asks the patient about exercise habits in his early years. Is this a relevant question to ask this patient? Why or why not?
A young woman is concerned about a 1-cm difference in the length of her legs. What is the best response to give this patient?
A 3-year-old boy has had anal itching that becomes worse at night. What do these symptoms indicate?
You are assessing a pregnant woman who has had a fourth-degree perineal laceration. Why is it necessary to assess this patient’s anal sphincter function?
You are about to perform a rectal examination of an older adult. What is the suggested position for this patient?
What is a clue to the diagnosis of Hirschsprung disease?
What do persistent, pencil-like stools suggest?
Distinguish between the stool of a formula-fed baby and a breastfed baby.
Create a chart or two-column list that compares the risk factors for colorectal cancer with those for prostatic cancer.
What are the risk factors for colorectal cancer?
What are the risk factors for prostate cancer?
What symptoms are associated with BPH?
JF is a 42-year-old patient who presents for an annual examination, but he complains that he has had a fever for the past few days and recently some urinary symptoms.
1- Describe the best method for a rectal examination during the physical assessment
2- What additional past medical history questions would you ask of JF since you suspect prostatitis?
3- During the rectal examination of JF with acute prostatitis, what findings would expect on physical examination? .
A, Correct procedure for introducing finger into rectum. Press pad of finger against the anal opening. B, As external sphincter relaxes, slip the fingertip into the anal canal. Note that patient is in the hips-flexed position.
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