Bates: Chapter 15 (Anus, Rectum, and Prostate) exam with correct answers 2024
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Bates: Chapter 15
Institution
Bates: Chapter 15
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 o...
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?
a) Both internal and external anal sphincter are under voluntary control.
b) The internal anal sphincter is under involuntary control, whereas the external anal
sphincter is under voluntary control.
c) Both internal and external anal sphincter are under involuntary control.
d) The internal anal sphincter is under voluntary control, whereas the external anal
sphincter is under involuntary control.
e) Control of the anal sphincters is variable between individuals. correct answers b)
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?
a) The rectum contains primarily somatic nerves, whereas the anal canal contains
primarily visceral nerves, making the anus the most likely source of this patient's
discomfort.
b) The anal canal has a rich somatosensory innervation, making poorly directed
examinations painful in this area.
c) The rectum contains primarily somatic nerves, whereas the anal canal contains
primarily visceral nerves, making the rectum the most likely source of this patient's
discomfort.
d) The dentate or pectinate line does not differentiate any neurological input, making the
area either proximal or distal to the line equally r correct answers b) 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?
, a) The median lobe of the prostate is located anterior to the urethra and is not palpable
on DRE.
b) All three lobes of the prostate are palpable on DRE.
c) A prostate of 5 cm diameter without palpable nodes or masses represents a normal
prostate examination.
d) The median sulcus divides the lateral lobes from the median lobe and is palpable on
DRE.
e) The seminal vesicles are palpable distal to the prostate on DRE. correct answers a)
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?
a) Sacrum
b) Pectinate line
c) Uterine fundus
d) Cervix
e) Prostate correct answers d) 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?
a) New‐onset anal fissures
b) Recent history of black, tarry stools
c) Long‐term history of hemorrhoids
d) Recent onset of small‐caliber stools
e) Remote history of anal pruritus correct answers d) 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 with
ulcerative colitis (UC) at age 37 years and has had irregular care for this condition since
then. His sole colonoscopy was done at the time of diagnosis 12 years ago. His only
relevant family history is of prostate cancer in his father; his mother and sisters are
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