Anus

Physicians

or advanced practice nurses.rectum and anus

are not assessed in all patients,
this assessment is a part of a total health assessment for
both men and women.
involves

only inspection, palpation-not important

Equipment
Clean gloves
Lubricant

history of the following:

Bright blood in stools,
tarry black stools,
diarrhea,
constipation,
abdominal pain,
excessive gas,
hemorrhoids, or rectal pain;

history of the following:

family history of colorectal cancer;
last stool specimen for occult blood was
performed and the results;
signs or symptoms of prostate enlargement
(e.g., slow urinary stream, hesitance, frequency,
dribbling, and nocturia).

Position
In adults,
left lateral or Sims position
A dorsal recumbent position
kneechest
lithotomy position
For males, a standing position while the client bends
over the examining table may also be used.

INSPECTION

 Inspect

the anus and surrounding tissue for

color,
integrity, and
Skin

lesions.
Then, ask the client to bear down as though
defecating.

NORMAL FINDINGS
Intact perianal skin;
Anal skin is normally more pigmented and moister
than perianal skin and
is usually hairless

DEVIATIONS FROM NORMAL

Presence of
fissures (cracks),
ulcers,
inflammations,
abscesses,
protruding haemorrhoids
lumps or tumors,
fistula openings, or rectal prolapse
protrusion of the rectal mucous membrane through the anus

 in

a woman,
cervix may be felt as a small, round mass when
palpating the anterior rectal wall.
Abnormal

findings include changes in consistency.

 The

prostate gland in men can be assessed for size,

shape, and consistency by palpation through the
anterior rectal wall;
the gland is normally smooth, firm
Abnormal

findings include enlargement or changes

in consistency (which occur in benign prostatic
enlargement or cancer).

Normal Age-Related Variations

OLDER ADULT
Anus is darker in color
Hemorrhoids are often present
Prostate gland may be enlarged