GENITO ANORECTAL

• Genito-anorectal assessment


  Thorough examination of genital and anorectal region of an individual
• Areas assessed in genito-anorectal examination

  • Reproductive system
  • Anorectal region
• Male genito-anorectal examination


  • Supine position for first examination
  • Inflammation (reddish and swelling)
• Phimosis


  Inability to retract the foreskin
• Hypospadias

  Birth defect where urethral opening is not located at the tip of the penis
• Epispadias


  Birth defect where urethral opening is located on the top of the penis
• Stricture


  Narrowing or tightening of the urethral meatus
• Priapism


  Painful, prolonged, unwanted erection
• High priapism


  Excessive blood flow, not fully rigid
• Hernia


  Protrusion of the intestine through the inguinal wall or canal
• Testicular cancer


  Occurs in young men 15-35
• Epididymitis


  Inflammation of the epididymis, where mature sperm is stored
• Assessment of male genital and pubic hair

  • Normal: Angular distribution, moderate amount
  • Abnormal: Excessive, patchy, malodorous
• Scrotum


  Should appear darker color, muscles contract when cold
• Pediculosis pubis


  Pubic lice infestation
• Inguinal area


  No bulge when relaxed, swelling when abnormal
• systematic examination of genital and anorectal region of an individual?

  Genito-anorectal assessment
• Female genitals and inguinal area


  • Inspect and palpate to include assessment of inguinal lymph nodes and external genitals
• Papanicolaou test


  Used to detect defects or cancer on cervix
• Lithotomy position


  Required position in surgery
• Cranial nerves

  • Olfactory (smell)
  • Optic (vision)
  • Oculomotor (movement of eye, eyelid, pupil, ciliary muscle)
  • Trochlear (moves eye downward and laterally)
  • Trigeminal (sense of face, forehead, nasal mucosa)
  • Abducens (moves eye laterally)
  • Facial (facial expression, taste)
  • Glossopharyngeal (tongue movement, swallowing, sensation of pharynx)
  • Vagus (sensation of medulla and larynx, swallowing, muscles)
  • Accessory (movement of shoulder)
  • Hypoglossal (protrusion of tongue)
• Clitoris


  Not exceed 1 cm (0-4 inch)
• Vaginal speculum


  2 blades and adjustable screw, insert through vagina
• Skene's and Bartholin's glands


  Secrete and lubricate the opening of urethra
• Internal genitalia


  • Examine with bacterius speculum in 45° position
• Cervix


  Upward, downward, unilateral movement
• Tuning fork test


  Used to assess hearing (bone conduction)
• example of Abnormal cervix?

  bilateral

  unilateral tranverse

  cervical eversion

  cervicitis
• Woman who doesn’t have child?

  nulliparous
• Woman who has multiple child?

  multiparous
• ANUS


  • jelly-inflammation
  • bright red-bleeding
  • black stool - G.1 tract bleed.
  • pale, yellow-pancreatitis bilary obstruction
  • occult bleeding- cancer of colon
• Positions


  • Sims- side lying
  • Lithotomy -back lying, feet support in stirrups recumbent back lying
• Fissure


  Stretching of and mbcusa
• Pilonidal cyst


  fluid filed Ander the skin,
• Nervous System


  • gather imput from sensory receptur and lend inator output to affectors
  • Sensory (afferent) division
  • Sensory neuron
• Swollen veins in rectum, usually painless but tend to bleed?

  hemorrhoids
• Stretching of anal mocusa?

  fissure
• Fluid filled sac under the skin?

  pilonidal cyst
• Rectum drop?


  rectal prolapse
• Central nervous system consist of?

  brain and spinal cord