Method Of Exam
Author: A. Chandrasekhar, MD |
Consultant: M. Klamut, MD |
Have the patient stand and learn forward, resting his hands on the examining table. Place a small amount of lubricant on your gloved index finger.
- Place your finger at the anus and wait for reflex sphincter relaxation.
- Gently insert your finger and examine as much of the rectal wall as possible.
Sequentially examine the right lateral, posterior and left lateral surfaces feeling for pelvic structures.
- Evaluate the prostate gland in men along anterior wall.
- Examine the posterior surface of the prostate.
- Evaluate the lateral lobes and the sulcus.
- Note the size, shape, consistency and tenderness.
- Note the rectal contents.
- Remove finger and evaluate the faeces on the gloved finger and save it for Guaic testing.
An alternate method: The rectal exam can also be done in the left lateral decubitus.
Normal:
Rectal exam is unpleasant.
- The sphincter has sufficient tone to grasp your finger.
- Soft stools may be felt.
- The walls of the mucosa are smooth.
- The prostate gland is about 2.5 cm in length, with a medial sulcus, is firm and non-tender.
- Stools can be seen on the gloved finger and retain it for Guaiac testing.