Conducting a Rectal Examination

All right, so when you're doing this,

practice both positions for the male.

So this is going to be elbows on the table,

but if you hold the model like this,

then you can practice if the patient prefers to lay on their side.

Okay, so I'll show you this way.

So you inspect the sort of whole perineum.

You're looking for lesions, hemorrhoids, whether there's drainage,

whether it looks erythematous.

You're trying, you won't necessarily be able to see it,

but for sphincter tone.

So you're looking for all of those things.

While you're here, you can also look at the posterior aspect

of the rest of the genitalia just for kind of being complete.

So you're inspecting for those things.

Then you want a lubricant on your finger

before you do the exam, and then you're walking the patient through it.

So you're going to feel my hands on the

outside of your leg and on your buttocks.

And what I want you to do is take a deep breath

in and out and try and bear down.

So when the patient bears down, what'll happen is you'll feel the sphincter tighten,

and then after it tightens, it should relax.

When you feel it relax, that's when it's easiest to sort of insert your finger.

So then you insert your finger.

Now, you don't necessarily need to go immediately to the prostate.

You also need to do kind of a rectal exam on the patient.

So you are feeling, you're turning your finger all the way around

so that you can feel the whole rectal canal.

Okay, so you're trying to feel for rectal masses.

You also have the patient bear down so you can feel the sphincter tone.

So can you bear down for me?

They bear down, you feel that.

Then you actually want to feel the prostate.

So your finger goes in as far as you can,

and then you're walking it sort of back and forth, back and forth,

until you reach the end of the prostate.

Okay, then the finger comes out,

and you're putting the contents that was on the glove,

one on this side, one on this side,

and then you'll do a hemocult.

So check for occult blood.

So once that dries, you use the developer.

So what I'm doing on the inside that you can't see is

when I'm, it's spinning like this to see what's in the rectal canal,

then all the way up over the prostate.

And once I get as high as I can,

it's sort of a sweeping motion back all of the way out,

okay, until you no longer feel prostate.

Okay, and then you're finished.