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07:41
Quantification of Levator Ani Hiatus Enlargement by Magnetic Resonance Imaging in Males and Females with Pelvic Organ Prolapse
Published on: April 17, 2019
Anatomical basis of digital rectal examination
E Joguet1, R Robert, J J Labat
1Faculty of Médecine, Laboratory of Anatomy, Nantes, France. etiennejoguet@hotmail.com
Surgical and Radiologic Anatomy : SRA
|June 7, 2011
Summary
This study introduces a method using index finger landmarks to help students practice rectal examinations. It simplifies palpating posterior rectal structures, overcoming fear and knowledge gaps.
Area of Science:
- Anatomy
- Medical Education
- Surgical Skills Training
Background:
- Rectal examination is challenging for students due to fear and lack of knowledge.
- Effective palpation techniques are crucial for accurate diagnosis and treatment planning.
Purpose of the Study:
- To develop a method for facilitating rectal examination practice, focusing on the posterior lateral rectal area.
- To address student difficulties in performing rectal examinations by providing clear anatomical landmarks.
Main Methods:
- Anatomical study of pelvis dissections and prints.
- Measurement of average index finger length.
- Defining three exploration levels based on index finger articulations and coccyx position.
- Utilizing a 180° hand rotation for identifying parietal structures.
Main Results:
- Three distinct palpation levels were identified for the posterior and lateral rectal area.
- Level 1: Upper anal canal, ischioanal fossa, ischium.
- Level 2: Levator ani muscle, ischioanal fossa, pudendal canal.
- Level 3: Sacrospinous ligament, ischiatic spine, internal obturator muscle.
Conclusions:
- Index finger landmarks aid in identifying parietal anatomical structures during rectal exams.
- Palpation success depends on patient factors and examiner technique.
- This method can improve student confidence and competence in rectal examinations.
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