How to do a rectal finger test

Rectal finger test is the doctor with a finger into the patient's anus, is to check the disease of a simple and easy but very important clinical examination methods. Rectal finger test does not require any auxiliary equipment. During the examination, the doctor's right hand wearing sterilized gloves, the index finger and the patient's anus external are coated with some lubricant or petroleum jelly, now generally used liquid paraffin oil.

The examination method is: the examiner's right index finger finger with finger cuffs, coated with lubricant (commonly used soap, liquid paraffin or petroleum jelly), in order to facilitate its insertion into the anus and can reduce the patient's discomfort. First check the skin around the anal verge, such as redness, swelling, tenderness, hard lumps, often suggesting that there is a perianal abscess; before and after the center of the tenderness, often suggesting that there may be anal fissure, can be further peeled open the anus to see if there is anal fissure; anal verge outside the ulcerated mouth and with the subcutaneous stripes leading to the anus, often for the anal fistula. After checking around the anal rim, the right hand index finger gently massage the anal rim, at the same time asked the patient to take a deep breath to reduce abdominal pressure, so that the sphincter muscle relaxation, and then slowly extend the index finger into the rectum; if suddenly insert the finger into the anus, the sphincter muscle will be spasm due to sudden stimulation, not only is not easy to insert, and will produce pain.

The patient's position can take the following three: (1) knee-chest: suitable for examination of male patients, especially for prostate and seminal vesicle examination, but also to check the anus, the rectum of the better position.　(2) Left lateral recumbent: suitable for examination of female patients, male patients can also be used.　(3) Supine: This position can be used when there is abdominal disease or when it is not easy to change the position, and it is especially suitable for the weak. The operator's right hand is placed under the patient's right thigh, and the left hand can be placed on the pubic bone to assist in the examination. The operator gently massages the fingertips at the anal opening for a few moments to get used to it, and asks the patient to breathe with his mouth open and his whole body relaxed to relax the anal sphincter, and then inserts his right index finger into the anus to touch the anus, the anal canal, and the parts of the rectum.

Importance

Anal diagnosis is significant and convenient, first, through the finger can touch the lower end of the rectum and the anal canal with or without swelling and pressure, tenderness, in order to diagnose whether there are benign tumors, malignant tumors, infections, fissures and other diseases. Secondly, the sphincter intersphenoidal groove can be touched through finger palpation to understand the tension of the sphincter to infer certain diseases. Thirdly, according to whether blood staining and blood color on the finger cuff, to assist in the early detection of rectal, colon cancer ulcerative colorectitis, hemorrhoids, anal fissure and other diseases. It can be said that most of the anal and intestinal diseases can be diagnosed basically through fingerprinting, and anal fingerprinting is an irreplaceable inspection method of instruments.　Line anal finger test, there are the following aspects of the content and significance: 1, first of all to be carried out is the anal sphincter and anorectal ring tightness check, anorectal ring is by the upper edge of the internal and external sphincter and the puborectalis muscle *** with the same composition, around the junction of the anal canal and rectum, the internal and external sphincter was ring, and the puborectalis muscle is only in the back and the sides of the existence of the anorectal finger test, the anal canal and the sides of the back of the anal canal and touch To, and in the anterior anal canal is not easy to touch, anal sphincter and anorectal ring is normal when the index finger can be smoothly into the anus, if the index finger through the difficulty or can not pass through the anus has a different degree of stenosis, and if the anal sphincter is too flaccid and weak, may be anal incontinence; 2, check the anorectal anterior and posterior walls and their surroundings with or without tenderness, throbbing, mass, and should pay attention to the size of the masses, hardness, mobility. The size, hardness, and mobility of the mass should be noted. For the lumps with higher position, anorectal finger-pointing can be done in squatting position or truncated position, these two positions can make the tumor move downward, and the rectal cancer in the higher part can be touched. If necessary, the double diagnosis of rectum and abdomen or the double diagnosis of rectum and vagina can be done, which can provide valuable information about the scope of cancer invasion; 3. In the anterior wall of rectum, men can touch the prostate gland, and women can touch the cervix, which should not be mistaken as pathological masses; 4. After the finger is withdrawn from the rectum at the end of the examination, it is necessary to see whether there is any blood or mucus on the finger liner, and a smear should be made if necessary.

Edit paragraph function

Rectal fingerprinting is a necessary means of examination in the anorectal department. If the surface of the fingerstick is found to have mucus, pus or blood, it will be suspected that there is inflammation in the rectum and anus or accompanied by tumor tissue rupture. If necessary, taking a bit of stool for routine and bacteriologic examination or performing histopathologic examination of the rectum may help in the diagnosis. About 80% of rectal cancers and rectal polyps can be detected early by this test. In addition, such as hemorrhoids, anal fistula, anal and perirectal abscess, anal papilla hypertrophy, anal papilloma and other diseases, but also through the "touch" the rectum and anus and was found.　Experts also told the author that the rectal fingerprinting and not only "specializing" in the anorectal department, it can also do the following "part-time": men's work area: male rectum in front of the bladder, prostate and seminal vesicle glands, the doctor through the "feel the rectum! "can understand the size of the prostate, texture, structure, and whether the patient has a sense of pressure and pain, so as to know whether the patient suffers from prostate hypertrophy, prostatitis.　In addition, we can not underestimate, rectal fingerprinting can be early diagnosis of prostate cancer, there are reports that the accuracy rate of up to 50% to 70%.　Gynecological workspace: It turns out that rectal fingerprinting can also be used to check for pelvic abscesses, pelvic inflammation and other diseases in women. Gynecologists in the unmarried women to do maternal examination, in order to protect the patient's hymen, usually using rectal fingerprinting, check the uterus and pelvis of some of the situation.　Orthopedic workspace: We can not imagine that pelvic fracture also need to "touch" the intestine, right? In fact, pelvic fracture is a common trauma. Although pelvic fracture combined with rectal injury is not common, but if the patient's sacrococcygeal region has obvious pressure pain, then the doctor will have to "feel" the bowel. Because this pain is mostly caused by the fracture end of the sacrum directly stabbing the rectum, a small number of sacral, sciatic fracture displacement and the rectum tear. In this case, the doctor can "feel" the broken end of the fracture, and there may be blood on the finger cuff.　Metastatic cancer, malignant tumors in the abdominal cavity, such as stomach cancer, can "fall" to the lowest part of the abdominal cavity (uterorectal fossa or vesicorectal fossa), and form metastatic cancer by "taking root", at this time, finger prick can find that there is something hard. In this case, finger examination can also find something hard in the area.　Some patients have high fever, convulsions and coma for unknown reasons. If the doctor finds that there is pus and blood stool or jelly-like mucus in the rectum through finger test, toxic dysentery will be considered. Then do a bacterial culture, if found pathogenic bacteria can be confirmed.

Contraindications

Anal finger examination has a lot of effect in the diagnosis of many anorectal diseases, and easy to operate, so it is one of the common examination methods used by anorectal doctors. But nothing is universal, and the anal finger is no exception. For example, the anal finger can not be used for anal fissure examination.