How do you tell if someone has good anal tone?

[TBV]

Something like this:

"You want me to do what?"

"For $300/hour."

"Oh, ok sure."

They make $20.50 at my school to get repeatedly violated. Where is their honor?

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[repititionition]

They make $20.50 at my school to get repeatedly violated. Where is their honor?

For most, it's at the bottom of their next bottle of vodka.

 

[Mad Jack]

I mean, there comes a day when you're in your 50s and you've had so many DREs that you just stop caring I guess.

 

[NickNaylor]

On my medicine rotation, one of third years was about to do his first rectal, so the attending stayed behind to observe him. Apparently he was going to go in with two fingers. Henceforth, he became Johnny "2-fingers."

 

[TBV]

On my medicine rotation, one of third years was about to do his first rectal, so the attending stayed behind to observe him. Apparently he was going to go in with two fingers. Henceforth, he became Johnny "2-fingers."

Better than Johnny "both-thumbs" i suppose

 

[NotYou20]

The first couple dozen DREs you do and all you'll be able to tell is that its warmer in there than outside. But one day you will feel your first prostate nodule and you will find a new and exciting hobby.

What the hell did I get myself into

 

[tiedyeddog]

On my medicine rotation, one of third years was about to do his first rectal, so the attending stayed behind to observe him. Apparently he was going to go in with two fingers. Henceforth, he became Johnny "2-fingers."

I always use two fingers. Go for the gold.

Getting back to the original question, as someone who has probably seen 20+ of the classic consult from the ED resident for a patient with "cauda equina for sure, absolutely no rectal tone, totally incontinent" only to go down there and actually have my fingers enter something resembling a chinese finger trap, I can ensure you of three things:

1. Rectal tone really isn't hard to assess.
2. I really doubt most ED residents understand cauda equina
3. if you tell me there is no rectal tone and I find the patient's anus is like a vice grip of death I will let you know you're *****. Don't lie about doing a rectal tone check, I will make you feel stupid.

 

[NickNaylor]

I always use two fingers. Go for the gold.

 

[Psai]

Would hate to get 2fingered by that blue guy

 

[repititionition]

On my medicine rotation, one of third years was about to do his first rectal, so the attending stayed behind to observe him. Apparently he was going to go in with two fingers. Henceforth, he became Johnny "2-fingers."

Someone in my class did their first one unsupervised and managed to go in with two.

This was only discovered after they told the story to us. Apparently the patient didn't even complain.

 

[Donald Juan]

Someone in my class did their first one unsupervised and managed to go in with two.

This was only discovered after they told the story to us. Apparently the patient didn't even complain.

Poor patient, but unless they've had several DREs, they wouldn't know any better. Your DRE was uncomfortable? Didn't feel good? Next you'll tell me your catheter is uncomfortable and your ABG was painful.

 

[VisionaryTics]

I always use two fingers. Go for the gold.

Getting back to the original question, as someone who has probably seen 20+ of the classic consult from the ED resident for a patient with "cauda equina for sure, absolutely no rectal tone, totally incontinent" only to go down there and actually have my fingers enter something resembling a chinese finger trap, I can ensure you of three things:

1. Rectal tone really isn't hard to assess.
2. I really doubt most ED residents understand cauda equina
3. if you tell me there is no rectal tone and I find the patient's anus is like a vice grip of death I will let you know you're *****. Don't lie about doing a rectal tone check, I will make you feel stupid.

God I am so glad I never have to stick my fingers in another man's ass.

 

[LivMoore]

This thread is gold.

 

[pre med 2014]

Digital rectal exam


Sent from my iPhone using SDN mobile

 

[MediCane2006]

I'm crying. This thread is amazing.

 

[Crayola227]

I always use two fingers. Go for the gold.

Getting back to the original question, as someone who has probably seen 20+ of the classic consult from the ED resident for a patient with "cauda equina for sure, absolutely no rectal tone, totally incontinent" only to go down there and actually have my fingers enter something resembling a chinese finger trap, I can ensure you of three things:

1. Rectal tone really isn't hard to assess.
2. I really doubt most ED residents understand cauda equina
3. if you tell me there is no rectal tone and I find the patient's anus is like a vice grip of death I will let you know you're *****. Don't lie about doing a rectal tone check, I will make you feel stupid.

yeah but I thought the whole thing with some nerve compression symptoms is that they can come and go?

there was someone I worked with once who would hold up their single digit and tell patients, "I know you've taken ****s way bigger than this finger, believe me, your rectum can handle it. It's all in your mind." Really seemed to put them at ease actually.

 

[AnatomyGrey12]

yeah but I thought the whole thing with some nerve compression symptoms is that they can come and go?

there was someone I worked with once who would hold up their single digit and tell patients, "I know you've taken ****s way bigger than this finger, believe me, your rectum can handle it. It's all in your mind." Really seemed to put them at ease actually.