Archive for September, 2007
The Anal region
Examination of the Anus
Throughout history, the idea of good bowel function has been a mental image of good health, and practically every human malady has at some period been judged better or worse, depending on the answer to the question, “How are the bowels?”
Bowel concern begins at birth, and grows to real awareness in mature years when activities begin to slow down, but it is in the senior years that good health is “proved” by statements claiming “wonderful bowels.” This picture in our minds that good health and good bowel function are closely associated is based largely on facts reflecting age, activities and physical abilities and probably not even the space age will greatly re-shape this idea. Diseases of the rectum and anus have always been vexing problems, often producing great pain and always demanding great sympathy. When Louis XIV had his rectal operation in 1686, his many attendants were ordered to wear bottom bandages out of sympathetic respect. Happily, treatment of rectal diseases today is held in great esteem everywhere.
Finally, the social aspect of bowel function has a great impact on modern living. Universal demand has brought about the scientific advances of modern plumbing, privation and sanitation, as we now know them, and the lack of these advances more than anything else would make our urban world of today nearly impossible. To view the anus directly, uncover the anal region and assume a squatting position eight to ten inches above a mirror lying on the floor. This will give a clear view of the anal region,
Fig. 120. The anal region normally reveals only the small, indented, puckered anus in its closed position. It is impossible to voluntarily open the rectum, but it can be stretched open by oncoming bowel matter or instruments introduced from outside.
The normal anus is a small, puckered and indented opening. It remains closed because the anus cannot open itself except by having something forced through it. Straining will make the anus stand out slightly and appear a little larger than usual. Its color and hair distribution follow individual body characteristics.
1. Examine the skin surface of the anal opening without straining. Observe any large skin folds, any distended veins, or any sore irritated appearing spots. Observe also the existence of any generalized irritation of the entire anal region. These findings may be indications of disease as external hemorrhoids, mere skin flaps, or anal itching, technically known as pruritis.
2. Note the contour of the anus and surrounding skin when straining. Observe any mass protruding from the anus, any pus or blood from the anal opening, or from a pimple-like opening near the anal opening. These findings may in
dicate internal hemorrhoids of fistula formation.
3. Observe the skin forming the anus itself. Examine upon straining for any raw, split appearance in the folds of anal skin. Such a skin crack is possibly a fissure.
4. Note the texture of the skin of the anus and its surroundings. Look closely for any whitened, thickened, water-soaked appearing skin of the anus and surrounding skin. Also look to see if there is any clear, water-like discharge
Fig. 121. The normal anus is a sphincter-type closure for the tube-shaped rectum. There are two sphincters for the anus: one is controlled automatically and the other is voluntary and controlled by the will.
about the anus and surrounding skin. These findings may accompany internal hemorrhoids, drug allergies or chronic irritation.
5. With one finger, gently press upon the skin surrounding the anus. Make note of any enlarged, reddened or boil-like sore surrounding the anus. Such a finding in this region is possibly an abscess or fistula.
6. Examine the skin in the fold between the buttocks. Look for any dimple-like indention of the skin two inches back of the anus, possibly discharging pus. This is probably a pilonidal cyst.
Hearing loss indications being slow and sure, it is not at all noticed by the sufferers but by the family friends or through a hearing test. Very high levels of noise emanating form tractors, factory machineries, fire arms, power tools cause hearing loss when the ear is not properly protected. A feeling of nervous tension, irritability or fatigue, are symptoms of hearing loss as the person tries to hear perfectly. The fist sign of hearing loss is mumbling and speech that is not clear. Other sure signs of hearing loss are straining himself to hear and understand others, misunderstanding, a request for repetition, or watching the speaker s face intently while listening.
Take Care of your Hearing Levels
Various other symptoms of hearing loss are (1)increasing the volume of TV and radio leading others to complain, (2)family history of hearing loss,(3)diabetes,(4)hear, thyroid, circulation problems. Not only these, recurring ear infections, constant rings in the ears, dizziness, exposure to ototoxic drugs and medications are also symptoms of hearing loss.
Many persons with hearing loss acknowledge it and feel embarrassed in meeting new people. Consequently they rarely visit their friends and lose the family reunion or chit-chat neighbor-hood. A feeling of depression and inability to hear properly is also a sign of hearing loss.
Specifically parents should be all alert and active in discovering the signs of hearing loss in their children. They should discuss with a pediatrician and get their children worsens. When a person is not startled or shocked when a loud noise is heard, it is a definite and sure sign of hearing loss. The person will not even turn to the direction of the sound. Carelessness and negligence on the part of parents in detecting these signs of hearing loss jeopardize their lives and lead to serious consequences. The result will be slow learning curve, difficulty in understanding speech and an in attentiveness very bad for school going children.
[tags]Auditory Nerve, Hearing Test[/tags]