A 62-year-old man came to the surgeon with complaints of passing blood stained stools and altered bowel habits for the last two months. His other complaints were pain radiating down the back of both thighs and weakness of hamstring muscles. On per rectum examination a growth was palpable on the posterior rectal wall. 1. What is the extent and dimensions of the rectum? 2. Mention the characteristic features of rectosigmoid junction. 3. What is ampulla of rectum? 4. Name the posterior relations of the rectum. 5. Which nerves are invaded by the growth? 6. Describe with the help of diagram the lymphatic drainage of rectum. 7. Describe the peritoneal relations of the rectum in male and female. 8. Write briefly on the development of rectum.

A10-year-old girl suffered from a rare malignancy in her brain and around her spinal cord. she had surgery, and most of the tumor mass was removed, but residual tumor remained in the brain and around the spinal cord. the girl's doctors informed her parents that chemotherapy and radiation were possible treatment options but could cause serious problems such as sepsis, a permanent loss of iq and stature, and even death. the parents wished to proceed with the therapy. while their child was undergoing aggressive chemotherapy and radiation, the parents did independent research and read of several drugs being administered for cancer in other states that were unapproved by the federal drug administration (fda) and were illegal in their home state but were touted by physicians using them as miracle cures." furthermore, one of the girl's doctors released the girl's medical records to another physician to get a "second opinion" without informing the parents. this particular physician is a member of the same country club as the parents. he happens to share facts from the medical records with other members who end up telling the girl's parents. the couple sued their child's physician for failure to disclose alternative treatments, thus depriving them of informed consent. the couples also sued the child's physician for sharing their daughter's records in violation of the girl's privacy. how should the court rule in both cases? did the child's physician involved follow the law? did he act ethically in either situation? explain your answer. under the doctrine of informed consent, should a physician be responsible for informing patients of all treatment options, even if some of the treatments are illegal or not yet proven effective?

Anurse is teaching a client who has a new prescription for nitroglycerin patches. the nurse should identify which of the following statements as an indication that the client understands the teaching? a. “i will move the patch to my leg if i get a headache.” b. “i will rotate the application site to avoid skin irritation.” c. “i will apply a new patch if i have chest pain.” d. “i cannot take a sublingual tablet of nitroglycerin after applying the patch.”

Anurse is teaching about a new prescription for infliximab to a client who has rheumatoid arthritis. which of the following information should the nurse include in the teaching? a. “you will receive a mantoux test before the initial medication dose.” b. “you might experience diarrhea during the first 2 weeks of treatment.” c. “you will receive the medication every week for 6 weeks.” d. “you should receive the intranasal influenza vaccine.”