Which of the following is NOT felt with a digital rectal examination?
**Core Concept**
The digital rectal examination (DRE) is a medical procedure used to assess the rectum, prostate gland, and surrounding structures. It involves inserting a gloved, lubricated finger into the rectum to feel for abnormalities such as tumors, bleeding, or inflammation. The DRE is a valuable tool for detecting rectal and prostate cancers, as well as assessing the rectal sphincter tone.
**Why the Correct Answer is Right**
During a DRE, the examiner can feel the prostate gland, the rectal mucosa, and the rectal sphincter tone. The prostate gland is a walnut-sized gland located below the bladder that surrounds the urethra. It is felt as a firm, smooth structure during a DRE. The rectal mucosa is the innermost layer of the rectum, and its texture and tone can be assessed during the examination. The rectal sphincter tone is also evaluated by feeling the muscle tone of the anal sphincter.
**Why Each Wrong Option is Incorrect**
**Option A:** The rectal ampulla is a region of the rectum that is not typically felt during a DRE.
**Option B:** The anal canal is felt during a DRE, but it is not typically assessed for its texture or tone.
**Option C:** The prostate gland is felt during a DRE, making this option incorrect.
**Clinical Pearl / High-Yield Fact**
The DRE is an essential part of the physical examination for men over 40 years old, as it can detect prostate cancer and other rectal abnormalities.
**Correct Answer: C. The prostate gland is felt with a digital rectal examination.