Adult Health Exam 4 (musculoskeletal & male reproductive disorders) Flashcards
(152 cards)
1
Q
how many bones in body
A
206
2
Q
what are osteoblasts vs osteoclasts?
A
blast = builders clast = remodelers
3
Q
osteocytes
A
mature bone
4
Q
what are the 5 diff types of bones
A
Long bones, short bones, flat bones, irregular bones, sesamoid bones
5
Q
what is compact bone vs spongy bone
A
Compact bone (cortical): dense and looks smooth
Spongy bone (cancellous): small lattice-like pieces called trabeculae
6
Q
what are the 2 types of marrow and what do they contain
A
Red marrow consists mainly of hematopoietic tissue
Yellow marrow consists mostly of fat cells
7
Q
how does estrogen affect bones?
A
Estrogen–induces chemical in osteoclasts that causes self destruction
Impact of menopause–decreases bone
8
Q
How do calcitonin and TFH affect bone growth
A
Calcitonin & TSH = inhibit osteoclastic activity, stops remodeling process
-anterior pituitary promotes bone growth
9
Q
how does parathyroid hormone affect bone growth
A
Parathyroid hormone = promotes activity for osteoblastic activity
10
Q
how does GH affect bone growth
A
Growth hormone = facilitate bone growth until adult bone is reached
11
Q
muscle strength is measured on what scale
A
0-5
12
Q
what are lab studies associated with bone probs
A
- Calcium (norm: 8.8-10.3 mg/dL)
- Phosphorus (3-4.5 mg/dL) is inversely proportionate to Ca
- Vitamin D
- Calcitonin + Parathyroid
- Estrogen stimulates osteoblasts
13
Q
what are imaging studies for bone issues?
A
XR, CT, MRI, arthrogram, DEXA (bone mineral density scan), bone scan, EMG, arthroscopic exam arthroscopy, arthrocentesis
14
Q
What is a DEXA scan?
A
- Considered the “Gold Standard” for osteopenia/osteoporosis diagnosis
- No prep required
- Obtain height/weight
15
Q
what happens to MSKL system with age
A
- Bone remodeling…
- Decrease in muscle fxn, mass & strength (sarcopenia)
- Decrease in motor neurons
- Decrease in joint/ligament/tendon flexibility and increase in stiffness
- Kyphotic posture
16
Q
What are the ACCESS risk factors for osteoporosis
A
A: alcohol C: corticosteroids C: low calcium E: estrogen low S: smoking S: sedentary lifestyle
17
Q
what is pathophys for osteoporosis and s/sx
A
Bone resorption activity is greater than bone rebuilding activity
Osteoclasts > osteoblasts
s/sx
“Silent” disease…
Dowager’s hump
Pathologic fracture
18
Q
how to diagnose osteoporosis?
A
- Bone density tests: DEXA Scans
- –Osteopenia vs osteoporosis
- Quantitative computed tomography
prevention is key
19
Q
what are nutritional changes for osteoporosis?
A
- -Calcium + vitamin D supplements (1st line PREVENTION!)
- -Recommended Calcium dosing for adults > 51: 1200mg/day
- -Recommended Vitamin D dosing: 800-1000iu
20
Q
what meds for osteoporosis
A
Ca, vitD biphosphonates (fosamax), calcitonin, estrogen agonist/antagonist, parathyroid, dual acting bone agent, monoclonal
21
Q
Calcium & vitamin D for osteoporosis
A
Ca dosing for adults >51 = 1200mg/day
Recommended Vitamin D dosing = 800-100 iu
Administration considerations = need together
22
Q
Bisphosphonates for osteoporosis
A
Oral (Fosamax; risedronate; ibandronate)
- -Fosamax = take on empty stomach w full glass of water, sit up for 30 min afterwards, SE is destruction of jaw bone
- or monthly IV
23
Q
Calcitonin for osteoporosis
A
made by thyroid, inhibits osteoclasts, can give as SQ injection, take vit d supp too
24
Q
Estrogen agonist/antagonist for osteoporosis (evista)
A
preventative & treats osteoporosis, SE are risk for DVT
25
Parathyroid hormone for osteoporosis
protective factor against hormone regulated bone loss, SQ inj
26
Dual-acting bone agent for osteoporosis
decrease osteoclast, incr osteoblast activity, balance bone turnover
27
Monoclonal (denosumab/Prolia), Evenity for osteoporosis
inhibit osteoclastic activity, reducing bone reabsorption, last option med, SQ injection 2x/year, SE decrease serum calcium (do not give if low)
Evenity = new dual action monoclonal antibody, inhibits osteoclasts and increases osteoblast activity for severe osteoporosis ---do not use if hx of MI/stroke
28
patient education for osteoporosis
```
Take medication as prescribed
Weight reduction
Adequate Calcium and vitamin D supplementation
Exercise
Avoid: alcohol, smoking
```
29
osteoarthritis
Progressive disease of articular cartilage (diarthrodial joints with synovial membrane)
30
risk factors for osteoarthritis
Risk factors =
Age
Female
Obesity (weight loss of 10% increases function of joint by 30%)
Occupation, manual labor
Poor diet = cartilage deteriorates from enzymes or nutrition
31
Articular Cartilage and involvement in osteoarthritis
-Chondrocytes make white smooth cartilage→ yellow & opaque with rough edges & softens. As it thins bones get closer
--causes central loss of cartilage, subchondral bone becomes more dense, osteophytes (bone spurs, classic sign*) develop
32
s/sx of osteoarthritis
- Localized joint s/sx = pain, swelling
- Asymmetrical
- Pain in AM, with weather changes, activity
- Eventually, pain all the time
- Loss of ROM (knee lock), cracking
- Bouchard's nodules = at proximal, RED
- Heberden's nodes = at distal osteophytes
33
what are bouchards nodules
proximal, red, osteoarthritis
34
what are heberdens nodes
at distal osteophytes, osteoarthritis
35
what is ESR for osteoarthritis indicative of
ESR (erythrocyte sedimentation rate) will be normal/elevated = indicates inflammation
36
what does increased CRP in osteoarthritis mean?
Increased CRP high sensitivity = indicates blood vessel injury, predictive test
37
what does osteoarthritis synovial fluid look like?
turbid, cloudy
38
how to determine RA vs osteoarthritis
Draw lab for rheumatoid factor to determine, negative = osteoarthritis; positive = RA
39
what is management for OA
- Conservative: phys therapy, NSAIDs, corticosteroid injections
- Prevent OA through exercise, weight bearing and wt loss
- GOAL = decrease pain, maintain mobility
40
what meds for OA
- -Tylenol, 4g/day max = Can also impact BG levels and cause fake low
- -NSAIDS = Considerations = careful with older, liver/renal insufficiency, higher risk for GI bleed (dark, tarry stools),
- -COX-2 inhibitors
- -Corticosteroid injections
- -Opioids--sparingly
- -Lidocaine patches
- -Glucosamine
41
what are different surgeries for OA
- -Debridement
- -Arthroplasty = resurface joint
- -Osteotomy = correct deformity by cutting bone, alter joint stress
- -Arthrodesis = fusion of joint
42
Sequence of progression of OA 6 steps
1 - Incongruity in joint surfaces leads to reduction in motion
2 - Osteophytes (bone spurs) form at joint margins
3 - Cartilage becomes softer and less elastic
4 - Erosion of articular surfaces
5 - Joint cartilage becomes yellow and granular
6 - Joint space narrows
43
joint replacement dx criteria
Dx = based on deformity, tissue destruction, loss of function
44
what are complications of hip, knee surgeries?
DVT, PE, Wound site infection, wound site infection, joint dislocation
45
pain meds pre/post arthroplasty
Pre op = nausea, stool softeners
| Post op = pain meds, beta blockers, normal meds, antithrombotics
46
what are the 6 Ps for assessing for distal limb function/clot
polar, pallor, pain, pulselessness, paralysis, paresthesias
47
What is pagets disease
bone disease
48
risk factors for pagets disease
Risk factors =
```
Genetics
measles as child
Male
Older than 50
Caucasian, european descent (dutch, british)
```
49
pathophys of pagets
accelerated bone remodeling
- Osteoblasts enlarged
- Osteoclasts overactive
50
where are the deformities of pagets usually
commonly skull, femur, tibia, pelvic bones, vertebrae
51
what does a radiographic exam for pagets look for
can for hot spots (weak spots)
52
what enzyme is elevated with pagets
Elevated ALP = enzyme made by bone cells, especially w overproducing bone cells
53
what meds for pagets
```
NSAIDs
COX2
calcitonin
bisphosphonates
denosumab
```
54
what does calcitonin do for pagets
```
Calcitonin = first line, decreases osteoclast activity, helps with collagen breakdown
SE = flushing :/
```
55
what are biphosphonates for pagets for
Bisphosphonates = helps with bone pain, decrease osteoclast activity
56
what does denosumab do for pagets
Denosumab = Monoclonal--inhibit osteoclastic activity, reducing bone reabsorption, last option med, SQ injection 2x/year, SE decrease serum calcium (do not give if low)
57
what are 2 surgical tx for pagets
Joint replacement
| Spinal decompression
58
what is prognathism with pagets
Skeletal changes (deformities) → enlargement of mandible joint (prognathism)
59
what other body issues come with pagets
hearing loss, fractures, bone deformities
60
what is rheumatoid arthritis
- -Chronic systemic autoimmune disease of joints, has remissions and exacerbations
- -RA characterized by synovitis and joint deformity
61
risk factors for RA
- Female
- Smoking leads to autoimmunity
- bacterial/viral infection that leads to autoimmunity
62
what is the cause of RA
--Presence of antigens to T cells triggers immune response → cytokine release + attack cartilage→ synovial fluid damaged → ↑ synovial fluid→ impaired movement + pain!
--Autoimmunity happens = RA has autoantibodies (RF)
63
what are the 4 stages of RA
1. Inflammation = synovitis after enzyme activation
2. Pannus formation = granulation tissue (MOST DESTRUCTIVE ELEMENT OF RA)
3. Fibrous ankylosis = tough fibrous
4. Bony ankylosis = calcification of fibrous connective tissue causes bones to be fused and immobilized. Fixation of joint
64
what are the s/sx of RA
- -Stiff in AM, inflamed joints, spongy deformed joints bilaterally (ulnar deviation, swan neck, boutonniere deformities, toe bunions)
- -Systemic itis = synovitis, episcleritis, scleritis, pleuritis (lung pleura), pericarditis
- -Rheumatoid nodules = extra articular, subQ, non tender nodes, can be in lung or eye
- -Sjorgren syndrome
65
what is sjorgren syndrome
Sjogren's syndrome = dry eyes keratoconjunctivitis sicca, dry mouth xerostoma, dry vagina
66
what are lab tests to dx RA
- -CBC--will see anemia typically
- -ESR (acute/chronic) and CRP increased--used to monitor response to tx
- -+ RA factor = supports dx of RA
- -ANA = antinuclear antibody = measures antibodies that destroy tissue (greater titer = more inflammatory)
- -Anti CCP (cyclic citrullinated peptides)
- -Synovial fluid analysis & tissue biopsy = Synovial fluid is turbid in RA
67
what is the priority time frame to treat RA. what is the goal?
first 2 years
GOAL of tx = control inflammation, decrease pain/stiffness
68
what are meds for RA
- -NSAIDS
- -Glucocorticoids (prednisone) = immunosuppressant
- -DMARDS
69
what are side effects of predinsone and steroids for RA?
- -Prednisone SE = mood changes, edema/retain Na which retains water, HTN, high BG, increased appetite, more susceptible to infection, moon face
- -Oral steroids can stunt growth if taken early
70
what are DMARDs for RA
antiRA drugs = alter immune system to slow disease process
| --methotrexate, plaquenil
71
what are SEs of DMARDs for RA
--Methotrexate = first line (SE = teratogen, oral sores (take daily folic acid), hepatotox, renal insufficiency, N/V, loss of appetite
--Plaquenil = antimalarial
SE = decrease UV light absorption, eye damage
72
what are other treatments for RA
-Paraffin baths to ease joint pain
-heat/cold alt q15 min (warm moist best)
-ROM/ADL assistance
balance/rest/work = resist naps, causes stiffness
-Nutrition = avoid processed foods that are inflammatory, eat fresh foods
-Surgery = joint replacement, fusion, synovectomy
73
what is scleroderma
Definition = autoimmune, t cells attack and body overproduces collagen
also called crest syndrome
74
what are the 2 types of scleroderma
```
Limited = legs, arms, face (slower process)
Diffuse = body (fast)
```
75
what are s/sx of scleroderma
- -Waxy skin, tightening of tissues
- -Blood vessels tighten up → increased BP
- -Lung tissue sclerosis → poor gas exchange
- -Organs tighten → dysphagia, renal probs, infection risk
- -Calcium deposits on skin
- -Raynaud's phenomenon = spasming of small vessels
- -Esophageal dysfunction
- -Sclerodactylyl = thick/tightening of skin on hands/fingers
- -Telangiectasia = dilation of capillaries causing red marks on surface of skin
76
what are drugs for managing scleroderma
- Calcium channel blockers for raynauds
| - DMARD meds
77
patient education for scleroderma
Protect from temp changes, avoid stressors, understand meds
78
what is systemic lupus erythematosus
--Chronic, multisystem, autoimmune, progressive, inflammatory disorder
--affects Skin, kidneys, hematologic, CNS
79
what are the 2 types of SLE
- -Discoid: skin only
| - -Systemic = Involves all connective tissues, Remissions and exacerbations
80
Precipitating factors/triggers for SLE
UV light exposure
Infection
Stress
81
what are risk factors for SLE
- -Genetics, race (3x ↑ in Afr. Am & Nat. Am.), gender (Women 10x > men; age 20 to 40)
- -Hormones: Worse at menarche and postpartum--estrogen enhances activity of SLE
82
what is the pathophys for SLE
Autoantibodies complexes are produced → trigger inflammation
Immune complexes cause vasculitis → thicken intimal lining → thrombus formation → deprive organs of arterial blood and oxygen
83
s/sx for SLE
general fatigue, weight loss, butterfly rash, alopecia, photosensitivity, polyarthralgia of hip/shoulder, pericarditis and pleuritits, nephritis, seizure activity, psychosis
84
damage to what organ from SLE is the number 1 cause of death of SLE
kidney failure
check creatinine, GFR
85
what are labs for dx of SLE
- -CBC: all cells are ↓= pancytopenia (especially thrombocytopenia and leukopenia)
- -↑ ESR + CRP (again, inflammation…)
- -ANAs against own DNA ** (most sp SLE marker)
- -Anti-Smith antigen is most unique to SLE
- -Low serum complement (C3, C4) = Depleted from inflammatory response
- -Skin biopsy = shows lupus cells and inflammatory cells
86
what are meds for SLE
- -Corticosteroids
- -NSAIDs
- -immunosuppressive therapy (Cyclophosphamide (Cytoxan) and Azathioprine (Imuran) (SE= drop in CBC)
87
long term management for SLE
- Chronic issues = infertility from steroids, risk of immunity towards fetus and spontaneous abortion
- Pregnancy + oral contraception
- Prevent exacerbations/fatigue → life balance!
- Be Sun smart: SLIP → SLOP → SLAP
- UTD on vaccines
- Dietary: anti-inflammatory diet
- Assess end-organ function = Dialysis or possible need for kidney transplant
88
what is Gouty arthritis
Arthritis of one joint by hyperuricemia = Presence of urate crystals = positive
89
pathophys of gout leading to tophi
Abnormal purine metabolism → ↑uric acid → urate crystals → tophi develop
90
what are the risk factors for gouty arthritis
Male only, 40-60--90% reoccur in 5 years, increases with incr BMI and age
91
what are 2 types of gout
- -Primary = hereditary error in metabolism of purine
| - -Secondary = caused by ETOH, chemo
92
what 2 things for dx of gout
- -Synovial fluid aspiration shoes presence of urate crystals
- -Uric acid in urine sample
93
what are the 3 phases of gout
1. Acute: Painful joint inflammation, red, tender, swelling of great toe joint (podagra)
2. Intercritical: between attacks
3. Chronic: pruritus, “Tophi” develop, renal calculi
94
what are meds for gout
- -NSAIDs
- -glucocorticoids (acute)
- -colchicine (for inflammation) = SE (diarrhea, n/v abd pain, take early with flares
- -antihyperuricemics (allopurinol) = reduce urice acid levels
95
what is antihyperuricemics for gout
Allopurinol = reduce uric acid levels
- -SE = upset stomach
- - take 2L of water per day
- - Encourage citrus foods
96
what are other managements for gout
- -Wt. loss, no ETOH or purine foods, push fluids (3-4 L/day)
- -Avoid beer, ale, wine—distilled liquor ok!
- -Avoid soy
- -Meds to avoid: aspirin (can increase uric acid), diuretics (can trigger attacks
- -Support inflamed joints, bedrest, ICE
97
fibromyalgia
Widespread PAIN triggered by a STRESSOR!
98
manifestations of fibromyalgia
- -Blood vessels don’t constrict leading to low BP and HR
| - -Body can’t suppress cortisol → oversensitive/overreact to PAIN signals
99
what may cause fibromyalgia
Trauma or autoimmune process
100
who is affected by fibromyalgia
women more than men
101
what med for fibromyalgia
pregabalin
102
What are 4 symptoms of issues with the male reproductive
- Pain with urination, ejaculation
- Bleeding
- Discharge
- Masses
103
What are 3 things to assess during exam of prostate
- -Assess for inguinal hernia: stand and cough/strain
- -Exam of rectum and prostate--draw prostate labs before invasive exam
- -Psych assessment
104
what is benign prostatic hyperplasia (BPH) pathophys
Pathophys = gland enlarges and pinches urethra which interferes with urine flow from the bladder
- -Exact cause unknown, but imbalance of estrogen and testosterone could be
- -Treatment = DHT inhibitor (slows growth by DHT hormone)
105
what are s/sx of BPH
Difficulty urinating, increased residual urine (predisposes to UTI), urine is cloudy
FUN
- -Frequency
- -Urgency
- -Nocturia
106
What does the I-PSS score for BPH asess
I-PSS score for degree to which issues are present --emptying, urgency, nocturia, straining etc
107
dx for BPH
Digital rectal exam (DRE)
Prostate sp antigen (PSA)
- -Norm = for men less than 50 = 2.5. Over 4 needs exam
- -May be elevated for 6 weeks post UTI--can cause false PSA reading
108
2 drugs for BPH
- a blockers
| - 5-alpha reductase inhibitors
109
How do alpha blockers
ALPHA BLOCKERS:
- -ACT ON A-1 RECEPTORS
- -SMOOTH MUSCLE RELAXATION
- -EX: TAMSULOSIN (FLOMAX); DOXAZOSIN (CARDURA)
110
how do 5 alpha reductase inhibitors work
5-ALPHA REDUCTASE INHIBITORS:
- -STOPS CONVERSION OF TESTOSTERONE TO DHT
- -EX: FINASTERIDE (PROSCAR)--also used for hairloss
111
what are 3 alternative tx for BPH
--Saw Palmetto = USED BY OVER 2 MILLION MEN, Helps improve flow
--African Plum = IMPROVES FLOW, LESSENS NOCTURIA
--RYE GRASS POLLEN = Reduces nocturia
112
what meds to avoid if you have BPH
- Tranquilizers
- OTC decongestants
- anticholinergics
113
What are 3 types of BPH surgical management
1st = Transurethral resection of the prostate (TURP)
2nd = transurethral incision of the prostate (TIUP or TIP)
3rd Open prostatectomy
Other = laser surgery to burn away hypertrophied tissues
114
what are 3 nursing considerations for after TURP for BPH
1. Subtract amount of irrigating solution for accurate I/O
2. Older men often get confused and “pick” at catheter—need to distract
3. Will complain of “urge to go!”
115
what is TURP for BPH
3 way catheter tube for 3-5 days post op
| --Irrigation, drain bladder, balloon
116
what are other post op considerations for TURP for BPH
- urinary catheter placed into bladder/cbi
- create traction via lateral taping to patient’s abdomen or thigh to reduce risk for bleeding!
- uncomfortable urge to void continuously
- inform the surgeon of any bleeding!
117
assessments/management for post op TURP for nurse
--Hemorrhage “light pink ok, ketchup no”
--Risk for DVT
fluid/electrolytes
--Meds to manage (analgesics, antispasmodics, antibiotics, stool softeners)
118
when removing catheter post TURP, what to look for
Post catheter removal--assess for urine retention
| --Keep eye on frequency, consistency, distension
119
what is a TIUP/TIP for BPH
2nd = transurethral incision of the prostate (TIUP or TIP)
| --Small to moderately enlarged prostate
120
what is an open prostatectomy for BPH
3rd Open prostatectomy
| --Large prostate with other complications like bladder damage/stones
121
what is erectile dysfunction and s/sx
- -Unable to achieve/maintain erection
- -Epidemiology --increases with age
- -Pathophy--surgery removing prostate
- -s/sx = inability to do/retain erection
122
what is dx for erectile dysfunction
Dx = can draw serum testosterone
123
what is med for erectile dysfunction
--PHOSPHODIESTERASE TYPE-5 (PDE-5) INHIBITORS: (VIAGRA, LEVITRA, CIALIS)
124
MOA of phosphodiesterase Type 5 inhibitors (viagra)
MOA: INHIBITS CGMP (SUBSTANCE THAT CAUSES SMOOTH MUSCLE RELAXATION)
125
Considerations for viagra (phosphodiesterase
1. Wont work without sexual stimulations
2. Do not take with nitro or alpha blockers→ hypoT
- -SE = facial flushing, vision changes, BP drop, headache
- -erection for longer than 3 hours is bad
126
What is MUSE for erectile dysfunction
Medicated urethral system for erection (MUSE)
- -Pellets in urethral which starts erection
- -SE = urethral burning, painful erection
127
what is Intervacernosal injection for erectile dysfunction
- -Erection for 30-60 minutes
| - -Risk for priapism --emergency
128
what is a vacuum device for erectile dysfunction
- -Pressure suction to cause erection
| - -Cumbersome device
129
what is surgical management for erectile dysfunction
-surgery to place an implant or penile prosthesis
--inflatable tube placed in penis; inflation bulb in scrotum
130
what is pt ed for erectile dysfunction
- -smoking & obesity increase ed risk
- -ed meds should not be taken w/nitrates
- -know med risk factors: hypoT, flushing etc
131
what are risks for prostate cancer
Risks = race, family hx, diet, chemicals, headaches, age
132
manifestations of prostate cancer
Manifestations = elevated PSA, trouble urinating, UTIs
133
what is management for prostate cancer
PSA test for early detection (if PSA over 4 need follow up)
DRE = digital rectal examination
Bx = tissue staged on gleason scale, highest score = 5
134
radiation--what is external beam vs brachytherapy for prostate cancer
Radiation
- -External beam = outside
- -Brachytherapy = internal (Caution = pt radioactive for period of time (2 weeks))
135
how old is testicular cancer usually found in
15-35
136
what cancer is inked to cryptorchidism
testicular cancer
137
what are 3 ways testicular cancer spreads
1. spread thru testis wall into bloodstream
2. spread thru lymph nodes
3. transported thru bloodstream to other organs
138
what are manifestations of testicular cancer
Manifestations = painless mass, swelling, hardness
139
how often to do testicular exam
once a month
140
what is diagnosis for testicular cancer
- -Physical assessment
- -Ultrasonography
- -Lab tests: Alpha-Fetoprotein (AFP); Beta human chorionic gonadotropin (hcg)
- -Surgery for seminomas followed by radiation and/or chemotherapy
141
what testicular cancer tumors are not responsive to radiation
Nonseminomas grow quickly and are not responsive to radiation
142
what is patient ed for testicular cancer
- -INFECTION
- -CHEMO S/E
- -NERVE DAMAGE FROM LYMPH NODE RESECTION
143
how to preserve male fertility when treatment for testicular cancer is needed
sperm preservation/ sperm bank
144
risk factors for male breast cancer
Risk factors = old, linked to BRCA 1&2, high alcohol, cryptorchidism, hot environments, working around gasoline
145
pathophys male breast cancer
UNCONTROLLED GROWTH OF ABNORMAL --> CELLS IN BREAST TISSUE
| MOST COMMONLY OCCURRING FORM IS DUCTAL CARCINOMA --> INVASIVE VS NONINVASIVE
146
clinical manifestations of male breast cancer
CLINICAL MANIFESTATIONS: swelling/lump in breast tissue, dimpling, redness, discharge, peau du orange
147
what hormone test done for male breast cancer to dx
ESTROGEN AND PROGESTERONE RECEPTOR TEST & HER2
148
causes of testicular trauma
RESULT FROM SPORTS INJURIES, KICK TO GROIN, MOTOR VEHICLE ACCIDENTS, SELF-MUTILATION, OR FALLS AND INJURY
149
pathophys of testicular trauma
Pathophys = TESTICULAR RUPTURE: INTEGRITY OF TUNICA ALBUGINEA IS ALTERED (HEMATOCELE), BLEEDING INTO SCROTAL WALL RESULTS IN A SCROTAL hematoma
150
3 categories of testicular trauma
- -blunt
- -penetrating
- -degloving
151
treatment for testicular trauma
- NSAIDs, ice, scrotal sling, bedrest 24-48 hours
| - surgery
152
what surgery is needed for degloving
skin graft
