Exam 3 - GU Flashcards
normal scrotum finding
L hangs lower than the R
what is the prostate gland
in front of anterior wall of rectum, 2cm behind symphysis pubis
when does puberty begin for boys and how long does it last?
9.5-13.5 y/o
lasts 2-5 years
first sign of puberty for boys
enlargement of testes
pubic hair
increase in penis size
tanner stage 1 - boys
prepubertal genitalia
tanner stage 2 - boys
enlargement of testes, scrotum
no enlargement of penis
tanner stage 3 - boys
penis begins to enlarge (length, then diameter)
testes, scrotum continue to enlarge
tanner stage 4 - boys
testes, scrotum continue to enlarge
penis continues to lengthen
enlargement of glans
tanner stage 5 - boys
genitalia of adult size, proportion
when does sperm production being to decrease?
around 40 y/o
when does testosterone begin to decrease?
after 30
decrease in testosterone results in what changes?
decrease in pubic hair, penis size scrotal hangs lower, less rugae pendulous scrotum testes decrease in size, less firm to palpation prostate gland beings to enlarge
benefits of circumcision
lower risk for STI, genital ulcer disease in males; reduce risk for contracting HIV through heterosexual contact
decrease risk for bacterial vaginosis and trich in females
highest ethnic ground for prostate cancer
African Americans
prostate cancer risk factors
increased age
African ancestry
family hx
inherited - BRCA 1, BRCA 2
urgency incontinence
sudden loss
stress incontinence
involuntary loss d/t physical straining such as laughing, coughing
weak pelvic floor muscles
what plays a role in UTI in younger males?
constipation
what is a predisposition to kidney stones
family hx
what can cause an increase risk for penile cancer?
10+ partners
meds that can cause ED
anti-depressants
HTN meds
meds that can lead to increase penile blood flow
nitro
imdur
isosorbide
Cialia
male positioning for prostate exam
L lateral decubitus
standing
litotomy
scrotal edema may indicate…
CHF
renal failure
local inflammation/infection
what is cryptorchidism?
absent testes
cryptorchidism increases the risk for
testicular cancer
what is tosion
twisting of the spermatic cord
medical emergency
reducible hernia
hernia will return when lying down or with gentle pressing
incarcerated hernia
can not be returned to abdominal cavity
strangulated hernia
blood supply cut off
pain, N/V; surgical emergency
perianal area 12:00 and 6:00
12: towards symphysis pubis
6: coccyx
when to start self testicular exams
13
common age range for testicular cancer
15-40
TSE for testicular exam
timing
shower
examine
avoid retracting foreskin in an infant until after
3 months old
hypospadias
urethral meatus is on the ventral (under) side of penis
priapism
erection lasting > 4 hours
phimosis
foreskin that cannot be retracted
paraphimosis
can not return foreskin
epispadias
urine does not exit through urethra
birth defect
Peyronie’s disease
curve penis
first signs of puberty in girls
breast development
pubic hair
when does puberty occur in girls?
8.5-13 y/o
how long does puberty last in girls?
3 years
when does menarche start in girls?
12-14 y/o
a menarche cycle last how long
18-45 days
how long does menarche ast
3-7 days
tanner stage 1 - girls/pubic hair
no hair
tanner stage 2 - girls/pubic hair
sparse, long downy
tanner stage 3 - girls/pubic
sparse, spreading
darker, coarser, curlier
tanner stage 4 - girls/pubic
adult type, smaller area
tanner stage 5 - girls/pubic
inverse triangle
meidal thigh surface
perimenopausal period/age
40-45
cervix color during pregnant
violet, blue
Chadwick’s sign
what causes an increase risk of vaginitis
oral BC abx DM menses, postpartum, menopause douching feminine spray local irritation
pt positioning for female GU exam
HOB up
arms at side or across chest
should you apologize about having to do an exam?
no
thick, white, curdlike discharge
candidiasis
labia may be erythematous
frothy, yellow, green discharge
trichamonas
thin gray, fishy odor discharge
bacteria vaginosis
green, malodorous discharge
gonorrhea
Goodell’s sign
soft, velvety cervix
early indication of pregnancy; 5-6 weeks
is a fallopian tube normally palpable?
no
palpable, pulsation of fallopian tube suggests
ectopic pregnancy
what is cystocele
bladder falls into vagina
what is rectocele
rectum falls into vagina
what is uterine prolaspe
uterus falls into vagina
mixed incontinence
stress + urge mixed together
overflow incontinence
frequent dribbling d/t inefficient bladder emptying
*spinal cord injuries, DM, neurological problems, enlarged prostate
