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Patient Assessment > Genital > Flashcards

Genital Flashcards

1
Q

Sacrococcygeal inspection for what in particular?

A

pilonidal dimpling and/or tufts of hair

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2
Q

Inspect anus for what?

A
  • skin characteristics and tags
  • lesions, fissures, hemorrhoids, polyps
  • fistulae
  • prolapse
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3
Q

Palpate posterior surface of prostate for what?

A
  • size
  • contour
  • consistency
  • mobility
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4
Q

Palpation through anterior rectal wall in females for?

A

cervix and uterus

  • size
  • shape
  • position
  • smoothness
  • mobility
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5
Q

Anal canal innervation (upper and lower)

A
  • lower half: somatic sensory nn. (sensitive)
  • upper half: autonomic control (insensitive)
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6
Q

Spaces between mucosal Columns of Morgagni in anus

A

crypts - anal glands empty into these

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7
Q

Hemorrhoid Types

A
  • anastomosing veins cross the columns
    • Zona hemorrhoidalis
    • Internal hemorrhoids
  • lower segment of anal canal
    • venous plexus that drains into inferior rectal veins
    • external hemorrhoids
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8
Q

Rectal storage of flatus and feces

A
  • ampulla- stores flatus and feces
  • Houston valves
    • 3 semilunar transverse folds - lowest can be palpated
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9
Q

Prostate lobes

A

3: median sulcus w/ left and right lateral lobes

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10
Q

Infant and Child UG Development

A
  • first stool 24-48h after birth - indicates anal patency
  • gastrocolic reflex - stool after each feeding
  • toilet training at 2-4 years
  • prostate underdeveloped until puberty
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11
Q

Pregnancy Complications

A
  • decreased GI motility - constipation
  • pressure in veins below enlarged uterus
  • hemorrhoids - aggravated by labor
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12
Q

Older Adult Complications

A
  • degeneration of afferent neurons in rectal wall
    • can’t relax anal sphincter
    • increase pressure sensation threshold
    • stool retention
  • loss of sphincter tone - incontinence
  • fibromuscular structures of prostate atrophy
    • benign hyperplasia of glandular tissue
    • loss of function of secretory alveoli
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13
Q

Genital/Rectal HPI

A
  • changes in bowel function
    • character, onset/duration, assoc. symptoms, meds: iron, lax.
  • anal discomfort (itch, pain, sting, burn)
    • related to postion/defecation, straining, blood/mucus, ADL disruption, meds: hemorrhoid creams
  • rectal bleeding
    • color, related to defication, amount, changes in stool, assoc. symptoms, meds: fiber, iron
  • males (change in urinary fx)
    • prostate hx, hesitancy/urgency/nocturia/stream/discharge, meds: antihist., anticholinergics, antidepressants, 5-alpha-reductase inhibitors
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14
Q

PMH

A
  • hemorrhoids
  • spinal cord injury
  • prostate
  • epesiotomy
  • colorectal CA or related (breast, ovarian, endometrial)
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15
Q

FH

A
  • rectal polyps
  • family colon CA
  • prostate CA
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16
Q

Personal/Social Hx

A
  • travel history
  • diet: fiber and animal fat
  • MSM
  • HPV vaccination
  • alcohol
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17
Q

Infants and Children Personal Hx

A
  • stool characteristics
  • BMs with crying, straining, bleeding
  • feeding habits
  • bowel control and potty training
  • associated symptoms
  • congenital anomalies
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18
Q

Pregnancy Personal Hx

A
  • gestation and estimated delivery date
  • exercise
  • fluid intake and diet
  • use of complimentary/alternative therapies
  • meds: prenatal vitamins, iron
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19
Q

Older Adult Personal Hx

A
  • change in bowel habits or character
  • assoc. symptoms
  • dietary changes
  • males: enlarged prostate and urinary symptoms
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20
Q

Prostate Exam

A
  • size, contour, consistency, mobility, tenderness
  • firm, smooth and slightly movable
  • about 4cm in diameter
  • 1cm protrusion normal
    • greater protrusion denotes enlargement
    • bogginess indicates BPH
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21
Q

loose hairs penetrating skin in sacrococcygeal area

A

pilonidal cyst

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22
Q

sign of HPV infection in anus

A

anal warts

(condyloma acuminata)

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23
Q

infection of soft tissue surrounding anal canal

ususally polymicrobial

A

perianal/perirectal abscess

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24
Q

tear in anal mucosa

A

anorectal fissure

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25
Q

inflammatory tract running from anus/rectum

to surface of perianal skin or other tissue

(caused by drainage of abscess)

A

anal fistula

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26
Q

commonly d/t fungus in adults and parasites in children

A

pruritus ani

27
Q

varicose veins below anorectal line covered by skin

or

above the anorectal junction covered by rectal mucosa

A

external / internal hemorrhoids

28
Q

Anus Skin Lesions

A
  • polyps (malignant or benign)
  • anal cancer
    • most squamous cell assoc. w/ HPV
    • adenocarinomas originate in glands near anus
    • basal cell carcinoma and malignant melanoma
  • colorectal cancer
    • most adenocarcinomas
29
Q

Prostate Disorders

A
  • prostatitis
  • benign prostatic hypertrophy (BPH)
  • prostatic cancer
    • 99% adenocarcinomas from gland cells in prostate
30
Q

Disorders in Children

A
  • imperforate anus
    • blind ending, stenosed, or fistulous connection to perineum, urinary tract, vagina
  • enterobiasis (roudworm, pinworm)
    • adult lives in rectum/colon and emerges at night to lay eggs in perianal skin
31
Q

Male Infant/Child Development

A
  • 12 weeks gestation: sexual differentiation
  • 3rd trimester: testicals descend from retroperitoneal space through inguinal canal
  • 3-4 years: prepuce separates from glans in uncircumcised
32
Q

HPV Immunization in Males

A
  • quadrivalent vaccine age 11-12
  • HPV4 for ages 13-21 not vaccinated or not completed 30-dose series
  • can recieve vaccine through age 26
    • MSM
    • immune compromised (HIV)
33
Q

Benefis of Circumcision

A
  • decreased UTIs
  • decreased transmission of some STIs
  • decreased acquisition of HIV
  • decreased penile cancer risk
34
Q

protrusion of peritoneal-lined sac through abdominal wall

A

hernia

  • indirect- soft swelling in area of internal ring
  • direct- swelling bulges anteriorly
  • femoral - occurs in fossa ovalis where femoral artery exits abdomen
  • strangulation - blood supply compromised
35
Q

inability to replace foreskin after retraction

A

paraphimosis

36
Q

urethral meatus on ventral surface of penis

A

hypospadias

37
Q

skin lesion associated with primary syphilis

A

syphilitic chancre

38
Q

lesion caused by HSV-2

A

genital herpes

39
Q

lesions caused by HPV

A

genital warts (condyloma acuminata)

40
Q

STI of lymphatics caused by Chlamydia trachomatis

A

lymphogranuloma venereum

41
Q

benign skin infection caused by pox virus

A

molluscum cantagiosum

42
Q

fluid accumulation in scrotum

A

hydrocele

43
Q

benign cystic accumulation of sperm in epididymis

A

spermatocele

44
Q

tortuosity and dilation of veins of

pampiniform plexus in spermatic cord

A

varicocele

45
Q

acute inflammation of testis secondary to infection

A

orchitis

46
Q

inflammation of epididymis often associated with UTI

A

epididymitis

47
Q

twisting of testis on spermatic cord

A

testicular torsion

48
Q

seminomas and nonseminomas arising from germ cells

A

testicular carcinoma

49
Q

congenital anomaly associated with XXY chromosomes

A

Klinefelter syndrome

50
Q

newborn genitalia not clearly male or female

A

ambiguous genetalia

d/t presence or absence of male hormone controls during development of sex organs

51
Q

Steps to Perform Male Urethral Swab

A
  • insert swab 1-2cm
  • rotate in one direction 10 seconds
  • withdraw swab, place into container, break at line
  • seal and label vial
52
Q

Breast Exam - Palpation

A
  • chest wall sweep
  • bimanual digital palpation
  • lymph node palpation (incl. axillae and infraclavicular areas)
  • all breast area in supine position
    • tail of Spence
    • nipples
53
Q

benign fluid-filled cysts cuased by duct enlargment

A

fibrocystic changes

54
Q

benign tumors of stromal and epithelial elements that represent a hyperplastic or proliferative process in a single termial duct

A

fibroadenoma

55
Q

ductal carcinoma from epithelial lining of ducts /

lobular carcinoma from glandular tissue of lobules

A

malignant breast tumors

56
Q

benign breast lump occurring as inflammatory response to injury

A

fat necrosis

57
Q

benign tumor of subareolar ducts

produce nipple discharge

A

intraductal papillomas and papillomatosis

58
Q

benign condition of subareolar ducts that produce discharge

A

duct ectasia

59
Q

lactation not associated with childbearing

A

galactorrhea

60
Q

surface manifestation of underlying ductal carcinoma

A

Paget disease

61
Q

inflammation and infection of breast tissue

A

mastitis

62
Q

breast enlargement in men

A

gynecomastia

63
Q

breast enlargement in girls before puberty

A

premature thelarche

Patient Assessment (7 decks)

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