Genitourinary Flashcards
What is the dorsal portion of the penis called
Corpus cavernosum
What is the ventral part of the penis called
Corpus sponginosum. The glans penis is the extension of the sponginosum
Where is the prostate gland located
Inferior to the bladder, just anterior to the rectal wall and before the corpus cavernosum begins (surrounds the urethra)
What muscle controls the scrotum
Cremaster muscle
Where is the epididymis located
On the posterolateral and upper aspect of the testicle
Function of the epididymis
Storage, maturation, and transit of sperm
Where is the vas deferens located
At the tail of the epididymis, ascends up as the spermatic cord and connects with the seminal vesicle to form the ejaculatory duct
What does the prostate produce
The majority of the ejaculatory fluid (fibrinolysin - liquifies semen)
What structure becomes engorged during erection
The corpus cavernosum (20-50mL)
What system controls erection
The ANS - Arterial dilation and decreased venous outflow.
What structures are a part of ejaculation
- Vas deferens
- Epididymides
- Prostate
- Seminal vesicles
What happens after orgasm
Constriction of the blood vessels of corpus cavernosum, and gradual detumescence
What do you observe during INSPECTION of genitals
- Hair distribution
- The skin on the penis
- Lesions or masses
- Urethral meatus
What does the palpation portion consist of
Circumcised vs uncircumcised. If uncircumcised, retract the foreskin
palpate the shaft for tenderness
What is a normal finding of uncircumcised
the foreskin should retract easily and a white cheesy sebaceous fluid may be present (smegma)
Phimosis
Foreskin is too tight nd cannot be retracted
Balanitis
Inflammation of the glans
What is phimosis caused by
May occur during first 6 years of life, or because of balanitis, precancerous
Paraphimosis
Retracted foreskin cannot resume normal place over the glans.
What are you looking for during stripping of the urethra
Any discharge (may indicate and STI)
What are you looking for during ureteral meatus inspection
- Position of the urethral opening
- Discharge
- Meatal stenosis
- Warts, ulcers, nodules
What are you looking for during scrotal inspection
- Appearance - redness
- Skin (lumps, thickening)
- Asymmetry
Why can the scrotum be asymmetric
Because the left testicle has a longer spermatic cord and is often lower
How do you palpate the testes
Using the thumb and first two fingers
What should a normal testicle feel like
Smooth and rubbery and free of nodules
What should the epididymis feel like
Nontender, smooth, discrete, larger cephalad
When do you transilluminate
Through the testicles, when a hydrocele or spermatocele is suspected (fluid or mass)
Hypospadias
Congenital defect in which urethral meatus(opening) is located on the ventral (underneath) surface of the glans or base of penis
What does the scrotum contain
- Testis
- Epididymis
- Spermatic cord - vas deferens
- Cremaster muscle
Chancre
Usually a single painless ulcer and is the primary (1st) stage of syphillis. usually seen on the glans
Condyloma
Genital warts caused by HPV, usually on glans or shaft of penis
Peyronie disease
A fibrous band (plaque) on the corpus cavernous. Very hard. May be trauma, congenital or inflammation
Hydrocele
Fluid accumulation in the scrotum-tunica vaginalis (common in infants)
Spermatocele
Benign cyst caused from accumulation of sperm. Occurs on epididymis. Will transilluminate
Varicocele
Abnormal tortuosity and dilation of veins within the spermatic cord (pampiniform plexus)and testes(most common on the left side)
Epididymitis
Inflammation of the epididymis (seen with UTI)
What does the fecal occult blood test
Test for the presence of blood in the fecal smear. Guiac card
What does the cremasteric reflex test for
The contraction of the scrotum (testis). This is under nervous control so if it does not contract it may be indicative of nerve damage or trauma
How do you palpate an inguinal hernia
Through the inguinal ring
What additional documentation is done with male adolescence
The tanner stages
What are you looking for in infants
Mostly congenital defects, masses, hernias, hydroceles
Tanner stage 1p
No pubic hair
Tanner stage 2p
Some hair, slightly pigmented (straight)
Tanner stage 3p
Dark hair, starting to curl
Tanner stage 4p
Pubic hair like adult, but does not extend any farther than inguinal fold
Tanner stage 5p
Adult distribution, hair spreads to thighs but not up
Tanner stage 6p
Hair going up linea alba
Tanner stage 1g
Testes, scrotum and penis the size of young child
Tanner stage 2g
Enlargement of scrotum and testes
Tanner stage 3g
Enlargement of penis and testes which are now in scrotum
Tanner stage 4g
Continued enlargement of penis and sculpting of the glans(not quite adult)
Tanner stage 5g
Penis reaching towards the bottom of the scrotum
Testicular tumor
found in the testicles, most are germ cell cancers. Painless mass
Epispadias
A rare birth defect of the penis in which the urethra ends in an opening on the upper aspect of the penis
Indirect inguinal hernia
soft swelling in area of internal ring, comes down canal and touches fingertip on exam
Direct inguinal hernia
bulge in area of Hesselbach triangle, bulges anteriorly pushes against side of finger on exam
Femoral hernia
Occurs farther down the grown, not felt in inguinal canal exam.
cryptorchidism
Absence of one or both testes from the scrotum. most common birth defect in men
