Lecture 4: Male Genitourinary System Flashcards
Structure and Function: Penis
- Corpora cavernosa
- Corpora spongiosum
- Glans
- Corona
- Urethra
- Foreskin
Other Structures of the Male Gen Sys
- Scrotum
- Rugae
- Cremaster/dartos muscles
- Testis
- Epididymis
- Vas deferens
- Spermatic cord
- Ejaculatory duct
- Inguinal area
- Inguinal ligament
- Inguinal canal (Internal and external ring)
- Femoral Canal
Other Structures of the Male Gen Sys
- Scrotum
- Rugae
- Cremaster/dartos muscles
- Testis
- Epididymis
- Vas deferens
- Spermatic cord
- Ejaculatory duct
- Inguinal area
- Inguinal ligament
- Inguinal canal (Internal and external ring)
- Femoral Canal
Developmental Considerations: Infants
- Descent of testes
- Observe first voiding, if possible
- If uncircumcised, foreskin tight in first 3 months
- Importance of documentation of findings on palpation of testes
- Hydrocele finding in boys under 2 years of age
- Careful inspection of inguinal area for bulge
Developmental Considerations: Adolescents
- Signs of puberty
- Tanner’s sexual maturity rating
- Note normal development of genitals by using sexual maturity rating charts
Developmental Considerations: Adults and older adults
- Sperm production begins to decrease at 40 yrs
- Testosterone declines gradually after 55 yrs
- Slower and less intense sexual response
- Sexual expression in later life (Physical changes do not interfere with libido)
- Thinner, greying pubic hair; decreased penis size
Cultural and Social Considerations
- Circumcision of male infants - religious and cultural values
- No med indication for male neonatal circumcision
- Parental knowledge of care of uncircumcised penis
- HPV vaccine approved for boys and men
Subjective Data: Health History
- Frequency, urgency, and nocturia
- Dysuria
- Hesitancy and straining
- Urine colour
- Past genitourinary history
- Penis: pain, lesion, discharge
- Scrotum: self-care behaviours, lump
- Sexual activity and contraceptive use
- STI contact
Additional health history questions: Infants and children
- Urination
- Toilet training
- Abnormalities
- Molestation
Additional health history questions: Preadolescents and Adolescents
- Puberty
- Nocturnal emission
- Erotic feelings
- Sexual activity
- Self-examination
- Molestation
Additional health history questions: Older Adults
- Prostate enlargement
- Incontinence
- Nocturia
- Sexual Function
Principles of Interviewing Adolescent Male Patients
- Ask Q’s appropriate for a boy’s age, but be aware that norms vary widely
- Ask direct, matter of fact questions; avoid sounding judgemental
- Start with a permission statement
- Try the ubiquity approach
- “Open the door” to later conversation
Objective Data: Penis
Inspect and Palpate
- Skin
- Glans
- Urethral meatus
- Pubic hair
- Urethral discharge
- Shaft
Objective Data: Scrotum
Inspect and Palpate
- Skin
- Testis
Objective Data: Urine Output
Assessment of urine output
- Norm 1500mL/da
- Moderate distension and urge to urinate with 200-250 mL
- Assessment with indwelling catheter
- Monitor for signs and symp of catheter-acquired urinary tract infection
- Risk factors: Prolonged catheterization, female gender, diabetes, malnutrition, old age, and impaired immunity
- Proper anchorage
