Male/Female genitals, breast, anus, rectum Flashcards
What is the most common site for breast cancers?
Upper outer quadrant
What are the breast lymphatics?
Central, pectoral (anterior), subscapular (posterior), lateral
What is gynecomastia?
Increased mass of the breast
Which lymph nodes drain the breast?
Sentinel/central lymph nodes
Will likely be biopsied if cancer is in question
What is the Tail of Spence?
Piece of breast tissue that goes into axillary region
What are breast exam techniques?
Pt sitting, disrobed to waist, arms at side
Also have pt with hands on hips bending forward slightly for inspection
What should one look for when examining for breast cancer?
Dimpling/concavities Redness Inflammation Size and symmetry Size, shape, direction, rashes,, ulceration, discharge of nipples
What is Peau d’Orange?
When the skin of the breast looks like an orange peel - sign of cancer
How does one palpate during the breast exams
With pt arms behind head, use pads of first 3 fingers, compress tissue gently, concentric circles
Palpate each nipple and gently compress to check for discharge
What characteristics are important if one finds a nodule?
Location Size Shape Consistency Movable Distinctness Nipple Lymphadenopathy
When should a clinical breast exam be given?
Age 20-39 every 3 years
>40 - yearly along with mammography
What is the cumulative lifetime risk factor for developing breast cancer?
1 in 7
What is leukorrhea?
Normal discharge from vagina
What are the 3 reasons for a female rectal exam?
Check the posterior portion of the uterus
Check the sphincter tone of the rectum
Guaiac testing (testing of stool for blood)
What is a rectocele?
When the rectal wall pushes against the vagina
Can cause a fistula
Increases the risk of infection
What to ask for in the ROS?
Menstrual History Sexual History Medical/Surgical History Medication Any complaints Last CBE, SBE Compliance, Mammography, Pap smear, digital rectal exam
What is amenorrhea?
Lack of a period
What is dysmenorrhea?
Painful periods
What is polymenorrhea?
Many periods
What is the lithotomy position?
Both legs in stirrups and shifted down on the table
What happens during the internal exam?
Locate the cervix Assess support of the vaginal wall Check for cystocele Check for uterine Prolapse Check for rectocele Inspect cervix and os Pap Smear Palpate the cervix Palpate the uterus Retroversion of the uterus Palpate each ovary
What is smegma?
Given off by glans penis - must be washes, or it can develop an infection
Which side of the scrotum hangs lower and why?
Left because sperm is sensitive to temperature and stays cooler in the environment
What is cryptorchidism?
When one testicle doesn’t descend and it’s not in the sac
Can self-correct or requires surgery
What is hypospadia?
When the urethra is on the underside of the penis
What are symptoms of BPH?
Increased urination, nocturia, ejaculation problems
What are 3 reasons for a male prostate exam?
BPH
Guaiac testing
Sphincter tone
Which type of hernia is more common in men?
Inguinal hernias
Which type of hernia is more common in women?
Femoral hernias
How does one check for a hernia?
Put hands in the area and have the pt cough
What should one look for during the ROS?
Sexual History Medical/Surgical History Medications Any complaints Last DRE, PSA blood test Clinical testicular and breast exam Self testicular and breast exam Compliance
What age is at the highest risk of testicular cancer?
15-40
What are signs of testicular cancer?
Lump
Rapid enlargement/swelling (hydrocele)
Painless mass, but aching in lower abdomen
Shriveling of testicle
What is a hydrocele?
Build up of fluid in the scrotum
What should you inspect during the male genital exam?
Penis Foreskin Smegma Phimosis Paraphimosis Glans; hypospadias Palpate shaft between thumb and first 2 fingers; feel for induration along ventral surface. Scrotum Testicular Cancer
What is phimosis?
Retraction of the foreskin
What is paraphimosis?
Putting foreskin back
How do you check for a hydrocele?
Transillumination
How far should the prostate protrude into the rectum?
No more than 1 cm
What should you look for during a rectal exam?
Lumps Ulcers Inflammation Rashes Excoriation Venereal warts Herpes Hemorrhoids, lesions, signs of trauma Sphincter for tone Nodules Irregularities
Does gynecomastia increase the risk of breast cancer?
No
What do you do if you suspect urethritis or inflammation of the Skene’s glands (paraurethral)?
Insert index finger into vagina, milk urethra gently from inside outward
