Male Genitaia Flashcards
What are the erectile tissue of the penis?
- Corpus spongiosum
*contains the urethra
*extends from the bulb of the penis to the cone shaped glans with its expanded base or corona - 2 Corpora cavernosa
What is the function of the penis
- Excretes urine
- Introduces sperm into vagina
In uncircumcised men what is the glans covered by?
- Loose, hood-like skin fold called prepuce or foreskin
- Smegma or secretions of the glans may collect
Where does the urethra open?
- Into a vertical slit-like urethral meatus
What are the testes and what are they covered by
- They are paired ovoid glands consisting primarily of seminiferous tubules and interstitial tissue
*covered by a fibrous outer coating tunica albuginea
What are the normal size of the testes
Pre-puberty
*1.5 to 2 cm
Post-puberty
*4 to 5 cm
What is the scrotum
A loose wrinkled punch of skin and underlying the tunica darts
What does the scrotum contain
Its divided into two compartments each contains a testicle
What covers the testis posteriorly
Tunica vaginalis
*derived from the peritoneum of the abdomen
What can lead to an indirect inguinal hernia
If the peritoneal lining remains and open channel to the scrotum
What leads to a hydrocele
- The parietal and visceral layers form a potential space for the abnormal fluid accumulation
What is the purpose of the vas deferens
- Transports sperm from the tail of the epidermis along to the urethra
*will ascend from the scortal sac (as the spermatic cord) into the pelvic cavity through the inguinal canal via the external inguinal ring
What helps form the ejaculatory duct
- Vas deferens and seminal vesicle
What contributes to seminal fluid
- Secretions from the vas deferens, seminal vesicles and prostate
Which testis hangs lower?
- Left
*will produce spermatozoa and testosterone
What is the purpose of the epididymis
- On the posterolateral surface of each testis
*provides a reservoir for storage, maturation and transport of sperm
Where are femoral hernias located
- Inside the femoral canal
*presents as emergencies with bowl incarceration or strangulation
Where are indirect inguinal hernias located
- Develop at the internal inguinal ring (into the abdominal canal)
*where the spermatic cord exits the abdomen
Where are direct hernias located
- Arise more medially due to weakness in the flor of the inguinal canal
*associated with straining and heavy lifting
When does sexual differentiation happen by?
12 weeks
*decent of tests may occur after birth
*undescended happens bc of cancer
When does complete separation of the prepuce happen?
- 3 to 4 years
What are the basic landmarks of the groin
- ASIS
- Iliac spine
- Pubic tubercle
- Inguinal ligament
Where does the inguinal canal lie?
- Lies above and parallel to the inguinal ligament
*forms a tunnel for the vas deferens
What where does the external inguinal canal open into?
- The scrotum
What produces inguinal hernias
- When loops of bowel force their way through weak areas of the inguinal canal
What question will help determine desire, arousal, orgasm and ejaculation
Desire
*have you maintained interest in sex
Arousal
*can you achieve and maintain an erection
Orgasm and ejaculation
*about how long does intercourse last
What can be associated with difficulty achieving and maintaining an erection
- Pain
- Character
- Associated symptoms
- Medications
What can be associated with difficulty with ejaculation
- Painful and premature
- Efforts tok treat
- Character of ejaculate
- Medications
What to document if there is an enlargement in the inguinal area
- Character
- Change in mass
- Pain in groin
- Efforts to treat
- Medications
What to include in the PMH
- Surgery of genitourinary tract
- Sexual history
- Chronic illness
Are testicular self-examinations recommended?
- No
*recommend to be aware of testicles
If there is swelling or sore on the penis or scrotum on children what does that indicate
- Cleanliness issue or sexual abuse
What does the USPTF think about testicular self examinations
D
When checking for hernias how should the patients be situated
- Stand
*examiner should sit on a chair or stool
How to test the cremasteric reflex
Stroke the inner thigh
*then the testicle will pull back
What are indirect inguinal hernias
- Extend into scrotum through the internal ring
*due to patent processes vaginalis - will stay open and creates a weak spot
*lateral to the inferior epigastric
Where do indirect inguinal hernias travel into?
- Into the scrotum through the internal ring
What is the most common hernias in males and females
Indirect inguinal hernias
*have patient turn head and cough
What are direct inguinal hernias
- Viewed as acquired hernia due to weakness of muscle wall “no sac”
*medial to inferior Epigastric vessels
*mostly fat and less bowl (less risk of incarceration (getting stuck on in the inguinal ring)
*associated with older, overweight males
What are femoral hernias
Acquired no sac
1. In triangle of inguinal ligament, femoral vein, and underside of pubic bone
*more common in females (still not more common than indirect)
*strangulation is common
If you are unable, to see the discharge that the patients reports due to an uncircumcised penis what should you do?
- Ask the patient to retract his foreskin
What does the epididymis feel like?
- Soft nodular, cordlike structure at the back of the testicle
If there is a hernia while the patient is standing what should you do?
- Have them lie down to see if the hernia goes away
*if it disappears it is almost always a hernia
What happens if the mass remains prominent when the patient lies down?
- Listen to the mass with a stethoscope, if bowel sounds are heard it is almost always a hernia
- Shine a light from behind the scrotum through the mass
*if a red glow is observed is is probably not a hernia
What is paraphimosis
Foreskin is retracted and wont move
What is hypospadias
Urethral meatus is below
What is molluscum contagiosum
- Waxy dome with a central umbilication (common in kids)
What does a varicocele feel like?
Bag of worms
How to treat testicular torsion
Try to turn the testicle externally
What is Klinefelter syndrome
Small testicles in adult, hypospadius, small penis, and undescended testicles may be present in infant\
*male patients have more female like characteristics
What steps to a male genitalia exam are done with the patient lying or standing?
- Inspect the pubic hair characteristics and distribution
- Retract the foreskin if the patient is uncircumcised
