male genital and rectal Flashcards
normal diameter of urethral meatus
5mm
what scrotal contents are you palpating for
- testes
- epididymis
- spermatic cord (vas deferens)
highest incidence of testicular cancer is in what age group
15-35 yo
hernia examination technique
- move slowly
- invaginate some scrotal skin
- use “cross-handed” method
- insert index finger into inguinal cana
- ask patient to “turn your head and cough” or valsalva
etiology of condyloma acuminata
genital warts: HPV
clinical presentation
- umbilicated pearly papular lesions
Molluscum contagiosum
- benign viral condition
clinical presentation
- acute phase begins as a painless papule that erodes into a painless ulcer
syphilitic chancre
*may become secondarily infected
etiology of symphilitic chancre
Treponema pallidum
what is the most common cause of non-gonococcal urethritis
chlamydia
idiopathic condition resulting in fibrosis in the corpora cavernosa and may develop penile curvature, painful erections, and occasional erectile dysfunction. Firm plaques in penile shaft are palpable
Peyronie’s disease
clinical presentation
- firm nodule or ulcer on penis that does not heal
- usually nontender
- more common in uncircumsized males
- will usually see inguinal lymphadenopathy
carcinoma of penis
what is the most common hernia
indirect inguinal hernia
indirect inguinal hernia
- above inguinal ligament, near the internal inguinal ring
- often extends into scrotum
direct inguinal hernia
- above the inguinal ligament
- rarel into the scrotum
- bulges anteriorly
- less common, usually in men > 40
femoral hernia
- below inguinal ligament
- never into scrotum
- least common, more common in women
clinical presentation
- varicose veins of scrotal vessels
- may slowly collapse if scrotum elevated while patient supine
- associated with infertility
varicocele
clinical presentation
- non-tender, fluid-filled mass within the tunica vaginalis
- transilluminates
hydrocele
clinical presentation
- painless, mobile mass just above the testis
- small than hydrocele, usually
- may transilluminate
spermatocele/epididymal cyst
clinical presentation
- local pain and swelling
- scrotum may be reddened
- often associated with UTI or prostate infection
acute epididymitis
clinical presentation
- testicular swelling and tenderness
- similar in appearance to epididymitis
- complication of mumps and other viral infections
acute orchitis: inflammation or infection of testis
clinical presentation
- intense pain
- red, swollen tender scrotum
- testis may be pulled upwards
testicular torsion: due to twisting of spermatic cord
**surgical emergency
clinical presentation
- firm, painless testicular nodule
- does not transilluminate
testicular tumor
anal fissure
- tear in the inside linign of the wall of the anus
- caused by stretching of anal mucosa
- severe pain with passage of stool. scant bleeding
perianal condylomata
- HPV
- lesions are skin colored or pink and range form smooth flattened papules to a verrucous, papilliform appearance
clinical presentation
- symmetrical enlargement of gland
- slowing of urine stream with difficulty starting stream
benign prostatic hypertrophy
