Male Genitalia Flashcards
What things should be asked under History of Present Illness in regard to male genitalia?
Difficulty achieving or maintaining erection.
Difficulty with ejaculation.
Discharge or lesions on the penis.
Infertility.
Enlargement in inguinal area.
Testicular pain or mass.
Patients should be asked what specific things in regards to difficulty achieving or maintaining erection?
Pattern of erection with one or more partners,
Alcohol and medication ingestion,
Curvature of erect penis
Erections unrelated to sexual stimulation
PACE
Patients complaining of difficulty with ejaculation, should be asked about what specific things?
Painful or premature ejaculation
Color and consistency of fluids,
Medications used on a regular basis.
Patients complaining of discharge or lesions on the penis should be asked what specific things?
Note the character of lesion (lumps, sores, rashes)
Note any discharge (color, consistency, odor).
Record any associated symptoms (e.g., itching or burning),
Exposure to sexually transmitted infections
Medications used.
Patients with Infertility issues should be asked what specific things?
Lifestyle factors (e.g., hot tub use),
Length of time attempting pregnancy,
Knowledge of fertile period of woman’s reproductive cycle,
Incidence of undescended testes,
Previous diagnostic studies (e.g., semen analysis or sperm antibody titers)
Medications used.
Patients complaining of enlargement in inguinal area should be asked what specific questions?
Questions relevant to an enlarged inguinal area
Address pain associated with lifting,
Change in size
Character of mass,
Groin pain,
Use of truss or other treatment
Medications used.
Patients complaining of testicular pain or mass should be asked what specific questions?
Patients should be assessed for changes in testicular size,
Events surrounding onset (e.g., sporting event),
Irregular lumps, soreness, or heaviness of testes,
Medications used.
Past Medical History will include what specific questions?
Previous genitourinary tract surgeries (e.g., surgery to correct hypospadias or hernia),
Sexually transmitted infections, and
Chronic illnesses (e.g., prostatic cancer, arthritis, or neurologic or vascular impairment).
Family History should include what information during a male genitalia exam?
Data should be collected on any infertility problems in siblings, hernias in family
members, and a family history of prostate, testicular, or penile cancer.
Personal and Social History should include what information during a male genitalia exam?
Relevant data include employment risks (e.g., exposure to toxins),
Exercise patterns,
Concerns about genitalia,
Testicular self-examination practices,
Concerns about sexual practices,
Reproductive function (number of children, form of contraceptive use)
Medications, alcohol,
Drugs that may interfere with sexual response.
The male genitalia consist of what?
Penis, testicles, epididymis, scrotum, prostate gland, and seminal vesicles.
What is the function of the penis?
excrete urine and to introduce semen into the vagina
What expands to form the glans penis?
The corpus spongiosum expands at its distal end to form the glans penis.
Describe the urethral orifice.
Urethral orifice is a slit like opening about 2 mm ventral to the tip of glans
Describe the scrotum.
Darkly pigmented and contains two pendulous sacs, each containing a testis, epididymis, spermatic cord, and muscle layer.
How is testicular temperature controlled?
Testicular temperature is controlled by altering the distance of the testes from the body through muscular action
Spermatogenesis requires temperatures lower than what?
Spermatogenesis requires temperatures lower than 37 Degrees Celsius.
What provides storage of the sperm?
The epididymis provides for the storage, maturation, and transmission of the sperm.
What forms the ejaculatory duct?
Vas Deferens, and Seminal Vesicles
What surrounds the urethra at the bladder neck?
The prostate gland.
What produces the major volume of ejaculatory fluid?
The prostate gland.
What is contained in the fluid from the prostate gland?
Fibrinolysin enzyme that liquefies coagulated semen.
How does an erection occur?
Erection of the penis occurs when the two corpora cavernosa become engorged with 20
to 50 mL of blood in response to the autonomic nervous system.
Erections are what kind of reflex?
Erection is a neurovascular reflex induced by psychogenic or local reflex mechanisms.
Orgasm is the emission of secretions from what?
The vas deferens, epididymides, prostate, and seminal vesicles
External genitalia are the same for males and females at 8 weeks of gestation, when does differentiation occur?
Differentiation occurs by 12 weeks of gestation
What trimester of pregnancy do the testes descend into the scrotum?
During the third trimester, the testes descend into the scrotum.
Examination of the genitalia involves what?
Examination of the genitalia involves inspection, palpation, and transillumination of
any mass found.
During examination of the penis, what should be apparent on inspection?
The dorsal vein should be apparent on inspection.
What is the term for when foreskin is tight and can’t be retracted?
Phimosis.
What should be noted during inspection of the scrotum and inguinal areas?
Size, contour, and the presence of hernia.
During palpation of testes, epididymis, and vas deferens, what should be noted?
Note size, contour, and characteristics of testes.
Uncircumcised males may have what as a result of nonretractable
foreskin?
Balanoposthitis
Penile discharge suggests what?
Penile discharge suggests inflammation or infection.
A pinpoint opening suggests what?
Pinpoint opening suggests meatal stenosis
What is a prolonged and often painful penile erection, may suggest a more
serious condition?
Priapism
Thickening of the scrotum from edema is associated with what?
Disease- It is more
Likely a result of consequences of general fluid retention associated with cardiac,
renal, or hepatic disease
Irregular testis texture is a sign of what?
Irregular testis texture is a sign of infection, cyst, or tumor.
Beaded or lumpy vas deferens suggests what?
Diabetes, tuberculosis, or inflammatory
changes.
How do you check for a hernia?
Insert your examining finger into the lower part of the scrotum and
carry it upward along the vas deferens into the inguinal canal.
The hernia is described as indirect if it lies where?
Within the inguinal canal
This type of hernia occurs more commonly in young men and is the most common of the abdominal
hernias.
Indirect Inguinal Hernia
Describe how the vas deferens should feel.
Describe how to palpate the vas deferens.
The vas deferens, itself feels smooth and discrete;
Palpate from the testicle to the inguinal ring
What is the proper way to evaluate the cremasteric reflex?
Stroke the inner thigh with a blunt instrument such as handle of the reflex hammer.
During transillumination, determine whether the mass is filled what?
Fluid, gas or solid material
A mass that does not transilluminate may indicate what?
Incarcerated hernia
A scrotum that remains flat, and undeveloped is a
good indication of what?
Cryptorchidism
A hard, enlarged painless testicle may indicate what?
A tumor
Varying degrees of maturation should be classified according to what?
The Tanner stages.
What are some Common abnormalities found during the male genitalia exam?
- Hernia
- Paraphimosis
- Hypospadias
- Syphilitic chancre lesion of primary syphilis
- Herpes
- Condyloma Acuminatum
- Lymphogranuloma
- Molluscum
- Peyronie Disease
- Penile Carcinoma
- Hydrocele
- Spermatocele
- Varicocele
- Orchitis
- Epididymitis
- Testicular Torsion
- Testicular Tumor
What is the inability to replace the foreskin to its usual position after it has been
retracted behind the glans?
Paraphimosis
What is a congenital defect in which the urethral meatus is located on the ventral
surface of the glans, penile shaft, or the perineal area?
Hypospadias
Painless lesion has indurated borders with a clear
base?
Syphilitic chancre lesion of primary syphilis
Syphilitic chancre lesion of primary syphilis generally occurs how long after exposure? Where are they most commonly located?
2 weeks after exposure.
Most commonly located on the glans
What is a viral infection that appears as superficial vesicles? Lesions may be located
on the glans, penile shaft or base. Painful and associated with inguinal
lymphadenopathy.
Herpes
What is a soft, reddish lesion that arises because of infection with a
papovavirus? The lesions are commonly present on the prepuce, glans penis. The lesions
may undergo malignant degeneration to squamous cell carcinoma.
Condyloma Acuminatum (Genital Warts)
What is an STI caused by a chlamydial organism? The lesions
appear on the genitalia. The initial lesion is a painless erosion at or near the coronal
sulcus.
Lymphogranuloma venereum
What is an STI caused by a poxvirus? The lesions are pearly gray,
often umbilicated, smooth, dome shaped, with discrete margins.
Molluscum contagiosum
What is characterized by a fibrous band in the corpus cavernosum that
results in deviation of the penis during erection?
Peyronie disease
What is cancer of the penis? Generally squamous and tend to occur in
uncircumcised men, who practice poor hygiene. Often appears as a painless
ulceration.
Penile carcinoma
What is a nontender, smooth, firm mass that results from fluid accumulation in
the tunica vaginalis? The mass will transilluminate.
Hydrocele
What is a cystic swelling occurring on the epididymis?
Spermatocele
What is an abnormal tortuosity and dilation of veins of the pampiniform plexus
within the spermatic cord? Most common on the left side and is painful. Occurs in
boys and young men and associated with reduced fertility
Varicocele
What is an acute inflammation of the testis? It is uncommon except as a
complication of mumps in the adolescent or adult.
Orchitis
What is inflammation of the epididymis? It is often seen in association with a
urinary tract infection. The epididymis is exquisitely tender and overlying scrotum
may be marked erythematous.
Epididymitis
What is a surgical emergency occurring most commonly in adolescents? It
has acute onset and is often accompanied by nausea and vomiting.
Testicular torsion
What is a neoplasm arising from the testicle appearing as an irregular,
nontender mass fixed on the testis? It does not transilluminate and is the most common
in males.
Testicular tumor
