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Patient Evaluation > Male Genitalia Anatomy and Pathologies & Urinary Bladder Catheterization (male / female) > Flashcards

Male Genitalia Anatomy and Pathologies & Urinary Bladder Catheterization (male / female) Flashcards

1
Q

Peyronie’s disease Tx?

A

expectant vs. surgical

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2
Q

Peyronie’s disease PE?

A

Nontender, hard, palpable plaques under the skin on penile shaft

Plaques are usually on dorsal surface

Crooked, painful erections

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3
Q

Venereal Warts
(Condyloma Acuminatum) is an infection with what ?

A

HPV

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4
Q

Paraphimosis patho and prevalence ?

A

Once prepuce is retracted, it cannot be returned to original position

More common in children and elderly (extremes of age)

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5
Q

Types of Catheters: Robinson?

A

Rubber, latex-coated (not if latex allergy), silicone-coated

One time use, “in-and-out”

To obtain a specimen or episodic relief of chronic obstruction

No balloon to secure position cause it not going to stay

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6
Q

Developmental scale/sexual maturity rating of males - Stage 1?

A

no pubic hair

fine body hair

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7
Q

Paraphimosis tx?

A

Compression of head of penis and advancement of prepuce

Emergent circumcision

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8
Q

Acute Orchitis patho?

A

Acutely inflamed testis

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9
Q

Inguinal Hernias - Course: Femoral?

A

bowel comes through the femoral canal

feel bulge over femoral area

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10
Q

Syphilis 3 stages?

A

Early - asymptomatic - people wont know it

Latent - chancre - we will see this one

Late

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11
Q

Physical Exam for Femoral Hernias - 
Palpation?

A

Palpate anterior thigh by femoral canal

Note bulge or tenderness with valsalva

Check females for femoral hernias, too

**femoral are less common but females more than men *

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12
Q

Physical Exam for Hernias
 -Palpation: Inguinal?

A

Right hand for patient’s right side

Left hand for patient’s left side

Invaginate scrotal skin with finger

Follow course of spermatic cord to external ring

Have pt strain or cough

Feel for a bulge

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13
Q

Catheter sizes: Charriere French scale - 0.33mm = ?

A

0.33 mm = 1 Fr

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14
Q

Femoral Hernia: point of origin?

A

below ing. lig.

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15
Q

Balanitis patho?

A

Inflammation of the glans

Variety of etiologies (yeast, bacteria, etc.)

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16
Q

Testicular Torsion tx if infarcted?

A

If infarcted – orchiectomy

May need contralateral orchiopexy

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17
Q

Torsion of Spermatic Cord patho?

A

Testicle twists on its spermatic cord

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18
Q

Causes of paraphimosis ?

A

Direct trauma

Failure to replace prepuce after urinating or washing

Infection (usually due to poor hygiene)

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19
Q

Inguinal Hernias etiology?

A

any condition that chronically increases intra-abdominal pressure

e.g. constipation, chronic bronchitis, prostatism, heavy lifting, ascites,
pregnancy, etc.

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20
Q

Nongonococcal urethritis organism?

A

Usually Chlamydia trachomatis (CT)

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21
Q

Cryptorchidism leads to ___________ _______ by _ y.o. and increased ____________

A

testicular atrophy

1

increased infertility

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22
Q

UBC follow-up care: Indwelling Catheterization?

A

Two major risks
Trauma
Infection

Secure with tape at all times, don’t snag tubing

Keep drainage bag below the bladder

Avoid kinks in tubing

Empty bag before completely full

Use care when emptying to avoid contamination

Monitor for signs of infection

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23
Q

Hernias - Severities: strangulated?

A

blood supply to bowel is compromised

N/V/acutely tender and it requires emergency surgery

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24
Q

Femoral Hernia: gender?

A

more females

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25
Q

Hypospadias patho and prevalence ?

A

Congenital displacement of urethral meatus to ventral surface of penis

Common – 1 in 300 male infants

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26
Q

Vas derferens extends up toward? and goes behind the?

A

toward the external inguinal ring and behind the bladder

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27
Q

Scrotum and contents PE - palpation?

A

Thumb and first 2 fingers

Examine bilaterally

Testes and Epididymis -
Size/shape
Consistency
Tenderness
Nodules

Spermatic cord
Follow its course up to external inguinal ring

If mass is noted in scrotum
Check for reduction when supine
Auscultate for bowel sounds
Try to determine top of mass

Inguinal lymph nodes

Discuss TSE

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28
Q

Scrotal edema is usually associated with ?

A

generalized edema as in CHF, nephrotic syndrome

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29
Q

Types of Catheters: Coude’?

A

Rubber, latex-coated (not if latex allergy), silicone-coated

Bent at distal tip so follows anterior surface of male urethra. Helps in patients with false passages which are typically on the posterior surface

bend at the tip to avoid false passages ( most false passages are posterior)

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30
Q

Developmental scale/sexual maturity rating of males - Stage 2?

A

long, slightly pigmented and curly

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31
Q

Fournier’s Gangrene prevalence and prognosis ?

A

Rare, but high death rate

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32
Q

Female Cath. anatomy?

A

Easier and more comfortably inserted

1.5 – 2”

**easier and more comfortable, balloon to keep it from falling **

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33
Q

UBC indications?

A

To obtain a sterile urine sample

To monitor urinary output

To facilitate urinary drainage in incapacitated patients - negates fluid retention

To bypass obstructive processes from disease or trauma of:
Urethra
Prostate
Bladder neck

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34
Q

Hernias - Anatomy: Internal inguinal ring?

A

internal opening of canal, 1 cm above midpoint of inguinal ligament

more lateral

pg 521

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35
Q

Phimosis tx?

A

circumcision

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36
Q

Epidermoid cysts PE?

A

Cysts on scrotal skin

Firm, nontender, yellowish - cause filled with keratin, common

Often +1

Benign

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37
Q

Hydrocele patho?

A

Peritoneal fluid fills the potential space within the tunica vaginalis

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38
Q

UBC patient positioning: Females?

A

supine with hips and knees flexed and abducted (dorsolithotomy)

Drape appropriately, expose only what is necessary - for modesty

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39
Q

Encountering Resistance?

A

Stricture or obstruction

Make sure catheter is well lubricated

Coude’-tipped catheter may help
Bent tip faces the anterior portion of patient’s urethra

If no success, call urologist:
Special bougie and followers
Flexible cystoscope
Suprapubic catheterization

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40
Q

Inguinal Hernias - Course: Direct?

A

bowel comes through weakness in the floor of the inguinal canal. More medial. Associated with straining and lifting.

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41
Q

Indirect Hernia: point of origin?

A

Above ing. lig.,

near INTERNAL ing. ring

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42
Q

Varicocele PE?

A

Asymptomatic if mild

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43
Q

Acute Epididymitis tx?

A

bedrest

scrotal elevation

p.o. antibiotics

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44
Q

Testicular Torsion tx?

A

try manual reduction (open book technique)

vs. surgical detorsion

**those directions will generally unkink them , if this doesn’t work then surgical is indicated **

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45
Q

Venereal Warts
(Condyloma Acuminatum) tx?

A

aim is to lengthen intervals and be scar-free

Liquid nitrogen
podophyllin
CO2 laser
No cure
Check for other STI’s
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46
Q

Direct Hernia: gender?

A

usually men

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47
Q

UBC potential complications?

A

Most complications are in males

Longer urethra

Urethral stricture is more common

Males: mental stenosis/stricture, stricture of urethra, bulbar urethral stricture, false prostatic urethral passages, spastic sphincter of the bladder

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48
Q

Syphilitic Chancre etiology?

A

Treponema pallidum (spirochete)

labs for confirmation

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49
Q

The vas deferens is joined by a duct from _______ _______ and enters _________ within the prostate

A

serial vesicle

urethra

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50
Q

Hydrocele PE?

A

Nontender, soft, oblong mass

Examining fingers CAN get above the “mass”

Transilluminates

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51
Q

Penis anatomy - circumcised means the _______ is removed and the ______ and ______ are now visible

A

prepuce and the glans and corona are visible

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52
Q

Scrotal edema tx?

A

treat cause

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53
Q

Nongonococcal urethritis tx?

A

dual therapy

treat partners!

**first morning urine specimen is th ebest **

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54
Q

Where is the epididymis located?

A

Posterolateral surface

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55
Q

Penis PE - inspection?

A 
Prepuce
Glans
Skin
Location of urethral meatus
Discharge
Nits/lice
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56
Q

Balanitis tx?

A

depends on cause

Bactroban topical cream

Monistat topical cream - if yeast

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57
Q

tests inner lining?

A

tunica vaginalis

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58
Q

Male: UBC procedure 3?

A

Hold penis at 90° angle from abdomen

Position urine catch container near or between patient’s legs

With sterile hand, lubricate first several inches of catheter
Some will inject lubricant/anesthetic into urethra directly

Insert catheter

May encounter slight resistance at sphincter, use gentle pressure

**little resistance at bend or a bladder neck - should not be to excessive though **

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59
Q

Syphilitic Chancre PE?

A

Large inguinal nodes, but nontender

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60
Q

Gonococcal urethritis dx?

A

Culture via urethral swab

or

DNA probe via urine sample

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61
Q

Peyronie’s disease etiology and age?

A

Etiology unknown

+45 y.o.

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62
Q

Sems is secreted from?

A

vas deferens

semi vesicles

prostate

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63
Q

genital herpes dx?

A

viral culture, HSV antigens

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64
Q

Indirect Hernia: age?

A

C >A

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65
Q

Male Cath. anatomy?

A

Distal tip of urethra to bladder 6-7”

More circuitous bends through penis and prostate

More strictures, BPH

more potential for complications

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66
Q

Catheter Sizes?

A

Various sizes available

Size selected depends on patient and on catheter’s purpose

Larger French sizes are slightly stiffer- Follow male anatomic curves better and easier, Less likely to double back

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67
Q

Penis PE - palpation?

A

Compress glans

omit in young health males

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68
Q

Inguinal Hernias - Course: Indirect?

A

bowel comes through inguinal canal, through external inguinal ring, following the course of the vas deferens into scrotum

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69
Q

Testicular Torsion is a _________ condition.

A

emergent

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70
Q

Venereal Warts
(Condyloma Acuminatum) pathology?

A

“Cauliflower” shaped, grows rapidly, moist, contagious

Check mouth and perianal areas too

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71
Q

Penile cancer PE?

A

Nodule or ulcer

Nontender

Slow-growing

Usually in uncircumcised male, hidden by prepuce

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72
Q

Developmental scale/sexual maturity rating of males - Stage 4?

A

hair assumes normal appearance and is not so think

hair is not on thigh

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73
Q

Femoral Hernia: age?

A

usually adult

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74
Q

Physical Exam for Inguinal Hernias -
Palpation?

A

Examining fingers cannot get above the scrotal mass

May reduce if supine

No transillumination

Positive bowel sounds in the scrotum

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75
Q

Nongonococcal urethritis gram stain and culture?

A

neg for GC

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76
Q

Small firm testes think ?

A

Klinefelter’s syndrome

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77
Q

Female: UBC procedure 1?

A

Urethral meatus superior to vaginal introitus and inferior to the clitoris

Meatus can sometimes be obscured by vaginal tissue if it is just inside the vaginal introitus

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78
Q

Lymphatic system in and around the penis? what location of nodes?

A

inguinal nodes

abdominal nodes

79
Q

Gonococcal urethritis PE?

A

Profuse yellow discharge and +/- dysuria

80
Q

True testes position during development?

A

abdominal

inguinal

suprascrotal

81
Q

Femoral Hernia: frequency?

A

least common

82
Q

Catheter sizes for adult women?

A

14-18 Fr

83
Q

Direct Hernia: frequency?

A

less common

84
Q

Gonococcal urethritis tx?

A

cephtriaxone IM + oral azithromycin

Dual therapy needed due to resistance

Treat partners! otherwise it is jus given back and forth

85
Q

Acute Orchitis PE?

A

Painful, tender, swollen

Difficult to identify the epididymis

Scrotal skin may be red

Negative Phren’s sign

86
Q

Syphilis rates are increasing for first time since ?

A

2006

87
Q

Femoral Hernia: course?

A

never in scrotum

88
Q

3 ports on the cath. for?

A

three ports ( irrigation, balloon inflation , urine)

89
Q

Varicocele tx?

A

none unless infertile

venous ligation, with good results

***couple trying to get pregnant and they cant you want to check sperm count and check for varicocele **

90
Q

Catheter size for pediatric boys?

A

5-12 Fr

91
Q

Acute Orchitis tx?

A

depends on cause

92
Q

Direct Hernia: on exam?

A

hernia pushes anteriorly, pushes side of finger

93
Q

Female: UBC procedure 3?

A

Open lubricant package, squirt on sterile tray

Open povidone-iodine swabs, put in dominant hand

OR use forceps and iodine-soaked cotton balls

Separate labia with nondominant hand
Note: This hand is no longer sterile!

Wipe urethral opening from anterior to posterior direction 3 x (R, L, middle)

Place urine container between patient’s legs

94
Q

Male: UBC procedure 1?

A

Drape patient with sterile drapes
Under buttocks, shiny side down
Exposing genital area with fenestrated drape

95
Q

Paraphimosis complications?

A

edema

Damage to tip of penis
Gangrene
Loss of tip of penis

96
Q

Male: UBC procedure 4?

A

Once past the sphincter, continue to pass catheter almost to the hub

Urine should begin to flow

Place end of catheter into urine catch container

Obtain sterile specimen, if necessary

97
Q

Acute Epididymitis PE?

A

Phren’s sign – pain is alleviated with scrotal elevation

Fever

Usually in young adult males

98
Q

Varicocele is associated with ___________

A

infertility - 30% of infertile males have this

99
Q

Fournier’s Gangrene patho?

A

Form of infectious necrotizing fasciitis of the perineal and genital areas

M>F

Rapidly progressive

**flesh eating disease of the groin, men get it more and it is rapidly progressive **

100
Q

Cryptorchidism have a increased risk of ?

A

testicular CA

30-50x

101
Q

UBC indications cont’d?

A

To hold urethral skin grafts in place

To act as a traction device to control bleeding

To provide bladder irrigation

To decompress a distended bladder from an acute process

To provide intermittent catheterization for patients with neurogenic bladder

To deliver antineoplastic medication directly to the source

102
Q

UBC patient positioning: Males?

A

supine with legs flat, partially abducted

Drape appropriately, expose only what is necessary - for modesty

103
Q

Small testis patho?

A

Less than 3.5 cm long in an adult

104
Q

Penis ROS3?

A

Risk factors for HIV/STD’s

Exposure to HIV (known or suspected)
do you think or do you know?

History of STI’s

Use of condoms - when and how much

Number of partners in past 6 months

Gardasil vaccination -

Oral/anal sex - will give you an idea to look for lesions ( condyloma in other places?)

105
Q

Indirect Hernia: frequency?

A

most common

106
Q

Which testes is lower?

A

left

107
Q

UBC contraindications?

A

Appearance of blood at the urethral meatus in a patient with pelvic trauma
Possible total or partial urethral transection

Allergy to materials used
Latex, rubber, tape, lubricants

Inability to pass the catheter or inflate balloon

Call the urologist!

108
Q

Penis ROS1?

A

Penile discharge
color, consistency, associated sxs

Sores/growths on penis or scrotum

Testicular self-exam (TSE)

Testicular pain/swelling

Testicular mass/lesion

109
Q

Syphilitic Chancre tx?

A

antibiotics (benzathine penicillin)

treatable and curable

110
Q

Testicular CA - Lymph drains to _________ nodes not ________ nodes

A

Lymph drains to abdominal nodes, not inguinal

111
Q

Hypospadias tx?

A

dependent on severity (reconstruction)

112
Q

Torsion of Spermatic cord PE?

A

Sudden onset of acutely tender testis

No associated UTI

Testis is retracted upward with absent cremasteric reflex

NO relief of pain with testicular support

More common in adolescents

sudden onset , unexplained groin pain, negative phren sign

113
Q

Three-Way Catheter?

A

Drain

Irrigate - Helps to prevent clots, clogging

Balloon inflation

114
Q

Urinary Bladder catheterization (UBC) definition?

A

Passage of a hollow device into the bladder through the urethra

Historically through perineum, using metal or glass tubes

115
Q

what is the size of each testes?

A

4-5 cm

116
Q

Developmental scale/sexual maturity rating of males - Stage 3?

A

become darker and curlier

pubic symphysis develops

117
Q

Male: UBC procedure 5? for foley cath?

A

Inflate Foley balloon with sterile water in pre-filled syringe

Gently tug on catheter until it stops

Attach drainage bag

Tape catheter to the abdomen:
Penis pointing toward umbilicus (if bedridden)
Apply bacitracin to urethral meatus 1-3 x day

ambulatory - put on leg but never above the bladder line cause then there will be back flow

118
Q

Cryptorchidism PE?

A

Empty scrotal sac, usually unilateral

119
Q

Hernias - Anatomy: External inguinal ring?

A

above and lateral to the pubic tubercle, triangular slit (Hesselbach’s triangle)

120
Q

Ectopic testes position during development?

A

superficial ectopic

presenile

femoral

traverse scrotal

perineal

121
Q

Varicocele mainly occur on the ?

A

left 90%

122
Q

Testicular CA tx?

A

Potentially curable if dx’d early

TSE - Teach patients to do monthly self-exam

123
Q

Condyloma incubation?

A

weeks to months

**penile warts typically seen in patients with other STDs, including genital herpes

got it from someone who maybe didn’t have lesion or anything **

124
Q

Syphilitic Chancre appearance?

A

Oval/round dark red lesion on indurated base

Painless

Contagious

125
Q

Inguinal Hernias H&P?

A

usually asxs.

126
Q

Catheter size for adult men?

A

16-18 Fr

127
Q

Acute Orchitis etiology?

A

postpubertal mumps (which can result in infertility) or secondary to epididymitis or virus

**kids w/o MMR vaccine , mumps in older child or adult can cause infertility, usually unilateral **

128
Q

Female: UBC procedure 2?

A

Gather supplies

Follow aseptic technique

Open kit in sterile manner

Drape patient – shiny side down

Put on sterile gloves

129
Q

tunica vaginalis has?

A

2 layers

and

potential space

130
Q

what is the function of the testes?

A

produce sperm and testosterone

131
Q

Torsion of Spermatic Cord complications?

A

Circulation is obstructed – testis can become necrotic – get Doppler

**get doppler to check blood flow to support tissue *

132
Q

Testicular CA peak

A

15-35 y.o.

133
Q

Scrotal edema PE?

A

Taut skin, pitting edema

134
Q

Varicocele patho?

A

Multiple tortuous varicose veins of the spermatic cord, separate from testis

Feels like “bag of worms”

Patient must stand for exam

Veins collapse when patient is supine and scrotum is elevated

**varicose veins of the spermatocord **

135
Q

Donning Sterile Gloves?

A

Open paper package
Grasp fold of paper and pull
laterally

Lift first glove, grasping outside of cuff only

Insert other hand

Gloved hand slips inside of cuff of remaining glove

Pull glove over bare hand

136
Q

Cryptorchidism patho?

A

Testis is undescended, lies in inguinal canal or abdomen

137
Q

Spermatocele Vs. Cyst of Epididymis ?

A

Painless, mobile, soft, cystic mass

Cannot differentiate the two by exam

Both will transilluminate

Tx
None unless symptomatic
Surgical excision

Spermatocele/Epididymal cyst

138
Q

Testicular tumor PE?

A

Painless nodule/mass, grows and spreads – multinodular, firm (not rubbery)

No transillumination - no diffuse glow

139
Q

Hernias - Anatomy: Femoral canal?

A

with index finger on artery, middle on vein, ring will be over femoral canal

140
Q

Acute Epididymitis caused by ?

A

Can be secondary to UTI or prostatitis – bacteria ascend from urethra or prostate

141
Q

UBC patient preparations?

A

Explain the procedure to the patient

It may make him/her feel like he/she must urinate - slightly uncomfortable but they willl not pee

It will be slightly uncomfortable

Need to hold still

142
Q

abdominal nodes drain?

A

testes

143
Q

Catheter sizes: Charriere French scale - 1mm = ?

A

1 mm = 3 Fr

144
Q

Penis ROS2?

A

History of prostate problems/surgery

History of inguinal hernia/repair

Sexual orientation/preference/satisfaction
“Do you prefer sexual partners that are male, female or both”

Libido - sex drive

Impotence - ability to get erection

loss of libido - ACE I , antidepressant

145
Q

Vas deferent begins where?

A

tail of epididymis

146
Q

Hydrocele PE - ascultation?

A

No bowel sounds

No reduction with
supine position - helps differentiate from hernia

147
Q

Hernias - Anatomy: Inguinal ligament?

A

from ASIS to pubic tubercle

148
Q

Female: UBC procedure 5? for foley cath?

A

Inflate Foley balloon with sterile water

Gently tug on catheter

Attach drainage bag

Tape catheter to inner thigh

Bacitracin or betadine to meatus 1-3 x daily

149
Q

Male: UBC procedure 5? for straight cath?

A

Once bladder is empty, remove catheter

Pinch off end so urine in cath does not spill on patient

Measure and record amount of urine obtained

150
Q

UBC materials?

A

Sterile tray or working area

Sterile collection container

Sterile gloves

Sterile lubricant or anesthetic lubricant

Cleansing solution (Betadine) - to clean around uretheral meatus

Sterile gauze or cotton balls

Sterile forceps to grasp cotton balls
(Or povidone-iodine cotton swabs)

Syringe filled with sterile water (5-30mL) - inflating the balloon - cannot be saline only water

Catheter tubing and bag

Sterile drapes

Catheter

151
Q

Hernias - Severities: incarcerated?

A

bowel does not return, it is trapped

gentle pressure to try and reduce it

152
Q

Hernias - Severities: reducible?

A

bowel returns to abdominal cavity, spontaneously or manually

153
Q

Acute Epididymitis patho?

A

Acutely inflamed epididymis

Difficult to identify epididymis on exam due to swelling and tenderness

154
Q

Hernias - Anatomy: Inguinal canal?

A

above and parallel to inguinal ligament

is the tunnel for the vas deferens

155
Q

Male: UBC pre-procedure?

A

More prone to urethral damage
Improper lubrication - used enough lube with no excessive force
Excessive force

Choose appropriate type and size catheter

Gather supplies

Follow aseptic technique ( extremely important)
Wash hands
Open kit in sterile manner – away from you first

156
Q

Indirect Hernia: gender?

A

both, males 4:1

157
Q

Direct Hernia: point of origin?

A

Above ing. lig.,

near EXTERNAL
ing. ring

158
Q

What is the spermatic cord made of?

A

vas deferens

blood vessels

nerve and muscles

159
Q

Venereal Warts
(Condyloma Acuminatum) prevention?

A

Gardasil before sexual debut:

encourage young kids
start at age 9

160
Q

Nongonococcal urethritis PE?

A

Scant, clear/white discharge

161
Q

Genital Herpes appearance?

A

Cluster of small vesicles, become shallow painful ulcers on a nonindurated base ( surrounding tissues is not red or swollen)

162
Q

Small soft testes think?

A

atrophy secondary to cirrhosis, myotonic dystrophy, estrogens, hypopituitarism, mumps

163
Q

Direct Hernia: course?

A

rarely into scrotum

164
Q

Penis anatomy - uncircumcised means that the prepuce is ______

A

intact

165
Q

Catheter sizes: Charriere French scale - 10mm = ?

A

10 mm = 30 Fr

166
Q

Gonococcal urethritis gram stain?

A

G- diplococci

167
Q

Physical Exam for Hernias
 -Inspection?

A

Inspect for visible bulges – inguinal and femoral areas

Inspect again with Valsalva

168
Q

Penis anatomy - 3 columns of erectile tissue

A

2 corpus cavernosa

1 corpus spongiosum – surrounding urethra

169
Q

Epispadias patho and prevalence ?

A

meatus on dorsal surface

rare

170
Q

inguinal nodes drain?

A

penis and scrotal surface

171
Q

Epididymis is ____ shaped?

A

comma

172
Q

Physical Exam for Hernias -
Inspection: patient and examiner positions?

A

Patient is standing,

Examiner is sitting

173
Q

Genital Herpes PE?

A

Tender inguinal nodes

Clear penile D/C, dysuria

On recurrence – fewer lesions and less pain

174
Q

Indirect Hernia: course?

A

often to scrotum

175
Q

Female: UBC procedure 4?

A

Lubricate first few inches of catheter

Insert catheter until urine starts to flow
If you miss the urethral opening, you need to obtain a new, sterile catheter (leave first one in place)

Insert approx 1/3 of catheter length

Place end of catheter in container

Obtain sterile specimen, if needed

Allow bladder to empty

176
Q

Female: UBC procedure 5? for straight cath?

A

Remove catheter

Pinch off end so urine in cath does not spill on patient

177
Q

Developmental scale/sexual maturity rating of males - Stage 5?

A

hair appears on thigh now

178
Q

Femoral Hernia: on exam?

A

Ing. canal is empty

179
Q

Direct Hernia: age?

A

usually +40

180
Q

UBC potential complications cont’d?

A

Urinary tract infection (UTI) -most frequent
if not sterile technique

Urinary tract inflammation ( anywhere along tract)

Urethral dilation

Urinary structural trauma

False passage in the urethra
Catheter into side wall of urethra and perforate

Catheter “doubles back”
Catheter tip reappears at urethral meatus

Patient-caused trauma
Patient pulls out inflated Foley

181
Q

Indirect Hernia: on exam?

A

hernias comes down canal to finger tip

182
Q

Types of Catheters: Foley?

A

Rubber, latex-coated (not if latex allergy), silicone-coated

Remains in the bladder

Balloon-secured after insertion

Inflated with sterile water

Two sizes of balloons
5mL – most common (inflate with 10 mL)
30 mL – traction stent after urologic procedures (inflate with 50mL)

Attached to a drainage bag

**foley is the one that stays, saline can crystalize along the lumen and then it will not deflate thats why only water is used*

183
Q

Genital Herpes tx?

A

p.o. acyclovir, valcyclovir, famvir

just help treat sxs.

No cure

  • *worse episode is the first one, recurrent bouts are less severe
    inch. 2-days

may have fever malaise *

184
Q

Genital Herpes sxs?

A

Burning, stinging sensation before vesicles appear

185
Q

Penis PE? considerations?

A

Consider having a chaperone in the room

Assess sexual maturity
sometime men will get erection during exam
it often happeneds

186
Q

UBC follow-up care: Short term or In-and-Out?

A

Complications are unlikely

Most common complication is UTI and irritation

Reassure that burning with first few urinations is normal

Monitor for dysuria, frequency, hematuria, pyuria, fever, back pain

187
Q

Small testes tx?

A

dependent on cause

188
Q

Male: UBC procedure 2?

A

Squirt lubricant packet onto sterile tray

Open packet of povidone-iodine cotton swabs and hold swabs in dominant hand
Or use forceps and sterile cotton balls dipped in betadine

Grasp penis with non-dominant hand
Note: this hand is no longer sterile!

Cleanse penis with iodine swabs
Swab head of penis first at meatal opening, then glans
If not circumcised, retract foreskin first

189
Q

Hernias considerations?

A

Difficult to differentiate direct from indirect on exam, but both need surgical correction

Femoral hernias more likely to strangulate because of thinner neck

190
Q

When do you want to use larger french catheters e.g.. 20-30 Fr?

A

to evaluate for blood clots

191
Q

Fournier’s Gangrene Tx?

A

Antibiotics and aggressive debridement

192
Q

Phimosis patho?

A

Inability to retract the prepuce

Congenital or acquired ( scarring - recurrent balanitis)

Possibly secondary to recurrent balanitis

193
Q

Scrotum and contents PE - inspection?

A

Skin
Rash, ulcer, inflammation
Include posterior surface

Contour ( visual assessment of size of scrotum)

Transillumination
Fluid ( transilluminate) vs. mass

194
Q

what is the epididymis ?

A

coiled spermatic ducts

Patient Evaluation (29 decks)

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