male genitalia and hernias

Question 1

Landmarks of the groin

Answer 1

• ASIS
• superior tubercle of the superior ramus
• inguinal ligament

Question 2

what is in the inguinal canal

Answer 2

internal and external inguinal ring

Question 3

what is in the femoral canal

Answer 3

femoral vein and femoral artery

Question 4

where does lymph drain

Answer 4

superficial inguinal nodes
deep inguinal nodes

Question 5

how to approach male health history

Answer 5

be direct, respectful, sensitive, and nonjudgemental

Question 6

what to ask male during health history

Answer 6

• penile discharge/lesions
• testicular or scrotal pain, swelling, redness, lesions
• trauma
• history of STD
• prior penile/scrotal surgery

Question 7

what questions to ask about penile discharge/lesions, testicular or scrotal pain, swelling, redness, lesions

Answer 7

• any changes pt noticed
• color/amount of discharge
• sores/growth
• itching/excoriations
• swelling or pain in testicles or scrotum

Question 8

what questions to ask about STDs

Answer 8

ask and document:
- sexual orientation
- previous genital symptoms or past STIs*
- sexual activity

ask about concerns for STIs*
and associated symptoms

Question 9

what to inspect on penis

Answer 9

• skin
• prepuce
• glans
• urethral meatus

Question 10

what to look for when palpating penis

Answer 10

tenderness or induration

Question 11

what to look at on skin of penis

Answer 11

• ventral and dorsal surfaces
• excoriations

Question 12

what to look at on prepuce of penis

Answer 12

• retract prepuce
• smegma (natural, thick, white or yellow substance that builds up on the genitals when the area isn’t washed regularly. It’s made up of dead skin cells, sweat, oils, and other fluids)
• phimosis (a condition that makes it difficult to retract the foreskin)
• paraphimosis (urologic emergency that occurs when the foreskin of an uncircumcised or partially circumcised male becomes trapped behind the corona)

Question 13

what to look at on glans of penis

Answer 13

• ulcers
• scars
• nodules
• signs of inflammation (balanitis)

Question 14

what to look at on urethral meatus of penis

Answer 14

discharge, inflammation, signs of hypospadias (a birth defect that affects the penis, causing urine to exit the body in an abnormal manner)

Question 15

proper technique for inspecting urethral meatus

Answer 15

compress glans with index finger and thumb to open meatus to further inspect for discharge

Question 16

painful deep lesion with ragged border

Answer 16

chancroid

Question 17

painless indurated border

Answer 17

syphilis

Question 18

single or multiple papules or plaques and cauliflower like. caused by HPV.

Answer 18

genital warts (condyloma acuminata)

Question 19

small scattered or grouped vesicles. caused by hsv 2.

Answer 19

genital herpes simplex

Question 20

birth defect in which the opening of the urethra is not located at the tip of the penis

Answer 20

hypospadias

Question 21

fibrous scar tissue that develops on the penis and causes curved, painful erections

Answer 21

peyronie’s disease

Question 22

what to inspect on scrotum

Answer 22

• skin
• scrotal contours
• inguinal areas

Question 23

what to palpate on scrotum

Answer 23

• testis
• epididymis
• spermatic cord

Question 24

• testicle rotates, twisting the spermatic cord that brings blood to the scrotum
• causes acute pain and swelling. can become erythematous and swollen
• loss of cremesteric reflex

Answer 24

testicular torsion

Question 25

for best outcomes of testicular outcomes, how soon should the medical emergency be treated

Answer 25

time critical less than 6 hours

Question 26

- fluid collection in the tunica vaginalis, which covers the testicle - transilluminates

Answer 26

hydrocele

Question 27

- enlargement of the veins within the scrotum - bag of worms feeling

Answer 27

varicocele

Question 28

the testis is acutely inflamed, painful, tender, and swollen. it may be difficult to distinguish from the epididymis. scrotum may be reddened. seen in mumps and other viral infections. usually unilateral.

Answer 28

acute orchitis

Question 29

usually appears as a painless nodule. any nodule within the testis warrants investigation for malignancy.

Answer 29

tumor of the testis (early)

Question 30

as a testicular neoplasm grows and spreads it may seem to replace the entire organ. the testicle feels heavier than normal

Answer 30

tumor of the testis (late)

Question 31

- inflammation of the epididymis - swollen, red or warm scrotum - common unilateral testicle pain and tenderness with a gradual onset - viral or STI

Answer 31

epididymitis

Question 32

painless, movable cystic mass just above the testis. both transilluminate.

Answer 32

spermatocele (contains sperm) or cyst of epididymis (does not contain sperm)

Question 33

how to inspect for groin hernias

Answer 33

- check inguinal region for asymmetry and bulging - best done with the pt standing

Question 34

who should perform testicular self exam

Answer 34

men at high risk for developing testicular cancer: - cryptorchidism (undescended testis) - history of cancer in contralateral testis - mumps orchitis - inguinal hernia - hydrocele in childhood - family history

Question 35

what ages should perform monthly self exam

Answer 35

age 15-35