male genitourinary system (chapter 25) Flashcards
what structures are included in the external male genital?
penis, scrotum
what structures are included in the internal male genital?
testis, epididymis, vas deferens
what glandular structures are accessory to genital organs?
prostate, seminal vesicles, bulbourethral glands
what are the three cylindric columns of erectile tissues?
2 corpora cavernosa (dorsal), corpus spongiosum (ventrally)
where are glans located?
distal end of shaft, corpus spongiosum -> cone of erectile tissue (corona= shoulder, glans join shaft)
why is the urethra considered as a conduit for both the genital and urinary systems?
urine (bladder) and semen (ejaculatory ducts) pass through urethra at different times
what’s the foreskin (prepuce)?
forms hood/flap over glans (often removed by circumcision)
name the fold of the foreskin that extends from urethral meatus ventrally
frenulum
what is the loose protective sac and is the continuation of the abdominal wall?
scrotum
what does the scrotal wall consist of?
thin skin lying in folds (rugae) & underlying cremaster muscle
describe the function of the cremaster muscle
controls size of scrotum (responds to ambient temp)
describe the testes
solid oval shape, suspended vertically by spermatic cord, produces sperm
why is the left testis lower than the right?
left spermatic cord is longer
what’s the double-layered membrane that covers each testis and separates it from the scrotal wall?
tunica vaginalis
describe the epididymis
-main storage site of sperm
-coiled duct system
-comma-shaped structure, curved over top, posterior surface of testis
describe the vas deferens
-muscular duct
-cont. with lower part of epididymis and with other vessels -> form spermatic cord
what joins the duct of seminal vesicle to form the ejaculatory duct?
the vas deferens (back & down, behind bladder)
where does the ejaculatory duct empty?
urethra
where does the spermatic cord run through?
inguinal canal of abdomen (ascends along posterior border of testis)
what drains into the inguinal lymph nodes?
lymphatics of penis and scrotal surface
what drains into the abdomen?
lymphatics of testes (not accessible to clinical exam)
what is a potential site for hernia development and is a juncture of the lower abdominal wall/thigh?
inguinal area (groin)
what are the openings in the inguinal canal?
-internal ring (1-2cm above midpt. of inguinal ligament)
-external ring (above + lateral to pubis)
where do the testes develop prenatally?
abdominal cavity near kidneys
what happens to the size of testes during prepubertal years?
slight increase in size
what’s the first sign of puberty in boys?
enlargement of testes
what follows the enlargement of testes during puberty?
pubic hair -> increase in penis size
T/F: men experience a definite end to fertility like women do
FALSE (sperm production decreases around 40, but continues on into 80s and 90s)
why are physical changes not evident later in life for men?
testosterone production declines after 30 but continues gradually
what are some physical changes that occur with a decrease in testosterone production?
-pubic hear & penis size decreases
-testes decrease in size, less firm to palpation
-increase in connective tissues in tubules (thickened and produce less sperm)
-decrease tone of dartos muscle
what happens when there’s a decrease tone of dartos muscle?
scrotal contents hang lower, rugae decreases, scrotum is pendulous
in the absence of disease, what are some causes of withdrawal from sexual activity?
-loss of spouse, depression, preoccupation with work
-martial or family conflicts
-side effects of med, heavy alcohol use
-lack of privacy, living with kids or nursing home
-economic or emotional stress
-poor nutrition or fatigue
what are the benefits of circumcisions according to the AAP?
-men: lower risk for certain STI (HPV, herpes simplex virus, genital ulcer disease
-women: decrease risk for bacterial vaginosis & trichomoniasis
-reduced risk for contracting HIV infection (heterosexual contact)
what are the two main causes of kidney failure (ESRD)?
hypertension & diabetes
what is the most common risk factor along with occupational exposure to chemicals for bladder cancer?
smoking
what type of cancer do you assess for painless hematuria?
bladder cancer
what type of subjective data questions do you want to ask about urinary habits?
frequency, urgency, nocturia
what’s dysuria (ask about when collecting subjective data)?
pain or burning with urinating
what type of subjective data questions do you want to ask about urine flow?
hesitancy, straining, changes in force stream, dribbling, UTIs
what do you ask about getting subjective data on urine color?
urine is clear, discolored, cloudy, foul-smelling, or bloody
what type of subjective data questions do you want to ask about GU hx?
-difficulty in controlling urine (urgency or stress incontinence)
-hx of kidney disease, kidney stones, flank pain, UTIs, prostate trouble
what do you ask about getting subjective data on the penis?
any problems (pain, lesions, discharge)
inspection & palpation: penis
-skin: wrinkled, hairless, w/o lesions, dorsal vein may be apparent (normal)
-glans: smooth, w/o lesions (foreskin should retract easily if uncircumcised)
-urethral meatus positioned centrally
-meatus edge: pink, smooth, w/o discharge (compress glans anterioposteriorly btw thumb & forefinger)
how do you go about inspecting the scrotum?
male holds penis out of way or you do w/ back of your hand
how do you palpate the scrotum?
-each scrotal half btw thumb & first two fingers
-each spermatic cord btw thumb & forefinger
