Male GU

Question 1

Shaft of penis columns

Answer 1

1. Corpus Spongiosum - contains the urethra
   forms bulb of penis ends as cone shaped glans and base the corona.
2. 2 Corpora Cavernosa

Question 2

vas deferens

Answer 2

Cordlike structure, extends from the epididymis passes through the external inguinal ring into abdomen and pelvis.

Question 3

Sperm passes

Answer 3

from testesand epididymis through vas deferens into urethra

Question 4

Penile lymphatics

Answer 4

penile and scrotal surfaces drain into the inguinal lymph nodes

lymphatics from the testis drain into the abdominal lymph nodes

Question 5

spermatic cord contents

Answer 5

1. arteries: tesicular, deferential, cremaster
2. Nerves - nerve to cremastersympathetic nerves.
   (genital branch of the genitofemoral nerve)

vas deferens
pampiniform plexus
lymphatic vessels
processus vaginalis

Question 6

Inguinal canal

Answer 6

lies parallel to the inguinal ligament

Question 7

external ring

Answer 7

triangular slitlike structure above and lateral to the pubic tubercle

Question 8

Internal Ring

Answer 8

Internal opening, 1cm above the midpoint of the inguinal ligament

Question 9

testes function

Answer 9

1. produce sperm and testosterone
2. 80% of testicular mass contains seminiferous tubules where spermatogenesis begins
3. Endocrine cells located in tissue between seminiferous tubules - leydig or interstitial cells - produce testosterone.

Question 10

ROS male GU

Answer 10

Urinary - pain, dysuria, change in flow, color
Penile discharge or lesions
Genital rashes
scrotal enlargement
groin mass or swelling
ED
Infertility

Question 11

Hypospadia

Answer 11

urethral opening on the ventral side of the penis shaft

Question 12

Epispadius

Answer 12

urethral opening on the dorsal aspect of the penis shaft

Question 13

Balantitis

Answer 13

inflammation of the glans penis (pften Candida)

Question 14

Condylomata acuminata

Answer 14

secondary syphilis

Question 15

Phimosis

Answer 15

cannot retract foreskin over glans

Question 16

Paraphimosis

Answer 16

entrapment of retracted foreskin behind coronal sulcus

Question 17

Hydrocele

Answer 17

collection of fluid between the 2 layers of the tunica vaginalis- painless gradually enlarging mass - **translumination

must evaluate with tesiticular sonogram - 10% of testicular tumors are associated with hydrocele

Question 18

Varicocele

Answer 18

dilation of the pmpiniform plexis from incompetent valves

**almost always of the left side

varicocele on the right side should raise suspicion of malignancy or abdominal mass

surgical correction - most common 15-25 year olds

Question 19

epipdymitis

Answer 19

ages 19-35

spread of infection to the bladder
common from gonorrhea and chlamydia

amiodarone can cause

Question 20

Prehn’s sign

Answer 20

lifting of testicle relieves pain = epidiymitis but not with testicular torsion

Question 21

Acute Orchitis

Answer 21

testicular pain and swelling, blood in semen
cause from mumps in childhood

** treated with antibiotics

Question 22

Incarcerated hernia

Answer 22

hernia cannot be returned to the abdominal cavity

Question 23

stangulated hernia

Answer 23

blood supply is cut off to the entrapped hernia

**extreme tenderness, vomitting and nausea— surgery req.

Question 24

Testicular cancer

Answer 24

one of highest cure rates - 90%

most common in ages 15-40 mostly caucasians

95% of testicular tumors are malignant

Question 25

Risk factors for testicular cancer

Answer 25

cryptoorchidism, inguinal hernia, mumps orchitis

Question 26

testicular torsion

Answer 26

medical emergency
needs intervention within 6 hours to save testicle

Question 27

Peyronie’s disease

Answer 27

palpable non-tender indurated thickening plaque of the tunica albuginea of the corpora
deveates erection which causes pain

Question 28

Priapism

Answer 28

associated with sickle cell - spinal cord injuries, leukemia and drugs
painful sustained erection

Question 29

Fournier’s

Answer 29

idiopathic gangrene of scrotum and perineyum
sub q emphysema

Question 30

gynecomastia causes

Answer 30

kleinfelter’s syndrome, prolactinoma, idopathic, drugs

Question 31

Obstructive BPH

Answer 31

hesitancy, intermittency, incomplete voiding, weak urinary stream, straining

Question 32

Irritative BPH

Answer 32

FRrequency, nocturia, urgency

Question 33

Prostate Cancer

Answer 33

1 non skin cancer found in men

80% >65 yr. old

Highest incidence in af. americans

Question 34

physical findings and symptoms of protate cancer

Answer 34

usuallyy silent, bone pain/pathologic fractures, firm/nodular area or hard fixed prostateon D rectal exam

Question 35

Behcet syndrome

Answer 35

painfull with minimal adenopathy

**Not an STD

Genital sores, inflamed eyes, and rashes

Question 36

HSV II

Answer 36

painful ulcer, tender with non-fulctuant inguinal adenopathy

Question 37

Chancroid

Answer 37

painful ulcer with tender fluctuant inguinal adenopathy

Question 38

syphilis

Answer 38

non painful ulcer with mild tender adenopathy

Question 39

granuloma - c. granulomatous (klebsiella)

Answer 39

non painful, bleeds easily firm inguinal adenopathy ** can mimic LVG

Question 40

LVG: chlamydia

Answer 40

non painful ulcer, tender unilateral fluctuant adenopathy

Question 41

Neurosyphilis

Answer 41

asymptomatic, sub acute meningitis - fever stiff neck

Question 42

Tabes Dorsalis

Answer 42

effects posterior column (proprioception) and dorsal roots (loss of reflexes, loss of pain and temp sensation)

Question 43

Prostate attributes

Answer 43

3 lobes surrounding urethra

posterior bi-lobed portion palpated via anterior rectal wall.

seminal vesicles not palpable

Question 44

rectal carcinoma

Answer 44

may feel a discrete hard mass, or may palpate a rectal shelf, indicative of a deeper lesion

Question 45

anorectal junction

Answer 45

pectinate or dentate line - is the boundary between somatic and visceral nerve supplies