Male GU Flashcards by ajriffic .

within the shaft ___________ is paired and __________ is singular

cavernosum is paired

spongeosum is singular

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___________ cells within seminiferous tubules make sperm

sertoli

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testosterone is synthesis in the ______ cells

leydig

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____________ is the serous membrane covering the testis (except the post aspect)

tunica vaginalis

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_________ provides a reservoir for sperm storage

epididymis

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_______ transports the sperm from the epididymis to the urethra

vas defrens (merges with seminal vesicles to make the ejaculatory duct)

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4 things in spermatic corrd

vas, nerves, blood vessels, and muscle fibers

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3 things that contribute to seminal fluid

vas, seminal vesicles, and prostate

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hypothalamus secretes LH and FSH… LH works on _____cells,,, FSH works on________ cells

LH- leydig testosterone

FSH- sertoli sperm

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1ry vs 2ry hypogonadism

1- d/t dysfxn of leydig or LH production -dec testosterone and inc gonadotropin releasing hormone
2 - d/t pituitary or hypothalamus lesions/dz - dec testosterone, dec gonadotropin releasing hormone

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___________ innervates the skin/pubis

illiohypogastric

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________innervates scrotum and medial thigh

genitofemoral

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prostate has 3 lobes; ___lateral and ___medial (#)

2 lat; 1 medial

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there is ________innervation proximal to the dentate line and _____innervation distal.

visceral

somatic

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male sexual maturity rating of ____ means they have vellus hair and are prepubertal

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male sexual maturity rating of 2 means…

sparse long hair slightly pigmented, enlargement of testes and scrotal skin pinks

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hair with a horizontal upper border would indicate a male sexual maturity rating of ___

5; they are an adult

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darker coarser hair spread sparsely with with an enlargement of length indicates a male sexual maturity rating of

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male sexual maturity rating of 4 means….

adult hair but in a smaller area, not spread to medial thighs, development of glands, testes larger and scrotal skin darkens.

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what are the 5 things you want to know for sexual hx (response section)

satisfaction
libido
ED
orgams acheived with ease?
premature ejaculation

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make sure you ask about scrotal….

heaviness, aching, buldging, pain

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6 things that can cause dysuria(painful urination)

cystitis(bladder infxn), UTI, urethritis, bladder stone, bladder tumor, prostatitis

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what are the 4 urinary obstructive sx

hesitancy/straining, weak stream, intermittancy, post void dribble

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incarcerated vs strangulated hernia

incarcerated- irreducible, @risk reduced blood

strangulated - irreducible, nd compromised blood supply (freq n/v/f, pain and redness at site, EMERGENT)

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hematochezia vs melana

hematoch- dt lower gi bleed - streaks | melana - dt upper gi bleed

what are the 3 reportable STI's and their importance ranking

chlamydia>gonnorrhea>syphillis

_______ is the most prevalent STI and can cause genital warts, anal CA, penile cancer, and oropharangeal ca

HPV

HPV vaccine reccomended for boys age ___ or ___ up until ___yo

11 or 12 until 21

increased risk of testicular ca(which is rare but highly treatable with) int those with _________

cryptorchidism (under dev testes)

_______ is the 2nd leading cause of CA death in men

prostate CA

______ is not a very effective way to detect prostate cancer

PSA (prostate specific antigen)

colonoscopy sb be done starting at age ____ if no sx present; then repeated every ____ yrs if clear and every ___ yrs if polyps found

50yo 10yrs with neg 3-5yrs with polyps

what 2 tests are alternatives to colonoscopy but must be done annually?

gFOBT- test for blood in stool | FIT- tests for abnormal DNA in stool

as mena age there is a gradual decline in testosterone leading to ___ry hypogonadism

primary

what are the physical effect of testosterone decline (8)

osteoporosis, testicular atrophy and dec in penis size, ED, loss of libido, depression, fatigue, forgetfulness

what are the risks of HRT? (6)

growth of breast/prostate, liver toxic, tumors, infertility, polycythemia, and abnormal lipids

hypospadias?

condition where urethral opening is on bottom of penis

epispadius?

condition where urethral opening is on the bottom of the penis

what is peyronie's dz

curvature in penis dt fiberous plaque developing

what is balanitis

inflamation of the glans and foreskin

Erythroplasia of Queyrat is..

cancer of glans, carcinoma in situ

phimosis is...

tight foreskin that cannot be pulled back over head fo the penis

paraphimosis is

foreskin is retracted or rolled and cannot be rolled back, can lead to gangrene

profuse yellow penile discharge suggests

gonnococcal urethritis

scant white/clear penile discharge suggests

nongonnoccal, likely chlamydia (need a gram stain)

a painless 2cm penile errosion with clean raised borders suggests

1ry syphillis (chanker)

what's the incubation period for syphilis?

9-90 days

a deep painful nonindurated ragged margin penile errosion suggest

chancroid of haemophilis ducryi

haemophilis ducryi has an incubation period of

3-7 days

what would be small scattered vesicles that turn into erosions?

genital herpes simplex

what's the incubation period for herpes?

2-7 days

_____ is caused by mites that burrow under the skin and make little red bumps

scabies

pearly papules with central umbilication is likely

molluscum contagiosum

pearly penile papules on the head of the penis should make you think....

it's a benign natural variant

condylomata acuminata is

genital warts ( look kind of like coral)

what is peyronie's disease

development of a fiberous plaque on the corpus cavernosum that leads to curvature (no treatment, only 15% resolve)

what is cryptorchidism

undesc testicle (in risk of CA)

scrotal edema can be caused by ____ and ____

CHF and dec albumin

what is tinea cruris?

jock itch; fungal infection, irregular border rash

what is pediculosis pubis

crabs

what is a spermatocele

epididymal cyst (off of the spermatic cord)

what is a hydrocele? how test?

tunica vaginalis is filled with fluid, test for hernia by doing transillumination with a flashlight

what is a vericocele?

vericose veins in scrotum, "bag of worms", inc risk of infert

what are the 5 risk factors for acute epidiymitis

sex, bladder obst, urogenital malformation, prolonged bike/motorcycle riding, running sports

what are the sx of acute epididymitis (6)

``` progressive UL scrotal pain erethema/swelling pos fever dysuraia freq urgency ```

what is prehn's sign?

lifting the scrotum relieves pain (epididymitis)

4 tx for acute epididymitis

ABx, scrotal elevation, ice pack, minimize activity

what is acute orchitis

swelling/pain in one or both tesiticles (entire testicle)

what is testicular torison? how long do you have to tx?

rotation of testis around spermatic cord and constriction of testicular artery; you have 6 hours to detorse

the ____ deformity inc risk for testicular torsion

bell clapper (tunica vaginalis wraps around entire testicle and epididymis)

with testicular torsion the _____ reflex is absent, and prehn's sign is _____.

cremater reflex absent (stroke inner thigh and testicles DON'T retract(abnnormal) prehn's sign is absent (elevation does not alleviate)

*what is the significance of prehn's sign in testicular torsion vs epididymitis?

prehn's sign= lifting testicles relieves pain pos in epididymitis (no pain) neg in torsion (pain still felt with lifting)

Inguinal nodes typically lie...

at the inguinal ligament (ASIS-pubic tubercle) or just below

a(n) ____ hernia can be felt sliding down to meet your finger at the external ring during a cough

indirect

what is a pilonidal cyst

congenital abnormality in which a draining fistula tract forms near the anus

Sensation is/is not felt: above the dentate line? below the dentate line?

``` above= no feeling below= feeling ```

external hemerhoids are ____ the dentate line | internal are _____ the dentate line

ext=below | int=above

external hemorhoids...

are painful but rarely bleed

internal hemorrhoids...

seldom painful (unless prolapsed), bleed with deification

3 risk factors for hemorrhoids

pregnancy, obesity, and straining with defication

3 Tx for hemorrhoids

stool softner, sitz bath, and avoid steroids

what are anal fissures? 3 causes?

small split/tear in mucosal lining (irritation during defication but no sx b/w bms); crohn's, dry hard stool,and intumentation/anal sex

*____ classification is used to locate anal fistula tract

Park's

rectal prolapse happens d/t _____ weakening

pelvic floor

what 6 signs in the Hx might suggest prostatitis

epididymitis, UTI, urethritis, BPH, phimosis(can't retract), urinary instrumentation (boggy LNs may be present acutely)

what are the 6 sx of BPH?

hesitancy/straining, weak flow, post pee dribble, feeling bladder still full, urge to urinate freq, dysuria(pain during urination)

4 signs of BPH seen on DRE

smooth, soft, mobile, boggy, and symmetrically enlarged

when considering BPH dx, must run ____, ____, and _____ tests because.....

BUN & creatinine - r/o obstructive uropathy or nephropathy and run a PSA to R/o prostate CA (can be elevated in BPH)

what are the 3 risk factors for prostate CA

80+, af amer descent, Fam Hx

____ pain can be a sing of prostate cancer b/c mets

back pain

what are 4 things found on DRE of prostate CA

induration(fiberous hardening), nodule, asymmetry, rock hard

thick yellow d/c with tender LNs is likely

gonorrhea