Male GU Flashcards
T/F men are more likely than women die or get injured at work
true
T/F men are less likely than women to attempt suicide ubt are more likely to suceed
true
T/F women over 75 have the highest rate of suicde
false, men
two categories of questions that concerning male gentalia
sexual function and screening for infection
sexual function questions of the male GU exam
how is your sex life
do you still have an interest in sex
do you have any concerns about getting an erections
do you have issues with the duration of intercourse (too long or too short)
infection questions to ask during the male GU exam
color, amount, presence of discharge
systemic signs of infection
penile lesions
scrotal lesions
painful erections or orgasm
Hx or risk factors for STI
two areas of erectile tissue in the penis
which of thse contain the urethra and form the glans
corpus spongiosum and corpus cavernosa
corpus spongiosum
prepuce
the fold of skin over the uncircumcised penis
smegma
the secretions that can be trapped in the prepuce
T/F the testes should always be smooth, without masses, and hard
false, they should be firm but not hard
tunica vaginalis
the serous membrane the covers the anterior and lateral parts of the testis
epididymis
the soft, comma shaped structure the functions as a reservior for storage, maturation, and transport of sperm
why would a herpes cause burning after urination rather than during
because the leasion might be on the meatus
hydrocele
accumulation of fluid in the tunica vaginalis
vas deferens
cord that passes through the external inguinal ring, down the spermatic cord, and into the tail of epididymis
signs of a vasectomy
a knot in the spermatic cord
landmarks of the groin
anterior superior iliac spine
pubic tubercle
inguinal ligament
where is the inguinal canal
what is in it
what is the internal and external opening
above and parallel to the inguinal ligament
the vas deferens
external/internal inguinal ring
inguinal hernia
a loop of bowel that has pushed through the inguinal canal
femoral hernia
a loop of bowel that pushes through the femoral canal
inspection of the penis notes
inspect all areas
if there is a discharge ask them to milk it
if there are painful lesions or nodule you will need to palpate them
educate uncircumsized men on hygiene
patient presents with a large scrotal mass or visable bulge in the inguinla area that disappears when they lay down
what does ithis indicate
what would you do if the mass remained
a hernia
auscultation with a stethoscope hearing bowel sounds = hernia
scrotal mass, shine a light behind the mass, if it glows red it probably not a hernia
at what age is testicular cancer most common
what is the prognosis
15-35
excellent with early detection
if there is a suspected hernia, what must be ruled out
an enlarged lymph node
two types of inguinal hernias
direct and indirect
how will direct inguinal hernias presnet
indirect
direct will rarely present in the scrotum
indirect will usually present in the scrotum
on inguinal exam there is a weakness in the inguinal ring during the cough
is that normal
yes
STI indicated by…
single painless chancre
single painful chancre
multiple painful chancre
syphilis
HSV
HSV or chancroid
EEP with direct inguinal hernia
less common, usualy in men over 40, rare in women
EEP indirect hernia
most common with any age, both sexes, and children
hypospadias
two urethral openings
peyronies disease
painful erections that can be indcated by nodules
phimosis
paraphimosis
the inability to pull the foreskin down the penis
the unability to pull the forskin up
signs of bowens disease
squamous cell carcinoma in situ that can be found on the penis, often looks benign
typical cause of scrotal edema
will it transluminate
trauma or infection
no
indcations for a hydrocele
fiungers can get above the mass
it will transluminate
cryptochordism
increases risk for
undescended testicle
testicular cancer and infertility
acute orichitis causes
what might the patient say they do because of this
infection or trauma
they have to wear tight underwear to support the affected area
acute epididymitis causes
infection and trauma
T/F epididymal cysts tend to drain and smell bad
true
causes of scrotal varicocele
increase portal pressure, venous obstruction
two categories of questions concerning the anorectal exam
Lower GU
lowe GI
lower GI questions
change in bowel function
change in size, color, consistency of school
blood
GU questions
difficulty starting
normal amount of urine or caliber
nocturia
dysuria
blood discharge
trauma
pain or stiffness of the lowerback, hips, thighs
health promotion for the anorectal examn
testicle self examn
HPV vaccine
screen for rectal, prostate, colorectal cancer
important note for patients who engage in anal sex
top, bottom, or both
anal canal
the short segment at the end of the GI tract
where does the anal canal change to the rectum
the anorectal junction (pectinate line)
blood in the ejactulate is indicative to what
trauma or pathology at the prostate
where is the prostate in the rectum
the anterior rectal wall
screening for rectal cancer
proctoscopy
should the anorectal exam be painful
not unless there is a fissure or ulcer
notes for the male anorectal exam
the prostate is rubbery and nontender
try to go above the prostate to feel the seminal vescles
note color of anything on the gloves
limitation of the digital prostate exam
you can only palpate the posterior side of the prostate, lesions could be anywhere
shape of the prostate
heart shaped with a central sulcus with two lobes
what is important to discern when a patient presents with symptoms of prostate enlargement
if the prostate enlargement is normal or pathological
thrombosed hemorroid
treatment
a vein with a clot in it
small ones will go away, large ones you lance and express
age specific considerations for the neonatal assessment
exam happens in the presence of the patient
swaddle and then undress as necessary to do the exam
dim lights and rock newborn to encourage eye opening
observe feeding when possible
demonstrate calming measures to parents
first neonatl exam happens _____
comprehensive exam happens _____
immediately after birth
within 24 hours
neonatal assessment sequence
head and neck
heart and lungs
abdomen and GU
lower extremities
back
ears and mouth
neurologic
hips
eyes
skin
apgar test
categories
apgar appearance 0-2
apgar pulse0-2
apgar grimace 0-2
apgar activity 0-2
apgar scores respiration 0-2
1min apgar normal
some nervous system depression
severe depression
8-10
5-7
0-4
5 minute apgar normal
high risk for CNS or organ dysfunction
8-10
0-7
classification for preterm
late preterm
term
post term
<34 weks
34-36 wks
37-42 wks
>42 weeks
classification for extremely low birth weight
very low
low
normal
<1000g
<1500g
<2500
>= 2500
increased risk for preterm babies
short term
long term
CV and respiratory issues
neurodevelopment
increased risks for late preterm babies
prematurity related complications
increased risks for post term babies
perinatal mortality or morbidity such as asphyxia and meconium
complications for babies that are small for gestational age
asphyxia
meconium aspiration
hypoglycemia
polycythemia
hypothermia
complicatons for babies that are large for gestational age
dystocia
hypoglycemia
congeital anomalies
when is the best time to do a comprehensive neonatal exam
why
1-2 hours after a feeding, becuase that is when they should be most alert
four things to pay special attention to during the comprehensive neonatal exam
color, size, posture and movement, resipiration
how will a normal full term baby lie
a symmetric position with the limbs semiflexed and legs partially abducted at the hips
T/F neonates should have spontaneous motor activity
treu
T/F flexed finges and slight tremors are abnormal for babies
false
T/F neonatal development is faster than at any other time
false, infancy is fastest
growth milestones for the infant
weight shuld have tripled, heigh should have increasd by 50% within the first year
describe the progression of neurlogical development in an infant
head before trunk
arms and legs before hands and fingers
congitive assessment of an infant
infants should know cause and effect
object permanence
use of tools
stronger anxiety
language assessment of the infant
infants should transition to cooing to squealing to babbling to saying 1-3 words by 1 yr old
what is the ballad score used for
to determine gestational age when te mom doesn’t know when the babies was concieved
social and emotional development of the infant
social tasks such as bonding, trust should be present
how does the structure of the PE differ in an infant
general
skin
head
thorax, lungs
heart
neck
breasts
abdomen
GU
musculoskeletal
nervous system
eyes
ears
mouth
nose
rectal
why are the Eyes, Ears, Mouth & Pharynx, Nose & Sinuses, Rectal done last in an infant PE
because you don’t want to make them mad earily
vital signs for infant exam
BP, pulse, respiration, temp, length, weight, head circumference
T/F weight should be taken with dirty diaper
false, it should be clean
normal BP at birth
1 month
6 months
70
85
90 systolic
normal RR infants
birth to 2 month (>60)
2-12 (>50)
implications of sustained infant HTN
renal artery disease
congenital renal disease
coarctation of the aorta
what indicates tachycardia in pulse
SVT
250bpm
>180 bpm
T/F fever can increase RR as much as 10resp/min/degree of fever
true
what might beindicated by very rapid, shallow breathing
cyanotic heart disease, right to left shunting, metabolic
tachypnea or increased respiratory effort indicateds what
pneumonia or bronchiolitis
nonpathological caues of fever
what constituites a fever in a neonate
swaddleing
anxiery
>100.4
testing for jaundice
press the skin, look for a yellowish tint indicative of jaundice
when a rectal exam be done on a neonate/infant
to check for imperforate anus
to assess rectal bleeding
erythema toxicum
a common condition usually statying 3-5 days after birth with small pustules on erythematous bases that usually resolves withinf 1-2 weeks