male GU

Question 1

corpora cavernosa and corpora spongiosum in the penis

Answer 1

• two corpora cavernosa which run along the sides of the spongiosum: Both erectile tissue
• Corpus spongiosum (with urethra running through it) ends in the glans

Question 2

what is the corona of the penis?

Answer 2

-Corona is widened area at base of glans

Question 3

visceral tunica in the testes- what does it encase?

Answer 3

Visceral tunica vaginalis encases the anterio/lateral testes, posteriorly the epididymis is NOT covered by the visceral tunica.

Question 4

The testes are encased in how many layers of tissue that are derived from the layers of the abdominal wall?

Answer 4

four

Question 5

dartos muscle and fascia: what does it do?

Answer 5

Contracts the scrotal skin to decrease the surface area thereby preserving heat in the body
(Not the same thing and the Cremasteric muscle which is in charge of the testes)

Question 6

4 layers of the spermatic cord

Answer 6

1. Peritoneum: the tunica vaginalis
2. Transversalis fascia: Internal spermatic fascia
3. Internal abdominal oblique muscles adds the cremasteric muscle
4. External abdominal oblique muscle adds the external spermatic fascia

Question 7

what is tested in the “turn your head and cough” rule?

Answer 7

external ring for inguinal hernia

Question 8

what two processes must be intact for an erection to occur? (extensive explanation of bloodflow process)

Answer 8

1. blood flow must increase to corpora cavernosa via pudendal artery,
2. venous outflow resistance must increase as result of blood trapping via venoocclusive mechanism,
   …Increase in blood inflow without outflow allows higher intracavernosal volume and pressure which results in increased penile length and rigidity

Question 9

lymph nodes: Penile and scrotal skin drain into the ____ ______

Answer 9

inguinal nodes

Question 10

lymph nodes: The testes considered “____ _____” drain into…

Answer 10

abdominal lymph system.

Question 11

three things to check the prepuce/foreskin for?

Answer 11

Phimosis- can’t retract foreskin
Paraphimosis- cannot reduce foreskin once retracted
Smegma- normal whitish material- normal

Question 12

what do you check the skin at the base of the penis for ? (3)

Answer 12

excoriations, nits or lice

Question 13

checking the urethra: how do you do this? what are you looking for?

Answer 13

compress glans to open urethra to look for

discharge. May need to “milk” urethra

Question 14

2 part inspection of the scrotum

Answer 14

Skin- looking for rashes, epidermoid cysts, skin cancer rare

Scrotal contour- swelling, lumps or veins

Question 15

palpation of the scrotum: part 1

Palpate each testis and epididymis between what fingers? where is the epididymis and what should it feel like?

Answer 15

1. Palpate each testis and epididymis between thumb and first two fingers. Epididymis is superior, posterior of the testicle, should feel nodular and cordlike

Question 16

palpation of scrotum: part 2
how do you palpate the spermatic cord? what are you noting ? (4)
what will pressure in the testes normally give you?

Answer 16

2. Palpate the spermatic cord including vas deferens from epididymis to internal ring
   Note size, shape, consistency, tenderness
   Pressure on testis normally will give deep visceral pain

Question 17

transillumination of the scrotum, how do you do it and what do the results mean?

Answer 17

Shine a light from behind the scrotum. Look for red glow.

Serous fluid will transilluminate, solids will not

Question 18

testicular pain is considered ___ _______, testicular torsion is a _______ ______

Answer 18

pain- emergency

torsion- surgical emergency

Question 19

what is “acute scrotum” and who does it generally happen to?

Answer 19

scrotal pain redness and swelling of acute onset, with usually normal UA.

• testicular torsion is the biggest worry with this.
• young men (under 30)

Question 20

testicular torsion longer than ___ hrs leads to ______ and _____ . while delay past ___ hrs causes _______ ____ and ______ ______.

Answer 20

6 hrs, ischemia and atrophy

12 hrs, progressive ischemia, irreversible damage

Question 21

Torsion confirmed by ______ ______ and _____ ______

Orchiectomy indicated if testis remains ______ and _______ after treatment

Answer 21

color doppler and nuclear scanning

dusky and cyanotic

Question 22

how do you fix testicular torsion (acutely)?

Answer 22

Manual detorsion by rotating testis 1 and ½ turns (usually) toward respective thigh (usually) = dramatic pain relief, blood flow confirmed by color doppler US

Question 23

how doe orchitis present? uni or bilateral? what can it be confused with? what are causes?

Answer 23

Acutely inflamed testis, painful, tender, swollen; scrotum may be red; usually unilateral;

• epididymis
• mumps and other viral infections;

Question 24

testicular tumor presentation?

Answer 24

painless nodule, may feel like a cauliflower if its progressed

Question 25

which is the most common hernia? who does it present often in? how does it present?

Answer 25

indirect hernia

• children
• With Valsalva will come down inguinal canal and touch tip of finger. often in scrotum

Question 26

less common tumor, thats usually in men over 40? how does it present?

Answer 26

direct hernia

-Rarely into scrotum. Bulges anteriorly pushing side of finger

Question 27

least common tumor, thats usually in women? how does it present?

Answer 27

femoral hernia

• Never into scrotum (if it is a man)
• Inguinal canal empty, More lateral than inguinal hernia