male GU Flashcards
corpora cavernosa and corpora spongiosum in the penis
- 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
what is the corona of the penis?
-Corona is widened area at base of glans
visceral tunica in the testes- what does it encase?
Visceral tunica vaginalis encases the anterio/lateral testes, posteriorly the epididymis is NOT covered by the visceral tunica.
The testes are encased in how many layers of tissue that are derived from the layers of the abdominal wall?
four
dartos muscle and fascia: what does it do?
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)
4 layers of the spermatic cord
- Peritoneum: the tunica vaginalis
- Transversalis fascia: Internal spermatic fascia
- Internal abdominal oblique muscles adds the cremasteric muscle
- External abdominal oblique muscle adds the external spermatic fascia
what is tested in the “turn your head and cough” rule?
external ring for inguinal hernia
what two processes must be intact for an erection to occur? (extensive explanation of bloodflow process)
- blood flow must increase to corpora cavernosa via pudendal artery,
- 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
lymph nodes: Penile and scrotal skin drain into the ____ ______
inguinal nodes
lymph nodes: The testes considered “____ _____” drain into…
abdominal lymph system.
three things to check the prepuce/foreskin for?
Phimosis- can’t retract foreskin
Paraphimosis- cannot reduce foreskin once retracted
Smegma- normal whitish material- normal
what do you check the skin at the base of the penis for ? (3)
excoriations, nits or lice
checking the urethra: how do you do this? what are you looking for?
compress glans to open urethra to look for
discharge. May need to “milk” urethra
2 part inspection of the scrotum
Skin- looking for rashes, epidermoid cysts, skin cancer rare
Scrotal contour- swelling, lumps or veins
palpation of the scrotum: part 1
Palpate each testis and epididymis between what fingers? where is the epididymis and what should it feel like?
- Palpate each testis and epididymis between thumb and first two fingers. Epididymis is superior, posterior of the testicle, should feel nodular and cordlike
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?
- 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
transillumination of the scrotum, how do you do it and what do the results mean?
Shine a light from behind the scrotum. Look for red glow.
Serous fluid will transilluminate, solids will not
testicular pain is considered ___ _______, testicular torsion is a _______ ______
pain- emergency
torsion- surgical emergency
what is “acute scrotum” and who does it generally happen to?
scrotal pain redness and swelling of acute onset, with usually normal UA.
- testicular torsion is the biggest worry with this.
- young men (under 30)
testicular torsion longer than ___ hrs leads to ______ and _____ . while delay past ___ hrs causes _______ ____ and ______ ______.
6 hrs, ischemia and atrophy
12 hrs, progressive ischemia, irreversible damage
Torsion confirmed by ______ ______ and _____ ______
Orchiectomy indicated if testis remains ______ and _______ after treatment
color doppler and nuclear scanning
dusky and cyanotic
how do you fix testicular torsion (acutely)?
Manual detorsion by rotating testis 1 and ½ turns (usually) toward respective thigh (usually) = dramatic pain relief, blood flow confirmed by color doppler US
how doe orchitis present? uni or bilateral? what can it be confused with? what are causes?
Acutely inflamed testis, painful, tender, swollen; scrotum may be red; usually unilateral;
- epididymis
- mumps and other viral infections;
testicular tumor presentation?
painless nodule, may feel like a cauliflower if its progressed
which is the most common hernia? who does it present often in? how does it present?
indirect hernia
- children
- With Valsalva will come down inguinal canal and touch tip of finger. often in scrotum
less common tumor, thats usually in men over 40? how does it present?
direct hernia
-Rarely into scrotum. Bulges anteriorly pushing side of finger
least common tumor, thats usually in women? how does it present?
femoral hernia
- Never into scrotum (if it is a man)
- Inguinal canal empty, More lateral than inguinal hernia
