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Advanced Health Assessment > Module 11: Male GU > Flashcards

Module 11: Male GU Flashcards

1
Q

What forms the shaft of the penis?

A

The corpus spongiosum (which contains the urethra), and two corpora cavernosa (which forms the bulb of the penis and ends in the cone shaped glans(corona)).

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2
Q

How big are your balls, I mean testes?

A

Approx. 4.5 cm long, ranging in size from 3.5 to 5.5 cm and the left usually lying lower than the right.

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3
Q

What do the testes produce?

A

Spermatozoa and testosterone.

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4
Q

What helps to development the masculine secondary sex characteristics like facial and body hair, musculoskeletal growth, enlarged larynx?

A

Testosterone.

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5
Q

A tightly coiled spermatic ducts that provide a resolver for storage, maturation, and transport for sperm from the testis to the vas deferens?

A

Epididymis

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6
Q

What can cause a lack of libido in a male?

A

It may arise from psychogenic causes such as depression, endocrine dysfunction, or side effects of meds.

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7
Q

What can cause erectile dysfunction?

A

Psychogenic causes, especially if early morning erection is preserved; also from decreased testosterone, decreased blood flow in the hypogastric arterial system, or impaired neural innervation.

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8
Q

Who is more common to have premature ejaculation?

A

Young men. Less common is reduced or absent ejaculation affecting middle-aged or older men. Causes include meds, surgery, neurological deficits, or lack of androgen. Lack of orgasm with ejaculation is usually psychogenic.

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9
Q

When assessing a patient with penile discharge?

A

Ask about amount, color, consistency, fevers, chills, rash, or any other associated symptoms.

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10
Q

Penile discharge may accompany gonococcal infections which are usually____ and nongonococcal urethritis which are usually ____ or _____?

A

Yellow; clear or white.

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11
Q

Who is at increased risk for STDS?

A

People with multiple partners, homosexuals, illicit drug users, or prior history of an STD.

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12
Q

T or F: STDS can involve any body opening where you have sex.

A

True.

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13
Q

What are some infections from oral-penile transmission?

A

Gonorrhea, chlamydia, syphilis, and herpes.

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14
Q

What may follow anal intercourse?

A

Symptomatic or asymptomatic proctitis.

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15
Q

In 2005, what did the CDC estimate?

A

19 million new STD infections. with almost half in the age group 15-24 years old.

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16
Q

What was the majority of diseases reported?

A

72% chlamydia, 25% gonorrhea, and 3% syphilis.

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17
Q

Why aren’t there more STDS?

A

Many cases are unreported and viral infections (HIV & the herpes) aren’t subject to requirements for mandatory reporting.

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18
Q

What else can be transmitted through sexual contact?

A

Hep B and genital ulcers such as chancroid.

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19
Q

Who should you encourage to perform a testicular self exam?

A

Men between 15 and 35 years of age should perform TSE MONTHLY.

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20
Q

What findings in a TSE should a man seek help for?

A

Any painless lump, swelling, or enlargement in either testicle, pain or discomfort in a testicle or the scrotum, a feeling of heaviness or a sudden fluid collection in the scrotum, or a dull ache in the lower abdomen or the groin.

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21
Q

If a man refuses to be examined what should you do?

A

Respect his wishes!

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22
Q

Is an erection common during an exam?

A

YEP!! Just continue the exam and don’t get flustered.

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23
Q

What is the prepuce?

A

The foreskin.

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24
Q

A tight prepuce that cannot be retracted over the glans?

A

Phimosis

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25
Q

A cheesy, whitish material that may accumulate normally under the foreskin.

A

Smegma…why would you describe something as cheesy. Thats disgusting.

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26
Q

A tight prepuce that once retracted, cannot be returned.

A

Paraphimosis. Edema will ensue.

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27
Q

Inflammation of the glans.

A

Balanitis. Inflammation of the glans and prepuce is Balanoposthitis.

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28
Q

What is a sign of crabs?

A

Pubic or genital excoriations. Could be scabies as well!

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29
Q

Hypospadias?

A

Congenital ventral displacement of the meatus on the penis.

30
Q

If you have profuse yellow discharge, what do you have?

A

Gonococcal urethritis. Diagnosis requires gram stain and culture.

31
Q

If you have scanty white or clear discharge, what do you have?

A

Non-gonococcal urethritis. Diagnosis requires gram stain and culture.

32
Q

What does an induration along the ventral surface of the penis suggests?

A

A urethral stricture or possibly a carcinoma.

33
Q

What does tenderness of such an indurated area on the penis suggest?

A

Periurethral inflammation secondary to a urethral stricture.

34
Q

Dome-shaped white or yellow papules or nodules formed by occluded follicles filled with keratin debris of desquamated follicular epithelium.

A

Epidermpid cysts are common, multiple, benign.

35
Q

Are epidermoid cysts skin cancer?

A

Rarely.

36
Q

A poorly developed scrotum on one or both sides suggests what?

A

Cryptorchidism (undescended testicle)

37
Q

What are some common reasons why scrotums swell?

A

Hehehehehe……sorry I am trying to keep a straight face. Indirect inguinal hernias, hydroceles, and scrotal edema.

38
Q

What would you have tender, painful scrotal swelling in?

A

Acute epididymitis, acute orchitis, torsion of the spermatic cord, or a strangulated inguinal hernia.

39
Q

If you have a painless nodule in the testis, must raise the possibility of what?

A

Testicular cancer, a particularly curable cancer with peak incidence between the ages of 15-35 years.

40
Q

Multiple tortuous veins in this area, usually on the left, may be palpable and even visible. What do they indicate?

A

A varicocele.

41
Q

If they are chronically infected, how will the vas deferens feel?

A

May feel thickened or beaded. A cystic structure in the spermatic cord suggests a hydrocele of the cord.

42
Q

Swellings containing serous fluid, as in a hydrocele, light up with a ____ glow, or transillumianate.

A

RED. Those containing blood or tissue, such as a normal testis, a tumor, or most hernias, do not.

43
Q

A bulge that appears on straining suggests a what?

A

hernia

44
Q

How do you examine for inguinal hernias?

A

Read Bates 10th ed. page 511.

45
Q

A bulge near the external inguinal ring suggests a what?

A

direct inguinal hernia.

46
Q

A bulge near the internal inguinal ring suggests what?

A

An indirect inguinal hernia.

47
Q

If you have a mass in your scrotum that you can hear bowel sounds, what would you suspect?

A

Bowel sounds may be heard over a hernia, but not over a hydrocele.

48
Q

What does it mean when a hernia is incarcerated?

A

Its contents cannot be returned to the abdominal cavity.

49
Q

What does it mean when a hernia is strangulated?

A

The blood supply to the entrapped contents is compromised. Suspect strangulation in the presence of tenderness, nausea, and vomiting.

50
Q

What is the anorectal junction often called?

A

Pectinate or edentate line. Visible on proctoscopic exam but not palpable.

51
Q

The prostate gland is small during childhood, but between puberty and approx. 20 years, it increases ….

A

Roughly five-fold in size. Prostate volume further expands as the gland becomes hyper plastic.

52
Q

Change in bowel patterns, especially stool of thin pencil-like caliber, may warn of?

A

Colon Cancer.

53
Q

Blood in the stool may be from polyps or cancer, also from?

A

GI bleed.

54
Q

Leading cancer diagnosed in men and the third leading cause of death in men following lung and colon cancer?

A

prostate.

55
Q

Risk of prostate cancer increases sharply with each advancing _____ after 50 years.

A

decade. African Americans have higher incidence.

56
Q

Prostate screening remains controversial.

A

True.

57
Q

ACS and AUA recommend combining DRE with testing for PSA beginning?

A

At age 50 for whites, 40 for african americans and men with with a positive family hx.

58
Q

What are the symptoms of prostate disorder?

A
  • Incomplete emptying of bladder
  • Urinary frequency or urgency
  • Weak or intermittent stream or straining to initiate flow.
  • Hematuria
  • Nocturia
  • Bony pains in pelvis.
59
Q

How to screen for colon cancer?

A
  • Identify patient risk, by age 20 or earlier if family hx
  • Average risk age 50 should be offered range of screening options to increase compliance: annual fecal occult blood testing, flex sig q 5 yrs, double contrast barium enema q 5 yrs, colonoscopy every 10 yrs.
  • Pts with increased risk should undergo colonoscopy q 3-5 yrs.
60
Q

No matter how you position the patient, your examining finger cannot reach the full length of the rectum.

A

True.

61
Q

Anal and perianal lesions include:

A

Hemorrhoids, venereal warts, herpes, syphilitic chancre, and carcinoma.

62
Q

What does a linear crack or tear suggest?

A

Anal fissure from large hard stools, IBS, or STDS.

63
Q

Tender, purulent, reddened mass with fever or chills accompanies:

A

Anal abscess.

64
Q

Abscesses tunneling to the skin surface from the anus or rectum amy form a clogged or draining?

A

Anorectal fistula. They may ooze blood, pus, or feculent mucus.

65
Q

Sphincter tightness may occurs with?

A

Anxiety, inflammation, scarring; laxity appears with some neurological disease.

66
Q

Colon cancer has an irregular border

A

True.

67
Q

Normal prostate:

A

Rounded, heart shaped structure approx. 2.5 cm long. Median sulcus can be felt between the two lateral lobes. Only the posterior surface of the prostate is palpable. Anterior lesions aren’t detectable by PE.

68
Q

Prostatitis:

A

Acute bacterial prostatitis presents with fever and urinary tract symptoms (freq., urgency, dysuria, incomplete voiding, and low back pain). The gland feels tender, swollen, “boggy”, and warm. >80% infections are caused by gram neg. aerobes (E.coli, enterococcus, and proteus.)

Chronic bacterial prostatitis associated with recurrent UTIs. May be asymptomatic or have dysuria or mild pelvic pain. Gland may feel normal without tenderness or swelling.

69
Q

Bening Prostatic Hyperplasia:

A

Nonmalignant enlargement of the prostate gland that increases with age. Urgency, frequency, nocturia, decreased stream, incomplete emptying, straining. Gland may be normal in size or may feel enlarged, smooth, and firm.

70
Q

Cancer of the Prostate:

A

Suggested by an area of hardness in the gland. A distinct hard nodule that alters the contour of the gland may or may not be palpable. As the cancer enlarges, it feels irregular and may extend beyond the confines of the gland. Hard areas are not alway malignant. Could also be prostatic stones, chronic inflammation, etc.

Advanced Health Assessment (12 decks)

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