NUR 362 - GU

Question 1

Tanner Staging

Answer 1

sexual maturity rating scale

Question 2

Scrotum

Answer 2

loose, wrinkled pouch that has two compartments, each contains a testicle

Question 3

Testicles

Answer 3

oval, rubbery structures that are about 4.5 cm long

left testicle lies somewhat lower than right

Question 4

Epididymis

Answer 4

comma-shaped structure, curved over the top and the posterior surface of the testis

Question 5

Adolescent changes

Answer 5

enlargement of the testes
pubic hair appears
penis size increases

Question 6

Aging adult changes

Answer 6

production of sperm continues into 80s and 90s
testosterone production declines after age 30
pubic hair decreases and turns gray
penis size decreases
scrotal contents hang lower
testes decrease in size and are less firm to palpation
less intense sexual response
ejaculation is shorter and less forceful

Question 7

Inspection of males

Answer 7

skin normally looks wrinkled, hairless and w/o lesions
glans looks smooth w/o lesions
urethral meatus positioned centrally
pubic hair distribution consistent with age

Question 8

Palpation of males

Answer 8

retract and place foreskin to original position (if uncircumcised)
compress glans between thumb and forefinger (should appear pink, smooth, no discharge)
shaft of penis between thumb and two fingers (smooth, semi firm, contender)
lift sack to inspect posterior surface
testes feel oval, firm and rubbery, and freely movable bilaterally
epididymis feels discrete, softer than tests, smooth, nontender
spermatic cord between thumb and forefinger (smooth and nontender)
inguinal region for hernial bulge
inguinal lymph nodes

Question 9

Hernia

Answer 9

bulge of intestine through a weakness in abdominal wall 
swelling while patient is standing 
inguinal, femoral, scrotal 
retracts when recumbent
protrudes with cough

Question 10

Female adolescent changes

Answer 10

breasts enlarge
duct system grows and branches
breast development occurs between 8-10
pubic hair development

Question 11

Pregnant woman changes

Answer 11

stimulates expansion of ductal system and development of true secretory alveoli
breasts enlarge and feel more nodular 
areolae become larger and darker
colostrum may be expressed
cervical and vaginal secretions increase

Question 12

Aging woman changes

Answer 12

estrogen and progesterone decrease
cessation of menses
uterus shrinks
vagina becomes shorter, narrower, less elastic
decreased vaginal secretions
breast glandular tissue atrophy
breasts droop and sag (accentuated by kyphosis)
axillary hair decreases

Question 13

Breast inspection

Answer 13

symmetry of size and shape
skin smooth and even color
lymphatic drainage areas (axillary and supraclavicular)
nipples symmetrical on same plane (protrude, flat, inverted)

Question 14

Breast palpation

Answer 14

pattern of palpation up/down or circular
assess for lumps, tenderness, warmth
axillary lymph nodes

Question 15

Breast self-examination

Answer 15

right after menstrual period (4 to 7 of the cycle)
palpate in the shower where soap and water will assist palpation or laying supine
lie down, pressure 3 middle fingers in a circular motion and use 3 levels of pressure
up and down pattern
sit up, examine underarm with arm slightly raised
surface changes with hands pushed on hips, shoulders hunched

Question 16

Pelvic examination

Answer 16

empty bladder
lithotomy position
inspection of mons hair distribution
labia minora/majora symmetric, plump and well formed
urethra position
vagina discharge, odor, bleeding
anus fissures, hemorrhoids

Question 17

Testicular self-exam

Answer 17

common malignancy in men 18-25
exam from 14-40
TSE: 
timing - once a month
shower - warm water relaxes scrotal sac
examine - check for lumps, inconsistency, heaviness