objective 19 Flashcards
what are the external genitalia structure>
penis and scrotum
what are the internal genitalia structures>
testis, epididymis, vas deferens
what are the 3 cylindrical columns of erectile tissue>
- 2 corpora cavernosa
- Corpus spongiosum
Cone of erectile tissue at the distal end of the shaft
glans
Where the glans joins the shaft
corona
Transverses the corpus spongiosum, the meatus forms a slit at tip of the glans
urethra
Hood or flap where the skin folds in and back on itself
prepuce
fold of the foreskin that extends ventrally from the urethral meatus
frenulum
Loose protective sac, continuation of the abdominal wall
scrotum
control the size of the scrotum (respond to ambient
temperature)
cremaster muscles
- One in each scrotal half
- Produce sperm
- Each is a solid oval structure
- Each measures 4-5 cm long x 3 cm wide in adults
testis
- Caps the testis
- Coiled, duct system
- Main site for sperm storage
epididymis
Muscular duct that is continuous with the lower part of the epididymis
vas deferens
Junction of the lower abdominal wall and the thigh
inguinal area
what are the landmarks of the inguinal areas?
- Inguinal ligament
- Inguinal canal
- Femoral canal
what are the developmental considerations of infants and adolescents?
- In utero, testes develop in the abdominal cavity near the kidneys
- The testes descend along the inguinal canal into the scrotum before
birth - Puberty:
- Enlargement of the testes is the first sign of puberty
- Followed by the development of pubic hair
- Increase in penis size
what are the developmental considerations of older men?
- Decreased sperm production (begins at approximately
age 40) - Decrease in testosterone production (after age 55-60
years) - Decrease in pubic hair (remaining hair turns gray)
- Decreased in penis size and size of testes
- Scrotum more pendulous
- Slower, less intense sexual response (declining
testosterone production)
what is the positioning for the exam?
- Client standing, underwear down:
- Drape for modesty (important for all clients)
- Examiner should be sitting
- Alternative position:
- Client supine for the first part of the examination and then stands to
check for hernia
what equipment do u need>
- For an external examination:
- Gloves
- Should be worn during all aspects of the examination
- Flashlight
how may the client feel?
- Feel apprehensive
- Feel it is an invasion of privacy
- Be modest
- Fear negative judgment
- Fear experiencing pain
- Fear having an erection during the examination and that it could be
misinterpreted by the examiner
what may the examiner feel?
- Feel embarrassed
- Feel apprehensive
- The examiner should portray confidence and be relaxed during the
examination. The examiner should not discuss genitourinary history or sexual
practices while performing the exam. The client may perceive this as being judgemental
what are the normal and abnormal of the skin?
- Normal: skin looks wrinkled, hairless, no lesions, the dorsal vein
may be apparent - Abnormal: inflammation, lesions
what is the normal and abnormal findings for hair distribution>
- Normal: At the base of the penis – pubic hair distribution is
consistent with age, no infestations - Abnormal: Infestation (pubic lice or nits), excoriated skin usually
accompanies infestation
what are the normal and abnormal findings of the glans?
- Normal: smooth, no lesions, ask an uncircumcised male to
retract foreskin – should move easy, some smegma may have
collected under the foreskin - Abnormal: inflammation on glans or corona, phimosis,
paraphimosis
what are the normal and abnormal findings of the urethral meatus?
- Normal: centrally positioned
- Abnormal: hypospadias, epispadias
what are the normal and abnormal findings of the shaft of penis?
- Normal: smooth, semi-firm, non-tender
- Abnormal: tenderness, nodule, induration
what are the normal ahd abnormal findings of the scrotum>
- Asymmetry is normal – the left scrotal half is usually lower than the
right - Abnormal: scrotal swelling, lesions
- Scrotal size varies with ambient room temperature
what are the normal and abnormal findings of the rugae>
Normal: no lesions except for sebaceous cysts
* Abnormal: Inflammation
what are the normal and abnormal findings of the testes?
- Normal: oval, firm, rubbery, smooth, equal bilaterally,
freely movable and slightly tender to moderate pressure - Abnormal: absence of testes, atrophied testes, fixed testes,
nodular testes, marked tenderness
what are the normal and abnormal findings of the epididymis?
- Normal: feels discrete, softer than the testis, smooth, non-
tender - Abnormal: induration, swollen and tender epididymis
(epididymitis)
what are the normal and abnormal findings of the spermatic cord?
- Normal: smooth, non-tender cord
- Abnormal: thickened cord; soft, swollen tortuous cord (varicocele`
procedure done only if swelling or
mass found:
* Darken room
* Shine strong flashlight from behind the scrotal contents
* Normal scrotal contents cannot be transilluminated, serous
fluid can be transilluminated and glows red; blood and tumors
cannot be transilluminated
transillumination
what are normal and abnormal findings of the inguinal region?
- Normal: none present
- Abnormal: bulge visible
what should you teach men?
- Examine after a warm bath or shower – heat from
warm water relaxes the scrotum - Carefully feel each testicle for any changes such
as lumps or tenderness - Compare two sides and note any differences
- It is normal for one testicle to be larger than the other
- Report changes to a physician as soon as
possible - Use a systematic pattern to check each testicle
by feeling it
what are the normal and abnormal findings of inguinal lymph nodes?
- Normal:
- No nodes palpable
- However, may occasionally palpate an isolated
node - Normal node feels small (less than 1cm),
soft, discrete, and movable - Abnormal:
- Enlarged, hard, matted, fixed nodes
