PHYSICAL EXAMINATION OF THE MALE GENITALIA Flashcards
HPI considerations
Difficulty achieving or maintaining erection.
Ask patients about
-pain with erection,
-pattern of erection with one or more partners,
-alcohol and medication ingestion,
-erections unrelated to sexual stimulation,
-curvature of erect penis.
HPI considerations
Difficulty with ejaculation
Pertinent data include:
-painful or premature ejaculation
-color and consistency of fluids,
-medications used on a regular basis.
HPI considerations
Discharge or lesions on the penis.
Note the…
-character of lesion (lumps, sores, rashes)
-discharge (color, consistency, odor).
-Record any associated symptoms (e.g., itching or burning),
-exposure to sexually transmitted infections,
-medications used.
HPI considerations
Infertility.
Patients reporting problems with conceiving should be assessed for
-lifestyle factors (e.g., hot tub use),
-length of time attempting pregnancy,
-knowledge of fertile period of woman’s reproductive cycle,
-incidence of undescended testes,
-previous diagnostic studies (e.g., semen analysis or sperm antibody titers)
-medications used.
HPI considerations
Enlargement in inguinal area.
Questions relevant to:
-enlarged inguinal area address pain associated with lifting,
-change in size or character of mass,
-groin pain,
-use of truss or other treatment,
-medications used.
HPI considerations
Testicular pain or mass.
Patients should be assessed for:
-changes in testicular size,
-events surrounding onset (e.g., sporting event),
-any irregular lumps,
-soreness,
-heaviness of testes,
-medications used.
Past Medical History considerations
Pertinent data include:
-previous genitourinary tract surgeries (e.g., surgery to correct hypospadias or hernia),
-sexually transmitted infections
-chronic illnesses (e.g., prostatic cancer, arthritis, or neurologic or -vascular impairment).
Family History Considerations
Data should be collected on:
-any infertility problems in siblings,
-hernias in family members,
-family history of prostate, testicular, or penile cancer.
Personal and Social History
Relevant data include
-employment risks (e.g., exposure to toxins),
-exercise patterns,
-concerns about genitalia,
-testicular self-examination practices,
-concerns about sexual practices,
-reproductive function (number of children, form of contraceptive use),
-use of medications, alcohol, or street drugs that may interfere with sexual response.
HPI considerations in older adults
Relevant data include:
-sexual activity patterns
-any changes in sexual response or desire.
HPI considerations in Adolescents.
Relevant data include knowledge of:
-reproductive function,
-presence of nocturnal emissions,
-enlargement of genitalia,
-sexual activity patterns,
-use of contraceptives,
-concerns of sexual abuse.
HPI considerations for Infants and children
-Information should be gathered on maternal use of sex hormones or birth control pills during pregnancy.
-Circumcised infants should be assessed for any complication from the procedure.
-Pertinent data for uncircumcised infants include hygiene measures and retractability of foreskin.
-Congenital anomalies (e.g., epispadias) and any incidence of scrotal swelling when infant is crying or having bowel movements
should be recorded.
-Notation should also be made of any swelling, discoloration, sores on penis or scrotum, and genital pain.
-Questions should be asked about any concerns with masturbation, sexual exploration, or sexual abuse.
Erection of the penis occurs when the two corpora cavernosa become engorged with _______ mL of blood in response to the autonomic nervous system.
20 to 50 mL
True/False
Examination
Patient may be lying or standing.
True
Examination of the genitalia involves…
-inspection,
-palpation, and
-transillumination of any mass found.
Findings associated with disorders: Adults
Pinpoint opening suggests…
meatal stenosis
Findings associated with disorders: Adults
a prolonged and often painful penile erection, may suggest a more serious condition.
Priapism
Findings associated with disorders: Adults
Beaded or lumpy vas deferens suggests…..
diabetes, tuberculosis, or inflammatory changes.
Findings associated with disorders: Adults
The hernia is described as _____ if it lies within the inguinal canal.
indirect
_______ is the inability to replace the foreskin to its usual position after it has been retracted behind the glans.
Paraphimosis
Findings associated with disorders: Adults
Uncircumcised males may have ______ as a result of nonretractable foreskin.
-this results from infection.
-Penile discharge suggests inflammation or infection
balanoposthitis
_______ is a congenital defect in which the urethral meatus is located on the ventral surface of the glans, penile shaft, or the perineal area.
Hypospadias
__________ generally occurs 2 weeks after exposure. Most commonly located on the glans. Painless lesion has indurated borders with a clear base.
Syphilitic chancre lesion of primary syphilis
_______ is a viral infection that appears as superficial vesicles. Lesions may be located on the glans, penile shaft or base. Painful and associated with inguinal lymphadenopathy
Herpes
