Scrotal Swelling

Question 1

Scrotal swelling

Answer 1

. Enlargement of scrotum

. Can be due to injury or underlying condition

Question 2

Testicular torsion

Answer 2

. Twisting of testicle on its spermatic cord producing acutely painful, tender, and swollen organ
. Absent cremaster reflex and upward retraction in scrotum

Question 3

Hydrocele

Answer 3

. Nontender fluff filled mass w/in tunica vaginalis
. Transilluminates
. Examining fingers can palpate above mass will scrotum

Question 4

Inguinal hernia

Answer 4

. Usually indirect
. Protrusion of abdominal content coming through deep and superficial inguinal rings
. Examining fingers can’t get above it w/in scrotum

Question 5

Femoral hernia

Answer 5

. Protrusion of abdominal content through femoral canal that lies below inguinal ligament lat. to pubic tubercle

Question 6

Incarcerated hernia

Answer 6

. Contents cannot be returned to abdominal cavity

Question 7

Strangulated hernia

Answer 7

. Blood supply to entrapped contents is compromised

. Usually assoc. w/ tenderness, nausea, and vomiting

Question 8

Penis shaft

Answer 8

. Formed by corpus spongiosum containing urethra and 2 corpora cavernosa
. Corpus spongiosum forms bulb of penis (ending in cone-shaped glans w/ corona/base)

Question 9

Testes

Answer 9

.4.5 cm long
. Left testis normally lies somewhat lower than right
. Produces sperm and testosterone
. Has epididymis on posterolat. Side

Question 10

Lower GU tract

Answer 10

. Vas deferens begins at tail of epididymis
. Ascends w/in scrotal sac as spermatic cord and passes through external inguinal sing on its way to abdomen and pelvis
. Behind bladder it is joined by duct from seminal vesicles and enters the urethra w/in prostate gland

Question 11

Groin landmarks

Answer 11

. ASIS
. Pubic tubercle
. Inguinal ligament

Question 12

Testicular carcinoma

Answer 12

. Lump or enlargement of either testicle
. Nontender and slow growing
. May present as lower abdominal or back pain or sudden collection of fluid w/in scrotum
. Most common cancer in males 15-35

Question 13

Lice

Answer 13

. Parasites that feed on blood

. Nits: eggs usually attached to hair shaft

Question 14

Scabies

Answer 14

. Mites that burrow and lay eggs in superficial skin
. Linear burrows can be seen
. Very itchy

Question 15

Phimosis

Answer 15

. Tight prepuce that cannot be retracted over glans

Question 16

Paraphimosis

Answer 16

. Tight prepuce that once retracted cannot be returned back over the glans

Question 17

Balanitis

Answer 17

. Inflammation of glans

Question 18

Balanopsosthitis

Answer 18

. Inflammation of glans and prepuce

Question 19

Hypospadius

Answer 19

. Congenital displacement of urethral meatus to inf. Surface of penis
. Meatus may be subcoronal, midshaft, or at junction of penis and scrotum

Question 20

Gonococcal urethritis

Answer 20

. Infection w/ inflammation of urethra caused by gonococcal or no gonococcal etiologies (chlamydia or ureaplasma urealyticum)

Question 21

Urethral strictures

Answer 21

. Narrowing of urethra caused by injury, infection, instrumentation, and non infectious etiologies

Question 22

Glans physical exam

Answer 22

. Note location of urethral meatus
. Compress gently btw index finer and thumb below to open urethral meatus
. Inspect for discharge (normally there is none)

Question 23

Normal epididymis on exam

Answer 23

. Located on sup. Post. Surface of each testicle
. Feels modular, soft, and cordlike
. Should not be confused w/ abnormal lump

Question 24

Position of doctor and patient for hernia examination

Answer 24

. Physician sitting in front of standing patient

. Asl patient to bear down making hernias easy to detect

Question 25

Scrotal hernia

Answer 25

. Large scrotal mass that can disappear when patient lies down
. If it doesn’t disappear, listen w/ stethoscope and if bowel sounds are heard it is a hernia
. If it transilluminates it is NOT a hernia