Unit 9 - Male & Female GU, STI's and Bowel Care Flashcards
What is micturition?
Voiding, urination
What makes up the urinary system?
Kidneys, Ureters, Bladder
What are the external structures of the male genitalia?
Penis (glans, corona, urethra, foreskin)
Scrotum (Rugae)
What is rugae?
Outside ridges on testicles that cause the wrinkles
What are the internal structures of the male genitalia?
Testes, epididymis, vas deferens, spermatic cord; cremaster muscle
If you were to uncoil the epididymis, how long would it be?
6 meters
How many days does it take for a sperm to mature when it reaches the vas deferens?
14 days
What is found in the inguinal canal?
Spermatic cord
What is found in the femoral canal?
Femoral artery/vein
What does the testes produce?
Sperm and testosterone
What is the purpose of the cremaster muscle?
Controls the size of scrotum for sperm production. Sperm needs to be not to hot or not to cold so the cremaster muscle will relax or contract to ensure that sperm will be the appropriate temperature.
What is polyuria?
Excessive urination
What is dysuria?
Difficulty voiding (burning, pain)
What is hematuria?
Blood in the urine
What is Nephrolithiasis?
Kidney stones
What is some subjective data that you should collect during a male genitourinary system?
Frequency, urgency, nocturia, dysuria Hesitancy and straining - starting? Urine colour - cloudy? hematuria? Odor GU Hx - incontinence? Kidney disease? Penis - pain, lesion, and/or discharge? Scrotum - self care behaviour; lumps? STI contact?
What is the best position to have the patient in upon male genitourinary assessment?
Preferably, you’d like the patient to be standing exposed and you to be sitting in a chair at eye level of the genitals to assess OR you can have the examiner stand and the patient lay supine.
True or false
The left scrotum is slightly lower then the right.
True, this is due to the spermatic cord is longer in the left.
When would you use transillumination?
If edema or mass is noted in the scrotum. Place light behind scrotal sac and shine through to illuminate any abnormalities.
What are the most common hernias in men?
Roughly 80% is inguinal hernias.
You want to see if they are reducible… can you pop them back in?
How do you assess inguinal hernias?
Have the man standing up, and on side that you wish to inspect, have patient shift weight onto opposite leg and place your index finger low on the scrotal half and push up into the external inguinal ring.Once inserted into the triangular slit like opening, get the patient to cough, or bear down. If they have a hernia you will feel something pop out.
What are the external structures of the female genitalia?
Mons pubis, labia majora/minora, clitoruis, frenulum, vestibule, urethral meatus, Skene’s/bartholin’s gland, perineum
What are the internal structures of the female genitalia?
Vagina (rugae), cervix (os), uterus, fallopian tubes, ovaries
Approx how long in the vaginal canal?
Roughly 9 cm’s
True or false
Urethras have a dual purpose in both men and women.
False. Men have dual purpose urethras were a woman does not.
What is some subjective data to collect upon a female genitourinary assessment?
menstrual history, obstetric history, menopause
self-care behaviours - pap smears
Urinary symptoms
Vaginal discharge… Unusual?
Sexual activity, contraceptive use, STI contact
How do you examine internal female genitalia?
Speculum and Bimanual examination
Approx how long is the rectum?
12 cm
Approx how long in the anal canal?
3.8 cm
What is one difference between the internal and external sphincters?
Internal sphincter is involuntary
External sphincter is voluntary (this is what children learn to control in potty training)
This structure is about the size of the golf ball and makes up 25% of the volume of semen and makes them mobile.
Prostate - accessory sex gland
How far should suppositories be inserted?
10 cm
How should a prostate normally feel?
Smooth, elastic and rubbery, slightly movable and non-tender
Around what ages do girls and boys go through puberty?
Female 8.5-13 yrs
Male 9.5-13.5 yrs
What age population is the most prevalent for STI’s?
15-24 year olds - lots of teaching required
What does TSE stand for?
Testicular self exam.
Timing, shower, examination
Who should be performing TSE’s?
Men starting age 13/14 - 49 years old
How should you perform TSE’s?
Zig zag pattern, hold scrotum in hand, gently reel with thumb and first two fingers.
What are you looking for in TSE’s?
Pain, lumps, swelling, heaviness in abdomen.
What are some examples of a bacterial STI?
Chlamydia*
Gonorrhea*
Trichomonas*
Syphilis*
- all cured with antibiotics
What are some examples of viral STI’s?
HPV, Herpes, Hepatitis B, HIV
NO CURE
What is common to many STI’s?
Many show no signs and symptoms, treatment must be sought, and can lead to infertility.
What is the best way to prevent acquiring an STI?
Abstinence, wearing a condom
What are hemorrhoids?
Varicose veins of the anal canal
What is the function of the GI system?
ingest food, breakdown food, prepare food for absorption, absorb fluid and nutrients, store and expel feces, and maintain fluid/electrolyte balance.
What are the major components of the GI system?
Mouth, esophagus, stomach, small intestine, large intestine, anus
What are different solutions available for enemas?
Hypertonic - sodium (Fleet) Hypotonic - tap water Isotonic - normal saline Soap Suds Other - Mineral oil, medication, micro
What is a hernia?
a weak spot in abdominal muscle wall (usually in are of inguinal canal or femoral canal) through which a loop of bowel may protrude.
What is cryptorchidism?
Undescended testes
A congenital defect in which urethra opens on the dorsal (upper) side of penis instead of at the tip.
Epispadias
A congenital defect in which urethra opens on the ventral (under) side of penis rather than at the tip.
Hypospadias
What is phimosis?
Foreskin advanced and tightly fixed over the glans penis.
The examiner is going to inspect and palpate for a hernia. During this examination the man is instructed to:
A) hold his breath during palpation
B) cough after the examiner has gently inserted the examination finger into the rectum
C) bear down when the examiner’s finger is at the inguinal canal
D) relax in a supine position while the examiner’s finger is inserted into the canal
C) bear down when the examiner’s finger is at the inguinal canal
During examination of the scrotum, a normal finding would be that:
A) the left testicle is firmer to palpation than the right
B) the left testicle is larger than the right
C) the left testicle hangs lower than the right
D) the left testicle is more tender to palpation than then right.
C) the left testicle hangs lower than the right
H.T. has come to the clinic for a follow-up visit. Six months ago, he was started on a new medication. The class of medication is most likely to cause impotence as a side effect; therefore, medication classes explored by the nurse are: A) antipuretics B) bronchodilators C) corticosteroids D) antihypertensives
D) antihypertensives
Prostatic hypertrophy occurs frequently in older men. The symptoms that may indicate this problem are:
A) polyuria and urgency
B) dysuria and oliguria
C) straining, loss of force, and sense of residual urine
D) foul-smelling urine and dysuria
C) straining, loss of force, and sense of residual urine
A 64 year old man has come for a health examination. A normal age-related change in the scrotum would be: A) testicular atrophy B) testicular hypertrophy C) pendulous scrotum D) increase in scrotal rugae.
C) pendulous scrotum
During palpation of the testes, the normal finding would be:
A) firm to hard, and rough
B) nodular
C) 2 to 3 cm long by 2 cm wide and firm.
D) firm, rubbery, and smooth
D) firm, rubbery, and smooth
A 20 year old man has indicated that he does not perform testicular self-examination. One of the facts that should be shared with him is that testicular cancer, though rare, does occur most commonly in men aged: A) under 15 B) 15-49 C) 50-65 D) 65 and older
B) 15-49
During the examination of a full term newborn male, a finding requiring investigation would be:
A) absent testes
B) Meatus centred at the tip of the penis
C) wrinkled scrotum
D) penis 2 to 3 cm in length
A) absent testes
During transillumination of a scrotum, you note a nontender mass that transilluminated with a red glow. This finding is suggestive of: A) scrotal hernia B) scrotal edema C) orchitis D) hydrocele
D) hydrocele
How sensitive to pressure are normal testes? A) somewhat B) not at all C) left more sensitive then right D) only when inflammation is present
A) somewhat
The congenital displacement of the urethral meatus to the inferior surface of the penis is: A) hypospadias B) epispadias C) hypoaesthesia D) hypophysis
A) hypospadias
An ashesion of the prepuce to the head of the penis, making it impossible to retract is: A) paraphimosis B) phimosis C) smegma D) dyschezia
B) phimosis
The first physical sign associated with puberty in boys is: A) height spurt B) penis lengthening C) Sperm production D) pubic hair development E) testes enlargement.
E) testes enlargement.
What is Bartholin’s glands?
Vestibular glands located on either side of the vaginal orifice, that secrete a clear lubricating mucus during intercourse.
A bluish discolouration of cervix that occurs normally in pregnancy at 6 to 8 weeks gestation.
Chadwick’s Sign
What is dysmenorrhea?
Abdominal cramping and pain associated with menstruation.
What is hegar’s sign?
softening of cervix that is a sign of pregnancy, occurring at 10 to 12 weeks gestation.
Vaginal lubrication is provided during intercourse by: A) the labia minora B) sebaceous follicles C) skene's glands D) bartholin's glands
D) bartholin’s glands
A young woman has come for her first gynecological examination. Because the patient has not has any children, the examiner would expect the cervical os to appear: A) smooth and circular B) irregular and slitlike C) irregular and circular D) smooth and enlarged
A) smooth and circular
A woman has come for an examination because of a missed menstrual period and a positive home pregnancy test. Examination reveals a cervix that appears cyanotic. This is referred to as: A) Goodell's sign B) hegar's sign C) tanner's sign D) chadwick's sign
D) chadwick’s sign
During the examination of the genitalia of a 70 year old woman, a normal finding would be: A) hypertrophy of the mons pubis B) increase in vaginal secretions C) thin and spares pubic hair D) bladder prolapse
C) thin and spares pubic hair
For a woman, history of her mother's health during pregnancy is important. A medication that requires frequent follow up is: A) corticosteroid B) theophylline C) diethylstibestrol D) aminoglycoside
C) diethylstibestrol
A woman has come for health care complaining of a thick, white vaginal discharge with intense itching. These symptoms are suggestive of: A)atrophic vaginitis B) trichomoniasis C) chlamydia D) candidiasis
D) candidiasis
To prepare the vaginal speculum for insertion, the examiner:
A) lubricates it with warm water or a water-soluble lubricant
B) lubricates it with petrolatum
C) warms it under the light, then inserts it into the vagina
D) lubricates it with hot water
A) lubricates it with warm water or a water-soluble lubricant
To insert the speculum as comfortably as possible, the examiner:
A) opens the speculum slightly and inserts in an upward direction
B) presses the introitus down with one hand and inserts the blades obliquely with the other
C) spreads the labia with one hand, inserts the closed speculum horizontally with the other.
D) pushes down on the introitus and inserts the speculum in an upward direction
B) presses the introitus down with one hand and inserts the blades obliquely with the other
Select the best description of the uterus.
A) anterverted, round asymmetrical organ
B) pear-shaped, thick-walled organ flattened anteroposteriorly
C) retroverted, almond-shaped asymmetrical organ
D) midposition, thick-walled oval organ
B) pear-shaped, thick-walled organ flattened anteroposteriorly
In placing a finger on either side of the cervix and moving it side to side, you are assessing: A) the diameter of the fallopian tube B) cervical motion tenderness C) the ovaries D) the uterus
B) cervical motion tenderness
Which of the following is (are) normal, common finding(s) on inspection and palpation of the vulva and perineum/
A) Labia majora that are wide apart
B)palpable bartholins glands
C) clear, thin discharge from paraurethral glands
D) bulging at introitus during valsalva manoeuvre
A) Labia majora that are wide apart
Which of the following is the most common bacterial STI in Canada? A) HPV B) gonorrhea C) trichomoniasis D) syphilis E) bacterial vaginosis
A) HPV
