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ME 536- Patient Care II > Male Genitourinary Exam > Flashcards

Male Genitourinary Exam Flashcards

1
Q

What is the shaft of the penis made of

A

3 columns of vascular erectile issue (2 corpus cavernosum and spongiosum)

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2
Q

Corpus spongiosum contains ______ and forms _______

A

the urethra, the bulb

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3
Q

The shaft is composed of ______

A

2 corpus cavernosum

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4
Q

Foreskin aka _______

A

prepuce

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5
Q

Scrotum is divided into two pouches and each contain

A

a testis

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6
Q

The testes are _______cm long

A

4.5cm

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7
Q

Which testicle lies lower

A

Left usually lower than the right

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8
Q

The function of the testes are to

A

make sperm and testosterone

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9
Q

Serous membrane covering the testis, except posteriorly

A

Tunical vaginalis

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10
Q

Epididymis is located on the ___________ surface

A

posteriolateral

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11
Q

What is within the epididymis

A

storage, maturation, transport of sperm

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12
Q

The epididymis can be confused for

A

a mass

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13
Q

Cordlike structure, beginning at the tail of the epididymis

A

Vas deferens

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14
Q

Epididymitis can be confused for

A

testicular torsion

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15
Q

The vas deferens is part of the

A

spermatic cord

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16
Q

Where does the vas deferens pass through

A

external inguinal ring

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17
Q

What does the seminal vesicle produce and where does it enter

A

seminal fluid, prostate gland

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18
Q

Anterior superior iliac spine (ASIS)
pubic tubercle
inguinal ligament

A

landmarks of the groin

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19
Q

Inguinal canal lies

A

above and parallel to the intgional ligament

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20
Q

The inguinal canal forms a tunnel for the

A

vas deferens

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21
Q

Exterior opening of inguinal canal

A

external intgional ring

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22
Q

Internal opening of inguinal canal

A

Internal inguinal ring

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23
Q

Where does the GI canal terminate

A

rectum and anus/anal canal

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24
Q

What two muscles hold the anal canal in position

A

the voluntary external anal sphincter and involuntary internal anal sphincter

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25
Q

Where does the angle of the anal canal lies roughly

A

between the anus and umbilicus

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26
Q

What nerves supply the anal canal

A

somatic sensory nerves

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27
Q

What demarcates the anal canal from the rectum

A

serrated line

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28
Q

Boundary between somatic and visceral nerve supplies

A

anorectal junction

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29
Q

The rectum serves as

A

storage for stool

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30
Q

The prostate is located

A

against the anterior rectal wall

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31
Q

What is the shape of the prostate

A

Rounded, heart shaped, size of a walnut (like a peach)

32
Q

Anatomical lobes of the prostate

A

anterior, median, right lateral, left lateral

33
Q

What are the only palpable lobes of the prostate

A

lateral lobes (right and left) and median sulcus

34
Q

Zones of the prostate

A

Central- around ejaculatory ducts
Transitional- surrounds the urethra
Peripheral- located posteriorly

35
Q

When do you do a sexual history

A

new patient comprehensive
annual check
patients with chronic illness/medications
major life cycle events
major surgical procedures

36
Q

When do you ask men about their sexual history

A

social history during relationships

37
Q

5Ps of sexual history

A

Partners: number of partners
Practices: risk assessment
Protection from STI
Past history of STI
Prevention of pregnancy

38
Q

Are you able to get an erection, maintain an erection, erections firm enough for intercourse, morning wood, problems with ejaculation
discharge from penis, sores, ulcers
testicular pain, testicular masses, pain in the scrotum
use of contraception, infertility
protection against STI

A

Specific ROS of questions for men

39
Q

Pediatric male genital exam

A

always be with a guardian or chaperone

40
Q

Adolescent or young adult male genital exam

A

palpation of anorectal or genital areas a chaperone is recommended

41
Q

Male GU exam is usually saved for

A

last

42
Q

best to have the patient standing and the examiner

A

sitting

43
Q

Proper clothing attire for male GU exam

A

gown on and remove underwear

44
Q

What happens if a dude gets a boner during the exam

A

stay professional and unflustered, “it is normal for that to happen” and continue the exam in a professional way

45
Q

Inspect the skin, ventral and dorsal surfaces
inspect the foreskin
inspect the glans
inspect the urethral meatus
palpate for any induration (not usually done in asymptomatic patient)

A

examination of the penis

46
Q

Smegma

A

white, cheesy material that can accumulate under foreskin (normal)

47
Q

How do you inspect for discharge

A

compress the urethral meatus slightly to look for discharge

48
Q

How do you palpate the testis

A

one handed: between thumb and first 2 fingers
Two handed: cradle the testicle at both poles in the thumb and fingertips of both hands

49
Q

What are you assessing for with testicle exam

A

size, shape, consistency, presence of nodules, tenderness

50
Q

What should testicles feel like

A

firm but not hard, non-tender and no masses

51
Q

What does the epididymis feel like with palpation

A

feels like a cord and is a bit nodular

52
Q

What does the vas deferens feel like with palpation

A

firmer and wire-like compared to the rest of the spermatic cord

53
Q

Where do you palpate the epididymis and the spermatic cord

A

posteriorly

54
Q

protrusion, bulge or projection or an organ or a part of an organ through the body wall that normally contains it

A

hernia

55
Q

what are common sites for hernias

A

umbilical
groin
inguinal (more common in males) direct or indirect
femoral (more common in females)

56
Q

Reproducible hernia

A

organ (bowel) can be pushed back into the correct location

57
Q

incarcerated hernia

A

organ or part of the organ is trapped and can’t be pushed back (irreducible)

58
Q

strangulated hernia

A

loss of blood supply to the trapped part of the organ

59
Q

What hernia are women more likely to get

A

femoral hernia

60
Q

Femoral hernia

A

least common, come through the femoral ring and start below the inguinal ligament and never travel to the scrotum

61
Q

How do femoral hernias present

A

40% present as emergencies with incarceration or strangulation

62
Q

Hesselbach’s triange

A

Rectus abdominis
Inferior epigastric artery and vein
Inguinal canal

63
Q

Inguinal hernias are located

A

above the inguinal ligament and extend below it

64
Q

Direct inguinal hernia

A

less common, usually in men >40
begin above inguinal ligament near public tubercle and external inguinal ring (within Hesselbach’s triangle)
Often due to a weakness in floor of the inguinal canal

OUTSIDE PUSHING ON CANAL

65
Q

Indirect inguinal hernia

A

most common, occurs in all ages and both genders
begin above inguinal ligament near its midpoint (internal inguinal ring) and travel through the inguinal canal and into the scrotum

GOES INTO SCROTUM

66
Q

What does turning head and cough do

A

increase abdominal pressure

67
Q

Examine for a hernia the patient should be

A

standing

68
Q

Where are you palpating for a hernia

A

external inguinal ring

69
Q

If a scrotal mass disappears after a patient lies down

A

it is a hernia

70
Q

If a scrotal mass remains after a patient lies down you need to

A

listen to it for bowel sounds
transilluminate it, if a red glow, likely not a hernia

71
Q

When do you do a rectal and prostate exam

A

colon cancer screening, evaluating GU symptoms, possible GI bleeding

50 with discussion

72
Q

What are the 2 positions for rectal exam

A

patient standing; lean forward and rest on exam table with hip flexed

Patient lying on the side with knees and hips flexed

73
Q

How do you do a rectal exam

A

separate the cheeks of the buttocks, inspect peri-anal area, digital rectal exam (wait for sphincter to relax- assess for tone, tenderness, irregularity and nodules)

74
Q

)The rectal exam will be _______ but not ________

A

uncomfortable, painful

75
Q

During the digital rectal exam you should insert your finger

A

as far as possible, rotate clockwise and counterclockwise

stool moves, masses do not

76
Q

USPSTF Recommendation for prostate cancer screening

A

Men aged 55-69 years C
Men over 70 D

77
Q

If a hemorrhoid is below the dentate line It will tend to be

A

painful

ME 536- Patient Care II (8 decks)

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