Chapter 19 Flashcards
1
Q
Testes job
A
Spermatogenesis
2
Q
Epidiymis job
A
Maturation of sperm
3
Q
Vas deferens job
A
Transport of sperm or urethra
4
Q
Seminal vesicles
A
Secretion to nourish sperm
5
Q
Prostate gland
A
Secretions to balance pH
6
Q
Cowper glands (bulbourethral)
A
Secretes alkaline mucus
7
Q
Penis
A
Ejeculation of semen
8
Q
Male hormones: follicle-stimulating hormone (FSH)
A
Initiates speratogenesis
9
Q
Male hormones: luteinizing hormone (LH)
A
Stimulates testosterone testosterone
10
Q
Male hormones: testosterone
A
Maturation of sperm, sex characteristics, protein metabolism, muscle development
11
Q
Congenital Abnormalities of the Penis: epispadias
A
Urethral opening on ventral or upper surface of the penis
12
Q
Congenital Abnormalities of the Penis: hypospadias
A
Urethral opening on dorsal surface (underside) of the penis
— either condition may result in incontinence or infection
13
Q
Treatment of epispadias and hypospadias
A
Surgical reconstruction
14
Q
Cryptorchidism
A
Testis fail to descend into scrotum properly
- reason not totally understood
15
Q
Ectopic testis
A
Testis positioned outside of scrotum
16
Q
Ectopic testis increased risk of what
A
Testicular cancer if not fixed by age 5
17
Q
Ectopic testis can cause what
A
Degeneration of seminiferous tubules and spermatogenesis
18
Q
Hydrocele
A
Occurs when excessive fluid collects in space between layers of the tunica vaginalis of the scrotum
19
Q
Hydrocele may result from what
A
Congenital defect
Injury, infection, tumor
20
Q
Hydrocele effects
A
Compromise blood supple or lymph drainage in testes
21
Q
Spermatocele
A
Cyst containing fluid and sperm that develops between the testis and epididymis
22
Q
Spermatocele may be related to what
A
Developmental abnormality
23
Q
Spermatocele treatment
A
Surgical remove all
24
Q
Varicocele
A
Dilated vein in the spermatic cord
- lack of valves allows back flow in veins; leads to increased pressure and dilation
25
Varicocele causes what
Impaired blood flow to testes and decreased spermatogenesis
26
Varicocele requires what
Surgery
27
Torsion of testes
Testes route on spermatic cord, compressing arteries and veins
28
Torsion of testes leads to what
Ischemia, scrotum swells
| Infaction of testes if torsion not reduced
29
Torsion of testes: cause
Spontaneous or follows trauma
30
Torsion of testes treatment
Manually and surgically
31
Prostatitis
Infection or inflammation of the prostate gland, most often caused by E. Coli
32
Prostatitis: Acute bacteria
Gland is tender and swollen, urine and secretions contain bacteria
33
Prostatitis: chronic bacterial
Gland only slightly enlarged, dysuria, frequency, urgency
34
Prostatitis: non bacterial
Urine and secretions contain large number of leukocytes
35
Prostatitis: asymtptomatic and inflammatory
Look up
36
Prostatitis usually what
Ascending infection
37
Prostatitis: occurs in who
```
Young men with UTIs
Older men with prostatic hypertrophy
STDs
Instrumentation (catheterization)
Through bacteremia
```
38
Prostatitis: treatment
Antibiotics (acute or chronic bacterial infection)
| Anti inflammatory drugs and prophylactic antibacterial agents
39
Prostatitis: symptoms
Pretty expected but go look on slide 11
40
Balanitis
Fungal infection of the glans penis
| - sexually transmitted
41
Balanitis: cause
Candida albicans
42
Balanitis: patho
Vesicles develop into patches; severe burning
43
Balanitis: treatment
Topical antifungal medication
44
Benign Prostatic Hypertrophy: what
Hyperplasia of prostatic tissue
- compression of urethra and urinary obstruction
45
Benign Prostatic Hypertrophy: related to what
Estrogen-testosterone imbalance
46
Benign Prostatic Hypertrophy: how can you discover it
Enlarged gland palpated on digital rectal examination
47
Benign Prostatic Hypertrophy: leads to what
Frequent infections
48
Benign Prostatic Hypertrophy: continues obstruction causes what
Distended bladder, dilated ureters, hydronephrosis, renal failure
49
Benign Prostatic Hypertrophy: s/s
```
Obstructed urinary flow / hesitancy starting urine flow
Dribbling
Decreased flow strength
Increased frequency and urgency
Nocturia
Dysuria occurs if infection is present
```
50
Benign Prostatic Hypertrophy: treatment
Drugs to slow enlargement
Tamulosin (smooth muscle relaxer)
Surgery
51
Prostate cancer: causes
High androgen levels, increased insulin-like growth factor, history of recurrent prostatitis
52
Prostate cancer: s/s
```
Hard nodule felt on periphery of gland
Hesitancy in urination
Decreased stream
Frequent urination
Recurrent UTI
```
53
Prostate cancer: diagnosis
Serum markers
- prostate-specific antigen (PSA)
- prostatic acid phosphate
Ultrasonography
- biopsy
- bone scans to detect metasteses
54
Prostate cancer: treatment
Surgery
Radiation
If androgen sensitive, then orchiectomy is effective, as well as antitestosterone drugs
New chemos are in clinical trials
55
What is the most common solid tumor in young men
Cancer of testes
56
Cancer of testes originates from what
One type of cell or mixed cells from various sources
57
Teratoma
Tumor consisting of mixture of different germ cells
58
Some malignant tumors secrete what? How is this helpful?
HcG or AFT, which serve as useful markers for diagnosis
59
Cancer of testes: typical spreading pattern
1. Appear in common iliac and para-aortic lymph nodes
2. Then to the mediastinal and supraclavicular lymph nodes
3. Then though the blood to the lungs, liver, bone and brain
60
Cancer of the testes: causes
Genetics (chromosome 12)
Predisposing factor (cryptorchidism)
Exposure to herbicides and other environmental agents
61
Cancer of testes: s/s
```
Hard, painless, unilateral tumor
Enlarged / heavy testes
Aching scrotum and pelvis
Hydrocele or epididymus May develop
Gynecomastia if tumor of hormone secreting
```
62
Cancer of testes: diagnosistic tests
```
Biopsy
Tumor markers
Ultrasound
CT
Lymphangiography
```
63
Cancer of testes: treatment
Combination of surgery, radiation, chemo
64
Vulva consists of what
Mons pubis and labia majora/minors
65
Mons pubis
Adipose tissue and hair covering the symphysis pubis
66
Labia majora and minora
Outer and inner thin folds of skin extending back and down from the mons pubis
67
Clitoris
Erectile tissue anterior to urethra
68
Vagina
Muscular, distensible canal extending upward from the Vulva to the cervix
69
Uterus
Muscular organ within which fertilized ovum may implant and develop
70
Cervix
Opening into uterus and neck of the uterus
71
Cervix: external os
Opening from vagina filled with thick mucus
| Prevents vaginal flora from ascending into the uterus
72
Cervix is composed of what
Internal and external os
73
Fallopian tubes (oviducts)
Tubes from ovaries to uterus
74
Ovaries
Produce ova and estrogen and progesterone hormones
75
Breasts
Glands produce colostrum and milk for newborn
| Adipose tissue
76
Cycle is how many days
May be from 21 to 45 days
77
Hormones and the men trial cycle: cycle consists of
Menstruation (days 1-5)
Endometrial proliferation and production of estrogen (days vary)
Maturation of ovarian follicle
Release of LH, causing ovulation
78
Process of the menstrual cycle
1. Follicle becomes the corpus luteum, produced progesterone
2. Vascularization of endometrium is preparation for implantation
º12 to 14 days prior to onset of next menstruation
79
What happens is implantation does not occur?
1. Corpus luteum atrophies
2. Uterine muscle contracts - ischemia
3. Endometrium degeneration
80
Normal position of uterus
Slightly anteverted and anteflexed
| Cervix downward and posterior
81
Structural abnormalities: Retroflexion of uterus
Uterus tipped posteriorly
May be excessively curved or bent
Marked retro version may cause back pain, dysmenorrhea, dyspareunia
In some cases, infertility may occur
82
Uterine displacement or prolapse: first degree
When cervix drops into vagina
83
Uterine displacement or prolapse: second degree
When cervix lies at opening to the vagina
| - body of uterus is in the vagina
84
Uterine displacement or prolapse: third degree
If uterus and cervix protrude through the vaginal orifice
- early stages of prolapse may be asymptomatic
- advanced stages cause discomfort, infection, and decreased mobility
85
Rectocele
Protrusion of the rectum into the posterior vagina
| - may cause constitution and pain
86
Cystocele
Protrusion of bladder into the anterior vagina
| May cause UTIs
87
Rectocele and Cystocele treatment
If severe, conditions are treated surgically to increase the support of the pelvic ligaments
88
Amenorrhea
Absence of menstruation
- may be primary or secondary
- primary = genetic
- secondary from hormonal balance
89
Dysmenorrhea
Painful menstruation caused by excessive release of prostaglandins as a result of endometrial ischemia
Usually begins a few days prior to menses lasts a few days after onset
NSAIDs for release
90
Premenstrual syndrome
Starts about 1 week before onset of menses; not exactly sure why this happens
Breast tenderness, weight gain, abdominal distention, bloating, irritability, emotional liability, sleep disturbances, depression, headache, fatigue
91
Premenstrual syndrome treatment
Individualized and may include exercise, limiting salt intake, use of oral contraceptives, diuretics, or antidepressant drugs
92
Abnormal menstrual bleeding cause
Usual cause is lack of ovulation, but a hormonal imbalances in the pituitary-ovarian axis may be a favor
93
Menorrhagia
Increased amount and duration of flow
94
Metrorrhagia
Bleeding between cycles
95
Polymenorrhea
Short cycles of less than 3 weeks
96
Oligomenorrhea
Long cycles of more than 6 weeks
97
Endometriosis
Endometrial tissue occurs outside the uterus
- responds to cyclical hormone changes
- bleeding leads to inflammation and pain
- fibrous tissue May cause adhesions and obstructions of the involved structures
98
Endometriosis cause
Unknown but thought to be linked to congenital in some cases
99
Endometriosis treatment
Hormonal suppression
| Surgical removal of ectopic tissue
100
Candidiasis
Form of vaginitis that is not sexually transmitted
| Cause: candida albicana
101
Candidiasis: opportunistic infection - how
Antibiotics
Pregnancy
Diabetes
Reduced host defenses
102
Candidiasis s/s
Red and swollen, intensely pruritic mucous membranes and a thick, white, curd like discharge
103
Candidiasis treatment
Antifungal meds
104
Candidiasis may extend where
Vulvar tissues
105
Pelvic Inflammatory Disease (PID): what
Infection of uterus, Fallopian tubes, and/or ovaries
| - may be acute or chronic
106
Pelvic Inflammatory Disease (PID): originates as what
As an ascending infection from lower reproductive tract
107
Pelvic Inflammatory Disease (PID): may occur because of what
Bacteremia
STD
Non-sterile abortion
Childbirth
108
Pelvic Inflammatory Disease (PID): scarring of tubes increases what
Risk of infertility and ectopic pregnancy
109
Pelvic Inflammatory Disease (PID): potential acute complications
Peritonitis
Pelvic abscesses
Septic shock
110
Pelvic Inflammatory Disease (PID): first sign.
Pelvic pain
- increased temp
- guarding
- nausea
- leukocytosis
- purulent discharge may be present
111
Pelvic Inflammatory Disease (PID): treatmetn
Aggressive antibiotic therapy in hospital
112
Leiomyoma (Fibroids): what
Benign tumor of the myometrium
| - usually multiple, well-defined, unencapsulated masses
113
Leiomyoma (Fibroids): common what
Reproductive years
114
Leiomyoma (Fibroids): s/s
Abnormal bleeding
May interfere with implantation
Often asymptomatic until large
115
Leiomyoma (Fibroids): treatment
Hormonal therapy or surgery
116
Leiomyoma (Fibroids): classification
By location
117
Ovarian cyst
Usually multiple, small, fluid-filled sacs (variety of types)
Physiological type lasts about 8-12 weeks and disappears without complications
118
When are ovarian cysts serious
When bleeding occurs, inflammation occurs
119
Ovarian cyst treatment
Surgical intervention
120
Ovarian cyst diagnosis
Ultrasound or laparoscopy
121
Polycystic Ovarian Disease: what
Fibrous capsule thickens around follicles of ovary
122
Polycystic Ovarian Disease: s/s
Absence of ovulation and infertility
Hormonal imbalance
Amenorrhea
Hirsutism
123
Polycystic Ovarian Disease: treatment
May be surgical wedge resection or drugs
124
Fibrotic breast disease: what
Broad range of breast changes and increased density of breast tissue
125
Fibrotic breast disease: patho
Cyclic occurrence of nodules or masses in breast tissue
126
Fibrotic breast disease: increased risk of what
Increase risk of breast cancer is atypical cells are present
127
Fibrotic breast disease: increased density does what to breasts
Makes breast self-examination difficult
128
Increased risk of cystic masses with what lifestyle habit
Caffeine intake
129
Carcinoma of the breast: most arise from what
Most arise from ductal epithelial cells
130
Carcinoma of breast: metastasize
Metastasis occurs via lymph nodes early in course of disease
131
Carcinoma of breast: most tumors are what
Unilateral
132
Carcinoma of breast: what influences treatment
Presence of estrogen and progesterone receptors on tumor cells
133
Carcinoma of breast: earlier onset associated with what
More aggressive growth
134
Carcinoma of breast: incidence
Incidence increases after 20 years old
| Most cases in women between 50 and 69 years
135
Carcinoma of breast: predisposing factor s
```
First-degree relative with the disease
Genetics
Longer and higher exposure to estrogen
Nulliparous or late first pregnancy
Lack of exercise
Smoking
High fat diet
Radiation therapy to chest
Cancer of uterus, ovaries or pancreas
```
136
Carcinoma of breast: initial sign
Single, small, hard, painless nodule
137
Carcinoma of breast: later signs
Distortion of breast tissue, dimpled skin, discharge of nipple
138
Carcinoma of breast: diagnosis
Mammogram
Ultrasound
Needle biopsy
139
Carcinoma of breast: treatment
```
Surgery
Lymph node removal
Radiation
Chemo
Hormone blocking agents
Estrogen receptor blockers
Drugs inhibiting estrogen production
```
140
Different breast cancer treatment drugs
Slide 37
141
Carcinoma of breast: how big is tumor when metestasis occurs
By the time tumor is 1-2cm in diameter
142
Carcinoma of breast: lymph node often involved
Axillary lymph node
143
Carcinoma of breast: secondary tumors
Bone
Lung
Brain
Liver
144
Carcinoma of cervix: cause
HPV
| - vaccines now exist against the causative stains of HPV
145
Carcinoma of cervix: prevention
Pap smears of cervical cells
| - start by age 20 or when sexually active (at intervals)
146
Pathophysiology of carcinoma of the cervix
Slide 40
147
Carcinoma of cervix: risk factors
```
Age < 40
HPV
Multiple partners
Early sexual intercourse
Smoking
Hx STD
```
148
Most common cancer in post menopausal women
Carcinoma of uterus
149
Carcinoma of Uterus: early indicator
Painless vaginal bleeding or spotting
150
Carcinoma of Uterus: risk factors
Age > 50
High dose estrogen hormone treatment without progesterone
Obesity
Diabetes
151
Carcinoma of Uterus: what cells
Arises from glandular epithelium
152
Carcinoma of Uterus: characteristics
Slow-growing but invasive
| Staging based on degree of localization
153
Carcinoma of Uterus: treatment
Surgery and radiation
154
Carcinoma of Uterus: what does NOT detect this cancer
Pap smear
155
Ovarian cancer: diagnosis
No reliable screening available
- large mass detected by pelvic examination
- transnational ultrasound
156
Ovarian cancer: why is it considered a silent killer?
Few diagnosed in early stage
157
Ovarian cancer: risk factors
```
Obesity
BRCA1 gene
Early menarche
Nulliparous or late first pregnancy
Use of fertility drugs
```
158
Ovarian cancer: what may protect
Oral contraceptives containing progesterone are someone protective
159
Ovarian cancer: treatment
Surgery and chemo
160
Infertility
Male and females
161
Infertility risk factors
```
Hormonal imbalances
Age of parents
Structural abnormalities
Infections
Chemo
Workplace toxins
Environmental factors
Idiopathic
```
162
Sexually Transmitted Diseases: bacterial infections
Chlamydial infection
Gonorrhea
Syphilis
163
Sexually Transmitted Diseases: viral infections
```
Genital herpes
Condylomata acuminata (genital warts)
```
164
Sexually Transmitted Diseases: protozoan infections
Trichomoniasis
165
Chlamydial infections: cause
Chlamydia trachomatis
166
Chlamydial infections: what’s effected in males
Urethritis and epididymitis
167
Chlamydial infections: s/s in males
Dysuria, itching, white discharge from penis (urethritis symptoms)
Painful swollen scrotum, usually unilateral, fever (epididymitis); inguinal lymph nodes swollen
168
Chlamydial infections: females
Often asymptomatic until PID or infertility develops
| Newborns may be infected during birth
169
Gonorrhea: cause
Neisseria gonorrhea
| Many strains have become resistant to penicillin and tetracycline
170
Gonorrhea: males
Most common site is urethra, which is inflamed
| Some males asymptomatic
171
Gonorrhea: females
Frequently asymptomatic
| PID and infertility are serious complications
172
Gonorrhea: newborns
May infect eyes of newborn, causing irreversible damage and blindness
173
Gonorrhea: spread
May spread systemically to cause septic arthritis
174
Syphilis: cause
Treponema pallidum (a spirochete)
175
Syphilis: primary stage
```
Presence of chancre at site of infection
- genital region
- anus
- oral cavity
Painless, firm, ulcerated nodule
```
176
Syphilis: s/s occur when
About 3 weeks after exposure
177
Syphilis: primary treatment
Lesion heals spontaneously but patient is still contagious
178
Syphilis: secondary stage
If untreated, flu-like illness with symmetrical rash (self limited but client remains contagious)
179
Syphilis: latent stage
May persist for years
| Transmission may occur
180
Tertiary syphilis
Irreversible changes
- gummas in organs and major bv
- dementia, blindness or motor disabilities
181
Tertiary Syphilis: transmission
Can be transmitted in utero
182
Tertiary Syphilis: baby born with it
Changes are not reversible
183
Tertiary Syphilis: treatment
Antimicrobial drugs
184
Syphilis: treatment cautions
Increase in antibiotic resistant strains causing an increase in prevalence
185
Herpes: cause
HSV-1 or HSV-2
186
HSV-1: transmission
Can be oral sex
187
Genital herpes: s/s
Recurrent outbreaks of blister-like vesicles on genitalia
- preceded by tingling or itching sensation
- lesions are extremely painful
188
Genital herpes: what happens after acute
Virus migrates back to dorsal root ganglion
189
Genital herpes: infection greater when
When symptoms are present
190
Genital herpes: reactivating is common and may be associated with what
- stress
- illness
- menstruation
191
Genital herpes: treatment
Antiviral drugs
192
Genital herpes: infection is considered what
Lifelong
193
Condylomata acuminata (Genital warts): cause
HPV
194
Condylomata acuminata (Genital warts): incubation period
Up to 6 months
195
Condylomata acuminata (Genital warts): symptoms
May be asymptomatic
- vary in appearance
- appear wherever contact with virus has occurred
196
Condylomata acuminata (Genital warts): can predispose to what
Cervial or vulvar cancer
197
Condylomata acuminata (Genital warts): treatment
Can be removed by different methods
198
Trichomoniasis: cause
Trichomonas vaginalis - a protozoan parasite
| - localized infection
199
Trichomoniasis: men
Usually asymptomatic
200
Trichomoniasis: women
May be sub clinical
Flares up when microbial balance in vagina shift
Causes intense itching
201
Trichomoniasis: treatment
Systemic treatment necessary for both partners
