Genitalia and back

Question 1

Rubric

Answer 1

Genitalia
Male – 7 Points
Penis – straight, curved (1)
Foreskin – do not retract (2)
Urethral meatus – midline, hypospadius, hyperspadius, patency by urination (2)
Scrotal sac - testicles – present….if not look in inguinal canal (2)

Female – 4 points
Labia (minora, majora) (1)
Urethral meatus – patency by urination (2)
Vagina – discharge can be present (1)

Anus – patent by stool (1)

Back – 10 points
Scapula – symmetry (1)
Lung sounds – auscultate posterior fields (4)
Spine – palpate each and every vertebrae (1)
Dimple? (1)
Hair tuft? (1)
Slate gray spots (formerly Mongolian spots)(1)
Gluteal folds – symmetrical (1)

Question 2

Genitalia, male

Answer 2

• -First assess the penis, is it straight or is there a curvature?
• -Look at the urinary meatus, can pull back on foreskin ever so slightly, but do not retract! Urethral meatus should be midline. Check for hypospadius or hyperspadius. Patency is confirmed by urination.
• -Next the scrotal sac is examined. Determine if testes are descended. To do this, keep one finger on the inguinal canal and then palpate down. Repeat for the other side. If one or the other has not descended look in inguinal canal. If not in inguinal canal, consult. Can order US.

Testicle reflex: in response to stroke, the testicle will rise.

Question 3

Genitalia, female

Answer 3

When assessing the female, you want to look at the labia majora and the labia minor. The majora will cover the minora fully in the term baby. Open the majora and the minora in order to assess the urethra. Patency is established by urination.

Examine the vaginal opening, there may be a skin tag and there may be some discharge. Note these.

Assess for anal wink. Stroke on the outside of stroke on the outside of the anus. The anal wink is contraction of the anal sphincter in resonse to pinprick stimulus of the perineum.

Question 4

Back and anus

Answer 4

Anus – patent established by stool

-Back - you want to assess the curvature of the back. Confirm that the spine is straigt.
-Scapula – symmetry
Lung sounds – auscultate posterior fields - done earlier.
Spine – palpate each and every vertebrae (1)
Dimple? (1)
Hair tuft? (1)
Slate gray spots (formerly Mongolian spots)(1)
Gluteal folds – symmetrical (1)
INCOMPLETE

Question 5

Hypospadius

Answer 5

An abnormal opening of the male urethra upon the undersurface of the penis. O a urethral opening into the vagina.

Question 6

Hyperspadius

Answer 6

An abnormal opening of the male urethra upon the upper surface of the penis (I am guessing).