Male genital and hernias

Question 1

Prepubertal boys

Answer 1

1.5 to 2 cm in length

Question 2

Post puberty

Answer 2

4 to 5 cm

Question 3

Wrinkles the skin

Answer 3

Dartos muscle

Question 4

Draw scrotum toward abdomen

Answer 4

Cremaster muscle

Question 5

cloaks the anterior two thirds of the testis

Answer 5

Parietal layer

Question 6

lines the adjacent scrotum

Answer 6

Visceral layer

Question 7

If the peritoneal lining remains an open channel to the scrotum it can give rise to an

Answer 7

indirect inguinal hernia

Question 8

The parietal and visceral layers form a potential space for the abnormal fluid accumulation

Answer 8

hydrocele

Question 9

ejaculatory duct

Answer 9

2.5 cm long

Question 10

Formed when the vas deferens merges with the seminal vesicle

Answer 10

Ejaculatory duct

Question 11

The left testicular vein empties into the _________.

Answer 11

left renal vein

Question 12

The right

testicular vein empties into the _________.

Answer 12

inferior vena cava

Question 13

develop at the internal inguinal ring, where the spermatic cord exits the abdomen.

Answer 13

Indirect inguinal hernias

Question 14

arise more medially due to weakness in the floor of the inguinal canal and are associated with straining and heavy lifting.

Answer 14

Direct inguinal hernias

Question 15

are more likely to
present as emergencies with bowel
incarceration or strangulation.

Answer 15

Femoral hernias

Question 16

Most common, all ages, both sexes. Often in children; may occur in adults.

Answer 16

Indirect inguinal hernias

Question 17

Less common. Usually in men older than 40 yrs; rare in women.

Answer 17

Direct inguinal hernias

Question 18

Least common. More common

in women than in men

Answer 18

Femoral hernias

Question 19

Above inguinal ligament, near its midpoint (the internal inguinal ring).

Answer 19

Indirect inguinal hernias

Question 20

Above inguinal ligament, close to the pubic tubercle (near the external inguinal ring).

Answer 20

Direct inguinal hernias

Question 21

Below the inguinal ligament; appears more lateral than an inguinal hernia. Can be hard to differentiate from lymph nodes.

Answer 21

Femoral hernias

Question 22

Often into the scrotum. The hernia comes down the inguinal canal and touches the fingertip.

Answer 22

Indirect inguinal hernias

Question 23

Rarely into the scrotum. The hernia bulges anteriorly and pushes the side of the finger forward.

Answer 23

Direct inguinal hernias

Question 24

Never into the scrotum. The inguinal canal is empty.

Answer 24

Femoral hernia

Question 25

suggest lice (crabs) or sometimes scabies in the pubic hair.

Answer 25

Pubic or genital excoriations

Question 26

is a tight prepuce that cannot | be retracted over the glans

Answer 26

Phimosis

Question 27

is a tight prepuce that, once retracted, | cannot be returned. Edema ensues.

Answer 27

Paraphimosis

Question 28

Is inflammation of the glans;

Answer 28

Balanitis

Question 29

is inflammation of the | glans and prepuce.

Answer 29

balanoposthitis

Question 30

is a congenital ventral displacement of the meatus on the penis

Answer 30

Hypospadias

Question 31

Profuse yellow discharge signals

Answer 31

gonococcal urethritis

Question 32

scanty white or | clear discharge signals

Answer 32

nongonococcal | urethritis

Question 33

Induration along the ventral surface | of the penis suggests a ______ or possibly a _______.

Answer 33

urethral stricture | carcinoma

Question 34

Tenderness in the indurated area suggests _______ from a urethral stricture.

Answer 34

periurethral inflammation

Question 35

There may be dome-shaped white or yellow papules or nodules formed by occluded follicles filled with keratin debris of desquamated follicular epithelium.

Answer 35

Epidermoid cysts

Question 36

A poorly developed scrotum on one or | both sides suggests

Answer 36

cryptorchidism

Question 37

Erythema and mild excoriation point to ________, not uncommon in this moist area

Answer 37

fungal infection

Question 38

the primary site of lymph node | involvement in testicular cancer

Answer 38

inferior vena | cava

Question 39

The vas deferens, if ________, may feel thickened or | beaded.

Answer 39

chronically | infected

Question 40

A cystic structure in the | spermatic cord suggests a _____________.

Answer 40

hydrocele | of the cord

Question 41

A bulge near the external inguinal | ring suggests a _________

Answer 41

direct inguinal hernia

Question 42

A bulge near the internal inguinal ring | suggests an ______________

Answer 42

indirect inguinal hernia

Question 43

Experts note that distinguishing the type of hernia is difficult, with sensitivity and specificity of _______, and ______.

Answer 43

74% to 92% | 93%

Question 44

A hernia is _________ when its contents cannot be returned to the abdominal cavity.

Answer 44

incarcerated

Question 45

A hernia is ________ when the blood supply to the entrapped contents is compromised

Answer 45

strangulated

Question 46

A congenital displacement of the urethral meatus to the inferior surface of the penis. The meatus may be subcoronal, midshaft, or at the junction of the penis and scrotum (penoscrotal).

Answer 46

Hypospadias

Question 47

Pitting edema may make the scrotal skin taut; seen in heart | failure or nephrotic syndrome.

Answer 47

Scrotal Edema

Question 48

Palpable, nontender, hard plaques are found just beneath the skin, usually along the dorsum of the penis. The patient complains of crooked, painful erections.

Answer 48

Peyronie Disease

Question 49

A nontender, fluid-filled mass within the tunica vaginalis. It transilluminates, and the examining fingers can palpate above the mass within the scrotum

Answer 49

Hydrocele

Question 50

An indurated nodule or ulcer that is usually nontender. Limited almost completely to men who are not circumcised, it may be masked by the prepuce. Any persistent penile sore is suspicious

Answer 50

Carcinoma of the penis

Question 51

Usually an indirect inguinal hernia that comes through the external inguinal ring, so the examining fingers cannot get above it within the scrotum.

Answer 51

Scrotal Hernia

Question 52

Small firm testes usually | ≤2 cm suggest _____________.

Answer 52

Klinefelter syndrome

Question 53

refers to gravity-mediated varicose veins of the spermatic cord, usually found on the left. It feels like a soft “bag of worms” in the spermatic cord above the testis, and if prominent, appears to distort the contours of the scrotal skin.

Answer 53

Varicocele