Male GU Flashcards
(48 cards)
What is in the ROS for male GU?
Urine first: Frequency of urination, urgency, hesitancy, retention
burning, pain with urination, polyuria, nocturia, hematuria, renal stones, reduced caliber of stream
Think Anatomy * Hernias, testicular pain or masses
penile discharge or lesions, STI’s and Tx’s, exposure to HIV, are you taking any precautions against HIV and STI’s?
Sexual interest, orientation, function -satisfaction/problems. What are your methods of contraception, ask about abuse
Why are men so difficult to communicate with?
- males hesitate to speak
- don’t feel comfortable
- anxiety is high and unexpressed
- they feel embarrassment
- Gender and age may affect interactions.
What constitutes professional demeanour?
- competence helps with patient trust confidence- or lack of it- can decrease or increase anxiety
- Acknowledge- patient’s bodily responses
- Always make patient comfortable
- Ask permission before proceeding
- Be respectful always,
- make the pt feel at ease with bodily responses “its a normal process”
PMhx Screening, what are age appropriate questions?
- Date of last prostate exam
- Date of last PSA and result if known
- Date of last testicular exam
- Gardasil? Zostavax?
When obtaining a sexual history what can you ask?
Age of first coitus, number of sexual partners, how is your satisfaction? and problems? heamtospermia. Abuse, contraceptive/protection, privacy
When you ask questions make sure they are:
open ended.
Why is anxiety high an unexpressed in males about GU concerns?
- They have anticipation of pain/discomfort
- Lack knowledge about proc
- previous bad experience with GU exam
- “urban legends” from friends
Why are males reluctant to seek preventitive healthcare or acknowledge need of assistance?
- access to health information is often limited: only look at media sources, internet, physician/clinician information available, go based off what family tell them.
- health beahaviors often neglected
How can your build the relationship with your male patient?
- ask open ended questions
- Maintain non-judgmental, respectful attitude
- Display tact, sensitivity, and humor when appropriate.
- explain what you are doing as you are doing it
- ask permission before proceeding
- pt consent is essential for invasive proc
What is the patients attitude affected by?
- cultural or religious beliefs
- previous positive or negative experiences
- what their friends tell them
What constitutes being sensitive towards your patient?
- Give the pt privacy to dress and undress
- Use drape to limit exposure
- Allow patient to cover up after exam
- Offer a tissue for cleaning.
Know anatomy for exam
Im not going to list it cause girl you know it :p
During a focused exam your are noting?
- any external abnormalities
- screening opportunity for testicular ca
- detection of hernias, swelling, or masses.
Relate findings and discuss them immediately with your patient
Before beginning the GU exam you should?
- explain the proc to the pt (diagrams or address pts concerns)
- Chaperone always
- Always wear gloves
- Perform exam with proper lighting
How should you position the patient?
Have pt lay in front of you and YOU raise his gown to umbiliquis
- note buldges or scars (herniation)
- look for obvious penile/scrotal abnormalities
- note any skin abnormalities on the penis, scrotum, or surrounding areas
How should you inspect the penis?
- first retract the foreskin (note circumcised or uncircumsized)
- Inspect glans (not inflamation, ulcers, nodules, or poor hygiene)
- return the foreskin to its natural position
- note location of urethral meatus (not discharge)
- palpate the shaft
Inspecting the scrotum you examine what ?
The skin of the scrotum, contour, swelling or buldges, testicles, epididymus
How do you perform testicular palpation?
-Gently palpate the tissue of the testes between thumb and forefinger—-> each side should feel the same.
-Palpate from the epididymus to superficial inguinal ring
- If a testicle is missing, ask the pt why
surgically or cogenitally -> document why
- make not of an swelling, erythema, pain, nodules
Cremastor reflex
-elicitated by light stroke of the superior medial (inner) thigh activates sensory nerve L1, L2
Nml finding - rise and fall of scrotum
What diagnosis is associated with testicular ca?
cryptoorchidism
What diagnosis is transilluminate?
The celes: hydrocele & spermatocele
Varicocele are tender ? T or F
False, the diagnosis that are tender are epididymitis, torsion, anteverted epididymitus.
The femoral canal lies _____ in relation to the inguinal ligament
below the inguinal ligament
What are the three surrounding structures of the hasselback triangle
- inferior epigastric (lateral)
- rectus abdominus (medial)
- inguinal ligament (inferior)
