male gu exam 3 Flashcards
common or concerning symptoms in male gu
-change in bowel habits
-blood in stool
-pain with defecation, rectal bleeding or tenderness
-anal warts of fissures
-weak stream of urine
-burning upon urination
Conduct a comprehensive male genital examination, including evaluation for hernias, rectum, and prostate problems
- Inspect the skin, prepuce, and glans (ulcers, scars, nodules, inflammation).
Inspect the urethral meatus (discharge), and, if indicated, strip or “milk” the penile shaft. - Palpate the shaft of the penis (induration, tenderness).
- Inspect the scrotum including skin, hair, and contour (lesion, swelling, veins, bulging masses, asymmetry).
- Palpate each testis including the epididymis and spermatic cord (presence, size, shape, consistency, symmetry, tenderness, masses, nodules).
- Perform special techniques as indicated:
o Evaluate for groin hernias:
Inspect for a groin bulge.
Palpate for an inguinal hernia (direct or indirect). Palpate for a femoral hernia.
o Evaluate for scrotal mass.
o Peduculosis pubis
lice or crabs
o Phimosis
tight prepuce that cannot be retracted over the penis
o Paraphimosis
= tight prepuce that, once retracted, cannot be returned. Edema ensues
o Balanitis
inflammation of the glans
o Balanoposthitis
inflammation of the glans and prepuce
hypospadias
congenital ventral displacement of the meatus on the penis
- Epispadias
congenital dorsal displacement of the meatus on the penis
common scrotal swellings
o Indirect inguinal swellings, hydroceles, scrotal edemas, testicular carcinoma
cryptorchidism
undescended testicle
. Summarize give patient education for testicular self-examination
- This examination is best performed after a warm bath or shower.This way, the scrotal skin is warm and relaxed. It is best to do the test while standing.
- Standing in front of a mirror, check for any swelling on the skin of the scrotum.
With the penis out of the way, gently feel your scrotal sac to locate a testicle. Examine each testicle separately. - Use one hand to stabilize the testicle. Using the fingers and thumb of your other hand, firmly but gently feel or roll the testicle between your fingers. Feel the entire surface. Find the epididymis. This is a soft, tube-like structure at the back of the testicle that collects and carries sperm and is not an abnormal lump. Check the other testicle and epididymis the same way.
- If you find a hard lump, an absent or enlarged testicle, a painful swollen scrotum, or any other differences that do not seem normal, do not wait. See your health care provider right away.
Recall the classification and presentation of hernias
- Direct hernia
o Bulge near external inguinal ring - Indirect hernia
o Bulge near the internal inguinal ring - Hernia is strangulated
o Blood supply to entrapped contents is compromised - Hernia is incarcerated
o Contents cannot be returned to abdominal cavity
what 3 columns of vascular erectile tissue form the shaft of the penis?
coprus cavernosum, corpus spongiosum (contains urethra)
what forms the bulb of the penis
corpus spongiosum
the testes (length, how they lie, what they produce)
- 4.5 cm long
-left lies lower than the right
-produce spermatozoa and testosterone
functions of the epididymis
provides a reservoir for storage, maturation, and transport of sperm
cowper’s or bulbourethral glands
a pair of pea shaped exocrine glands located posterolateral to the membranous urethra.
The bulbourethral gland or Cowper’s gland, which is homologous to the Bartholin’s gland in females, produces a pre-ejaculate that cleanses and lubricates the urethra prior to the arrival of the semen.
name the basic landmarks of the groin
anterior superior iliac spine, pubic tubercle, and the inguinal ligament
what forms a tunnels for the vas deferens
inguinal canal
