Health Exam 4 - Male systems

What are the external structures of the male genitalia?

Penis

Scrotom

What are the internal structures of the male genitalia?

testes

Spermatic cord/ vas deferens

Epididymis

What is the accessary gland for a male?

Prostate gland

What are the 3 cylindric columns of erectile tissue in the penis?

Corpus cavernosa - 2 - dorsal side

Corpus spongiosum - 1 - ventral side

For urination and reproduciton

What is the corona?

Sections where glands joins the shaft

What is the urethra?

Inside shaft - for urinary system

What is the prepuce?

The foreskin - glands covered with fold of skin

What is the frenulum?

Where foreskin meets the underside of penis, a small V skin fold

What does the scrotum hold and its function?

Holds two testes

Function - keeps testes at right temperature

What are the cremasteric muscles and its function?

Controls size of scrotum by responding to temperatures

Cold = contraction

Warm - relaxed and lowers

Where does the sperm stored and mature?

The epididymis

What happens to the prostate with age?

It get enlarged due to a change a hormone imbalance and cell growth

What can happen if the prostate is enlarged and left untreated?

Bladder urinary tract or kidney problems

How do you inspect the inguinal area (groin)?

Ask pt to turn his head and cough or bear down as if he were having bowel movements

If bulges appear = indicate a hernia

What is a femoral hernia?

Portion of intestine bulges through femoral canal

What is a inguinal hernia?

A portion of intestine bugles into the inguinal canal

How do you palpate for a hernia on the right side?

Pt will shift his weight to the opposite legs, left leg

What are the inguinal hernia signs/ symptoms?

A bulge in the groin area, becomes more obvious when clients is upright and coughs/strains

Pt will have a burning/ aching sensation

What is some important subjective data?

Scrotum - undescended testicles, bulging, swelling, lumps, masses, self exam testes

What does the term cryptorchidism mean?

Undescended testicles

How do you palpate for urethral discharge?

Gently squeeze the glands between the thumb and index finger in order to visualize the discharge

What is the purpose of smegma?

To provide protections and lubrication to the penis

A secretion in the skin folds

What is hypospadias?

Displacement of urinary meatus in the ventral surface of penis

What is epispadiasis?

Displacement of urinary meatus in the dorsal surface of the penis

What is priapism?

Prolonged erection of penis 2-4 hrs, higher in those w sickle cell anemia

If not treated = Necrotic

What is hydrocele?

Enlarged scrotal sac results from fluid/serous fluid collection

What is a varicocele?

Enlargement of veins within the scrotum.

What is an indication of hydrocele or spermatocele?

they will light up with a red glow with transilumination

How do you indicate hematocele or tumors?

There will be no transillumination

Who is at risk of getting Testicular cancer ?

Men who had undescended testicles at birth or men who are infertile

When should you self examine your testicles?

Monthly, every 4 weeks after a warm bath or shower so the scrotum can be relaxed

What is testicular torsion?

Sudden twisting of spermatic cord

What is spermatocele?

Fluid filled sack in the epididymis

What is prehns sign?

Pain relieved by elevation of the testes/scrotum caused by epididymitis

What is Phimosis?

Foreskin, non retractable over penis tip

What is parapimosis?

Inability to replace the foreskin, pain and swelling

What happens if parapimosis is untreated?

Gangrene will occur on the penis

What happens when foreskin if left in a retracted position in parapimosis?

Leads to venous congestion and edema of the foreskin

What is orchitis?

Inflammation of the testes, associated with mumps- infertility

Symptoms - Pain, swelling, heaviness, fever

Does transillumination occur with orchitis?

NO

What is peyronie disease?

Development of non cancerous fibrous scare tissue, hard, non tender sq plaques on dorsal or lateral surface of penis

What are some results of peyronie disease?

Erectile dysfunction

Where is the prostate gland located?

In front of anterior rectal wall behind synthesis pubis, surrounds bladder neck and secretes milks alkaline fluid

What separates the prostate gland?

Median Sulcus

Where are the 2 pairs of seminal vesicles located and their function?

Posterior to the urinary bladder

Secrete fluid rich in fructose to provide energy for sperm and alkalinity to enhance sperm mobility

Where are the 2 bulbourethral located and their function?

Located behind prostate

Secretes clear viscous fluid before ejaculation

What indication suggests benign prostatic hypertrophy (BPH)??

An enlarged smooth, firm slightly elastic postage that may not have a median sulcus

What is prostatitis and its cause?

Inflammation of the prostate

Caused by a bacterial infection (E.coli)

What is a Digital rectal exam (DRE)?

Palpate the prostate through the rectum, classified as the amount of protrusion into the rectum

What age is recommended for a DRE?

After 40 yrs

What is a prostate specific antigen (PSA)?

PSA feels may be elevated in engine prostate hypertrophy or with infection or inflammation of the prostate

What is the normal range of PSA?

4ng - normal

What age is recommended for PSA?

50 or older

Do the testes decrease with age?

They DO NOT decrease in size

What are some abnormalities of the anus?

Hemorrhoids

Fissure

Pilonidal cyst (with tuff or hair)

What is a pilondial cyst?

Abnormal skin growth located at tailbone, at top buttocks and contains hair/skin

What is an annual fissure?

Tear in the anal muscle and lining, the opening where feces are excreted

A swollen skin tag is often present/ itching

What causes an Anal fissure?

Constipation

Passage of hard, large stools

inflammatory bowel disease

What is a perianal abscess?

A cavity of pus, caused by skin infection

Causes throbbing pain/redness/hard and tenderness/fever

What are hemorrhoids?

Painless papule caused by varicose veins

Internal - Above the anorectic junction

External - Below the anorectal line

May cause bleeding/itching

What is the management for hemorrhoids?

Rubber band ligation

Cryotherapy

Radio frequency ablation and laser therapy

Excision surgeries

What is Anal cancer and its symptoms?

Cancer of the annus

Bleeding/ pain/ itching/ discharge/ may be asymptomatic

What is the preferred position for rectum exams?

The left lateral position

Define melena and where it comes from

Black, tarry stool from bleeding higher up in the GI

What is occult blood?

Hidden blood in the stool

What is dyschezia?

Chronic constipation with defect reflex for defecation

What is encopresis?

fecal incontinence or soiling

Typically used for children or those who are bedridden with long periods of constipation

What is steatorrhea?

Excess fat in the stool

What is stress incontinence?

involuntary urine loss with physical strain, sneezing, or coughing

What is urge incontinence?

Involuntary loss of urine with abrupt desire to void

What is urge incontinence cause by?

Neurological diseases such as cerebrovascular accident or MS which impairs the sphincter to contract and relax

What is overflow incontinence?

Loss of urine with over distended bladder

What is a common cause of overflow incontinence?

Prostatic hypertrophy in men

Neuropathy is common in both genders

What is functional incontinence?

Inability to get to the bathroom in time or to understand the cues to void due to cognitive/mobility problems

What are some sexually transmitted disease?

Gonorrhea

Chlamydia

Syphilis

Herpes 1 and 2

Genital warts

What are the symptoms of gonorrhea?

Foul smelling, green, yellow, white, discharge

May have epidiymitis, proctitis, pharyngitis

The epidiymitis can present as unilateral testicular pain without discharge or dyuria

What are the 4 stages of syphilis?

1. primary

2. secondary

3. latent

4. tertiary

What is the first symptoms of primary syphilis?

A small sore called chancre that is painless, within 2-4 weeks they erode to a red round oval, superficial ulcer with yellow discharge

What occurs in secondary syphilis?

A rash starts on the trunk of the body and eventually covers the entire body along with other symptoms

Hair loss/ fever/ sore throat/ fatigue/ weight loss/ swollen lymph nodes/ sores

What is the latent stage of syphilis ?

Known as the hidden stage and can last years

Without treatment the disease can cause major problems - neurological/ heart/ liver/ bone/joint

What is the treatment for syphilis?

Penicillin

What happens the tertiary stage?

Memory loss/ deafness/ paralysis/ neuro problems

What are some characteristics of herpes 1 and 2?

Painful, shallow, blister like vesicle lesions, ulcer and surrounded by erythema

Ulcer can be on penis and scrotum

What does HSV 1 cause?

Cold sores around mouth

What does HSV 2 cause?

Genital herpes, clustered and painful

What is the first symptoms of HPV?

Genital warts

Which HPV is the most common?

6 and 11

What are the characteristics of genital warts?

Firm, never shiny, moist, painless, and can be multiple like a cauliflower patch

Located behind the corona, shaft of penis and around the anus

Who is at risk of getting genital carcinoma?

Men with a history of cryptorchidism

What will be seen with penilie cancer?

Penis will be discolored with a lump, red, raised warty growth or an ulcer with watery discharge