Epc08 - Male Genital Exam

Front 1

The Penis:

The shaft of the penis is formed by three columns of vascular erectile tissue:
-The ..., containing the urethra
-The two ...

The corpus spongiosum forms the bulb of the penis, ending in the cone-shaped ... with its expanded base, or ....

Back 1

corpus spongiosum
corpora cavernosa
glans
corona

Front 2

The Penis:

In uncircumcised men, the glans is covered by a loose, hoodlike fold of skin called the ... or foreskin where ..., or secretions of the glans, may collect.

The urethra opens into the vertical, slitlike urethral ....

Back 2

prepuce
smegma
meatus

Front 3

The Testes:

The testes are ovoid, somewhat rubbery
structures approximately 4.5 cm long.

The ... testis usually lies somewhat lower
than the ....

The testes produce spermatozoa and
testosterone.

Back 3

left
right

Front 4

The Testes:

-The ... is a loose, wrinkled pouch divided into two compartments, each containing a testis.
-Covering the testis, except posteriorly, is the serous membrane of the ....
-On the posterolateral surface of each testis is the softer comma-shaped ..., which provides a reservoir for storage, maturation, and transport of sperm.

Back 4

scrotum
tunica vaginalis
epididymis

Front 5

The Lower Genitourinary Tract:

-The ..., a cordlike structure, begins at the tail of the epididymis.
-It ascends within the scrotal sac (as the ...) and passes through the external inguinal ring on its way to the abdomen and pelvis.
-Behind the bladder it is joined by the duct from the seminal vesicle and enters the urethra within the prostate gland.

Back 5

vas deferens
spermatic cord

Front 6

look at slide 7-8

Back 6

ok

Front 7

Questions concerning the male genitalia may be classified into what 2 categories?

Back 7

sexual function
symptoms of infection

Front 8

In General:

-A good genital examination may be done with the patient either standing or supine.
-When checking for hernias, the patient should ... and the examiner ...

Back 8

stand
should sit on a chair or stool

Front 9

If a large scrotal mass is found, ask the patient to lie down. If the mass disappears, it ... a hernia.

If the mass remains:
-Listen to the mass with a stethoscope. If bowel sounds are heard, it ... a hernia.
-Shine a strong light from behind the scrotum through the mass (transillumination). If a red glow is observed, it ... a hernia.

Back 9

is
is
is probably not

Front 10

slide 22

Back 10

ok

Front 11

Emphasis: Evaluating a Possible Scrotal Hernia

-If you find a large scrotal mass and suspect that it may be a hernia, ask the patient to lie down.
-The mass may return to the abdomen by itself.
-If so, it ... a hernia.
-If not: Can you get your fingers above the mass in the scrotum?
-Listen to the mass with a stethoscope for ... sounds.

Back 11

is
bowel

Front 12

Examples of abnormalities (hernias):

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

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

Suspect ... in the presence of tenderness, nausea, and vomiting and consider ... intervention (sooner, not later).

Back 12

incarcerated
strangulated
strangulation
surgical

Front 13

If the hernia is found medial to the inferior epigastric vessels, is it direct or indirect?

Back 13

direct

Front 14

know slide 29

Back 14

ok

Front 15

When detected early, testicular carcinoma has an excellent prognosis.

Risk factors include ..., which confers a high risk for testicular carcinoma in the undescended testicle;
-a history of carcinoma in the contralateral testicle;
-mumps orchitis;
-an inguinal hernia;
-and a hydrocele in childhood.

Back 15

cryptorchidism

Front 16

Cryptorchidism:

The testis is atrophied and may lie in the inguinal canal or the abdomen, resulting in an undeveloped .... Cryptorchidism markedly increases the risk for ....

Back 16

scrotum
testicular cancer

Front 17

... (Condyloma acuminatum): are rapidly growing excrescences that are moist and often malodorous. They result from infection by human papillomavirus.

picture on slide 36

Back 17

Venereal Wart

Front 18

...:

A cluster of small vesicles, followed by shallow, painful, nonindurated ulcers on red bases, suggests this type of infection. The lesions may occur anywhere on the penis. Usually there are ... lesions when the infection recurs.

picture on slide 37

Back 18

Genital Herpes
fewer

Front 19

A ... usually appears as an oval or round, dark red, PAINLESS erosion or ulcer with an indurated base.
Nontender enlarged inguinal lymph nodes are typically associated.
... may be multiple and, when ... infected, may be painful.
They may be mistaken for the lesions of herpes.
They are infectious.

picture on slide 38

Back 19

syphilitic chancre
Chancres
secondarily

Front 20

... is a congenital displacement of the urethral meatus to the inferior surface of the penis. A groove extends from the actual urethral meatus to its normal location on the tip of the glans.
When discovered is a newborn, defer ... until after urologic consultation.

picture on slide 39

Back 20

Hypospadias
circumcision

Front 21

...:

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

picture on slide 40

Back 21

Peyronie's Disease

Front 22

...:

May appear as an indurated nodule or ulcer that is usually nontender. Limited almost completely to men who are not circumsized in childhood, it may be masked by the prepuce. Any persistent penile sore must be considered suspicious.

picture - slide 41

Back 22

Carcinoma of the Penis

Front 23

Scrotal Edema:

Pitting edema may make the scrotal skin ....
This may accompany the generalized edema of CHF or nephrotic syndrome.

picture – slide 43

Back 23

taught

Front 24

Scrotal Hernia:

A hernia within the scrotum is usually a/an ... inguinal hernia.
It comes through the external inguinal ring, so the examining fingers ... get above it within the scrotum.

picture – slide 44

Back 24

indirect
cannot

Front 25

Hydrocele:

A hydocele is a nontender, fluid-filled mass within the tunica .... It transilluminates, and the examinining fingers ... get above the mass within the scrotum.

picture – slide 47

Back 25

vaginalis
can

Front 26

...:

The testis is acutely inflamed, painful, tender, and swollen.
It may be difficult to distinguish from the epididymis.
The scrotum may be reddened.
Seen in mumps and other viral infections; usually ...lateral.

picture – slide 48

Back 26

Acute Orchitis
uni

Front 27

slides 49-50

Back 27

ok

Front 28

Acute Epididymitis:

An acutely inflamed epididymis is tender and swollen and may be difficult to distinguish from the testis.
The scrotum may be reddened and the vas deferens inflamed. It occurs chiefly in adults. Coexisting ... infection or ... supports the diagnosis.

slide 51

Back 28

urinary tract
prostatitis

Front 29

A painless, movable cystic mass just above the testis suggests a ... or an .... Both transilluminate. The former contains sperm, and the latter does not, but they are clinically indistinguishable.

slide 52

Back 29

spermatocele
epididymal cyst

Front 30

... refers to varicose veins (paminiform plexus) of the spermatic cord.
Usually found on the .... It feels like a soft “bag of worms” separate from the testis, and slowly collapses when the scrotum is ... in the supine patient.
Infertility may be associated.

slide 53

Back 30

Varicocele
left
elevated

Front 31

Torsion of the Spermatic Cord:

Torsion, or twisting, of the testicle on its spermatic cord produces an acutely painful, tender, and swollen organ that is ... upward in the scrotum. The scrotum becomes red and edematous. There is no associated ... infection.
Torsion, most common in ..., is a ... emergency because of obstructed circulation.

Back 31

retracted
urinary tract
adolescents
surgical