Health Assessment Exam #6

Front 1

Cremasteric muscle

Back 1

Contracts and relaxes the scrotum. This action alters the distance of the testes from the body to cool or warm the testes/ regulates the testicular temperature.

Front 2

Vas Deferens

Back 2

Begins at the end of the epididymis, travels the spermatic cord, goes through the inguinal canal, then unites with the seminal vesicle to form the ejaculatory duct.

Front 3

Urethral Orifice

Back 3

Located 2mm to the tip of the glans.

Front 4

Hypospadia

Back 4

The urethral meatus is on the ventral surface of the glans. (underside)., an abnormal condition in males in which the urethra opens on the under surface of the penis

Front 5

True

Back 5

True or False?
It is normal for the penis and testicles to be of a darker pigmentation than the body skin.

Front 6

Spermatogenesis

Back 6

The production of sperm that is dependent on the maintenance of testicular temperature below the normal body temperature of 98.6 degrees F or 37 degrees C.

Front 7

Smegma

Back 7

Usually found below the retracted skin of the uncircumcised male. It is a cheesy white material that is formed by the secretion of sebaceous material by the glans and the desquamation of epithelial cells from the prepuce; lubricates the cavity between the foreskin of the penis and the glans, allowing smooth movement between them during intercourse.

Front 8

Phimosis

Back 8

An abnormal tightness of the foreskin preventing retraction over the glans. Usually congenital or related to recurrent infections or diabetes. The foreskin cannot easily be retracted. Retracting the foreskin could lead to further adhesion formation. Ask patient about history or any infections.

Front 9

Paraphimosis

Back 9

Difficulty replacing the retracted foreskin of the penis to its normal position after it has been retracted behind the glans.

Front 10

Scrotal thickening with Pitting Edema

Back 10

Usually seen on males with history of cardiac, renal or hepatic disease. This is caused by fluid retention.

Front 11

Prostate gland.

Back 11

The major volume of ejaculatory fluid comes from

Front 12

Indirect Hernias

Back 12

Hernias found within the inguinal canal are called _________ __________.

Front 13

Hernia

Back 13

If a mass can be reduced, or pushed back into place, it is suggestive of a __________.

Front 14

Hydrocele

Back 14

If it feels fluid filled, use a light for trans illumination to verify if it is fluid filled as this is suggestive of a ________.

Front 15

Older Male

Back 15

Ejaculatory volume increases with age, erections develop more slowly, sperm viability decreases, and the scrotum becomes more pendulous.

Front 16

Inguinal hernias

Back 16

the most common type of hernia in children.

Front 17

12

Back 17

Sexual differentiation in the fetus occurs by week __ of gestation.

Front 18

Testicular Torsion

Back 18

The twisting of the spermatic cord, which cuts off the blood supply to the testicle and surrounding structures within the scrotum. Nausea is also common with this condition. The cremasteric reflex is absent also. {This reflex is elicited by lightly stroking the superior and medial (inner) part of the thigh (direction of stroke is irrelevant). The normal response is an immediate contraction of the cremasteric muscle that pulls up the testis on the side stroked (and only on that side). }

Front 19

Epididymitis

Back 19

Swelling (inflammation) of the epididymis, the tube that connects the testicle with the vas deferens

Front 20

Penile erection

Back 20

_______ _______ occurs when 20-50ml of blood is contained in the corpora cavernosa.

Front 21

Orchitis

Back 21

Swollen, tender testis; this is uncommon unless seen as a complication of mumps in the adolescent or adult.

Front 22

Peyronie disease

Back 22

Fibrous band in the corpus cavernous. It results in unilateral deviation of the penis during erection.

Front 23

Testicular Cancer

Back 23

Common in males 15-30 years of age. Self examination should be strongly encouraged. Monthly self-examination is recommended as a screening test well as sexually transmitted infections for all males starting at 15 years of age. It is encouraged during bathing because the scrotal skin is less thick at this time and because the scrotum hangs looser because of the warmth. Inspection is first, followed by palpation.

Front 24

Diabetic neuropathy

Back 24

Can cause a reduction in tactile perceptions; insensitivity to painful stimulation.

Front 25

Syphillis

Back 25

A painless indurated lesion with a clear base can form on the glans penis from this STD.

Front 26

Genital Herpes

Back 26

In males presents as painful superficial vesicles on an erythematous base.

Front 27

Condyloma Acuminatum

Back 27

Genital warts, soft, reddish lesions that present on the prepuce, glans penis, and shaft. These lesions can undergo malignant degeneration.

Front 28

Molluscum contagiosum

Back 28

Smooth, dome-shaped lesions with an umbilicated center of a pearly gray color due to poxvirus.

Front 29

Autonomic nervous system.

Back 29

The adult internal sphincter is controlled by the?

Front 30

Defecate

Back 30

When the rectum fills with feces, the sensation to _________ is the result.

Front 31

Rectum, Sigmoid Colon

Back 31

Ascending from the anus is the _________, then the _____________, which is at the proximal end of the rectum.

Front 32

Imperforate anus

Back 32

Failure to pass meconium stool. Lightly touching the anal opening of an infant should produce a contraction referred to as the anal wink. Not having the wink may indicate a lower spinal cord lesion.

Front 33

Hirschsprung disease

Back 33

A consistently empty rectum in the presence of constipation; failure to pass meconium in the first 24 hours of birth along with a gradual onset of abdominal distention and vomiting can be presenting signs. A disease of the large intestine that causes severe constipation or intestinal obstruction. Some children with this disease can't pass stool at all, which can result in the complete blockage of the intestines, a condition called intestinal obstruction. People with this disease are born with it and are usually diagnosed when they are infants.

Front 34

Penlight, lubricating jelly, gloves and fecal occult blood items.

Back 34

Equipment needed when examining the anus, rectum, and prostate are...

Front 35

Aging/Older Adult

Back 35

Elevated pressure threshold for the sensation of rectal distention and susceptible to constipation. They also experience fecal incontinence and prostate glandular hypertrophy. Urinary stream questions and questions related to dribbling should be asked of the older male since hypertrophy of the prostate can gradually impede urine flow. Prostate hypertrophy, when palpated feels smooth, rubbery, and symmetric.

Front 36

Prostate Cancer

Back 36

African American males have 50% more incidence than White males. A normal PSA score [prostate specific antigen] is less than 4 ng/mL. 4-10 scores are considered borderline. Older men have higher levels and may not be suggestive of disease. During exam, any hard, irregular and painless nodules usually indicate cancerous growth.

Front 37

Colorectal Cancer

Back 37

History of intestinal polyps, diets low in fiber and high in animal fats, and the ethnic background of Ashkenazi Jewish decent are all risk factors.

Front 38

Scarring or pressures from internal masses.

Back 38

Persistent pencil-shaped stools =

Front 39

Obstructive jaundice

Back 39

Light tan or gray stools=

Front 40

Upper intestinal tract bleeding

Back 40

Black tarry stools=

Front 41

Pinworms or Candida

Back 41

Can cause perirectal irritation and itching Pinworms, or enterobiasis are detected by applying cellulose tape to the perianal folds, then pressing the tape on a glass slide. The worms stick to the tape.

Front 42

Thrombosed Hemorrhoids

Back 42

Blue, shiny masses at the anus which contain clotted blood and are very edematous and painful.

Front 43

Lower spinal deformities

Back 43

Sinuses, tufts of hair, and dimpling in the pilonidal area may indicate _________ _________ _________ in an infant.

Front 44

increases

Back 44

Ejaculatory volume ____________ with age.

Front 45

Autonomic nervous system

Back 45

Coordinates the internal environment of the body by the sympathetic and parasympathetic nervous systems.

Front 46

Sympathetic nervous system

Back 46

Stimulation of the sympathetic branch of the autonomic nervous system prepares the body for emergencies for fight or flight [stress response].

Front 47

Parasympathetic nervous system

Back 47

Functions in complementary and counterbalancing manner to conserve body resources and maintain day to day body functions like digestion and elimination.

Front 48

Cerebellum

Back 48

Coordination of fine motor movements

Front 49

Cerebral Cortex

Back 49

Function consists of determining intelligence, personality, and motor function.

Front 50

Cerebrum

Back 50

Holds memories, allows you to plan and enable you to imagine and think.

Front 51

Temporal lobe

Back 51

Responsible for the perception and interpretation of sounds and determination of their source.

Front 52

Frontal lobe

Back 52

Contains the motor cortex associated with voluntary skeletal movement.

Front 53

Parietal lobe

Back 53

Recognition of body parts and awareness of body position [proprioception] are dependent on the parietal lobe. Olfactory sense is processed in the parietal lobe.

Front 54

Occipital lobe

Back 54

Primary vision center

Front 55

Wernicke area

Back 55

Reception of speech and interpretation of speech.

Front 56

Cranial Nerves

Back 56

Nerves that are peripheral nerves that arise from the brain rather than the spinal cord.

Front 57

Hypothalmus

Back 57

Major processing center of internal stimuli for the ANS, it maintains temperature control, water metabolism, body fluid osmolarity, feeding behavior, and neuroendocrine activity.

Front 58

Thalamus

Back 58

Major integrating center for perception of various sensations such as pain and temperature, servings as the relay center between the basal ganglia and cerebellum. Conveys all sensory impulse [not olfaction] to and from the cerebrum before their distribution to appropriate associative sensory areas.

Front 59

Epithalamus

Back 59

Houses the pineal body and is responsible for sexual development and behavior

Front 60

Cerebral Spinal Fluid

Back 60

Circulates between an interconnecting system of ventricles in the brain and around the brain and spinal cord....a shock absorber.

Front 61

Peripheral Neuropathy

Back 61

Disorder of the peripheral nervous system that results in motor and sensory loss in the distribution of one or more nerves, in hands and feet usually. A diminished sense of pain is one characteristic. A tuning fork should be used to check for decreased or absent vibratory sensation below the knees.

Front 62

Deep pressure sensation testing

Back 62

Squeeze trapezius, calf, or biceps muscle to cause discomfort. When superficial pain sensation is not intact, then further assessments of temperature and deep pressure sensation are performed.

Front 63

Cephalocaudal

Back 63

Motor maturation proceeds in a ____________ direction. Motor control of the head and neck develops first, followed by the trunk and extremities.

Front 64

Aging

Back 64

Sensory perception of touch and pain are diminished. Stimuli takes longer due to the velocity of nerve impulse slowing down. The number of cerebral neurons is thought to decrease by 1% a year beginning at 50 years of age. Because of the number of reserve cells, clinical signs do not readily appear.

Front 65

Circulatory

Back 65

__________ problems should be discussed with patient assessments/history as these may be associated with neuro defecits.

Front 66

Dermatome

Back 66

The area of body surface innervated by a particular spinal nerve

Front 67

Nerve Routes

Back 67

Nerve pathway and spinal accessory area

Front 68

stroke, aneurysm, and brain surgery.

Back 68

Neuro past medical history should include data concerning neurovascular problems such as __________, __________, and ________ __________.

Front 69

Inspection

Back 69

____________ starts and is the most often used technique for evaluating the neurologic system.

Front 70

Romberg test

Back 70

Tests for loss of balance; drunk driving test

Front 71

Finger to nose test

Back 71

Tests coordination and fine motor function.

Front 72

Cerebellar gait or Cerebellar ataxia

Back 72

Feet wide based with a staggering gait lurching from side to side and often swaying of the trunk.

Front 73

Dystonic ataxia

Back 73

Jerky dancing movements that appears non-directional.

Front 74

Steppage gait

Back 74

Hip and knee are elevated excessively high to lift the plantar flexed foot off the ground. The foot is brought down with a slap and the patient is unable to walk on the heels.

Front 75

Tabetic stamping

Back 75

When legs are positioned far apart, lifted high, and forcibly brought down with each step. The heel stamps the ground.

Front 76

Stereognosis

Back 76

The ability to recognize an object through touch and manipulation.

Front 77

Tactile agnosia

Back 77

The inability to recognize objects by touch [which usually suggests a parietal lobe lesion].

Front 78

Graphesthesia

Back 78

The ability to recognize a number traced on the skin.

Front 79

Brown-Sequard Syndrome

Back 79

Parietal spinal sensory syndrome when pain and temperature sensation occur one or two dermatomes below the lesion on the opposite side of the body from the lesion. Propioceptive loss and motor paralysis occur on the lesion side of the body.

Front 80

Patellar

Back 80

To assess spinal levels L2-L4, the _________ reflex should be tested.

Front 81

Monofilament Testing

Back 81

The monofilament is placed on several smooth spots of the patient's plantar foot for 1 second. Adequate pressure applied by the monofilament is measured by the bend of the monofilament.

Front 82

Triceps tendon reflex

Back 82

The triceps tendon when directly hit with the reflex hammer just above the elbow, will cause contraction of the triceps muscle and extension of the elbow.

Front 83

Ankle clonus testing

Back 83

This is tested when reflexes are hyperactive. Support he patient's knee in a flexed position and briskly dorsiflex the foot with your other hand. If clonus is present, there is recurrent ankle plantarflexion movement, as long as the examiner retains the foot in dorsiflexion. Sustained clonus signifies the hypertonia of an upper motor neuron lesion.

Front 84

Deep tendon reflex scoring

Back 84

+1= sluggish or diminished reflex
+2= active or expected response
+3= more brisk than expected
+4= brisk, hyperactive, intermittent or transient clonus.

Front 85

Nuchal rigidity

Back 85

Stiff neck, can be a sign associated with meningitis and intracranial hemorrhage. Lift head of patient to touch chin while patient lies in supine position. Pain and resistance to neck motion are associated with _________ ____________. The Brudzinski test should be the first test done.

Front 86

Brudzinski Sign

Back 86

Severe neck stiffness causes a patient's hips and knees to flex when the neck is flexed.

Front 87

Meningitis

Back 87

An inflammatory process in the meninges. It is a life threatening illness if not rapidly treated with appropriate antibiotics.

Front 88

Kerning sign

Back 88

Positive when the thigh is bent at the hip and knee at 90 degree angles, and subsequent extension in the knee is painful (leading to resistance).

Front 89

XII

Back 89

Test cranial nerve ___ by observing the infant suck and swallow: you may pinch the nose and observe for mouth to open and the tip of the tongue to rise in a midline position.

Front 90

VII

Back 90

Test cranial Nerve ___ by watching the infant's facial expression when crying.

Front 91

VIII

Back 91

Cranial Nerve ____ can be assessed by clapping your hands and watching the infant blink.

Front 92

Tonic neck reflex

Back 92

This must disappear before the infant can roll over or bring hands to his face. This should disappear by 6 months of age.

Front 93

Birth and 1

Back 93

Major brain growth and myelinization occurs between ____ and ___ year(s) old.

Front 94

Reduced, plantar, upward

Back 94

Older Adult: The ability to differentiate colors is ________ in older age. The _________ reflex can be diminished or absent, and there is a reduced ability to gaze ________.

Front 95

Guillain-Barre Syndrome

Back 95

Acute idiopathic polyneuritis is an acute polyradiculoneuropathy that commonly follows a nonspecific infection that occurred 10-14 days earlier. It is characterized by ascending symmetric weakness with sensation preserved. An increase in the severity occurs over days or weeks. A decrease or absent strength and sensory loss may result along with motor paralysis and respiratory muscle failure.

Front 96

Parkinson Disease

Back 96

A degenerative disorder of the central nervous system. The motor symptoms of this disease result from the death of dopamine-generating cells in the substantia nigra, a region of the midbrain; the cause of this cell death is unknown. Bilateral pill-rolling of hands is a common sign manifested. The altered gait of those with the disease include short shuffling steps, the posture is stooped forward, and the arms have limited swing.

Front 97

Ipsilateral Horner Syndrome

Back 97

A CVA [stroke] involving the posterior inferior cerebellar artery can produce a neurological sign in the eye. This artery supplies the lateral and posterior portion of the medulla.

Front 98

Myasthenia gravis

Back 98

Chronic autoimmune neuromuscular disease involving the lower motor neurons and muscle fibers. The immune system of infected individuals produces antibodies that destroy acetylcholine receptor sites at the neuromuscular junction. This blocks the nerve impulse from reaching the muscle and produces muscle fatigue.

Front 99

Encephalitis

Back 99

Acute inflammation of the brain and spinal cord, involving the meninges. Often caused by a virus such as the herpes simplex virus.

Front 100

Multiple Sclerosis

Back 100

Progressive autoimmune disorder characterized by a combination of inflammation and degeneration of myelin in the brains white matter, leading to obstructed transmission of nerve impulses and decrease brain mass and obstructed transmission of nerve impulses.

Front 101

Cerebral Palsy

Back 101

Permanent disorder of movement and posture development associated with nonprogressive disturbances that occurred in the developing fetal or infant brain.

Front 102

Cranial Nerve XI problem

Back 102

Can't shrug your shoulders with resistance

Front 103

7, 10, 2, 6

Back 103

Transferring objects hand to hand begins at __ months. Purposeful release of objects is noted as a normal finding by __ months. Purposeful movements, such as reaching and grasping for objects, should begin at about __ months of age. Taking objects in one hand begins at __ months.