Nurs 605: Chapter 13

Front 1

3 Columns of Vascular Erectile Tissue
What do they form?

Back 1

*Corpus Spongiosum
*2 Corpora Cavernosa

**Shaft of the penis

Front 2

Corpus Spongiosum forms the .......

Back 2

Corpus Spongiosum forms the bulb of the penis

Front 3

secretions of the glans that may collect under the prepuce of foreskin

Back 3

*Smegma

Front 4

Location of the Urethra

Back 4

*ventrally in the shaft of the penis

Front 5

The testes contain which 2 structures?

Back 5

1) Interstitial Tissue
2) Seminiferous Tubules

Front 6

______________ ____________ from the hypothalamus stimulates pituitary secretion of ______________________ ____________________ & _________________ ________________.

Back 6

Gonadotropin-releasing hormone from the hypothalamus stimulates pituitary secretion of luteinizing hormone & follicle-stimulating hormone.

Front 7

________________ __________________ acts on interstitial Leydig cells to promote the synthesis of testosterone.

Back 7

Luteinizing hormone acts on interstitial Leydig cells to promote the synthesis of testosterone.

Front 8

Which enzyme triggers pubertal growth of the male genitalia, prostate, seminal vesicles, & secondary sex characteristics (facial & body hair, musculoskeletal growth, & larynx enlargement-low-pitched voice)

Back 8

5-alpha dihydrotestosterone

Front 9

Role of Follicle-Stimulating hormone

Back 9

*regulates sperm production in germ cells & Sertoli cells of the tubules

Front 10

cloaks the anterior two-thirds of the testis & can accumulate fluid

Back 10

Tunica Vaginalis

Front 11

Epididymis

Back 11

*consists of tightly coiled spermatic ducts
*provide a reservoir for storage, maturation, & transport of sperm from the testis to the vas deferens

Front 12

During ejaculation, a cord-like structure that transports sperm from the tail of the epididymis along a somewhat circular route to the urethra

Back 12

*vas deferens

Front 13

Each vas is closely associated with these 3 structures and make-up the ...

Back 13

*each vas is closely associated with blood vessels, nerves, & muscle fibers.
*these structure make up the spermatic cord

Front 14

Secretions from which 3 structures contribute to seminal fluid...

Back 14

*vasa deferentia
*seminal vesicles
*prostate

Front 15

Male sexual function depends on normal levels of __________________, adequate _________ ____________ ___________ to the inferior epigastric ___________ & its cremasteric & pubic branches, and intact _____________ _________________ from alpha-adrenergic & cholinergic pathways.

Back 15

Male sexual function depends on normal levels of TESTOSTERONE, adequate ARTERIAL BLOOD FLOW to the inferior epigastric ARTERY & its cremasteric & pubic branches, and intact NEURAL INNERVATION from alpha-adrenergic & cholinergic pathways.

Front 16

What 2 types of stimuli trigger an erection from venous engorgement of the corpora cavernosa?

Back 16

1) Visual, auditory, & erotic cues
2) Tactile stimulation

Front 17

Visual, auditory, & erotic cues trigger ....

Back 17

Sympathetic outflow from higher brain centers to the T11 through L2 levels of the spinal cord

Front 18

Tactile stimulates initiates impulses from the genitalia to ________ to _______ reflex arcs. Stimulating which pathway and through which nerve?

Back 18

Tactile stimulation initiates sensory impulses from the genitalia to S2 to S4 reflex arcs & parasympathetic pathways through the pudendal nerve.

Front 19

Increased levels of which 2 substances result in local vasodilation of the penis?

Back 19

1) Nitric oxide
2) Cyclic GMP

Front 20

Lymphatics from the penile & scrotal surfaces drain into which nodes?

Back 20

*inguinal nodes

Front 21

Lymphatics of the testes drain where?

Back 21

*abdominal nodes

Front 22

Inguinal Hernias

Back 22

*when loops of bowel force their way through weak areas of the inguinal canal

Front 23

Indirect hernias form where?

Back 23

*at the internal inguinal ring, where the spermatic cord exits the abdomen

Front 24

Direct inguinal hernias arise where?

Back 24

*more readily from weakness in the floor of the inguinal canal
*associated with straining & heavy lifting

Front 25

Which hernias are more likely to present as emergencies?

Back 25

*Femoral hernias are more likely to present as emergencies with bowel incarceration or strangulation.

Front 26

Psychological Causes for Lack of Libido

Back 26

*depression
*endocrine dysfunction
*medication side effects

Front 27

Psychological causes for erectile dysfunction are expected if....

Back 27

*early morning erection is preserved

Front 28

Physiologic Causes for Erectile Dysfunction

Back 28

*decreased testosterone
*decreased blood flow in the hypo-gastric arterial system
*impaired neural innervation
*DM

Front 29

Possible Causes for Reduced or Absent Ejaculation affecting Middle-Aged or Older Men

Back 29

*medications
*surgeries
*neurologic deficits
*lack of androgen

Front 30

Profuse yellow penile discharge in ......
Scanty white or clear discharge in .......

Back 30

*yellow penile discharge = gonorrhea
*white penile discharge = non-gonococcal urethritis from Chlamydia

**definitive diagnosis requires Gram stain & culture

Front 31

rash, tenosynovitis, mono-articular arthritis, not always with urogenital symptoms can occur in....

Back 31

*disseminated gonorrhea

Front 32

Most common STI

Back 32

*Chlamydia

Front 33

2 Populations at Highest Risk for acquiring HIV/AIDS

Back 33

*African American men
*men having sex with men

Front 34

CDC Recommendations for HIV/AIDS Testing

Back 34

*universal testing from ages 18 to 64, regardless of risk

Front 35

Recommendation for HPV vaccination with Gardasil

Back 35

*boys and men ages 9 through 26 for prevention of genital warts

Front 36

Testicular cancer is _____________, but most common cancer for men ages _______ to _________.

Back 36

Testicular cancer is RARE, but most common cancer for men ages 15 to 34.
*more common in white men

Front 37

A good genital exam can be performed with the patient in which 2 positions?

Back 37

1) standing
2) supine

Front 38

To check for hernias or varicoceles, how should be the patient be positioned? The provider?

Back 38

To check for hernias or varicoceles, patient should be standing.
Provider should sit comfortably on a chair or stool.

Front 39

Retraction of the foreskin or prepuce is essential for....

Back 39

*detection of chancres & carcinomas

Front 40

cheesy whitish material that may accumulate normally under the foreskin

Back 40

*smegma

Front 41

a tight prepuce that cannot be retracted over the glans

Back 41

*phimosis

Front 42

a tight prepuce that, once retracted, cannot be returned with

Back 42

*paraphimosis

Front 43

inflammation of the penile glans

Back 43

*balanitis

Front 44

inflammation of the penile glans and prepuce

Back 44

*balanoposthitis

Front 45

a congenital ventral displacement of the urethral meatus

Back 45

*hypospadias

Front 46

To compress the glans of the penis which 2 fingers should be utilized?

Back 46

*index finger above
*thumb below

Front 47

Induration along the ventral surface of the penis could suggest which 2 conditions?

Back 47

1) urethral stricture
2) carcinoma

Front 48

dome-shaped white or yellow papules or nodules formed by occluded follicles filled with keratin debris that appear on the scrotum

Back 48

*epidermoid cysts
**common, multiple, benign

Front 49

cryptorchidism

Back 49

*an undescended testicle
**testis is atrophied & may lie in the inguinal canal or abdomen resulting in an unfilled scrotum
**markedly raises the risk for testicular cancer

Front 50

Common Causes for Scrotal Swelling

Back 50

*indirect inguinal hernias
*hydrocele
*scrotal edema
**rare, testicular cancer

Front 51

Epididymis feels _____________ & _____________.

Back 51

*nodular & cordlike

Front 52

Causes of Painful, Tender Scrotal Swelling

Back 52

*acute epididymitis
*acute orchitis
*torsion of the spermatic cord
*strangulated inguinal hernia

Front 53

Transillumination of the Scrotum

Back 53

*shine a beam of light from behind the scrotum through the swelling in the scrotum
*swelling containing serious fluid light up with a red glow
*swelling containing blood or tissue (normal testis, tumor, or most hernias) do not

Front 54

What maneuver allows for easier detection of any hernias?

Back 54

*Valsalva maneuver (patient strains & bears down) to increase intra-abdominal pressure

Front 55

Bulge near the external inguinal ring suggests a _________ inguinal hernia.
Bulge near the internal inguinal ring suggest a _________ inguinal hernia.

Back 55

*EXTERNAL Inguinal Ring = DIRECT Inguinal Hernia
*INTERNAL Inguinal Ring = INDIRECT Inguinal Hernia

Front 56

Detecting a direct or indirect mass warrants.....

Back 56

*surgical evaluation

Front 57

True or False. A large scrotal mass that returns to the abdomen by itself when the patient lies down is considered a scrotal hernia.

Back 57

True

Front 58

____________ _____________ may be heard over a hernia, but not a hydrocele.

Back 58

*bowel sounds

Front 59

A hernia is considered incarcerated when .....

Back 59

*contents cannot be returned to the abdominal cavity

Front 60

A hernia is considered strangulated when .....

Back 60

*blood supply to the entrapped contents is compromised

Front 61

When is a strangulated hernia suspected?

Back 61

*in the presence of tenderness, nausea & vomiting

Front 62

Risk Factors for Testicular Cancer

Back 62

*Cryptorchidism (high risk for CA in the undescended testicle)
*h/o carcinoma in the contralateral testicle
*mumps orchitis
*inguinal hernia
*hydrocele in childhood

Front 63

When is a self-testicular exam best performed?

Back 63

*after a warm bath or shower because the heat relaxes the scrotum

Front 64

Causative Agent of Genital Warts

Back 64

*HPV

Front 65

Associated Manifestations with Genital Herpes Simplex

Back 65

*fever
*malaise
*HA
*arthralgia
*local pain & edema
*lymphadenopathy

Front 66

Chancre appear with which STI?

Back 66

*syphilis

Front 67

Chancre

Back 67

*PAINLESS erosion up to 2 cm in diameter
*base is clean, red, smooth, & glistening
*borders are raised or indurated
*heals within 3 to 8 weeks

Front 68

Causative Agent of Primary Syphilis

Back 68

*Treponema pallidum, a spirochete

Front 69

Lymphedema in Primary Syphilis

Back 69

*inguinal lymphedema may develop within 7 days
*lymph nodes feel rubbery, non-tender, & mobile

Front 70

red papule or pustule that forms a PAINFUL deep ulcer with ragged non-indurated margins; contains necrotic exudate & a friable base

Back 70

*Chancroid

Front 71

Pitting Scrotal Edema can be seen in which 2 disease states?

Back 71

*Heart failure
*Nephrotic syndrome

Front 72

painful, non-tender, hard plaques found just beneath the skin (usually along the dorsum of the penis)
*patient c/o crooked, painful erections

Back 72

*Peyronie's Disease

Front 73

non-tender fluid-filled mass within the tunica vaginalis

Back 73

*hydrocele

Front 74

True or False. The examining fingers CAN get above a mass within the scrotum, if it is a hydrocele.

Back 74

True

Front 75

indurated nodule or ulcer that is usually non-tender

Back 75

*carcinoma of the penis
**limited almost completely to men who are uncircumsized

Front 76

True or False. With a scrotal hernia, the examining fingers CANNOT get above the mass within the scrotum.

Back 76

*True

Front 77

Normal Testicle Length in Adults

Back 77

*less than or equal to 3.5 cm

Front 78

Small, firm testes measuring less than or equal to 2 cm are seen in which condition....

Back 78

*Klinefelter's syndrome

Front 79

Small, soft testes suggest ........ and are seen in which disease states?

Back 79

*suggest atrophy
**cirrhosis
**myotonic dystrophy
**use of estrogens
**hypo-pituitarism
**may follow orchitis

Front 80

testis is acutely inflamed, painful, tender, & swollen
scrotum may be reddened

Back 80

*acute orchitis

Front 81

Cause of Acute Orchitis

Back 81

*mumps
*other viral infections
**usually occurs unilaterally

Front 82

a painless, moveable cystic mass filled with sperm just above the testis; without sperm

Back 82

*spermatocele; cyst of the epididymis

Front 83

Most Common Cause of Acute Epididymitis

Back 83

*Chlamydia infection
*co-existing urinary tract infection or prostatitis support this diagnosis

Front 84

Varicocele or varicose veins of the spermatic cord usually occur on which side?

Back 84

LEFT

Front 85

Which disease produces a firm enlargement of the epididymis that may be tender & a thickening or beading of the vas deferens?

Back 85

*tuberculosis

Front 86

Most Common Type of Hernia

Back 86

*Indirect Inguinal Hernia

Front 87

hernia comes down the inguinal canal & touches the examiner's fingertip

Back 87

*indirect inguinal hernia

Front 88

hernia bulges anteriorly & pushes the side of the examiner's finger forward

Back 88

*direct inguinal hernia

Front 89

inguinal cavity is empty

Back 89

*femoral hernia
**may be difficult to differentiate from lymph nodes