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64 Cards in this Set
- Front
- Back
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transition zone
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majority of BPH
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Central zone
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originating at the ejaculatory ducts
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70% of the prostate and 70% adenocarcinoma 90% prostatitis
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Peripheral zone
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Prostatitis
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inflammation of the peripheral zone
-pain and bogginess on prostate exams -bacteriuria on end catch urine -increase PSA |
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BPH
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chronic enlargement of the prostate gland
-prostate doubles between ages 30-50 |
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Prostatic carcinoma
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age 50-90
-spread to bone -acute urinary abstruction 50% palpable on rectale exams |
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what posisition does the patient lay during a rectal exam
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lateral decubitus
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when inserting your finger into the rectum your finger is pointed towards?
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umbilicus
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hard, irregular , nontender mass to palpate on rectal =
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cancer of the prostate
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large inflamed "boggy" tissue of prostate =
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prostatisi
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anorectal junction
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boundary of skin and rectum mucosa. changes in somatic and visceral nerve supply
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anorectal fistula
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out in the somatic not as worried about
-crampy pain = internally -burn pain = externally |
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urethritis
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common cause- Chlamydia Trachomatis
-dysuria with discharge -culture tip -multiple infections may cause urethral strictures |
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venereal warts
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chondyloma accuminata
-single or multi - cauliflower looking caused by HPV -incubation weeks to months -asymptomatic, nontender |
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Genital Herpes
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small red grouped or scattered vesicles
-tender to palpation -HSV II causative organism -incubation 2-7 days -painful |
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Hypospadius
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congenital displacement of urethra to inferior surface of the penis (urethra on underside of the penis)
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Carcinoma
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indurated nodule or ulcer
nontender nearly all liminited to uncircumcised men |
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testicular cancer
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age 15-35
tumor marker- AFP bHCG spread to chest and brain |
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orchiectomy
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removal of the testical
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cryptorchidism
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testicals do not descend
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scrotal hernia
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usually indirect
cannot palpate above it may you steth to assess bowel sounds |
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cryptorchidism
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atrophied testicle
nonpalpable in scrotum or will not stay "down" resulting in empty scrotum |
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acute orchitis
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inflamed,tender swollen testicle
usually unilateral and viral |
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acute epididymitis
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actuely inflamed epididymis
tender to palpation superior to testicle may have in concomitant UTI or prostatitis |
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Spermatocele
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painless moible cystic mass superior to the testicle that contains sperm
-transilluminates |
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testicular cancer early
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painless nodule on the testicle
indurated and smooth generally presents in 3rd and 4th decade of life |
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testicular cancer advance
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may replace the entire testicle and spread to lung and brain
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Testicular torsion
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acutely painful, tender, swollen testicle of sudden onset
onset is normally during a sport |
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during pap smear what type of cells do you want
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columnar epithelium
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rectocele
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causes difficulty with defecation
(weakness in the rectal wall) |
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cystocele
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causes trouble urinating and stress incontinence
(the bladder has dropped and is coming from the top) |
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when can a uterus be palpated through the rectum
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when it is retroflexed or retroverted
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may feel the fundus of the uterus at the ??
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the umbilicus at about 22 weeks
(every 2 weeks it moves up) |
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menarche
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onset of menstrual
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amenorrhea primary cause
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pregancy
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menorrhagia
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heavy mestral bleeding
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metrorrhagia
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Uterine bleeding at irregular intervals, particularly between the expected menstrual periods.
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polymenorrhea
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menstral 21 days or sooner intervals
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oliomenorrhea
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infrequent periods
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hypomenorrhea
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very short and light periods
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post coital bleeding
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bleeding after sex
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cervical carcinoma
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females aged 15-40
associated with HPV discovered during pap smear |
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biopsy on colposcopy
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biopsy the cervix
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Ovarian carcinoma
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cannot be felt on PAP smear
run in families seen on ultrasound or CAT scan RISK- BRACA1 and or BRACA2 mutations |
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G=
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gravida or total number of pregnancies
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Para
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pregnancy outcomes
REMEMBER FPAL |
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which quadrent of the breat are you most concerned with?
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upper outer quadrent
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e-val abdomen order is important whats the order?
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look
listen feel percuss |
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bell side of steth listen for?
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bruits
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listening posts for bruits
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aorta
renal artery iliac artery femoral artery |
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normal liver is ___ cm in the midsternal line
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4-8
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normal liver is ___ cm in the right midclavicular line
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6-12
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hepatomegaly is measured in
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cm below the costal margin and it is concered if it is 6cm below the costal margin
(have patient exhale and you should feel the liver slide down) |
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Ascites
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Free fluid in the peritoneal cavity
most common cause is portal hypertension results in abdominal distension (when percussing it becomes dull away from center and you know there is fluid in there) |
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fluid waves (ascites)
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tap on one side and feel it on the other
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palpate spleen in
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right lateral decubitus position
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Postive Rebound tenderness
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implies peritoneal inflammation (peritonitis) and is inducative of an acute abdomen/ perforation
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Costovertebral angle tenderness
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(kidney punch)
distinguish abdominal vs kidney pain |
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Kidney Vs Ureteral pain
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kidney will go on back
ureteral pain loan to groan pain |
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McBurney's sign
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right lower quadrent tenderness 1/2way between the umbilicus and the ASIS
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Rovsing sign
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pain felt in the RLQ with palpation of the LLQ
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Psoas Sign
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increase in pain from passive extension of the right right joint that stretches the iliopsoas muscle
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obturatior sign
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pain caused by passive internal rotation of the flexed thigh
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Murphy's sign
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deep inspiration exacerbates the pain during palpation of the RUP and halts inspiration(is for gallbladder)
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