Male Genitalia

Front 1

Inspection- penis

Back 1

condition of skin

glans

shaft

urethral meatus

urethral discharge

Front 2

inspection and palpation

Back 2

-groin and pubic area

-penis

-scrotum

-sacrococcygeal areas

-perineal area

-inguinal region and femoral area

Front 3

Inspection- groin and pubic area

Back 3

-with patient supine, inspect the groin

observe gential hair distributio

-expected findings: skin clear, intact and smooth

-hair diomand shaped pattern

-hair appears coarser than at the scalp and has no parasites

Front 4

Inspecting penis

Back 4

observe penis for surface characteristics, colour, lesions and discharge

-inspect dorsal and ventral surfaces

-ask the uncircumsized patient to retract the prepuce

--

Front 5

-expected finding

Back 5

-dorsal vein apparent on dorsal surface of penis

-no edema, lesions, discharge or nodules

-in the circumsized patient, the glans and corona are visible, lighter in colour than th eshaft and free of smegma

-in uncircumsized penis, prepuce retracts easily

Front 6

inspecting foreskin

Back 6

-skin on or at the base of penis - chancres, ulcers, nits or lice

Front 7

prepuce(foreskin)

Back 7

may require retraction if client is not circumsized to ensure detection of possible chancres or cnacers

-encourage client to do it himself

-foreskin should retract smoothly

-note presence and odour of smegma

-return foreskin to normal position after inspecting to prevent paraphimosis

Front 8

smegma

Back 8

cheesy, white or yellow material normally found under foreskin

Front 9

phimosis

Back 9

a congenital narrowing of the opening of the foreskin so that it cannot be retracted

Front 10

paraphimosis

Back 10

uncommon medical condition in which the foreskin of an uncircumcised penis becomes trapped behind the glans penis, and cannot be reduced (pulled back to its normal flaccid position covering the glans).

Front 11

inspecting the glans

Back 11

expected: glistening pink, smooth and bulbous

Front 12

unexpected fidings- glans

Back 12

balanitis, ulcers, scars, nodules, inflammation, discharge(sample and culture speimen)

Front 13

hypospadias

Back 13

urethral meatus on underside

Front 14

epispadias

Back 14

meatus on upper side

Front 15

inspect and palpate the shaft

Back 15

-smooth without lesions or pain

Front 16

unexpected finding- shaft

Back 16

genital warts(condylomat acuminata)

Front 17

urethral meatus

Back 17

assess position of meatus

inspect and palpaet the external urinary meatus - strip or milk the penis from base toward glans

- note colour , consistency or odour of any discharge

Front 18

palpate penis

Back 18

palpate between thumb and 1st two fingers

-note tenderness, induration

Front 19

scrotum- inspect and palpat

Back 19

-skin

-testis

-epididymis

-spermatic cord

-any masses

Front 20

inspecting scrotum

Back 20

-ask patient to hold penis out of the way and inspect the scrotal septum

-inspect the anterior and posterior scrotum for any sores or rashes

-skin: lift the scrotum to examine its underside

-rashes, cysts, skin cancers

Front 21

palpate scrotum

Back 21

-palpate scrotal contents for noduls, lesions or tenderness

-scrotal contours- swelling, lumps, distended veins(varicocele), crypotorchidism, hydrocele, acute epididymitis, torsion of spermatic cord

Front 22

expected findings scrotum

Back 22

-divided into two sacs, sebaceous cysts commonly noted, assymmetry is normal, left usually lower than right

-anterior and posterior skin darker in pigmentation with a rugous or wrinkled surface

-smooth nontender scrotal contents

Front 23

scrotum palpate

Back 23

each testis and epididymis between thumb and first two fingers

-each spermatic cord, including the vas deferns, between thumb and fingers from epididymis to the superficial inguinal ring- variocele is an unexpected finding

Front 24

transillumation of scrotal sac

Back 24

-done to assess for mass or fluid

-contents do NOT normally transilluminate

-hydroceles and spermatoceles contain fluid and transilluminate

-red glow may indicate hydrocele

-tumours and hernias do not

-use a bright penlight and press light against scrotal sax

Front 25

hydrocele can mean

Back 25

congestive heart failure

Front 26

hydrocele

Back 26

the accumulation of serous fluid in a body sac.

Front 27

varicocele

Back 27

veins become enlarged inside your scrotum

Front 28

inspection of sacrococcygeal areas

Back 28

-inspect for surface characteristics and tenderness

expected findings: skin is clear and smooth with no palpable masses or dimpling

unexpected findings: a dimple with an inflamed tuft of hair or a tender palpable cyst in the sacrococcygeal area

Front 29

inspection of perineal area

Back 29

-with the patient on his side, spread the buttocks and inspect the perineal area

expected: skin surounding the anus is coarse with darker pigmentation

unexpected: warts, loose sphincter, lesions, hemorrhoids, fissures, fistulas, or polyps

Front 30

inspection and palpation of perineal area

Back 30

-ask patient to "bear down" and inspect the area while the patient is performing the valsalva maneuver

Front 31

palaption of the perianal area

Back 31

palpate any abnormal areas on the scarococcygeal and perianal areas, noting lumps or tenderness

Front 32

palpation of perineal area

Back 32

place pad of lubricated finger over anus and gently press on the sphincter's edge. wait for the sphincter to relax then insert fingertip into anal canal

-pause and allow patient to adjust to your giner, then contiue to insert finger fully - not sphincter tone of the anus by asking patient to squeeze anal muscles around your finger

Front 33

palpate anus

Back 33

rotate fingers 180 degrees to examine the posterior and lateral walls of the rectum

-sweep fingers across the anterior and anterolateral walls of the rectum

-note texture and elasticity of the rectal lining. assess for tenderness, induration, irregularities or nodules

Front 34

prostate exam

Back 34

-inform patient that you're going to examine his prostate gland and that they may feel an urge to urinate when it is palpated

-sweep fingers over prostate gland(found anteriorly through rectal wall)

-identify lateral lobes and median sulcus

Front 35

prostate

Back 35

-note size, shape, surface, mobility, consistency of prostate, and identify any nodules or tenderness

Front 36

normal prostate is:

Back 36

-rubbery

-smooth

-nontender

-with a prominient median sulcus

Front 37

note colour of any

Back 37

fecal matter on the glove, test it for occult blood

Front 38

femoral hernias

Back 38

similar to inguinal hernias, but they protrude through the femoral canal which lies below the inguinal ligament

Front 39

check for hernia- inspect

Back 39

person standing and bear down, cough to ilicit bulging

Front 40

check for hernia- palapte

Back 40

if mass present, listen for bowel sounds, rule out incarcerted or strangulated hernia, gently try to reduce it unless it is incarcerated

Front 41

indrect inguinal hernia

Back 41

takes path from the abdomen, through teh inguinal canal, into the scrotal sac

-can be reduced into the scrotum because it goes back into the inguinal canal

-more likely to strangulate than direct

Front 42

direct inguinal hernia

Back 42

does not come through inguinal canal, but actually comes through abdo wall

Front 43

direct and indirect

Back 43

can co-exist

Front 44

____________ cancer is the second leading cause of cancer deaths in men and women

Back 44

colorectal

Front 45

one in _____ will develop prostate cancer in their lifetime

Back 45

7

Front 46

excluding non-melanoma skin cancer, _______ cancer is the most common

Back 46

prostate

Front 47

which muscle in anal canal is under volutnary contral

Back 47

psoas muscle

Front 48

health prmotion

Back 48

stds and hiv

-hernias

-testicular cancer

-prostate cancer

-colorectal cancer

-

Front 49

testicular cancer

Back 49

-most common malignancy in men early to middle age and fastest growing malignancy in this age group in canada, 15-35

-5 year survival rate>96%

Front 50

risk factors testicular cancer

Back 50

undescended testicle(crytorchidism)

-mumps(orchitis)

-hydrocele

-personal previous history or fam history

unusual testicular development

-inguinal hernia

Front 51

testicular self exam

Back 51

should be done montly

Front 52

gen guidelines for self exam

Back 52

-after a warm bath or shower

-stand in front of mirror, inspect for swelling of scrotum

-feel size and weight of each testicle(normal for one to hang lower or be slightly heavier)

-use both hands to examine each testicle- thumb on top, cup index and middle fingers under testicle

-roll the testicle gently between the thumbs and fingers, smoothness, report lumps ASAP

Front 53

__________________ is the most frequently reported STI in canada

Back 53

chlaymidia

Front 54

______ has the fastest growing rate of incidence

Back 54

syphillis

Front 55

____% of canadians with HIV are male

Back 55

80

Front 56

__________ and ______________ ar the most adversely age groups affected by stis and hiv

Back 56

adolescents and young males

Front 57

risk factors for inguinal hernias

Back 57

-muscle deficiency

-physical stress

-intra-ab press

-smoking

-aging

-pelvic fractures and trauma

-connective tissue disease

-systemic illnesses

Front 58

conseling for hernias

Back 58

-stress that some risk factors are modifiable

ex. activities that increase intra-bab pressure

Front 59

nonmodifiable factors

Back 59

genetic predisposition to weakness in ab wall

Front 60

prostate cancer

Back 60

-asymmetric shape

-hard consistency

-discrete nodule may be palpable

-median sulcus often obscured

Front 61

_________ is teh leading cancer diagnosed in canadian men, and _________ leading cause of death

Back 61

men, third

Front 62

primary risk factors for prostate cancer

Back 62

age, ethnicity, fam history

Front 63

__________ is the leading cause of death from cancer when numbers for men and women ae bomined

Back 63

colon

Front 64

reduce risk of colon cancer by

Back 64

incresing physical activity

limiting alc

-using NSAIDs

-eliminating tobacco

Front 65

screen for colon cancer

Back 65

-men and women over 50 should have fetal occult blood test or fecial immunochemical test at least every 2 years

-positive test requires follow up-colonoscopy

Front 66

older adult

Back 66

-distention of rectum

-elevated pressure threshold for the feeling of rectal distention, causing retetion of stool

-incontinence

-pubic hair becomes finer, grayer, less plentiful

-testosterone levevls decrease

-erection becomes more dependent on tactile stimulation and less responsive to erotic cues

-penis decreases in size, testes drop lower in the scrotum

-fibromuscuar structures of the prostate gland atrophy

Front 67

testicular cancer

Back 67

age 15 to 49

genetic background

-crytorchidism

-history of testicular cancer in other testicle

-fam history

Front 68

prostate cancer

Back 68

-3rd leading cause of cancer death in men

-family history of prostate cancer

-age: highest incidence is in older men, 75% of new cases occur in men older 65 years

-men of african descent have highest incidence of prostate cancer- two times higher than white men

Front 69

penile cancer

Back 69

phimosis- foreskin of penis cant be pulled back

60 years or older

compromised personal hygiene

sexual promiscuity

-use of tobacco products

-possible link with human papillomavirus

Front 70

___ in 28 men will die from prostate cancer

Back 70

1

Front 71

common symptoms related to male genitalia and rectum

Back 71

-pain

-difficulty peeing(weak stream, frequent urination

-erectile dysfunction

-change in sexual desire

-penile lesions

-scrotal swelling, heaviness, pain or aching

-bulge in groin

-rectal bleeding, itching, burning

-anal pain

-passing gas

-dribblign

Front 72

priapism

Back 72

long lasting painful erection

not sexual excitement, results from vein thrombosis in the corpora cavernosa

Front 73

most painful condiotins of anus and rectum

Back 73

perianal abscess , rectal fissure, hemorrhoids