Term
| __ kidney is lower than the ___ kidney b/c of the liver. |
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Definition
| - right kidney lower than the left kidney |
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Term
| Which testicle usually hangs lower? |
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Definition
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Term
| what to note about genital hair: |
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Definition
- distribution
- texture
- thickness
- Tanner Staging, if appropriate |
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Term
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Definition
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Term
|
Definition
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Term
| What should you inspect and palpate on male GU exam? |
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Definition
- circumscribed or uncircumscribed
- if uncircumscribed, retract foreskin, but don't forget to replace it
- urethral meatus, note location of orifice, and gently open it, if there is discharge could be inflammatory/infectious disease |
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Term
| Explain fibrosis of the shaft and what disease it is associated with: |
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Definition
- seen with Peyrone's disease
- due to trauma, there is scarring of shaft that causes it to curve to one direction
- not dangerous but you should note it |
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Term
| ___ on scrotum indicate development. |
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Definition
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Term
| Scrotum is usually assymetric, with left testis lower than the right. It is usually ___ than ___. It should have ___ and may have ____ ____. Observe and palpate the scrotum for ___, __, and ___. |
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Definition
- darker than skin
- ruggae
- may have epidermoid cysts (nodularities)
- color changes, edema, temperature |
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Term
|
Definition
|
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Term
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Definition
| - soft, smooth, nontender |
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Term
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Definition
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Term
| To check for a hernia, use one finger to follow the ___ ___ from the ___ to the __ ___. Then ask the patient to ___ or cough. Feel for any lesions felt from the external ring or around the external ring. Visually note any lesions inguinal or femoral area. |
|
Definition
- vas deferens
- scrotum
- external ring
- valsalva |
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Term
| Direct inguinal hernias go through ___ ____. |
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Definition
|
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Term
| Indirect inguinal hernias go through the ___ ___ ___ and the ___ ___ ___. |
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Definition
- deep inguinal ring
- superficial inguinal ring |
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Term
| Femoral hernias occur below the __ ___. |
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Definition
|
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Term
| To find the inguinal ring, palpate the ___ __ __ ___ and the __ ___. |
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Definition
- anterior superior iliac spine
- pubic tubercle |
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Term
| If testies don't come down within the first year of life, they must be surgically descended for what two reasons? |
|
Definition
- so they can make sperm and be fertile later in life
- so that they can be palpated later in life to check for cancer |
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Term
| Borders of Hesselbach's triangle: |
|
Definition
- lateral border: inguinal ligament
- superior border: inferior epigastric vessels
- medial border: rectus abdominus muscle |
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Term
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Definition
- cannot reduce it
- have to worry about blood being cut off to that area
- emergency surgery |
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Term
|
Definition
| - the blood supply has definitely been cut off to the area |
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Term
|
Definition
- can push it back in
- good sign |
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Term
| So when you document a hernia, you have to say if its ___ or not. |
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Definition
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Term
| Femoral hernias are more common in ____. |
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Definition
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Term
| Normally a scar forms at the umbilicus, that barricades this area. In some people it doesn't, so you get an outie. If it gets bigger, thats when you know its a hernia. This is common in children, but as long as its reducable, you don't do anything until age __ or __. |
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Definition
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Term
| Generally femoral hernias do not hurt, but if they become non-reducable, they hurt. |
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Definition
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Term
| A hydrocele is ___ ___ where it shouldn't be. |
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Definition
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Term
| Testies in an unborn baby are usually at the kidneys and descend with a peritoneal layer, the ___ ___, which is connected to the abdominal cavity. This usually closes off and becomes the ____ ___, but if it does not, you get a ___ ___. These will get larger during the ___ and smaller at night. |
|
Definition
- processus vaginalis
- tunica vaginalis
- communicating hydrocele
- day
- night |
|
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Term
| In adults you can get a ___ ___, caused by infection or trauma that causes fluid to accumulate in the ___ ___. But this fluid can't move into the abdomen b/c its closed off, so you get fluid trapped around the testies. Eventually it will get reabsorbed. You don't do anything for it. |
|
Definition
| - non-communicating hydrocele |
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Term
| clinical signs of a hydrocele: |
|
Definition
- painless, enlarged scrotum
- may increase/decrease in size
- no other GU symptoms |
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Term
| physical exam of a hydrocele: |
|
Definition
- superior and anterior to testicle
- + transilumination
- usually unilateral |
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|
Term
| A hydrocele transilluminates b/c its just fluid. If it was blood or a mass, it wouldn't glow. |
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Definition
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Term
| A spermatocele is a ___ ___ ___ of the ____. It is completely painless and most people don't realize its there until its palpated at an exam. Cancer of the epididymus is rare, but still probably do an ultrasound to make sure its just a spermatocele. |
|
Definition
- benign cystic mass
- epididymus |
|
|
Term
| PE findings of spermatocele: |
|
Definition
- discreet cystic mass less than 1 cm
- negative valsalva |
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|
Term
| Varicocele is dilation of the ____ ____. More common in the left than on the right. Usually not a problem, but can contribute to infertility, in which case surgery can be done. |
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Definition
|
|
Term
| Varicocele is normal in 15-20% of men, but causes infertility in __% of men. Clinically it will be small to medium, but usually ___. Upon physical exam, you will note ___ and it will feel like a ___ ___ ___. |
|
Definition
- 40%
- asymptomatic
- fullness
- bag of worms |
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Term
| A varicocele is made up of veins that contain inadequate ___. |
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Definition
|
|
Term
| If you see a varicocele on the right side, you need to rule out abdominal cancer. It is more common on the left b/c it drains at a sharper angle on the left. |
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Definition
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Term
| orchitis is an inflamed ___, usually a __ cause like ___, so also check for an inflamed parotid gland. Mumps will make you ___ so this is important. |
|
Definition
- testis
- viral
- Mumps
- sterile |
|
|
Term
|
Definition
- acute inflammatory reaction of the testis secondary to infection
- can have VIRAL, bacterial, or trauma cause
- symptoms of infection, history of antecedent infection, nausea
- physical findings: swelling, pain to palpation, scrotal erythema, epididymitis
- may have penile discharge |
|
|
Term
| Hydroceles, spermatoceles, and varicoceles are usually ___, but orchitis is ____. |
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Definition
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|
Term
| Testicular torsion more common in teenage boys while sleeping due to overactive cremasteric reflex. Also can happen during activity. Wake up with horrible pain. Patient's with this have a ___ ___ deformity meaning the ___ is not anchored to the ___ so its easier for torsion to occur. Severe pain, nausea, vomiting, red and tender scrotum. This is cutting off blood supply, so the testies can become necrotic. Needs to be diagnosed and treated asap to save the testies. This will not ____, a hydrocele will. Usually is twisted medially, so to untwist, you twist it ___ on the left, and ___ on the right. |
|
Definition
- Bell Clapper deformity
- testies
- scrotum
- will not transilluminate
- clockwise
- coutnerclockwise |
|
|
Term
| With testicular torsion, the ___ ___ will be absent and you will see a negative ___ ___. |
|
Definition
creamastseric reflex
Prehn's sign |
|
|
Term
| explain positive and negative Prehn's signs: |
|
Definition
- Positive Prehn's sign: elevating the scrotum relieves pain
- Negative Prehn's sign: elevating the scrotum does not relieve pain (torsion) |
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Term
| Epididymitis is caused by ___ of infectious material from the ___ all the way back to the epididymus. So could be __ or ___(common cause). Also can be caused by ___ spread. Usually insidious onset, meaning it comes on ___. Physical findings will be ___, ____ ___, a __ ___ __, and present __ ___. Treat with antibiotics, elevation and ice. |
|
Definition
- reflux
- urethra
- UTI or gonarrhea
- hematogenous
- slowly
- pain
- swollen epididymus
- positive prehn's sign
- present creamsteric reflux |
|
|
Term
| If pt is younger than 35, you treat epididymitis like it is ___ or ___, until you get the culture back. If its an older patient, consider ___ ___, like E. coli. |
|
Definition
- gonarrhea
- clamydia
- intestinal bacteriaDif |
|
|
Term
| Differences between epididymitis and testicular torsion: |
|
Definition
- testicular torison: absent cremasteric reflex, negative prehn's sign
- epididymitis: present cremasteric reflex, positive prehn's sign |
|
|
Term
|
Definition
- an erection that lasts too long
- medical emergency
- can get it with sickle cell anemia or with pple that take erection meds |
|
|
Term
| Balanitis is inflammation of the ___ ___. It is more common in ___ pts b/c if foreskin gets swollen it can cut off blood to glans. |
|
Definition
- glans penis
- uncircumscribed |
|
|
Term
|
Definition
- unable to retract the foreskin
- treatment is circumcision |
|
|
Term
|
Definition
- medical emergency
- can retract the foreskin, but you can't put it back
- it will get edema and cut off the blood supply to the glans penis
- can happen due to medical errors, like when you put in a catheter |
|
|
Term
|
Definition
| - congential ventral displacement of the urethral meatus on the penis |
|
|
Term
|
Definition
| - congential abnormality where the urethral meatus exits the penis on the dorsal surface |
|
|
Term
| Herpes simplex produces ___ ___. |
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Definition
|
|
Term
|
Definition
|
|
Term
| symptoms of internal hemorrhoids: |
|
Definition
streaking of blood on stool, not mixed in
- more common with constipation |
|
|
Term
| External hemorrhoids can become incarcerated and strangulated. So if you can't reduce it, it needs ___. |
|
Definition
|
|
Term
|
Definition
- usually in men
- filled with oil and debris
- at top of butt crack |
|
|
Term
| Raised ulcerated area around anus, think __ ___. |
|
Definition
|
|
Term
|
Definition
| part of rectum falls out of anus |
|
|
Term
| Puberty with women starts with ___ ___. Puberty for men starts with __ ___. |
|
Definition
- breast development
- testicular enlargment |
|
|
Term
| What zones of the prostate enlarge with age? |
|
Definition
- transitional zone
- central zone |
|
|
Term
| What zone of the prostate is most likely to get cancer, and thus is the reason why rectal exams are so necessary? |
|
Definition
|
|
Term
|
Definition
| benign prostatic hypertrophy |
|
|
Term
| Possible positions for male rectal exam: |
|
Definition
- Sims position: left lateral with right knee flexed
- standing with hips flexed leaning against exam table |
|
|
Term
| With prostate exam you also need to do: |
|
Definition
| Hemoccult aka Guaiac Card |
|
|
Term
| For the Sacrococcygeal and Perianal area check for lumps, rashes, inflammation, excoriation, scars, cysts, and dimpling. Check the anus for skin tags, warts, external hemorrhoids, fissures, or fistulas, and have your patient bear down to check for prolapse Note sphincter tone. |
|
Definition
|
|
Term
| Palpate lateral and posterior walls of rectum, they should be ___. If there are nodules think ___. At completion of exam have pt ___ with finger fully extended in rectal vault. |
|
Definition
- smooth
- cancer
- valsalva |
|
|
Term
| Anterior rectal wall and prostate should be __, ___, and ___ ___. |
|
Definition
- firm
- smooth
- slightly movable
forehead- hard
nose= normal
chin= soft |
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