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PD male genitalia
Terms in this set (42)
1. Corpora Cavernosa (2)-smooth muscle functions in ejaculation
2. Corpus Spongiosum
4. Shaft-erectile tissue
6. Glans penis-covers end of corpora cavernosa.
7. Corona-prominent margin on dorsal of penis
8. External Meatus of urethra-slit-like opening on tip of glans penis
9. Prepuce (foreskin)-free fold of skin on distal end of penis.
*Prepuce removed during circumcision.
10. Smegma-mucus and epithelial cells-provide lubricant during sexual intercourse.
1. Prostatic (posterior) portion-common ejaculatory duct and prostatic ducts enter this portion.
2. Membranous portion-external urethral sphincter; Cowper's bulbourethral glands.
3. Cavernous (anterior) portion.-longest; Cowper's ducts enter
Pouch containing testes.
*Major role of scrotum is temperature regulation of testes.
Ovoid, smooth and approximately 3.5-5 cm in length.
--*Left usually lower than right.
Covered with tunica albuginea testis.
Epididymis--> vas deferens.
Role of epididymis is storage, maturation and transit of sperm.
--*Function: spermatogenesis (produce sperm) and testosterone production
What's the blood supply of the testies
-*Blood supply: Testicular artery; Pampiniform plexus ( venous drainage).
-Right testicle drains directly into inferior vena cava, left drains into left renal vein.
Lymph of testies
-Pre-aortic and pre-caval nodes, NOT inguinal adenopathy.
*Neoplasm and inflammation of the testis produce adenopathy intra-abdominally, NOT inguinal adenopathy.
Descent of the teses
-both testes in scrotum at birth normally
-Gubernaculum develops in inguinal fold at 12 weeks
-Gubernaculum and processus vaginalis essentially obliterated in spermatic cord by birth.
--*5% male infants --> imperfect descent of testis (cryptorchidism)
What's in the spermatic cord?
1. Vas deferens-joins seminal vesicle to form ejaculatory duct
2. Testicular arteries
3. Testicular veins
Size of two almonds or a large walnut (4 x 3 x 2 cm)
Five lobes (3 lobes are located on the posterior surface but only the two laterals are palpable via digital exam)
1. *Posterior lobe-frequently affected by cancer
2. Lateral lobes (2)--> benign hypertrophy
3. Median lobe--> contains glandular tissue and alveoli involved in production of ejaculatory fluid; benign hypertrophy
5. Anterior lobe-of little clinical importance
Anatomy and Physiology-Older Adults
Increased ejaculate volume
Decreased sexual activity
Orgasm less intense
Pubic hair finer and balding
Decrease in sperm viability
Aching pain in costo-vertebral angle (CVA)
acute pyelonephritis, obstructive hydronephrosis
Spasmodic, colicky pain
upper ureteral dilatation, may refer to testis on same side
lower abdominal fullness and suprapubic pain
spermatic cord, testicle or prostate pathology, lymphadenitis, hernia, herpes zoster
any disease of testis or epididymis (epididymitis, orchitis, torsion, tumor)
always consider referred pain from ipsilateral ureter with testicular pain.
painful, persistent erection of penis, not a result of sexual excitation; Due to thrombosis of corpora cavernosa (sickle cell anemia, leukemia)
Passage of air in urine--> "bubbles of gas in the urine" Causes-introduction of air by instrumentation, fistula to bowel or UTI with gas-forming bacteria (E. coli, clostridia)
Presence of fecal material in urine-RARE. Cause-intestinovesicular fistula, urethrorectal fistula (seen with diverticulitis, cancer and Crohn's disease)
Pus in urine from inflammation of urinary tract.
Causes-bacteria (most common cause), neoplasms, kidney stones
Cystitis and Prostatitis are common causes of pyuria.
Changes in Urine Flow
Definition-passing urine more often than normal. *Urinary frequency is the most common symptom of the GU system.
Urinary frequency at night.
*Causes-decreased bladder size, bladder wall irritation, increased urine volume.
Change in Urine Flow:
Prostatic hypertrophy-most common cause in men of decreased bladder capacity; overflow incontinence
2. Cystitis-frequency d/t mucosal irritation
3. Diabetes mellitus-polyuria, polydipsia, increased appetite
4. Diabetes insipidus-polyuria, polydipsia, prefer water, due to
intra-cranial lesions, headaches, visual disturbances, visual
Red Urine causes
1. Hematuria-blood in urine.
2. Vegetable dyes/vegetables (beets)
3. Drugs-pyridium (orange)
-*Hernia-most common cause of swelling in groin. Reduce in size with
*Hernia-most common cause of swelling in groin. Reduce in size with
- more common
*Questions should address possibility of venereal disease
Some common penile lesions
Clinical Correlations of Penile Lesions:
Chancroid--> very painful, purulent grayish surface
Genital warts--> multiple verruca, painless, no lymphadenopathy
Granuloma inguinale (LGV)
Carcinoma of the penis
Clinical Correlations of Scrotal Enlargement:
1. orchitis--> inflammation of one or both testicles
2. varicocele--> decreased fertility
- venereal disease
- exposure to x-rays
- urological surgical procedure
Catheter on the dorsal side of the penis
-can make a new opening for the urthera
Position of genital exam
Lying down then standing.
Inspection and palpation with patient lying
Inspection and palpation with patient standing
use a penlight
primary lesion usually nontender, single lesion; indurated; usually adenopathy
very painful, purulent grayish surface--> granulation; usually tender adenopathy, multiple lesions
benign; pinpoint, dark red, slightly raised telangiectatic lesions on scrotum. Common age over 50
RARE; sex-linked inborn error of glycosphingolipid metabolism. Pain, fevers, diffuse angiokeratomas in "bathing suit" distribution
Inspect for Groin Mass:
Patient to cough or strain-look for sudden bulge--> inguinal or femoral hernia
constriction of the preputial orifice so foreskin cannot be retracted.
retracts but gets caught
inflammation of the glans and prepuce. Phimosis may predispose patient.
inflammation of the glans penis alone.
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