Health Assessment Male Repro
Terms
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- corona
- where glans meets penile shaft
- corpus cavernosum, corpus spongiosum
- cavernosum more outside layer, spongiosum more inside layer of shaft (surrounds urethra)
- scrotal wall
- rugae, cremaster muscle (contracts with cold, relaxes with heat)
- epididymis
- lies top and posteriolateral to testis; transports sperm via ducts; connects to vas deferens
- fetal sex differentiation & male development
- differentiation by 12 wks; testes descend in 3rd t (retroperitoneal to inguinal canal to scrotum)
- male puberty: onset, 1st sign, duration
- 9.5-13.5 yo; testicular enlargement 1st, then hair development & penile enlargement; 3 years
- sexual changes after 55-60 yo
- longer to achieve erection, maintain erection longer wo ejaculation, less intense orgasm, rapid detumescence & longer refractory state, grey pubic hair, penile size decreases, scrotum more pendulous
- urinary complaints for men
- dysuria, frequency, urgency, nocturia, hesitancy, straining, urine characteristics, incontinence
- penile complaints
- pain, lesions, discharge
- scrotal complaints
- pain, swelling, masses
- inguinal complaints
- pain, enlargement
- hydrocele
- presentation: painless enlarged scrotum; usu happens congentially boys 1-2 yo or secondarily men >40; fluid accumulates superior and anterior to testes; usually associated with hernias, usually unilateral
- varicocele
- dilation of pampiniform venous plexus in scrotum; impairs sperm production probably through thermoregulation
- phimosis
- foreskin of uncircumsized male cannot be retracted; usually physiological in infants; pathological in older children and adults who were previously about to retract foreskin
- paraphimosis
- retracted foreskin cannot be put back in original location; can be medical emergency if blood flow is compromised
- balanitis
- inflammation of glans penis due to poor personal hygiene; can result in phimosis
- Cryptorchidism
- undescended testicle, empty scrotal sac
- spermatocele
- epididymal retention cyst, thin milky fluid containing sperm
- direct inguinal hernia
- through external ring, doesn't usually enter scrotum
- indirect inguinal hernia
- through internal ring, most common type, can remain in canal or enter scrotum
- femoral hernia
- herniation through femoral ring and canal, below inguinal ligament
- anus anatomy--length & innervation
- 2.5-4.0 cm, lower half somatic sensory nerves, upper half autonomic non-sensitive
- internal, external sphincter
- internal, involuntary; external, voluntary
- anal columns
- columns of Morgani, anorectal juntion, each column has vein & artery
- site of internal hemorrhoids
- upper anal columns with vein & artery
- site of external hemorrhoids
- lower anal canal with venous plexus
- rectal physiology
- 12 cm long, highly innervated (any rectal trauma painful)
- rectal ampulla
- just above anal canal, rectum dilates and turns posterior, stores flatus & feces
- valves of houston
- 3 semilunar transverse folds, lowest palpable on left
- fetal development
- rectum by 7 wks, patent anus by 8 wks
- infants development
- internal & external sphincters involuntary until spinal cord maturity by 18-24 mo.
- pilonidal cyst
- cyst in sacrococcyeal area believed to be result of hair entering skin & causing inflammatory process
- median sulcus
- middle of prostate
- seminal vesicles
- extend out & above prostate, secrete fructose to nourish sperm
- cowper's gland
- inferior to prostate, either side of urethra, size of pea, secrete fluid for semen transport
- What might you feel on prostate?
-
boggy: infection, rubbery/boggy: BPH,
hardness/mass: cancer, fibroid, stone - prostatitis-acute (bacterial)
- chills, fever, pain in lower back or genital area, urinary frequency often at night, similar to UTI
- prostatitus-chronic
- very rarely bacteria. Most of the time pelvic pain of unknown cause (CP/CPPS). Distinguis bt BPH by pain after ejaculation with CP.