Chapter 25: Male genitourinary System
Exam 2022
The Male Genitalia - Answer- -penis
-scrotum
-testis
-epididymis
-vas deferens internally
What is
... [Show More] the scrotum? - Answer- -loose protective sac
-continuation of the abdominal wall
What is rugae? - Answer- -thin skin lying in folds
-helps elongates
What is the cremaster muscle? - Answer- -controls the size of the scrotum by
responding to ambient temperature
-this is to keep the tests at 3 degrees C below the abdominal temp
What do the testis do? - Answer- -produce sperm
Which testes hangs lower? - Answer- -the left because the left spermatic cord is
longer
What is the epididymis? - Answer- -coiled duct system and the main storage site of
sperm
What is the vas deferens? - Answer- -this duct approximates with other vessels
(arteries and veins, lymphatics, nerves) to form the spermatic cord
Adults and Aging Adults - Answer- -older man does not experience a definite end to
fertility, production of sperm begins to decrease around 40 years, but can continue
into the 80s and 90s
-testosterone production declines after age 30, but very gradually
-pubic hair decreases and turns gray
-penis size decreases
-scrotal contents hang lower
-rugae decreases
-scrotum looks pendulous
-testes decrease in size and are less firm to palpation
-prostate gland surrounding upper urethra undergoes an expected tissue hyperplasia
in 80% of men over 60
What is benign prostatic hyperplasia (BPH)? - Answer- -not cancer
-causes an obstructed urine stream and risk for UTI
What occurs from the declining testosterone production? - Answer- -leaves older
male with a slower and less intense sexual response and erection takes longer to
develop and is less full or firm
-ejaculation is shorter and less forceful
-volume of seminal fluid is less than when he was younger
What is the withdrawal from sexual activity caused by? - Answer- -loss of a spouse,
depression, preoccupation with work, marital or family conflict, side effects of
medications (antihypertensives, psychotropics, antidepressants, antispasmodics,
sedatives, tranquilizers or narcotics, and estrogens), heavy use of alcohol, lack of
privacy, economic or emotional stress, poor nutrients, fatigue
What is circumcision? - Answer- -elective procedure that removes all or part of the
foreskin (prepuce) form the penis
-medical benefits include reduced risk of acquiring HIV
-American Academy of Pediatrics proposes that the health benefits outweigh the
risks
-procedure should be covered by insurance
-reduce risk of UTI and STI
-non therapeutic procedure
-complications: pain, bleeding, swelling, inadequate skin removal
Subjective Data - Answer- -frequency, urgency, nocturia
-dysuria
-hesitancy and straining
-ruin color
-past genitourinary history
-penis
-scrotum, self care behaviors
-secular activity and contraceptive use
-STI contact
Frequency - Answer- -average adult voids 5-6 times/day , varying with fluid intake,
individual habits
What is polyuria? - Answer- -excessive urination
What is oliguria? - Answer- -diminished <400mL/24 hours
What is nocturia? - Answer- -peeing at night
-note: increase risk of falls at night
-may be caused by diuretic medication, habit, or fluid ingestion 3 hours before
bedtime; coffee and alcohol
-fluid retention from mild heart failure or varicose veins produces nocturia because
recumbent at night mobilizes fluid
What is dysuria? - Answer- -painful urination
-burning is common in acute cystitis, prostatic, urethritis
Hesitancy issues - Answer- -hesitancy
-straining
-loss of force and decreased caliber
-terminal dribbling
Urge Incontinence - Answer- -involuntary urine loss from overactive destructor
muscles in bladder
Stress Incontinence - Answer- -involuntary urine loss with physical strain, sneezing,
or caught NG, caused by weakness of pelvic floor
Enlarging Prostate - Answer- -early symptoms of enlarging prostate may be tolerated
or ignored
-later symptoms are more dramatic: he matures, UTI
Inspect and Palpate penis - Answer- -skin is normally wrinkles, hairless, and without
lesions, the dorsal vein may be apparent
-glans looks smooth and without lesions, ask uncircumcised male to pull back
foreskin
-urethral meats is positioned. Just about centrally
-at base of penis, pubic hair distribution is consistent with age, hair is without pest
inhabitants
What is phimosis? - Answer- -narrowed opening of prepuce so cannot retract
foreskin
What is paraphimosis? - Answer- -painful constriction of glans by retracted foreskin
What is hypospadias? - Answer- -ventral location of meatus
What is epispadis? - Answer- -dorsal location of meatus
Inspect and Palpate Scrotum - Answer- -palpate gently each scrotal half between
thumb and two fingers
-contents should slide easily
-normally feel oval, firm, rubbery, smooth, and equal bilaterally
-freely moveable and slightly tender to moderate pressure
Scrotal Swelling - Answer- -edema may be taught and pitting
-occurs with heart failure, renal failure, or local inflammation
Inspect and Palpate for Hernia - Answer- -inspect inguinal area for bulge a person
stands and as he strains down, normally none is present
-have man "bear down"
Self-Care: Testicular Self Examination (TSE) - Answer- -13-14 years old through
adulthood
-testicular cancer is rare, occurs most often between 15-35
-associated with history of cryptorchidism and other factors
TSE - Answer- -timing, once a month
-shower, warm water relaxes scrotal sac
-examine, check for changes, report changes immediately
When is a good time to examine the testicles? - Answer- -during the shower or bath,
when your hands are warm and soapy and the scrotum is warm
-feels rubbery with a smooth surface, like a peeled hard boiled egg
-if you notice firm, painless lump; a hard area; or an verbal enlarged testicle, call
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