Chapter 25: Male genitourinary System Exam 2022

Chapter 25: Male genitourinary System Exam 2022 The Male Genitalia - Answer- -penis -scrotum -testis -epididymis -vas deferens internally What is 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 provider Assess Urinary Function - Answer- -urinalysis —> pale yellow to amber -normal pH is 4.5-8.0 -little or no protein, no glucose, fewer than 5 RBC or WBC per high-powered field in microscope What does specific gravity measure? - Answer- -concentration of urine from very dilute (1.003) to concentrated (1.030) Abnormal Findings for Assessing Urinary Function - Answer- -cloudiness suggests presence of WBC, bacteria, casts -certain drugs or foods can change urine color What is proteinuria? - Answer- -indicates protein in urine -glomerular disease in nephron What is glycosuria? - Answer- -indicates glucose in urine -hyperglycemia occurring with diabetes Blue Urine - Answer- -medication side effect: amitriptyptyline, indocin -foods: asparagus -dye after prostate surgery Dark Gray Urine - Answer- -urine contains melanin, melanuria Tea Urine - Answer- -liver disease, esp with pale stools, jaundice -myoglobinura -some medications or food dyes -blood in urine Pink Urine - Answer- -with menses -some foods: beets, berries, food dyes -some laxatives -kidney stones -UTI Red Urine - Answer- -blood in urine -nephritis, cystitis -cancer (prostate, bladder) -following prostate surgery CONTINUES......