Chapter 25 JARVIS Flashcards

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Questions and Answers

A 2-year-old boy has been diagnosed with physiologic cryptorchidism. What will the nurse most likely observe during the assessment?

Absence of the testis in the scrotum, but the testis can be milked down (correct)

Testes that are hard and painful to palpation

Atrophic scrotum and a bilateral absence of the testis

Testes that migrate into the abdomen when the child squats or sits cross-legged

What is a common assessment finding in a boy younger than 2 years old?

Penis that looks large in relation to the scrotum

Inflamed and tender spermatic cord

Presence of a hydrocele, or fluid in the scrotum (correct)

Presence of a hernia in the scrotum

During an examination of an aging man, what finding would the nurse expect?

Enlargement of the testes and scrotum

Change in scrotal color

Decrease in the size of the penis (correct)

Increase in the number of rugae over the scrotal sac

What does the presence of multiple soft, moist, painless papules in the shape of cauliflower-like patches on the shaft of the penis suggest?

Genital warts Signup and view all the answers

What do findings of swelling in the scrotum that increases with increased intra-abdominal pressure and decreases when lying down indicate in a 16-year-old male?

Indirect inguinal hernia Signup and view all the answers

During a testicular examination on a 25-year-old man, which finding is considered normal?

Testes that feel oval and movable and are slightly sensitive to compression Signup and view all the answers

Which finding during the inspection of the scrotum and testes of a 43-year-old man would require additional follow-up?

Skin on the scrotum is taut Signup and view all the answers

What do severe pain of sudden onset in the scrotal area, somewhat relieved by elevation, and a red, enlarged, painful scrotum indicate?

Epididymitis Signup and view all the answers

What type of hernia is indicated by a painless round swelling close to the pubis that is easily reduced when the individual is supine?

Direct inguinal Signup and view all the answers

What is the medical term for prolonged, painful erection of the penis without sexual stimulation?

Priapism Signup and view all the answers

What do the findings of a red, round, superficial ulcer with a yellowish serous discharge on the penis suggest?

Syphilitic chancre Signup and view all the answers

How should the nurse document the finding of trouble starting a urine stream?

Hesitancy Signup and view all the answers

What do clusters of small vesicles surrounded by erythema on the glans indicate?

Genital herpes Signup and view all the answers

What condition is indicated if the male patient's foreskin is fixed and tight, and will not retract over the glans?

Phimosis Signup and view all the answers

Which tests should be performed for a 55-year-old man worried about prostate cancer? (Select all that apply)

Digital rectal examination (DRE) Signup and view all the answers

Which assessment findings support the diagnosis of orchitis in a 16-year-old boy after mumps? (Select all that apply)

Scrotal skin that is reddened Signup and view all the answers

Which is a structure of the external male genital?

Scrotum Signup and view all the answers

Which is an accessory glandular structure for the male genital organs?

Prostate Signup and view all the answers

Which of these statements is true regarding the penis?

The corpus spongiosum expands into a cone of erectile tissue called the glans. Signup and view all the answers

When performing a genital examination on a 25-year-old man, how should the nurse proceed if noticing deeply pigmented, wrinkled scrotal skin?

Consider this finding as normal, and proceed with the examination. Signup and view all the answers

Which statement concerning the testes is true?

The cremaster muscle contracts in response to cold and draws the testicles closer to the body. Signup and view all the answers

Where is sperm produced?

Testes Signup and view all the answers

What is a hernia?

A hernia is a loop of bowel protruding through a weak spot in the abdominal muscles. Signup and view all the answers

What is the first sign of puberty in boys?

The first sign of puberty is an enlargement of the testes. Signup and view all the answers

Which finding is an expected or normal change during aging in men?

Decreased penis size Signup and view all the answers

What can cause withdrawal from sexual activity later in life?

Side effects of medications Signup and view all the answers

What is burning during urination called?

Dysuria Signup and view all the answers

Which statement is most appropriate to begin a sexual history from a male adolescent?

Often adolescents your age have questions about sexual activity. Signup and view all the answers

What is an appropriate question for obtaining a genitourinary history from an older man?

Do you need to get up at night to urinate? Signup and view all the answers

What should the nurse do when a male patient has an erection during a genital examination?

Reassure the patient that this is a normal response and continue with the examination. Signup and view all the answers

What is a normal finding when examining the glans?

Smegma may be present under the foreskin of an uncircumcised male. Signup and view all the answers

What does a ventrally positioned urethral meatus indicate?

Hypospadias Signup and view all the answers

What should the nurse do when collecting urethral discharge for examination?

Compress the glans between the examiner's thumb and forefinger, and collect any discharge. Signup and view all the answers

What does the presence of multiple firm, nontender, yellow 1-cm nodules in the scrotum indicate?

Sebaceous cysts Signup and view all the answers

What does a red glow during transillumination of the scrotum indicate?

Suspect the presence of serous fluid in the scrotum. Signup and view all the answers

What is the correct action when performing a genital examination on a male patient?

Having the patient shift his weight onto the left (unexamined) leg when palpating for a hernia on the right side. Signup and view all the answers

Which statement is true regarding the incidence of testicular cancer?

Men with a history of cryptorchidism are at the greatest risk for the development of testicular cancer. Signup and view all the answers

How should a patient perform a testicular self-examination?

If you notice an enlarged testicle or a painless lump, call your health care provider. Signup and view all the answers

What should the nurse do for a 2-month-old uncircumcised infant during a genital examination?

Retracting the foreskin should be avoided until the infant is 3 months old. Signup and view all the answers

Study Notes

External Male Genital Structures

The external male genital structures consist of the penis and scrotum.
Internal structures include the testis, epididymis, and vas deferens.

Accessory Glandular Structures

The prostate, seminal vesicles, and bulbourethral glands are accessory glandular structures for male genital organs.

Anatomy of the Penis

The corpus spongiosum expands at the tip into the glans, exhibiting erectile tissue.
The penis comprises three columns of erectile tissue, not two.
The prepuce is the fold of foreskin covering the glans, not the shaft.

Normal Scrotal Appearance

Deeply pigmented, wrinkled scrotal skin with large sebaceous follicles is considered a normal finding post-adolescence.

Testicular Location and Lymphatics

The right testis is positioned lower than the left due to the shorter spermatic cord on the right.
Lymphatic vessels from the testes drain into inguinal lymph nodes.

Sperm Production

Sperm is produced in the testes; the prostate and epididymis do not produce sperm.

Understanding Hernias

A hernia is characterized by a loop of bowel protruding through a weak spot in the abdominal muscles, not a prenatal abnormality.

Signs of Puberty in Boys

The first sign of puberty in boys is the enlargement of the testes, typically beginning between ages 9 and 10.

Aging Changes in Male Anatomy

Normal aging may lead to decreased penis size, diminished pubic hair, and altered rugae over the scrotal sac.

Factors Influencing Sexual Activity

Side effects of medications can contribute to reduced sexual activity in older men along with other factors like loss of spouse or life stress.

Urethral Symptoms

Dysuria is the medical term for burning during urination, often seen in conditions like prostatitis.

Conducting a Sexual History

Initiating a sexual history with a non-judgmental permission statement helps adolescents feel comfortable discussing sexual activity.

Expected Changes in Older Adults

Asking about nocturia (urination at night) is relevant for older male patients as it can indicate underlying health issues.

Responding to Erection During Examination

Acknowledge the erection as a normal physiological response and continue the examination to maintain professionalism.

Normal Findings in the Glans

Smegma may be present under the foreskin of uncircumcised males but the glans should appear smooth and lesion-free.

Urethral Meatus Positioning

A ventrally positioned urethral meatus indicates hypospadias, an abnormality that should be assessed further.

Collecting Urethral Discharge

To collect urethral discharge for examination, compress the glans to obtain a sample.

Scrotal Nodules

Yellow, firm, nontender nodules in the scrotum often represent sebaceous cysts, a common finding.

Transillumination of the Scrotum

A red glow during transillumination suggests the presence of serous fluid in the scrotum.

Correct Examination Technique

Shift the patient's weight onto the opposite leg when palpating for a potential hernia on the examined side.

Testicular Cancer Risk Factors

Cryptorchidism significantly increases the risk of developing testicular cancer; early detection improves the cure rate.

Testicular Self-Examination Guidance

Advise patients to report any firm, painless lumps or enlarged testicles to their healthcare provider.

Examination of Infants

Avoid retracting the foreskin of uncircumcised infants until they are at least 3 months old to prevent complications.

Physiologic Cryptorchidism

In physiologic cryptorchidism, the testis may not be palpable but can be milled down in response to gentle manipulation.

Common Findings in Young Boys

Hydrocele, or fluid accumulation in the scrotum, is a typical assessment finding in boys under 2 years of age.

Expected Findings in Aging Males

Aging may lead to a decrease in penis size while other aspects of anatomy like the scrotum may show less rugae and pendulous characteristics.### Genital Assessment Findings
Multiple soft, moist, painless papules in a cauliflower-like shape on the penis indicate genital warts (Human Papillomavirus - HPV).
Genital carcinoma usually presents as raised, warty growths or ulcers, primarily on the glans or foreskin.
Genital herpes manifests as painful clusters of small vesicles, typically on the glans, foreskin, or anus.
Syphilitic chancres appear as solitary ulcers with a nontender base within a few weeks of infection.

Inguinal Hernias

Indirect inguinal hernias are characterized by a soft swelling that increases with intra-abdominal pressure, often accompanied by pain when straining; it decreases in size when supine.
Direct inguinal hernias usually occur in older men due to acquired weakness and are also painless.
Femoral hernias present with constant pain and can become strangulated.
Incisional hernias occur at surgical incision sites.

Testicular Examination Norms

Normal testes are oval, firm, rubbery, smooth, and slightly sensitive to compression; they are freely movable.
Any presence of subcutaneous plaques, dry or scaly scrotal skin, or hard masses typically indicates abnormal findings.

Scrotal Condition Considerations

Taut skin on the scrotum may suggest swelling and potential pitting edema that requires follow-up.
Normal anatomy includes the left testicle typically hanging lower than the right and the scrotum's responsive contraction to cold.

Acute Scrotal Pain Diagnosis

Epididymitis presents with severe, sudden scrotal pain relieved by elevation, with an enlarged and very tender scrotum.
Testicular torsion causes excruciating unilateral pain and a swollen scrotum with one testis higher than normal.

Erectile Dysfunction Drug Teaching

Priapism is a serious side effect of erectile dysfunction medications that involves prolonged, painful erection without sexual stimulation.

Urological Assessment Terms

Difficulty starting a urine stream is referred to as hesitancy; urgency represents the need to urinate immediately, while frequency denotes increased urination.

Conditions of the Foreskin

Phimosis occurs when the foreskin cannot retract over the glans, which may be congenital or due to infection-related adhesions.

Prostate Cancer Screening

Men aged 50 and older, particularly those with family histories of prostate cancer, should undergo annual testing including PSA blood tests and digital rectal exams (DRE).

Signs of Orchitis

Orchitis is indicated by swollen, tender testes, reddened scrotal skin, and a non-transilluminating mass.

Assessment Findings for Scrotal Issues

In orchitis, assess for swollen, tender testis, and reddened scrotal skin; transillumination of masses indicates hydrocele, not orchitis.

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Test your knowledge on the external male genital structures through these flashcards. This quiz covers important concepts related to male reproductive anatomy, focusing on identifying key components and their functions. Perfect for students studying health sciences or biology.