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73 Cards in this Set
- Front
- Back
Inspection- penis |
condition of skin glans shaft urethral meatus urethral discharge |
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inspection and palpation |
-groin and pubic area -penis -scrotum -sacrococcygeal areas -perineal area -inguinal region and femoral area |
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Inspection- groin and pubic area |
-with patient supine, inspect the groin observe gential hair distributio -expected findings: skin clear, intact and smooth -hair diomand shaped pattern -hair appears coarser than at the scalp and has no parasites |
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Inspecting penis |
observe penis for surface characteristics, colour, lesions and discharge
-inspect dorsal and ventral surfaces -ask the uncircumsized patient to retract the prepuce -- |
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-expected finding |
-dorsal vein apparent on dorsal surface of penis -no edema, lesions, discharge or nodules -in the circumsized patient, the glans and corona are visible, lighter in colour than th eshaft and free of smegma -in uncircumsized penis, prepuce retracts easily |
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inspecting foreskin |
-skin on or at the base of penis - chancres, ulcers, nits or lice |
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prepuce(foreskin) |
may require retraction if client is not circumsized to ensure detection of possible chancres or cnacers -encourage client to do it himself -foreskin should retract smoothly -note presence and odour of smegma -return foreskin to normal position after inspecting to prevent paraphimosis |
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smegma |
cheesy, white or yellow material normally found under foreskin |
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phimosis |
a congenital narrowing of the opening of the foreskin so that it cannot be retracted |
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paraphimosis |
uncommon medical condition in which the foreskin of an uncircumcised penis becomes trapped behind the glans penis, and cannot be reduced (pulled back to its normal flaccid position covering the glans). |
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inspecting the glans
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expected: glistening pink, smooth and bulbous |
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unexpected fidings- glans |
balanitis, ulcers, scars, nodules, inflammation, discharge(sample and culture speimen) |
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hypospadias |
urethral meatus on underside |
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epispadias |
meatus on upper side |
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inspect and palpate the shaft |
-smooth without lesions or pain |
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unexpected finding- shaft |
genital warts(condylomat acuminata) |
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urethral meatus |
assess position of meatus inspect and palpaet the external urinary meatus - strip or milk the penis from base toward glans - note colour , consistency or odour of any discharge |
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palpate penis |
palpate between thumb and 1st two fingers -note tenderness, induration |
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scrotum- inspect and palpat |
-skin -testis -epididymis -spermatic cord -any masses |
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inspecting scrotum |
-ask patient to hold penis out of the way and inspect the scrotal septum -inspect the anterior and posterior scrotum for any sores or rashes -skin: lift the scrotum to examine its underside -rashes, cysts, skin cancers |
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palpate scrotum |
-palpate scrotal contents for noduls, lesions or tenderness -scrotal contours- swelling, lumps, distended veins(varicocele), crypotorchidism, hydrocele, acute epididymitis, torsion of spermatic cord |
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expected findings scrotum |
-divided into two sacs, sebaceous cysts commonly noted, assymmetry is normal, left usually lower than right -anterior and posterior skin darker in pigmentation with a rugous or wrinkled surface -smooth nontender scrotal contents |
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scrotum palpate |
each testis and epididymis between thumb and first two fingers -each spermatic cord, including the vas deferns, between thumb and fingers from epididymis to the superficial inguinal ring- variocele is an unexpected finding |
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transillumation of scrotal sac |
-done to assess for mass or fluid -contents do NOT normally transilluminate -hydroceles and spermatoceles contain fluid and transilluminate -red glow may indicate hydrocele -tumours and hernias do not -use a bright penlight and press light against scrotal sax |
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hydrocele can mean |
congestive heart failure |
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hydrocele |
the accumulation of serous fluid in a body sac. |
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varicocele |
veins become enlarged inside your scrotum |
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inspection of sacrococcygeal areas |
-inspect for surface characteristics and tenderness expected findings: skin is clear and smooth with no palpable masses or dimpling unexpected findings: a dimple with an inflamed tuft of hair or a tender palpable cyst in the sacrococcygeal area |
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inspection of perineal area |
-with the patient on his side, spread the buttocks and inspect the perineal area expected: skin surounding the anus is coarse with darker pigmentation unexpected: warts, loose sphincter, lesions, hemorrhoids, fissures, fistulas, or polyps |
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inspection and palpation of perineal area |
-ask patient to "bear down" and inspect the area while the patient is performing the valsalva maneuver |
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palaption of the perianal area |
palpate any abnormal areas on the scarococcygeal and perianal areas, noting lumps or tenderness |
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palpation of perineal area |
place pad of lubricated finger over anus and gently press on the sphincter's edge. wait for the sphincter to relax then insert fingertip into anal canal -pause and allow patient to adjust to your giner, then contiue to insert finger fully - not sphincter tone of the anus by asking patient to squeeze anal muscles around your finger |
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palpate anus |
rotate fingers 180 degrees to examine the posterior and lateral walls of the rectum -sweep fingers across the anterior and anterolateral walls of the rectum -note texture and elasticity of the rectal lining. assess for tenderness, induration, irregularities or nodules |
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prostate exam |
-inform patient that you're going to examine his prostate gland and that they may feel an urge to urinate when it is palpated -sweep fingers over prostate gland(found anteriorly through rectal wall) -identify lateral lobes and median sulcus |
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prostate |
-note size, shape, surface, mobility, consistency of prostate, and identify any nodules or tenderness |
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normal prostate is: |
-rubbery -smooth -nontender -with a prominient median sulcus |
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note colour of any |
fecal matter on the glove, test it for occult blood |
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femoral hernias |
similar to inguinal hernias, but they protrude through the femoral canal which lies below the inguinal ligament |
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check for hernia- inspect |
person standing and bear down, cough to ilicit bulging |
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check for hernia- palapte |
if mass present, listen for bowel sounds, rule out incarcerted or strangulated hernia, gently try to reduce it unless it is incarcerated |
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indrect inguinal hernia |
takes path from the abdomen, through teh inguinal canal, into the scrotal sac -can be reduced into the scrotum because it goes back into the inguinal canal -more likely to strangulate than direct |
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direct inguinal hernia |
does not come through inguinal canal, but actually comes through abdo wall |
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direct and indirect |
can co-exist |
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____________ cancer is the second leading cause of cancer deaths in men and women |
colorectal |
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one in _____ will develop prostate cancer in their lifetime |
7 |
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excluding non-melanoma skin cancer, _______ cancer is the most common |
prostate |
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which muscle in anal canal is under volutnary contral |
psoas muscle |
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health prmotion |
stds and hiv
-hernias -testicular cancer -prostate cancer -colorectal cancer - |
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testicular cancer |
-most common malignancy in men early to middle age and fastest growing malignancy in this age group in canada, 15-35 -5 year survival rate>96% |
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risk factors testicular cancer |
undescended testicle(crytorchidism)
-mumps(orchitis) -hydrocele -personal previous history or fam history unusual testicular development -inguinal hernia |
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testicular self exam |
should be done montly |
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gen guidelines for self exam |
-after a warm bath or shower -stand in front of mirror, inspect for swelling of scrotum -feel size and weight of each testicle(normal for one to hang lower or be slightly heavier) -use both hands to examine each testicle- thumb on top, cup index and middle fingers under testicle -roll the testicle gently between the thumbs and fingers, smoothness, report lumps ASAP |
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__________________ is the most frequently reported STI in canada |
chlaymidia |
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______ has the fastest growing rate of incidence |
syphillis |
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____% of canadians with HIV are male |
80 |
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__________ and ______________ ar the most adversely age groups affected by stis and hiv |
adolescents and young males |
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risk factors for inguinal hernias |
-muscle deficiency -physical stress -intra-ab press -smoking -aging -pelvic fractures and trauma -connective tissue disease -systemic illnesses |
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conseling for hernias |
-stress that some risk factors are modifiable ex. activities that increase intra-bab pressure |
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nonmodifiable factors |
genetic predisposition to weakness in ab wall |
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prostate cancer |
-asymmetric shape -hard consistency -discrete nodule may be palpable -median sulcus often obscured |
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_________ is teh leading cancer diagnosed in canadian men, and _________ leading cause of death |
men, third |
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primary risk factors for prostate cancer |
age, ethnicity, fam history |
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__________ is the leading cause of death from cancer when numbers for men and women ae bomined |
colon |
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reduce risk of colon cancer by |
incresing physical activity limiting alc -using NSAIDs -eliminating tobacco |
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screen for colon cancer |
-men and women over 50 should have fetal occult blood test or fecial immunochemical test at least every 2 years -positive test requires follow up-colonoscopy |
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older adult |
-distention of rectum -elevated pressure threshold for the feeling of rectal distention, causing retetion of stool -incontinence -pubic hair becomes finer, grayer, less plentiful -testosterone levevls decrease -erection becomes more dependent on tactile stimulation and less responsive to erotic cues -penis decreases in size, testes drop lower in the scrotum -fibromuscuar structures of the prostate gland atrophy |
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testicular cancer |
age 15 to 49
genetic background -crytorchidism -history of testicular cancer in other testicle -fam history |
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prostate cancer |
-3rd leading cause of cancer death in men -family history of prostate cancer -age: highest incidence is in older men, 75% of new cases occur in men older 65 years -men of african descent have highest incidence of prostate cancer- two times higher than white men |
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penile cancer |
phimosis- foreskin of penis cant be pulled back 60 years or older compromised personal hygiene sexual promiscuity -use of tobacco products -possible link with human papillomavirus |
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___ in 28 men will die from prostate cancer |
1 |
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common symptoms related to male genitalia and rectum |
-pain -difficulty peeing(weak stream, frequent urination -erectile dysfunction -change in sexual desire -penile lesions -scrotal swelling, heaviness, pain or aching -bulge in groin -rectal bleeding, itching, burning -anal pain -passing gas -dribblign |
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priapism |
long lasting painful erection not sexual excitement, results from vein thrombosis in the corpora cavernosa |
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most painful condiotins of anus and rectum |
perianal abscess , rectal fissure, hemorrhoids |