Male Genitourinary System

Chapter 24

Elsevier items and derived items 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Chapter 24: Male Genitourinary System

Structure and Function

Subjective DataHealth History Questions

Objective DataThe Physical Exam

Abnormal Findings

Elsevier items and derived items 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Slide 24-2

Chapter 24: Male Genitourinary System

Structure and Function

Penis

Corpora
cavernosa

Corpora
spongiosum

Glans

Corona

Urethra

Foreskin
Elsevier items and derived items 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Slide 24-3

Chapter 24: Male Genitourinary System

Scrotum

Rugae

Cremaster muscle

Testis

Epididymis

Vas deferens

Spermatic cord

Ejaculatory duct
Copyright Connie Cooper
Elsevier items and derived items 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Slide 24-4

Chapter 24: Male Genitourinary System

Structure and Function

(cont.)

Inguinal area

Inguinal
ligament

Inguinal canal

Internal ring

External ring

Femoral canal

Elsevier items and derived items 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Slide 24-5

Chapter 24: Male Genitourinary System

Subjective Data
Health History Questions

Frequency, urgency, and nocturia

Dysuria

Hesitancy and straining

Urine color

Genitourinary history

Elsevier items and derived items 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Slide 24-6

Chapter 24: Male Genitourinary System

Subjective Data
Health History Questions
(cont.)

Penispain, lesion, and/or discharge

Scrotumself-care behaviors; lump

Sexual activity and contraceptive use

Sexually transmitted disease contact

Elsevier items and derived items 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Slide 24-7

Chapter 24: Male Genitourinary System

Principles of interviewing
adolescent male patients:

Ask questions that seem appropriate for boys age but

be aware that norms vary widely.

Ask direct, matter-of-fact questions. Avoid sounding

judgmental.

Start with a permission statement. Often boys your

age experience

Try the ubiquity approach, When did you rather

than Do you

Sometimes all you do is open the door to later

conversation
Elsevier items and derived items 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Slide 24-8

Chapter 24: Male Genitourinary System

Additional History for

Preadolescents and Adolescents

Around age 12 to 13 years

Who can you talk to

Boys around age 12 to 13 years have a

normal experience

Teenage boys have other normal experiences

and wonder if they are the only ones who
ever had them

Elsevier items and derived items 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Slide 24-9

Chapter 24: Male Genitourinary System

Additional History
(cont.)

Often boys your age have questions about

sexual activity.

Has a nurse or doctor ever taught you

Has anyone ever touched your genitals

Elsevier items and derived items 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Slide 24-10

Chapter 24: Male Genitourinary System

Additional History
for the Aging Adult

Any difficulty urinating?...

Do you need to get up at night

A man in his 70s, 80s, or 90s

Elsevier items and derived items 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Slide 24-11

Chapter 24: Male Genitourinary System

Objective DataThe Physical Exam

Preparation

Position

Apprehension regarding exam

Equipment needed

Gloves

Occasionally need
Glass slide for urethral specimen
Materials for cytology
Flashlight

Elsevier items and derived items 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Slide 24-12

Chapter 24: Male Genitourinary System

Objective DataThe Physical Exam

(cont.)

PenisInspect and palpate

Skin

Glans

Urethral meatus

Pubic hair

Urethral discharge

Shaft
Elsevier items and derived items 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Slide 24-13

Chapter 24: Male Genitourinary System

Objective DataThe Physical Exam

(cont.)

ScrotumInspect and palpate

Skin

Testis

Epididymis

Spermatic cord

Any mass

Note characteristics

Transillumination
Elsevier items and derived items 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Slide 24-14

Chapter 24: Male Genitourinary System

Objective DataThe Physical Exam

(cont.)

Check for herniaInspect and

palpate

Person standing and straining

down
Palpation technique

Inguinal lymph nodes

Teach testicular selfexamination
T = Timing
S = Shower
E = Examination points

Elsevier items and derived items 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Slide 24-15

Chapter 24: Male Genitourinary System

Sample Charting

Elsevier items and derived items 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Slide 24-16

Chapter 24: Male Genitourinary System

Sample Charting
(cont.)

Elsevier items and derived items 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Slide 24-17

Chapter 24: Male Genitourinary System

Abnormal Findings

Male Genital Lesions

Herpes progenitalis

Syphilitic chancre

Condylomata acuminata (genital warts)

Carcinoma

Urethritis (urethral discharge and dysuria)

Elsevier items and derived items 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Slide 24-18

Chapter 24: Male Genitourinary System

Abnormal Findings
(cont.)

Abnormalities of the Penis

Phimosis

Paraphimosis

Hypospadias

Epispadias

Peyronies disease

Priapism

Urethral stricture
Elsevier items and derived items 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Slide 24-19

Chapter 24: Male Genitourinary System

Abnormal Findings
(cont.)

Abnormalities in the Scrotum

Absent testis; cryptorchidism

Small testis

Testicular torsion

Epididymitis

Spermatic cord varicocele

Spermatocele
Elsevier items and derived items 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Slide 24-20

Chapter 24: Male Genitourinary System

Abnormal Findings
(cont.)

Abnormalities in the Scrotum

Early testicular tumor

Diffuse tumor

Hydrocele

Scrotal hernia

Orchitis

Scrotal edema
Elsevier items and derived items 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Slide 24-21

Chapter 24: Male Genitourinary System

Abnormal Findings
(cont.)

Inguinal and Femoral Hernias

Indirect inguinal

Direct inguinal

Femoral

Elsevier items and derived items 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Slide 24-22

Chapter 24: Male Genitourinary System

Which of the following introductions would

be the best way to start your question
when interviewing an adolescent?
A.

Often young men your age

B.

I worry that you might

C.

Do you

D.

You dontdo you?

Elsevier items and derived items 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Slide 24-23

Chapter 24: Male Genitourinary System

Which of the following topics will be least

embarrassing to a male patient?
A.

Elimination (urination)

B.

Sexual function

C.

Reproduction

D.

Sexually transmitted infection exposure

Elsevier items and derived items 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Slide 24-24