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CS1 Male Pelvis
| Question | Answer |
|---|---|
| Developmental changes: Infants | 1.Sexual differentation 8-12 weeks. 2.Seperation of prepuce from glans (3-4yrs old). |
| Developmental changes: Adolescents | 1.pubic hair. 2.Genital enlargement. |
| Developmental changes: Elderly | 1.Thinning of pubic hair. 2.Pendulous scrotum. 3.Slower erction/ ED |
| Tanner Stage 1 | Prepubertal |
| Cryptorchidism | Failure of one or both testicles to descend from the abdomen into the scrotum. **Increases risk of scrotal cancer and infertility. |
| Testicular Torsion | EMERGENCY that occurs in newborns/adolescents where the spermatocords twist. Cuts off BL supply to the testis. **Will lack a cremasteric reflex due to Genital branch of Genitofemoral N impengement. |
| Epididymitis | Inflammation of the epididymis associated with bacterial infections (UTI or STI). |
| Varicoceles | Abnormal dilation of veins of the pampiniform plexus. "Bag of worms" in the scrotum. **Most common on the left side since the L testicle hangs lower due to increased venous pressure. |
| Testicular Carcinoma | Painless mass in the testicles. |
| Cuases of scrotal enlargement | 1.Testicular torsion. 2.Varicocele. 3.Hyrdocele (clear fluid in tunica vaginalis, Transilluminates). 4.Spermatocele (non-tender mass on epididymis, Transilluminates). 5.Hernia (Pre-peritoneal fat and bowl can enter the scrotum). 6.Tumor. 7.Epididy |
| Most common form of male hernias | Indirect Inguinal. Passes through both inguinal rings and the inguinal canal. Usually congenital from the descention of the testicals. **Will feel on finger tip when palpating. |
| Direct Inguinal Hernia | Pre-peritoneal fat and bowel Pass through the inguinal triangle and exit the SUPERFICIAL Inguinal ring. **Usually do not enter the scrotum and Dr will feel it against the side of finger tip. |
| Femoral Hernia | Bowel passes through the fossa ovalis and enters the femoral canal. **More common in women. |
| Penile Cancer Risks | 1.Lack of circumcision. 2.Condyloma acuminatum. |
| Hypospadias | CONGENITAL. Urethra is located on the ventral surface. |
| Epispadias | CONGENTIAL. Urethra is located on the dorsal surface. |
| Phimosis | Inability to retract foreskin from the glans. |
| Priapism | Pain due to thromobosis of corpora caversnosa. **Could be from sickle cell or leukemia. |
| Balanitis | Inflammation of the glans ONLY |
| Balanoposthitis | Inflammation of the glans AND prepuce |
| Smegma | cheesy white material under foreskin |
| ED | Inability to Acheive or Maintain an erection. |
| Penile Discharges | 1.Purulent (gonococcal, chronic prostatitis). 2.Bloody (ulceration, neoplasm, urethritis). |
| Dysuria | Painful urination due to UTI, urethral stenosis, urethral stricture. **Could be due to Pneumaturia, Fecaluria, Pyuria. |
| Polyuria | Excessive volume of urine (>2L/day) |
| Nocturia | Increased night time urination (>2X/night) |
| Incontinence | inability to voluntarily urinate |
| Hematuria | BL in urine. **Only initially: urethral bleeding. **Terminally: bladder neck/posterior urethra |
| Width and lobes of prostate | Two fingers width wide (3-4cm). 5 lobes **Two lateral lobes and dividing sulcus are the only ones palpable |
| Normal Prostate texture | Firm, smooth, slightly movable, non-tender. **it should slightly protrude into the rectum. |
| Benign Prostatic Hyperplasia (BPH) | When natural prostatic enlargement from testosterone with age becomes problematic. Usually seen with middle and lateral lobe enlargement. **Symptoms: Dysuria, inc frequency, urgency, nocturia, weak stream. |
| Risk Factors of Prostate Cancer | 1.Age > 50yrs. 2.African American. 3.Family Hx. 4.Diet high in animal fat |
| What lobe of the prostate is most prone to cancer? | Posterior Lobe **May be able to palpate stoney or hard nodules. |
| Prostate specific Antigen (PSA) | Protein produced by the prostate that increases with cancer. **Difficult to use to differentiate b/w BPH and cancer |
| Prostatic Grades (Normal to +4) | +1: 3 fingers. +2: 4 fingers. +3: > 4 fingers. +4: Most anterior pelvic outlet. |
| ColoRectal Cancer Risk factors | 1.Age > 50y/o. 2.Family Hx: polyposis, Gardner's syn, Peutz Jegher's syn. 3.PMHx of polyps, Crohn's disease, Gardener's syn, ovarian/endometrial cancer. |
| Internal vs External Hemorrhoids | Internal: Vericosities above the anorectal junction (pectinate line). No pain, bleeding. External:Varicosities below the anorectal junction (pectinate line). Protrude with pressure, cause pain. |
| Fissures | tares in the anal mucosa posterior to midline. Caused by passage of large hard stool. Painful with itching |
| Puritus Ani | Perianal burning and irritation caused by chronic inflammation of perineal skin. **usually caused by fungal infection (adults), parasites (children). |
| T12-L2 Sympathetics control? | Ejaculation/orgasm, inhibits bladder contraction (Detrusor muscle), decreases ureteral peristalsis. |
| S2-S4 parasympathetic control? | Erection, bladder contraction |
| Infertility | 30% of the time caused by males |
| What two causes of scrotal enlargements would cause severe pain? | 1.Epidydimitis (increases). 2.Torsion (sudden, <20y/o) |
Created by:
WeeG
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