Male GU (ACTUAL) Exam 2022/2023 Graded A+

There are three columns of vascular erectile tissue in the male penis. Name them. - ANS Corpus Spongiosum Corpus Cavernosa (Cause there's two of these ^_^) Describe the Glans. - ANS The glans is the cone shaped end of the penis The prepuce in females is the covering of the clitoris. Males also have a prepuce. What is its more common name? What does it cover? and what is the procedure that would remove it called? - ANS Foreskin Glans of the Penis Circumcision The Vagina is a horizontal slit, the Urethral meatus of the penis is a __________________ slit. - ANS vertical The pouch that contains the testes is called the ______________. - ANS Scrotum The serous membrane that covers the testes is called the _______________. - ANS Tunica Vaginalis This structure stores sperm in tightly coiled tubes. It sits just on the posterior-lateral surface of each testicle. What is its name? - ANS Epidydimus Name the tube which carries sperm from the Epididymus to the semical vesicles. - ANS Vas Deferens Besides the vas deferens the spermatic cord contains these structures (3) - ANS Vessels, Nerves, muscle What is the approximate size of a normal prostate gland? Describe its shape, and consistency. - ANS 3 cm x 3.5 cm bi-lobed, heart shaped, consistency of a rubber ball How many lobes does the prostate gland have? Name them. - ANS Anterior lobe (Fibromuscular stroma) Posterior lobe (Peripheral zone) Middle lobe (Central Zone) 2 Lateral lobes (transitional /Periurethral) Palpating the prostate gland through a rectal exam is useful for screening for prostate cancer because of what convenient idiosyncracy of prostate anatomy? - ANS The prostate gland is just anterior to the rectum yes, but what I'm getting at is that the Posterior Lobe (Closest to the rectum) is the one with the glandular tissue that is most susceptible to cancer. When taking a sexual history what are two things you must do before you start? - ANS 1. Explain why you need the information. 2. Ask permission A good student doctor should be conversant with several common GU complaints. Name six. - ANS Pain, Dysuria, Change in Flow, Hematuria, Lesions, Discharge, Rashes Theres 7, but if you know most of them you should be okay. What structures should be included in an inspection of the penis? - ANS Skin Hair Prepuce/foreskin (if intact) Glans, Meatus. What is the quick procedure that should be done in order to complete the inspection of the penis? - ANS Compression of the glans to express any discharge. (Milking/stripping the penis for a sample if necessary. You can ask the patient to do this for you) What testing should be done on any discharge from the penis? - ANS STD testing Chlamydia - WBC Gonorrhea - WBC with Gm(-) intracellilar diplococci Trichomonas - WBC with moving organisms GEN Probe - Chlamydia & GC Palpation is next, of course you need to palpate the penis, what are you looking for during this procedure, and what other area must you palpate in connection? - ANS We are looking for tenderness, nodules, masses, inflammation. Palpate the inguinal areas for lymph nodes, masses, hernias or tenderness What should be included in the inspection and palpation of the scrotum? - ANS Inspection of the skin and scrotal contours. Palpation of the testes and epididymis and spermatic cord. In order to examine a patient for a potential hernia one would perform what procedure? Describe it. - ANS Proper technique for evaluating a hernia. Finger slides up the inguinal canal. Also palpate the inguinal areas. Ask the patient to cough or bear down. Explain the four steps in the performance of a DRE (Digital Rectal exam) - ANS 1. Inform the patient of what is going to happen. 2. Lubricate your gloved index finger. 3. Place your finger pad on the external sphincter and ask the patient to relax the sphincter muscles. 4. Slowly roll and insert the finger as the sphincter relaxes as far as possible. What structures are you looking for in the DRE? - ANS Mostly the prostate *Specifically the inferior aspect*, and potentially any rectal polyps. Looking to find masses, nodules, tenderness. What is the difference between an indirect, direct and femoral hernia? And which of the three are the most and least common? - ANS Indirect - most common for both sexes. Above inguinal ligament often into the scrotum. Direct - less common, usually in men, rare in women. Above the inguinal ligament. Rarely into scrotum. Femoral - least common. More common in women than men. Below the inguinal ligament. Never into the scrotum. Most hernias are reducible and don't require surgery. In what circumstance would you require surgery for a hernia? - ANS Incarceration. (The hernia, not the patient) You are educating your male patient in the proper techniques for a self-examination. What are the three steps you teach him? - ANS Best performed during or after a bath or shower. 1. Examine each testicle with both hands. Gently roll the testicle between the thumbs and fingers. 2. Locate the epididymis on the posterior surface of the testicle. 3. Follow up with a physician if you find any lumps or tenderness. What is the name of the position you would place your patient in on his left side in order to perform a rectal exam? - ANS Sim's Position or left lateral decubitus