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HXPX - Male Genitalia, Breasts And Axillae, Rectum,Prostate, Obstetrics Exam Study Guide
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HXPX - Male Genitalia, Breasts AndAxillae, Rectum,Prostate,
Obstetrics Exam Study Guide
Male Genitalia Inspection and Palpation is __________ _______________? - Answer Done
simultaneously
Inspect shaft of penis for (5) - Answer ulcers, warts, rashes, trauma, dorsal vein
Palpation/inspection of foreskin (4) - Answer retracts freely
Minimal white smegma is normal
inspect for lesions, erythema
replace foreskin after exam
Phimosis - Answer A tightening of the foreskin of the penis that may close the opening of
the penis.
Examination of scrotum - Answer observe for masses larger than sebaceous glands or
cysts, tenderness or lesions
If any edema, consider cardiac, hepatic, or renal disease (ascites)
Scrotal suspension - Answer normally asymmetric; left longer than right
Varicocele - Answer prominently dilated and tortuous veins along spermatic cord
"bag of worms"
most common on left side, not pathologic
Scrotal mass or enlargement identified, you should then - Answer transilluminate sac to
determine if solid or cystic
If light transilluminates scrotal sac well - Answer hernia or hydrocele
If mass in scrotal sac does not transilluminate - Answer bowel, testicle, or other solid or
blood-filled mass
Testicular torsion - Answer twisting of testicle causing ischemia
aggravated with elevation
,usually requires surgery
Examining for Inguinal/Femoral Hernia - Answer Inspect any bugling from inguinal area
to scrotum
Insert pointing finger into scrotal sac and reach up to inguinal canal
Ask patient to cough or bear down
If hernia is present, a soft, contender mass will bulge against finger
If femoral hernia suspected, palpate anterior thigh over femoral canal and have patient
bear down again, feeling for any bulge
Direct Hernia - Answer palpable medial to external canal; will hit finger from the side
Indirect Hernia - Answer most common; palpable directly in external canal; will directly
hit top of finger
A strangulated hernia that cannot be pushed back in - Answer can become ischemic
and requires surgery
Urethritis - Answer inflammation of the urethra that is commonly due to infection by
bacteria
Gonorrhea and chlamydia - Answer STIs; Often occur together
Symptoms:
A yellow vaginal discharge
Painful or frequent urination
Vaginal bleeding between menstrual periods
Rectal bleeding, discharge, or pain
cause tender scrotum
Syphilis - Answer STI
sores commonly occur on the vulva, vagina, anus, or penis, most often is spread
through sexual contact, but can be spread by touching the rash, warts, or infected blood
during the secondary stage of infection
Primary Stage Syphilis - Answer Syphilis first appears as a painless chancre. This sore
goes away without treatment in 3-6 weeks.
Secondary stage—The next stage begins as the chancre is healing or several weeks
after the chancre has disappeared, when a rash may appear on the soles of the feet and
palms of the hands. Flat warts may be seen on the vulva. During this stage, there may be
, flu-like symptoms. This stage is highly contagious.
Latent and late stages—The rash and other symptoms go away in a few weeks or
months, but the disease still is present in the body. If untreated, the disease may return
in its most serious form years later.
Problems associated with syphilis - Answer Heart problems, neurologic problems, and
tumors may occur, leading to brain damage, blindness, paralysis, and even death. The
genital sores caused by syphilis also make it easier to become infected with and
transmit human immunodeficiency virus (HIV).
Trichomonas - Answer STI; seen using microscopic exam
Cryptorchidism - Answer An undescended testicle that hasn't moved into its proper
position in the scrotum before birth. Usually just one testicle is affected, but about 10
percent of the time both testicles are undescended. Can be corrected surgically.
Puts patient at higher risk for cancer
Herpes 1 - Answer oral herpes; cold sores
Herpes 2 - Answer genital warts or sores around the genitals or rectum
External hemorrhoids - Answer in the anus, where there are many more pain-sensing
nerves, so they tend to hurt as well as bleed.
Internal hemorrhoids - Answer far enough inside the rectum that you can't usually see or
feel them.
They don't generally hurt because you have few pain-sensing nerves there.
Bleeding may be the only sign of them
Anal Fissures - Answer tear in the lining of the lower rectum (anal canal) that causes
pain during bowel movements.
don't lead to more serious problems.
red blood - indicates more caudal
black blood - upper GI bleed
Inspect external gluteal areas for - Answer lesions, rashes, pilonidal area for cysts, hair,
dimpling
Inspect between gluteal fold for - Answer lesions, skin tags, hemorrhoids, fissures,
lacerations, trauma
What to note for during insertion of finger into anal canal: (5) - Answer sphincter tone,
tight bands, acute tenderness, masses, hemorrhoids
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