CVA tenderness
related to sudden distension of renal capsule-think pyelonephritis
ureteral distention
ie kidney stones, results in severe pain; can radiate to groin; patient cannot become comfortable on the table. No PE findings
bladder distention
Can cause lower abdominal pain and...
hydrocele - nontender fluid filled mass within the tunica vaginalis
testicular torsion - twisting of testicle on spermatic cord
acute pain and swollen
retracts into scrotum becoming tender and swollen
NEG pyrin’s sign
Pyrin’s Sign - relief of pain when elevation of testicle
testicular CA - No transillumination
Usually, painless nodule
Cryptorchidism-testicle never descends into scrotum
RISK FOR TESTICULAR CANCER
Epididymitis - Acutely inflamed epididymis
Tender and swollen
Co-existing infection usually
Positive Phrens sign (relief of pain with elevation of the testicle)
Varicocele - Varicosities of the pampiniform plexus of the veins form a soft, irregular
mass in the scrotum
Bag of worms
Spermatocele - painless movable cystic mass just above testis
transilluminates
contains sperm
acute orchitis - Inflammation of one or both testes
Usually due to infection, mumps
, indirect hernia - common at all ages
Originates above inguinal ligament and often passes into the scrotum through the
external ring
May touch the examiners finger in the inguinal canal
Direct hernia - less common than indirect
Originates above the inguinal ligament near external inguinal ring and rarely enters
scrotum
Femoral hernia - more common in women
Originates below inguinal ligament more lateral than inguinal hernia, never enters
scrotum
incarcerated hernia - ts contents cannot be returned to the abdominal cavity
strangulated hernia - the blood supply to the entrapped contents is compromised
when to suspect strangulation - in presence of tenderness, nausea, and vomiting
phimosis - inability to retract the foreskin over the glans
paraphimosis - occurs when the foreskin cannot be replaced in its normal position after
it is retracted behind the glans
Tip the penis may swell after foreskin is retracted
hypospadias - Congenital displacement of the urethral meatus to the inferior surface of
the penis
epispadias - Developmental anomaly in which the urethral meatus is on the dorsal side
of the penis
Pyronine’s Disease - irregular fibrosis of septum or sheath of corpus cavernosum penis,
extending into tunica albuginea
priapism - Erection is sustained by reflex or central nerve stimulation, or by local
mechanical causes, such as thrombosis, hemorrhage, neoplasm, injection of vasoactive
agents, and inflammation of the penis
syphilis - painless chancre
chancroid - h. dacrya
punched out ulcer
lymphogranuloma venereum - C. tracheitis
vesicular papules nodular
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