External Male Genitalia.330.No Pix.Gsu

2,055 views

Published on

Published in: Health & Medicine, Education
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
2,055
On SlideShare
0
From Embeds
0
Number of Embeds
28
Actions
Shares
0
Downloads
28
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

External Male Genitalia.330.No Pix.Gsu

  1. 1. External Male Genitalia Nursing 330 Governors State University Shirley Comer
  2. 2. Relevant History <ul><li>Frequency, urgency, Nocturia dysuria </li></ul><ul><li>Hesitancy or straining </li></ul><ul><li>Urine color </li></ul><ul><li>Penile pain, lesion, discharge </li></ul><ul><li>Scrotal lumps, pain </li></ul><ul><li>Sexual activity and contraceptive use </li></ul><ul><li>STD </li></ul>
  3. 3. Inspection Penis <ul><li>Skin- color, lesions, nodules </li></ul><ul><li>Assess any discharge </li></ul><ul><li>Retract uncircumcised foreskin- should move easily </li></ul><ul><ul><li>Phimosis= can not retract </li></ul></ul><ul><ul><li>Paraphimosis = cannot replace once retracted </li></ul></ul><ul><li>Urinary meatus central </li></ul><ul><ul><li>Can be displaced </li></ul></ul>
  4. 4. Inspect and Palpate Scrotum <ul><li>Scrotal size dependant on room temperature </li></ul><ul><li>Asymmetry common – left lower than right </li></ul><ul><li>Lift and Inspect posterior surface may be sebaceous cyst (yellow nontender) </li></ul><ul><li>Palpate testes, epididymis and spermatic cord between thumb and forefinger </li></ul><ul><ul><li>Oval and firm </li></ul></ul><ul><ul><li>Smooth and moveable </li></ul></ul><ul><ul><li>Should be sl tender </li></ul></ul><ul><ul><li>Epididymis non tender </li></ul></ul>
  5. 5. Inspect and Palpate for Hernia <ul><li>Inspect inguinal region for a bulge as pt is standing and as he strains down </li></ul><ul><li>Palpate inguinal canal- ask pt to shift wt to unexamined leg </li></ul><ul><ul><li>Palpate up the spermatic cord invaginating the scrotal skin as you go. </li></ul></ul><ul><ul><li>External inguinal ring will feel triangular </li></ul></ul><ul><ul><li>Insert finger and ask pt to bear down- should feel nothing </li></ul></ul>
  6. 6. Regional Lymph Nodes <ul><li>Palpate Horizontal chain </li></ul><ul><ul><li>Located inferior to inguinal ligament </li></ul></ul><ul><li>Palpate Vertical chain </li></ul><ul><ul><li>Located along upper inner thigh </li></ul></ul><ul><li>May normally palpate isolated enlarged node </li></ul>
  7. 7. Testicular self Exam <ul><li>Testicular cancer rate highest among men 15 to 34 yo </li></ul><ul><li>Perform monthly </li></ul><ul><li>Shower is a good place to perform as scrotum is warm </li></ul><ul><li>Palpate testicle, epididymis and spermatic cord for lumps between thumb and 2 forefingers </li></ul>
  8. 8. Age Specific Considerations <ul><li>Infants </li></ul><ul><ul><li>cryptorchidism – undescended testicles </li></ul></ul><ul><ul><li>should descend by 3 months </li></ul></ul><ul><ul><li>may migrate r/t immature inguinal rings </li></ul></ul><ul><li>Aging male </li></ul><ul><ul><li>thinner hair </li></ul></ul><ul><ul><li>testicles smaller and less firm </li></ul></ul><ul><ul><li>scrotum more pendulous </li></ul></ul><ul><ul><li>may sit on scrotum and cause lesions </li></ul></ul>
  9. 9. Practice Exam Question <ul><li>Your 25 year old male patient becomes sexually aroused during your genital assessment. He is extremely embarrassed. What should you do? </li></ul><ul><li>A. Set limits about sexual behavior </li></ul><ul><li>B. Continue the exam as if nothing has occurred </li></ul><ul><li>C. Tell him it happens and excuse yourself for 10 minutes </li></ul><ul><li>D. Have the PHCP perform the exam </li></ul>
  10. 10. Rationale <ul><li>C is the correct answer. This is a physiological response that is not sexually motivated. Allow the pt to relax and then continue the exam. </li></ul><ul><li>B is incorrect because you cannot adequately exam the genitalia in this state </li></ul><ul><li>D is an option if the pt is too embarrassed to have you continue the exam </li></ul>

×