Copyright 2002, Delmar, A division of Thomson Learning Chapter 21 Male Genitalia Copyright 2002, Delmar, A division of Thomson Learning

Copyright 2002, Delmar, A division of Thomson Learning Competencies Identify the anatomic landmarks of the male genitalia. Describe the characteristics of the most common male reproductive chief complaints. Perform inspection, palpation, and auscultation on an adult male. (continues) Copyright 2002, Delmar, A division of Thomson Learning

Copyright 2002, Delmar, A division of Thomson Learning Competencies Explain the pathophysiological rationale for abnormal findings. Document male reproductive assessment findings. Describe the pathological changes that occur in the male reproductive system with the aging process. Copyright 2002, Delmar, A division of Thomson Learning

Copyright 2002, Delmar, A division of Thomson Learning Anatomy Testes Seminal vesicles Bulbourethral glands Epididymis Ductus deferens (continues) Copyright 2002, Delmar, A division of Thomson Learning

Copyright 2002, Delmar, A division of Thomson Learning Anatomy Ejaculatory ducts Urethra Scrotum Penis Glans penis Spermatic cord Copyright 2002, Delmar, A division of Thomson Learning

Copyright 2002, Delmar, A division of Thomson Learning Physiology Spermatogenesis Male sexual function Erection Lubrication Emission Ejaculation Copyright 2002, Delmar, A division of Thomson Learning

Copyright 2002, Delmar, A division of Thomson Learning Health History Age Adolescent to young adult Middle to older adult Race Caucasian Copyright 2002, Delmar, A division of Thomson Learning

Common Chief Complaints Urethral discharge Palpable mass Erectile dysfunction Penile lesion Scrotal pain Copyright 2002, Delmar, A division of Thomson Learning

Characteristics of Chief Complaint Quality Quantity Associated manifestations Aggravating and alleviating factors Setting Timing Copyright 2002, Delmar, A division of Thomson Learning

Copyright 2002, Delmar, A division of Thomson Learning Past Health History Medical history Male-genitalia specific Nonmale-genitalia specific Surgical history Medications Antibiotics, antihypertensives, psychotropics Communicable diseases STDs, penile lesion (continues) Copyright 2002, Delmar, A division of Thomson Learning

Copyright 2002, Delmar, A division of Thomson Learning Past Health History Allergies Spermicides Injuries/accidents Special needs Childhood illnesses Mumps Orchitis (continues) Copyright 2002, Delmar, A division of Thomson Learning

Copyright 2002, Delmar, A division of Thomson Learning Past Health History Family Social Substance use Sexual practices Work environment Health maintenance Safe sex Routine testicular exams Copyright 2002, Delmar, A division of Thomson Learning

Copyright 2002, Delmar, A division of Thomson Learning Assessment Equipment Culture supplies Nonsterile gloves General approach Physical environment Decrease apprehension Privacy Copyright 2002, Delmar, A division of Thomson Learning

Copyright 2002, Delmar, A division of Thomson Learning Inspection Hair distribution Penis Size, shape, lesions, swelling, inflammation Scrotum Size, shape, lesions, inflammation, swelling, nodules (continues) Copyright 2002, Delmar, A division of Thomson Learning

Copyright 2002, Delmar, A division of Thomson Learning Inspection Urethral meatus Location, discharge Inguinal area Bulges, masses Copyright 2002, Delmar, A division of Thomson Learning

Inspection: Abnormal Findings Alopecia Lice or nits present Penile lesions Hypospadias Epispadias (continues) Copyright 2002, Delmar, A division of Thomson Learning

Inspection: Abnormal Findings Hydrocele Spermatocele Varicocele Urethral discharge Hernias Copyright 2002, Delmar, A division of Thomson Learning

Copyright 2002, Delmar, A division of Thomson Learning Palpation Penis Assess for tenderness, pulsations, masses Urethral meatus Assess for discharge Scrotum Assess for masses, tenderness, spermatic cord Inguinal area Assess for hernias Abnormal findings Copyright 2002, Delmar, A division of Thomson Learning

Palpation: Abnormal Findings Vascular insufficiency Penile edema Urethral discharge Spermatocele Cryptorchidism Orchitis Scrotal edema Hernias Copyright 2002, Delmar, A division of Thomson Learning

Copyright 2002, Delmar, A division of Thomson Learning Auscultation Scrotum Abnormal findings Presence of bowel sounds may indicate indirect inguinal hernia Copyright 2002, Delmar, A division of Thomson Learning

Gerontological Variations Thinner pubic hair Decreased testosterone levels Penile and testicular atrophy Slightly decreased spermatogenesis Increased time to obtain erection Increased risk for impotence Copyright 2002, Delmar, A division of Thomson Learning

Copyright 2002, Delmar, A division of Thomson Learning Normal Findings Triangular shaped distribution of pubic hair Penile skin is free of lesions and inflammation Penile shaft skin is loose and wrinkled Foreskin retracts easily (continues) Copyright 2002, Delmar, A division of Thomson Learning

Copyright 2002, Delmar, A division of Thomson Learning Normal Findings No discharge from foreskin Scrotal skin is pigmented, rugated, and thin No lesions, nodules, swelling, or inflammation are present in the scrotal area Left scrotal sac is lower than the right (continues) Copyright 2002, Delmar, A division of Thomson Learning

Copyright 2002, Delmar, A division of Thomson Learning Normal Findings No bulges or swelling are present in the inguinal area Penis is nontender Able to palpate a pulse on the dorsal side of the penis Urethral meatus is free of discharge (continues) Copyright 2002, Delmar, A division of Thomson Learning

Copyright 2002, Delmar, A division of Thomson Learning Normal Findings Testicles are firm, ovoid, smooth, and equal in size Spermatic cord is smooth and round Small, freely mobile lymph nodes are present in the inguinal area The inguinal area is free from bulges or palpable masses No bowel sounds are present in the scrotum Copyright 2002, Delmar, A division of Thomson Learning

Copyright 2002, Delmar, A division of Thomson Learning Special Techniques Androscopy Used to identify skin lesions Urethral culture Used to identify causative organism of penile discharge Transillumination of the scrotum Used to determine the etiology of a scrotal mass Copyright 2002, Delmar, A division of Thomson Learning