1. GU ANATOMY AND PHYSIOLOGY
and HISTORY & PHYSICAL EXAM

2. KIDNEYS Two kidneys, purplish brown organs
Located below the ribs toward the back
Remove waste from the blood
Keep a stable balance of salts and other substances
Produce erythropoietin, aids in the formation of red blood cells

4. GROSS ANATOMY

5. Adrenal gland caps each kidney
Enclosed within Gerota’s fascia
Each adrenal receives three arteries
Right adrenal vein empties into the vena cava
Left terminates in the left renal vein
Lymphatic vessels drain into the lumbar lymph nodes

6. HISTOLOGY Functioning units of the kidneys are nephrons
Secretory portion contained in the cortex
Excretory portion is the collecting tubule

7. BLOOD SUPPLY One renal artery, branch of the aorta
Renal artery divides into the anterior and posterior branches
Renal veins are paired with the ateries
Accessory renal vessels are common

9. URETERS
Two ureters
Narrow tubes carry urine from the kidneys to the bladder
Adult ureter 30 cm long

10. STONES

11. BLADDER Triangular-shaped, hollow organ Located in the lower abdomen
Attached by ligaments to other organs and pelvic bones
Nerves alert when time to urinate
Two sphincter muscles circular muscles that keep urine from leaking

14. HISTOLOGY OF THE BLADDER
Bladder is composed of transitional epithelium
Beneath is well-developed submucosal layer
Detrusor muscle is made of a mixture of smooth muscle fibers, three different layers

15. MALE GU ANATOMY Seminal vesicles lie cephalic to the prostate
Spermatic cord extends from the internal inguinal ring
Epididymis connected to the testis by numerous ducts, markedly coiled

16. PENIS AND MALE URETHRA
Two corpora cavernosa and the corpus spongiosum, contains the urethra
Aterial supply internal pudenda arteries
Each artery divides into a deep artery of the penis
Dorsal vein lies external to Buck’s fascia
May be 15 to 23 cm in length

18. PROSTATE GLAND Fibromuscular and glandular organ
Inferior to the bladder
Weighs about 20 g
Contains the posterior urethra
Consists of 5 lobes
Glands drain into the major excretory ducts, which open in the floor of the urethra

19. Digital Rectal Exam

20. TESTIS Average testicle 4X3X2 cm Dense covering, tunica albuginea
Covered anteriorly and laterally by serous tunica vaginalis
Blood supply associated with that of the kidneys

21. SCROTUM Beneath skin of the scrotum dartos muscle
Three fascial layers from the abdominal wall
Two sacs divided by septum of connective tissue
Helps to regulate environmental temperature

22. Normal Male Anatomy

23. Paraphimosis

24. An Interesting Thought:
More money is spent today on Viagra and breast reconstruction than on Alzheimer's research. So by the year 2040, there will be lots of elderly people walking around with perky boobs, huge erections, and no idea what to do with them.

26. FEMALE PELVIC ANATOMY Ovaries Uterine fallopian tubes Uterus Cervix
Urinary bladder
Ureters
Vagina
Rectum

27. FEMALE URETHRA About 4 cm long
Lies beneath the pubic symphysis anterior to the vagina
Arterial supply from the vesical, vaginal, and internal pudendal arteries
Lymphatic drainage from the external portion is to the inguinal and subinguinal lymph nodes

31. NORMAL DEVELOPMENT OF THE GU SYSTEM
Three embryonic kidneys
pronephros weeks
mesonephros 5 weeks
metanephros 5 weeks
Nephrogenesis complete at 34 – 36 weeks

33. NORMAL DEVELOPMENT Bladder and ureter development third week
of gestation
Formation of the trigone by day 33
Urine production by weeks gestation
Genital formation begins during the fifth week of gestation

34. GU ASSESSMENT OF THE INFANT AND CHILD
Abdomen: pain, masses
External genitalia: normal or abnormal
Consider sexual abuse: must be reported

35. Tanner System

38. Balanitis

39. Elements of Examination
Constitutional
Head, face, eyes, ears, nose, mouth and throat
Neck
Respiratory
Cardiovascular
Gastrointestinal (Abdomen)
Lymphatic
Musculoskeletal/Extremities
Skin
Neurologic

40. MALE GENITOURINARY EXAM
Scrotum: lesions, cysts, rashes
Epididymides: size, symmetry, masses
Testes: size, symmetry, masses
Urethral meatus: size, location, lesions, discharge
Penis: lesions, presence or absence of foreskin, foreskin retractibility, plague, masses, scarring, deformities

41. DIGITAL RECTAL EXAM
Prostate gland: size, symmetry, nodularity, tenderness
Sphincter tone, presence of hemorrhoids, rectal masses

42. FEMALE GENITOURINARY EXAM
External genitalia: general appearance, hair distribution, lesions
Urethral meatus: size, location, lesions, prolapse
Bladder: fullness, masses, tenderness
Vagina: general appearance, estrogen effect, discharge, lesions, pelvic support, cystocele, rectocele

43. Female Cervix: general appearance, lesions, discharge
Uterus: size, contour, position, mobility, tenderness, consistency, descent or support
Adnexa: masses, tenderness, organomegaly
Anus, perineum