1. Male reproductive system
L/ Hanaa Hammad

2. Learning outcome
At the end of this Lesson the study participants will be able to:
Name 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.
Explain the pathophysiological rationale for abnormal
findings.

3. Learning outcome cont’d
Document male reproductive assessment findings.
Describe the pathological changes that occur in the
male reproductive system with the aging process.

4. Anatomy and Physiology

5. Anatomy and Physiology cont’d
Penis
Testes
Scrotum
Bulbourethral glands
Seminal vesicles
Epididymis
Ejaculatory ducts
Urethra
Glands penis
Spermatic cord
Ductus deferens

6. Anatomy and Physiology cont’d
Testes: Are two-egg shaped structure.
Function of Testes:
Testosterone hormone secretion.
Spermatogenesis = sperm production
Epididymis: A comma shaped tube, lies along & sides of each testis.
Function: It is a storage & maturation site of sperm which takes from 1 to 3 weeks.

7. Anatomy and Physiology cont’d
Seminal vesicles: Are two pouches along the posterior surface of the urinary bladder, directly in front of the rectum?
Function: Secret about 60% of fluid volume of semen.
Prostate Gland: Doughnut-shape, encircle urethra, lies just below the bladder.
Function: It secretes about 35% of fluid volume of semen.

8. Anatomy and Physiology cont’d
Bulbo urethral gland: A pea sized gland inferior to the prostate and Secretes about 5% of fluid volume of semen.
Penis: Three cylindrical masses of erectile tissue.
Function:
Micturition.
Introduce semen into vagina.

9. Health History Personal history Present & past history.
Common Chief Complaints(Urethral discharge Palpable mass ,Erectile dysfunction ,Penile lesion,
Scrotal pain

10. Characteristics of Chief Complaint
Quality , Quantity , Associated manifestations , Aggravating and alleviating factors , Setting , Timing
Assessment

11. Examination Equipment Needed for Male
Gloves.
Glass slide for urethral specimen
Materials for cytology
Flashlight

12. Positioning for Male Examination
Position male standing with undershorts down, with appropriate draping.
Examiner should be sitting. (Male may be supine for first part of exam, standing for hernia check.
3. Take time for patient to discuss genitourinary history.

13. Inspection & palpation of male reproductive system
Assessment
Normal Finding
Inspect Penis & Glands
Penis skin wrinkled, hairless, no lesions the glands, smooth no lesions.
Retract uncircumcised foreskin to original position.

14. Inspection & palpation of male reproductive system
Deviations from Normal:
Pubic lice or nits-
Hypospadias- ventral location of meatus.
Epispadias- dorsal location of meatus
ulcer, grouped vesicles
Himosis - unable to retract foreskin
Stricture- narrowed opening
Edges that are red, edematous, purulent discharge
Nodule, tenderness

15. Inspection and palpation of male scrotum
Assessment
Normal Finding
Inspect scrotum as male holds penis.
Palpate gently each. Half between thumb and first two fingers
Asymmetrical (left scrotal half lower than right)
Scrotal size varies with room temp.
Contents should easily slide. Testes palpable, oval, firm, rubbery, smooth, equal bilateral and freely movable.
Epididymis feels discrete, softer than testis, smooth, nontender

16. Inspection & palpation of male scrotum
Assessment
Normal Finding
Inspect each spermatic cord between thumb and forefinger along its length from Epididymis to external inguinal ring
Should feel smooth, nontender cord.
Deviations from Normal:
Scrotal swelling (edema). Lesions
Absent testes , Nodules swollen, tender epididymis
Hernia, hydrocele, tumor.

17. Inspection for hernia Assessment
Inspect inguinal region for bulge as patient stands and strains
Palpate right side of inguinal canal by asking patient. to shift wt. onto left leg. Place right index finger low in the right scrotal half. Palpate up length of spermatic cord
Deviations from Normal:
Feels like triangular slit like opening, may go easier
if you ask patient . to bear down.
Bulge at external inguinal ring or femoral canal

18. Palpate for hernia

19. Palpate for hernia Assessment Normal Finding
Palpate inguinal lymph nodes by palpating horizontal chain along groin inferior to ligament and vertical chain along inner thigh
feels small, soft, discrete, and movable.
Deviations from Normal:
Palpable herniatino mass bumps your fingertip or pushes against the side of your finger.

20. Gerontological Variations
Thinner pubic hair
Decreased testosterone levels
Penile and testicular atrophy
Slightly decreased spermatogenesis
Increased time to obtain erection
Increased risk for impotence

21. 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

22. Thank you