Male Genitourinary System Chapter 24 Structure and Function

�Structure and Function �Subjective Data—Health History Questions �Objective Data—The Physical Exam �Abnormal Findings Slid

Subjective Data— Health History Questions �Frequency, urgency, and nocturia �Dysuria �Hesitancy �Urine and straining

Subjective Data— Health History Questions (cont. ) �Penis—pain, lesion, and/or discharge �Scrotum—self-care �Sexual behaviors;

Principles of interviewing adolescent male patients: � Ask questions that seem appropriate for boy’s

Additional History for the Aging Adult • Any difficulty urinating? . . . •

Objective Data—The Physical Exam (cont. ) �Penis—Inspect and palpate �Skin �Glans �Urethral meatus �Pubic

Objective Data—The Physical Exam (cont. ) �Scrotum—Inspect and palpate �Skin �Testis �Epididymis �Spermatic cord

Abnormal Findings Male Genital Lesions �Herpes progenitalis �Syphilitic chancre �Condylomata acuminata (genital warts) �Carcinoma

Abnormal Findings (cont. ) Abnormalities of the Penis �Phimosis �Paraphimosis �Hypospadias �Epispadias �Peyronie’s disease

Abnormal Findings (cont. ) Abnormalities in the Scrotum �Early testicular tumor �Diffuse tumor �Hydrocele

Abnormal Findings (cont. ) Inguinal and Femoral Hernias �Indirect inguinal �Direct inguinal �Femoral Slid

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Male Genitourinary System Chapter 24

�Structure and Function �Subjective Data—Health History Questions �Objective Data—The Physical Exam �Abnormal Findings Slid e 24 -2

Subjective Data— Health History Questions �Frequency, urgency, and nocturia �Dysuria �Hesitancy �Urine and straining color �Genitourinary history Slid e 24 -3

Subjective Data— Health History Questions (cont. ) �Penis—pain, lesion, and/or discharge �Scrotum—self-care �Sexual behaviors; lump activity and contraceptive use �Sexually transmitted disease contact Slid e 24 -4

Principles of interviewing adolescent male patients: � Ask questions that seem appropriate for boy’s age but be aware that norms vary widely. � Ask direct, matter-of-fact questions. Avoid sounding judgmental. � Start with a permission statement. “Often boys your age experience…” � Try the ubiquity approach, “When did you…” rather than “Do you…” � Sometimes all you do is “open the door” to later conversation Slid e 24 -5

Additional History for the Aging Adult • Any difficulty urinating? . . . • Do you need to get up at night… • A man in his 70 s, 80 s, or 90 s… Slid e 24 -6

Objective Data—The Physical Exam (cont. ) �Penis—Inspect and palpate �Skin �Glans �Urethral meatus �Pubic hair �Urethral discharge �Shaft Slid e 24 -7

Objective Data—The Physical Exam (cont. ) �Scrotum—Inspect and palpate �Skin �Testis �Epididymis �Spermatic cord �Any mass ◦ Note characteristics ◦ Transillumination Slid e 24 -8

Abnormal Findings Male Genital Lesions �Herpes progenitalis �Syphilitic chancre �Condylomata acuminata (genital warts) �Carcinoma �Urethritis (urethral discharge and dysuria) Slid e 24 -9

Abnormal Findings (cont. ) Abnormalities of the Penis �Phimosis �Paraphimosis �Hypospadias �Epispadias �Peyronie’s disease �Priapism �Urethral stricture Slid e 24 -10

Abnormal Findings (cont. ) Abnormalities in the Scrotum �Early testicular tumor �Diffuse tumor �Hydrocele �Scrotal hernia �Orchitis �Scrotal edema Slid e 24 -11

Abnormal Findings (cont. ) Inguinal and Femoral Hernias �Indirect inguinal �Direct inguinal �Femoral Slid e 24 -12