Академический Документы
Профессиональный Документы
Культура Документы
Glands
Testes
- scrotum (one testis in each
compartment)
- composed of tiny tubules
(seminiferous tubules) embedded
in connective tissue containing
interstitial cells
- ducts emerge to enter the head
of epididymis
- Seminiferous tubules carry on
spermatogenesis (formation of
spermatozoa – male sex cells)
- Interstitial cells secrete
testosterone, increases protein
synthesis, induces growth of
secondary sexual characteristics &
promotes development of brain in
fetus
Male Reproductive System
Accessory glands
Seminal vesicles
- secrete nutrient-rich fluid (30%
of semen)
Prostate gland
- secretes 60% of semen
- prostatic secretion is alkaline
(increases sperm motility
- contains enzyme acid
phosphatase
Bulbourethral glands (Cowper’s
glands)
- secrete alkaline fluid that
lubricates urethra prior to
ejaculation
Male Reproductive System
Ducts
Epididymis
- conducts seminal fluid (semen)
from testes to vas deferens
- sperm mature while semen is
stored prior to ejaculation
Vas deferens (seminal ducts)
- conduct sperm & small amount
of fluid from each epididymis to
an ejaculatory duct
Ejaculatory ducts
- ejaculate semen into urethra
Urethra
Male Reproductive System
External Supporting structures
Scrotum
- contains testes, epididymis &
first part of seminal duct
- allows sperm to develop at 2-
3 degrees below body
temperature
Penis
- contains large vascular spaces
that when filled with blood
causes erection
- contains urethra
Male Reproductive System
Internal Supporting structures
Spermatic cords
- fibrous tubes located in each
inguinal canal
* testicular torsion results in
twisting of spermatic cords
URETHRAL DISORDERS
1. Which of the following terms is used to describe the
opening of the urethra on the dorsum of the penis?
A. Epispadias
B. Hypospadias
C. Urethral stricture
D. Urethritis
Epispadias
Epispadias is a congenital anomaly in which the urethral
opening is on the dorsum of the penis and is usually repaired
through plastic surgery when the boy is very young.
Hypospadias
Hypospadias is a congenital anomaly in which the urethral
opening is on the underside of the penis and is usually repaired
through plastic surgery when the boy is very young.
Urethral stricture
Urethral stricture is a condition in which a section of urethra is
narrowed.
Urethritis
Urethritis refers to inflammation of the urethra and is
commonly associated with sexually transmitted disease.
Pathology: developmental anomalies or inflammatory process
Risk: congenital, instrumentation, improper hygiene
Dx: PE and clean catch UA
Cardinal sign:
Hypospadia: urethral meatus on lower(ventral) aspect
Epispadia: urethral meatus on upper(dorsal) aspect
Phimosis: unretractable foreskin
Balanitis: infection of foreskin and dysuria
Urethritis: dysuria and penile discharges
DOC: oral or topical ABx or steroids/ surgical correction for
congenital anomaly
Nurse concern: IEC on males with intact foreskin to retract
foreskin prior to voiding and penile hygiene after voiding or sex.
PROSTITIS
Pathology: ascending infection
Risk: instrumentation,alcohol,caffeine, spicy foods
Dx: UA and PE
Cardinal sign: Acute: dysuria, fever, discharges
pain during ejaculation
Chronic: asymptomatic or nocturia
\DOC: ABx
Nurse concern: IEC on avoiding alcohol and caffeine
BPH
1. Nursing assessment of the patient with BPH would
most likely reveal:
a. 25 – 75 ml
b. 10 – 25 ml
c. 75 – 100 ml
d. 5 – 10 ml
7. Constant bladder irrigation is performed during
the first few days after his surgery. The rationale
for doing this is to:
a. Bladder spasm
b. Urinary bleeding
c. Dribbling of urine
d. Fever
Pathology: hypertrophy of prostate from decrease testosterone
and increase estrogen which increases sensitivity to
dihydrotestosterone(DHT)decrease urethral diameter.
Risk: age above 40
Dx: Prostate biopsy and USG
Cardinal sign: asymptomatic to difficulty starting voiding, weak
stream, nocturia, and dribbling.
\DOC: finasteride ( proscar) to inhibit the action of DHT
Nurse concern: IEC on prostatectomy, CBI, post op bladder
spasms, avoidance of NSAIDs 10 days prior to operation.
PROSTATE CANCER
Prostate Cancer
Slow malignant change in
the prostate gland that
spreads by direct invasion of
surrounding tissues &
metastasizes to the bony
pelvis & spine
Most common site of cancer
in men (21%)
Dihydrotestosterone – only
factor clearly associated with
development of prostate
cancer
1. Incidence of prostate cancer in Asian countries is
rising rapidly as reported by health bulletins,
why is this?
a. Surgery
b. Anti-androgen
c. Chemotherapy
d. Radiation
Pathology: similar to BPH
Risk: age, ethnicity, chemical exposures
Dx: PSA more than 4.0; DRE, USG
Cardinal sign: depends on stage:
A1= asymptomatic
B2= enlarged prostate
C3= urinary symptoms, rectal or pelvic pain
D4= ++ lymph, bone, liver, lung area pain
\DOC: Hormone therapy and chemo-radiation Tx
Other Tx: TURP
Nurse concern: testosterone dependent at early stage; client will become
impotent if abdominal prostatectomy is done; age of client at diagnosis is
usually 65; assess mouth for stomatitis, for signs of dehydration, and for
suicidal tendencies; Support for body image or sexual issues.
TESTICULAR CANCER
1. Which of the following terms refers to surgical
removal of one of the testes?
A. Orchiectomy
B. Circumcision
C. Vasectomy
D. Hydrocelectomy
Rare form of cancer
Most common cancer in
young men (15 – 35 y/o)
Unknown cause
High incidence in
cryptorchidism or
atrophic testis
Pathology: germ or stromal cell carcinoma, seminoma
replacing parenchymal tissues.
Risk: Hx of cryptorchidism, trauma, DES exposure, low
birth weight, prematurity
Dx: HCG, AFP, LDH
Cardinal sign: painless, hard nodule on one side of testes.
Usual metastases on lymph, lung, bone and GI.
\DOC: Etopside (Vepesid) plus cisplatin chemo.
Other Tx: orchiectomy
Nurse concern: IEC on sperm banking if client desires
fertility and on TSE.
DYSFUNCTIONAL UTERINE
BLEEDING
Pathology: lack of progesterone, adenomyosis, fibroid tumors (
intramural, submucosal, subserosal)
Risk: age( adolescent, 30-40s), family history, stress, weight
changes, oral contraceptive, IUD, PID, polyps, athletic activity,
blood dyscrasias.
Dx: CBC, HCG, pelvic USG, pap smear, hysteroscopy
Cardinal sign: Amenorrhea, oligomenorrhea, menorrhagia,
metrorrhagia, post menopausal bleeding.
\DOC: hormones ( Progesterone) , oral contraceptive
( 3-6mos), iron supplements
Other Tx: myomectomy, hysterectomy.
Nurse concern: Diagnosis is confirmed thru response to meds or
thru biopsy; use of bleeding calendar.
DYSMENORRHEA
1. A 15 year old client complains of persistent
dysmenorrhea. The nurse would encourage her to:
A. Sim’s position
B. Fowler’s position
C. Lithotomy position
D. Supine position with knees flexed
Pathology: ascending infection during ovulation, menstruation,
douching, birthing, abortion and surgery. Common pathogen:
neisseria gonorrhea, Chlamydia tracomatis, E. coli, Gardnerella
vaginalis.
Risk: IUD, oral contraceptive, STDs, multiple sex partners, 15-24
women who are nulliparous.
Dx: History, C&S, Pap smear
Cardinal sign: low abdominal pain, vaginal discharges,
dysmenorrhea, dyspareunia, dysuria
\DOC: ABx and anti-protozoal( metronidazole-flagyl)
Nurse concern: Completion of ABx, avoiding douching; IEC on
complications ( infertility, ectopic pregnancy, pelvic abscess)
ENDOMETRIOSIS
Pathology: growth of endometrial tissue outside uterus which
responds to hormonal mechanism of menstrual cycle blood &
tissue cannot shed off causing inflammation, scarring, further
growth and infertility.
Risk: nulliparity, family history
Dx: Laparoscopy and history
Cardinal sign: dysmenorrhea, dyspareunia, dysuria, painful BM
during menses.
\DOC: Hormone therapy ( Lupron), NSAIDs to inhibit
prostaglandin synthesis, synthetic GRH to raise estrogen and
progesterone
Nurse concern: Common side effect of meds are hot flashes,
fluid retention, gall stone and withdrawal bleeding; Provide
support on fertility issues.
CERVICAL CANCER
1. When the results of a Pap smear are reported as
class 5, the nurse recognizes that the common
interpretation is:
A. malignant.
B. normal.
C. probably normal.
D. suspicious.
malignant.
A class 5 Pap smear, according to the Bethesda
Classification, indicates squamous cell carcinoma.
normal.
A class 1 Pap smear is interpreted as normal.
probably normal.
A class 2 Pap smear is interpreted as probably normal.
suspicious.
A class 3 Pap smear is interpreted as suspicious.
2. For women aged 19-39 years, recommended health
screening diagnostic testing includes which of the
following?
A. Pap smear
B. Mammography
C. Cholesterol and lipid profile
D. Bone mineral density testing
Pap smear
A Pap smear is recommended for women aged 19-39 years, as
well as for women aged 40 and older.
Mammography
Mammography is recommended for health screening for women
aged 40 years and older.
Cholesterol and lipid profile
Cholesterol and lipid profile is recommended for women aged
40 years and older.
A. Hemorrhage
B. Lymphedema
C. Self esteem disturbance
D. Pain
6. Post op mastectomy, The nurse would do the
following to prevent unnecessary injury to the Arm of
the client except:
A. It is stimulating
B. It will cause nervousness and insomnia
C. It will contribute to additional bone
demineralization
D. It will cause tachycardia and arrhythmias
2. Aling Maria, age 35 is a premenopausal woman. In
teaching premenopausal woman about breast self
examination, you will instruct her to perform monthly
BSE:
A. After Menstruation
B. First day of menstruation
C. Last day of menstruation
D. During Menstruation
Physiology: ending of ovarian function ccuring on 40-50’s.
Dx: History
Cardinal sign: From decrease estrogen levels: absence of menses,
hot flashes, stress incontinence, vaginitis, dry skin, weight gain,
osteoporosis.
From psychologic effects: normal sexual urges,
seen as end of womanhood, nervousness, dizziness.
A. Dyspareunia
Dyspareunia is a common problem of the aged female.
B. Amenorrhea
Amenorrhea refers to absence of menstrual flow.
C. Dysmenorrhea
Dysmenorrhea refers to painful menstruation.
D. Endometriosis
Endometriosis is a condition in which endometrial tissue seeds in other
areas of the pelvis.
2. The opening into the vagina on the perineum is termed the:
A. introitus.
The introitus is the vaginal orifice.
B. adnexa.
Adnexa is a term used to describe the fallopian tubes and
ovaries together.
C. cervix.
The cervix is the bottom (interior) part of the uterus that is
located in the vagina.
D. hymen.
The hymen is a tissue that may cover the vaginal opening
partially or completely before vaginal penetration.
3. An opening between the bladder and the vagina is called a:
A. vesicovaginal fistula.
A vesicovaginal fistula may occur because of tissue injury sustained
during surgery, vaginal delivery, or a disease process.
B. cystocele.
A cystocele is a downward displacement of the bladder toward the
vaginal orifice.
C. rectocele.
A rectocele is a bulging of the rectum into the vagina.
D. rectovaginal fistula.
A rectovaginal fistula is an opening between the rectum and the vagina.
THANK YOU!!!
http://stuffednurse.blogspot.com
eye_contact_poor@yahoo.com