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A comprehensive overview of the physical assessment of the male genitalia, inguinal area, anus, rectum, and prostate gland. It covers the normal and abnormal findings that healthcare professionals should be aware of during a physical examination. Key points, such as the importance of wearing disposable gloves, inspecting and palpating various anatomical structures, and documenting the findings. It also discusses potential risk diagnoses, such as the risk for ineffective therapeutic regimen management, ineffective health maintenance, and impaired skin integrity in the rectal area. This information is crucial for healthcare providers, particularly those working in the field of urology, andrology, or men's health, to ensure accurate assessment, diagnosis, and appropriate management of male reproductive health issues.
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Review of the Male Reproductive System Male Genitalia Inguinal Area Anus and Rectum Prostate Gland
Normal Findings: Normally scrotal contents do not transilluminate. Abnormal Findings: Swellings or masses that contain serous fluid (hydrocele, spermatocele) — light up with a red glow. Swellings or masses that are solid or filled with blood (tumor, hernias, or varicocele) — do not light up with a red glow. Assessment of scrotal mass found during examination. Auscultation - Ask the client to lie down. Note whether the mass disappears. If it remains, auscultate it for bowel sounds. Finally, gently palpate the mass and try to push it upward into the abdomen Normal Findings: (^) Normal findings are not expected Abnormal Findings: Bowel sounds auscultated over the mass indicate the presence of bowel and thus a scrotal hernia. Bowel sounds will not be heard over a hydrocele. PHYSICAL EXAMINATION Inguinal Area Inspect for inguinal and femoral hernia. Inspect the inguinal and femoral area for bulges. Normal Findings: The inguinal and femoral area are normally free from bulges. Abnormal Findings: Bulges that appear at the external inguinal ring or at the femoral canal when the client bears down may signal a hernia. Palpate for inguinal hernia and inguinal nodes. Normal Findings: Bulging or masses are not normally palpated. Abnormal Findings: A bulge or mass may indicate a hernia. Palpate inguinal lymph nodes. If nodes are palpable, note size, consistency, mobility or tenderness. Normal Findings: No enlargement or tenderness is normal. Abnormal Findings: Enlarged or tender lymph nodes may indicate an inflammatory process or infection of the penis or scrotum. Palpate for femoral hernia. Palpate on the front of the thigh in the femoral canal area. Ask the client to bear down or cough. Feel for bulges. Repeat on the opposite thigh. Normal Findings: (^) Bulges or masses are not normally palpated. Abnormal Findings: Bulge or mass palpated as client bears down or coughs. PHYSICAL EXAMINATION Anus and Rectum Selected positions for Anorectal Examination Inspect the perianal area. Spread the client’s buttocks and inspect the anal opening and surrounding area.
Normal Findings: The anal opening should appear hairless, moist, and tightly closed. The skin around the anal opening is more coarse and more darkly pigmented. The surrounding perianal area should be free of redness, lumps, ulcers, lesions, and rashes. Abnormal Findings: Lesions may indicate STIs, cancer, or hemorrhoids. A thrombosed external hemorrhoid appears swollen, itchy, painful, and bleeds when the client passes stool. A previously thrombosed hemorrhoid appears as a skin tag that protrudes from the anus. A painful mass that is hardened and reddened suggests a perianal abscess. (^) A swollen skin tag on the anal margin may indicate a fissure in the anal canal. Redness and excoriation may be from scratching an area infected by fungi or pinworms. A small opening in the skin that surrounds the anal opening may be an anorectal fistula Thickening of the epithelium suggests repeated trauma from anal intercourse. Inspect the anal opening for any bulges or lesions. Ask the client to perform Valsalva’s maneuver by straining or bearing down. Normal Findings: No bulging or lesions appear. Abnormal Findings: Bulges of red mucous membrane (^) may indicate a rectal prolapse. Hemorrhoids or an anal fissure may also be seen. Inspect the sacrococcygeal area. Inspect this area for any signs of swelling, redness, dimpling, or hair. Normal Findings: Area is normally smooth, and free of redness and hair. Abnormal Findings: A reddened, swollen, or dimpled area covered by a small tuft of hair located midline on the lower sacrum suggests a pilonidal cyst Palpate the anus Normal Findings: The client can normally close the sphincter around the gloved finger. The anus is normally smooth, non tender, and free of nodules and hardness. Abnormal Findings: Poor sphincter tone may be the result of a spinal cord injury, previous surgery, trauma, or a prolapsed rectum. Tightened sphincter tone may indicate anxiety, scarring, or inflammation. Tenderness may indicate hemorrhoids, fistula, or fissure. Nodules may indicate polyps or cancer. Hardness may indicate scarring or cancer. Palpate the rectum Note tenderness, irregularities, nodules and hardness.