What is the function of testosterone
Development and maintenance of male secondary sexual characteristics
Which cells produce testosterone?
Leydig cells
Opening at the end of the penis
external urethral meatus
Purpose of the scrotum
keep the testes temperature regulated 5 degrees below body temp
Contents of the gonad in Males
90% seminiferous tubules 10% produces testosterone
Sperm are development from which cells?
Spermatogonia
Where is vesiculase found
seminal vesicles
What is the function of vesiculase
causes semen to clot after ejaculation
Which nervous system stimulates an erection
Parasympathetic nervous system
Which nervous system is responsible for ejaculation
sympathetic
How is erectile dysfunction is caused by which two ways
slow arterial inflow or fast venous drainage to corpus cavernosum
Infertility
inability to contribute to conception, inability of a couple to conceive after 1 year of unprotected intercourse
What percentage of infertility are due to primary sperm disorders in men
35%
What is considered an abnormally low sperm count
below 15 million sperm per ml of semen
Azoospermia
presence of NO sperm in semen
Testicular Azoospermia
caused by testicular trauma, infection, cancer, childhood illness
Post-testicular or obstructive azoospermia
sperm cant be released due to blockage or surgery
Pretestiscular Azoospermia
testes are healthy but imbalance of hormones or cancer treatments results in impairment of stimulatory signals
Impaired sperm/semen emission can be due to
retrograde ejaculation
A large underlying pathology for impaired sperm emission is
impaired nervous function( i.e. diabetic neuropathy)
Diagnosis of infertility is
semen analysis
What is a hypospadias
birth defect in boys in which the opening of the urethra is not located at the tip of the penis
Epispadias
opening in the dorsum of the penis
Phimosis
inability to retract foreskin of the penis over the glans
Physiologic Phimosis
adhesions between epithelial layers of the inner prepuce and glans of the pubery
Pathological Phimosis
poor hygiene, infection, inflammation and scarring and may predispose to squamous carcinoma
Balanitis
inflammation of the glans of the penis, commonly found in uncircumsized men
What is the common causative agent for balanitis
fungal infection
Balanitis xerotica obliterans
inflammatory disease, sclerotic patch at tip of glans which can constrict urethral opening
Condyloma acuminatum
STD cauliflower like growth caused by HPV
Bowen Disease
squamous carcinoma in situ, remains in the basement membrane
Squamous Carcinoma
most common invasive malignancy that usually forms on or under the foreskin
Peyronie disease
noncancerous condition resulting from fibrous scar tissue of the corpus cavernosum.Distorts the erect penis causing painful erection
Priapism
prolonged erection of the penis
Most common cause of priapism
impaired venous outflow from inflammation of drug therapy
An erection that last longer than _____ hours is priapism
4
Urethritis
inflammation of the urethra caused by infection
Most common infection resulting in urethritis
Sexually transmitted infection
Inguinal Hernia
protrusion of the bowel into he inguinal canal or scrotum through a weak spot in the abdominal wall muscles
Tinea Cruris
fungal infection that causes a red and itchy rash in warm and moist areas of the body.Caused by fungal tinea
Varicocele
enlargement of veins within the scrotum varicose veins of the scrotum
Hydrocele
accumulation of fluid in the sac of the tunica vaginalis that surrounds the testis. Can develop from inflammation or injury
Cryptorchidism
a condition in which one or both of the tested fail to descend into the scrotum. The most common congenital abnormality
What is at risk with a cryptorchidism
10X risk for testicular malignancies
Orchitis
swelling or inflammation of the tested Bacterial or viral infections can cause, usually unknown
Mumps can sometimes cause
orchitis
Epididymitis
inflammation of the epididymisusually from retrograde infection from bladder, urethra or prostate
<35 common cause of epididymitis is
STI
>35 common cause of epididymitis
urinary pathogen
Spermatocele
cysts of sperm in the epididymis from blockage in duct or inflammation
Testicular Torsion
rotation of the testicles resulting in twisting of the spermatic cord
Testicular torsion does not interrupt ______ inflow but does interrupt _______ drainage
arterial;venous
What can develop from testicular torsion
hemorrhagic infarction and congestion
Orchipexy
surgery to move and or permanently fix testicle in the scrotum
T/F: A majority of testicular neoplasms are malignant
T
Germ cell tumors are ________
totipotent
Teratoma
a benign lesion composed of all different types of tissue (hair, nails, teeth)
Seminoma
most common type of testicular tumor, composed of immature germ cells; highly treatable with early detection
Seminoma grows _____ and metastasize _____
slowly;later
Embryonal carcinoma are composed of
primitive cells
Yolk sac carcinoma are composed of
yolk sac cells occurs in young boys
choriocarcinoma contain
placental chorionic type cells
Sex chord/ stromal tumors
arise from primitive embryologic sex cord-stromal tumors
Sex chord/ stromal tumors can cause symptoms of
hormone production
Prostates primary function
produce and nourish sperm with seminal fluid
normal function of the prostate depends on
androgens, usually testosterone
Prostate specific antigen (PSA)
enzyme that dissolves clotted semen and allows sperm ti migrate upward into the female genital tract
Acute bacterial prostatitis
usually caused by gram-negative rods like E. coli; present with fever, low back pain, voiding symptoms of: frequency, urgency, & dysuria.
digital rectum examination (DRE)
examination of the prostate gland by finger palpation through the anal canal and the rectumprostate cancer usually develops in palpable areas of this exam
Chronic bacterial prostatitis
usually harder to diagnosis, usually near asymptomatic or present with low back pain, suprapubic or pelvic pain /discomfort
chronic nonbacterial prostatitis
AKA pelvis pain syndrome, signs and symptoms of prostatitis not caused by bacterial infection
benign prostastic hyperplasia
nearly all men develop with age, from nodular hyperplasia of the gland and supporting tissue, gland may be enlarged 3-5X and may protrude into bladder. abnormal testosterone metabolism
The biggest issue with BPH is
obstruction of the bladder to prevent complete emptying of urine
Prostatic Carcinoma
malignant tumor of the prostate gland70% incidence for men in their 70-80's most common malignancy over breast and lungless lethal
Most prostatic carcinoma are
androgen independent
prostatic intraepithelial neoplasia
process of going from normal to dysplasia to carcinomaatypical cells that contain molecular changes found in carcinoma
High grade PIN is considered
Carincoma in situ
Prostatic carcinoma are not ______
obstructive
Prostate carcinoma almost always metastasize to _____
Bone
PSA is neither ______ or _______
sensitive or specific
Prostatic carcinoma is graded from
the Gleason Scale 1- well differentiated5- poorly differentiatedcombine two scores of two areas scores from 2-10