which section of the anal canal is sensitive to pain and innervated by somatic sensory nerves?
lower half
which section of the anal canal is under autonomic control and relatively insensitive?
upper half
what portion of the prostate is accessible during DRE?
posterior surface
what is made of smooth muscle and under involuntary autonomic control?
internal sphincter
what is made of striated muscle and under voluntary control?
external sphincter
the urge to defecate is caused by stimulation of?
internal sphincter
actual defecation is controlled by?
external sphincter
what is the nerve supply to the lower half of anal canal?
somatic sensory nerves
where is the prostate located?
base of the bladder surrounding the urethra
what percent of men over 70 have BPH?
70-90%
consistency of prostate with BPH?
boggy, squishy, smooth
SHOULD BE NONTENDER
why is BPH a problem?
acute urinary retention may occur causing recurrent infections
incomplete bladder emptying leads to?
urinary stasis
what is the 2nd leading cancer death in males over 65?
prostate cancer
how many men will have prostate cancer?
1 in 6
most common type of prostatic carcinoma?
adenocarcinoma
cancer from the prostate is responsible for what amount of metastasis?
60% of all skeletal metastasis
what are the risk factors for prostate cancer?
over 50
african american
diet high in animal fat
what are other causes of hard nodules on the prostate besides cancer?
prostatic calculi
prostatic TB
prostate granulomata
what are normal PSA levels?
less than 4 ng/ml
4-10 borderline
over 10 high
symptoms of acute prostatitis?
high fever, flu like, perineal, prostate and LBP
urinary obstruction
dysuria, nocturia, hematuria
arthralgia and myalgia
what are DRE results of acute prostatitis?
enlarged and warm and VERY painful
what develops as a complication of acute prostatitis, urethritis and epididymitis?
prostate abscess
what is the MC cancer in young men?
testicular
fluid filled scrotum
hydrocele
congenital defect, urethral opening on DORSUM of penis
epispadius
urethral opening on VENTRAL surface of penis
hypospadius
inflammation of glans and prepuce
balanoposthitis
swelling of glans
balantitis
tight foreskin will not retract over glans
phimosis
prolonged painful erection
priapism
HEMOGLOBINOPATHIES- sickle cell or leukemia
describe torsion of testis on spermatic cord
babies to teens
pain
nausea, vomit
surgical emergency
describe epididymitis
bacterial infection
teens to adults
gradual onset of pain, fever
nodular epididymus
what is a sebaceous material secreted by glans penis and epithelium
smegma
testicular tumors are usually
malignant
what can HPV cause in men?
penile cancer
what causes a painless erosion at or near coronal sulcus; mucus plug before AM urination?
chlamydia
what causes watery or purulent discharge from penis?
gonorrhea
testicular cancer is 5x more common in?
caucasian males
what increases testicular cancer risk?
cryptorchidism or elevated testicular temp for long period of time
what is the common age range for testicular cancer?
20-35
highest city prevalence of HIV
washington DC
common clinical concerns of AIDS patients
MI
osteoporosis
lipodystrophy, lipoatrophy
what is 100x easier to catch than HIV because it can live outside the body for several days?
Hep B
low testosterone is associated with?
declining cognition
what is the 2nd leading cause of cancer death in US?
colon cancer
hypogonadism of andropause causes?
decreased: cognition, libido, coronary vasodilation, hemoglobin
obesity, heart disease and osteoporosis
low vit D and calcium in diet is risk factor for?
colon cancer
when should you get a colonoscopy?
over 50 unless risk factors
every 5-10 after that
colorectal cancer screening could save how many lives per year?
18,800
what is the 3rd most common type of cancer and 2nd most common cause of cancer death?
colorectal cancer
what population is at greatest risk of colorectal cancer?
AA and alaska natives
what is the number assigned to prostate cancer severity?
gleason score
gleason score good and bad?
big is bad
1= good
5= bad
what is the worst case scenario for gleason score?
gleason 10= both areas given score of 5
what is the term for radioactive seeds planted in prostate?
brachytherapy