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Male Reproductive Problems.docx

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NURS 201
Marywyatt Sindlinger

Male Reproductive Problems BENIGN PROSTATIC HYPERPLASIA (BPH)  Benign prostatic hyperplasia (BPH) is prostate gland enlargement due to increased epithelial cells and stromal tissue.  BPH results from endocrine changes associated with the aging process.  The compression of the urethra leads to clinical symptoms including decrease in caliber and force of the urinary stream, difficulty in initiating voiding, intermittency and dribbling.  Conservative and initial treatment is “watchful waiting” when there are no symptoms or only mild ones. Drug therapy may also be used.  Invasive treatment of symptomatic BPH involves prostate resection or ablation. PROSTATE CANCER  Prostate cancer is the most common cancer among men, excluding skin cancer.  Risk factors include family history, age, and ethnicity.  Symptoms of prostate cancer are similar to those for BPH, including dysuria, hesitancy, dribbling, frequency, and urgency.  Elevated levels of prostate-specific antigen (PSA) indicate prostatic pathology, although not necessarily prostate cancer.  The conservative approach to management is “watchful waiting.”  Invasive therapies include radical prostatectomy and cryosurgery. Treatment may also include drugs, hormones, chemotherapy, and radiation.  The nursing role is to encourage patients, in consultation with health care providers, to have annual prostate screening (PSA and digital rectal examination) starting at age 50 or younger if risk factors present. PROSTATITIS  The term prostatitis describes a group of inflammatory and noninflammatory conditions affecting the prostate gland.  It includes acute bacterial prostatitis, chronic bacterial prostatitis, chronic prostatitis/chronic pelvic pain syndrome, and asymptomatic inflammatory prostatitis.  Antibiotics are used for acute and chronic bacterial prostatitis. EPIDIDYMITIS  Epididymitis is an acute, painful inflammatory process of the epididymis secondary to an infectious process, trauma, or urinary reflux down the vas deferens.  Antibiotic use is important for both partners if transmission was through sexual contact.  Conservative treatment consists of bed rest with elevation of scrotum, use of ice packs, and analgesics. STRUCTURES AND FUNCTIONS  The human nervous system is a highly specialized system responsible for the control and integration of the body’s many activities.  The nervous system can be divided into the central nervous system (CNS) and parts of the peripheral nervous system (PNS). o The central nervous system consists of the brain and spinal cord. o The peripheral nervous system consists of the cranial and spinal nerves and the autonomic nervous system (ANS).  The nervous system is made up of two types of cells: neurons and neuroglia. o The neurons of the nervous system come in many different shapes and sizes, but they all share common characteristics: (1) excitability, or the ability to generate a nerve impulse; (2) conductivity, or the ability to transmit the impulse to other portions of the cell; and (3) the ability to influence other neurons, muscle cells, and glandular cells by transmitting nerve impulses to them. o Neuroglia, or glial cells, provide support, nourishment, and protection to neurons.  Nerve impulses originate within a neuron as an action potential that moves along the body of the cell (axon) until it reaches the end of the nerve fiber. From there, it is transmitted across the junction between nerve cells by a chemical interaction and then, the impulse will move across the next neuron as an action potential. o A synapse is the structural and functional junction between two neurons. It is the point at which the nerve impulse is transmitted from one neuron to another or from neuron to glands or muscles. o A neurotransmitter is a chemical agent involved in the transmission of an impulse across the synaptic cleft. CENTRAL NERVOUS SYSTEM  The major structural components of the CNS are the spinal cord and brain. Spinal Cord  The spinal cord is continuous with the brainstem and exits from the cranial cavity through the foramen magnum. A cross section of the spinal cord reveals gray matter that is centrally located and is surrounded by white matter.  Specific ascending and descending pathways in the white matter can be identified. o In general, the ascending tracts carry specific sensory information to higher levels of the CNS. o Descending tracts carry impulses that are responsible for muscle movement.  Lower motor neurons are the final common pathway through which descending motor tracts influence skeletal muscle, the effector organ for movement. The cell bodies of these cells are located in spinal cord and the axons innervate the skeletal muscles. Brain  The brain consists of the cerebral hemispheres, cerebellum, and brainstem.  The cerebrum is composed of the right and left hemispheres. Both hemispheres can be further divided into four major lobes. o The frontal lobe controls higher cognitive function, memory retention, voluntary eye movements, voluntary motor movement, and expressive speech. o The temporal lobe contains Wernicke’s area, which is responsible for receptive speech and for integration of somatic, visual, and auditory data. o The parietal lobe is composed of the sensory cortex, controlling and interpreting spatial information. o Processing of sight take place in the occipital lobe.  The basal ganglia, thalamus, hypothalamus, and limbic system are also located in the cerebrum.  The brainstem includes the midbrain, pons, and medulla. The vital centers concerned with respiratory, vasomotor, and cardiac function are located in the medulla.  The brainstem contains the centers for s
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