NR 509 Final Review Questions Week 5
Chapter 20 Male genitalia
1. A 67-year-old electronics technician with a history of hypertension and
type 2 diabetes presents for his yearly physical examination and complains
of progressively worsening erectile dysfunction (ED). While counseling him,
the clinician mentions that multiple processes must take place to achieve an
erection. Which of the following structures would be most affected by
vascular deficiencies related to his preexisting medical conditions and is
likely contributing to his symptoms?
Corpora cavernosa
Rationale: The corpora cavernosa are two structures within the shaft of the
penis that become engorged with venous blood during erection. Patients with
a history of cardiovascular disease such as hypertension and other diseases,
such as diabetes, that cause limitations of blood flow are common causes of
ED. Ejaculatory duct is incorrect. It is a conduit for seminal fluid from the
seminal vesicle and terminal vas deferens to the urethra and is not involved
in the process of an erection. Epididymis is incorrect. It is a structure on top
of each of the testicles that provides a reservoir for storage, saturation, and
transport of sperm from the testes and is also not involved in the process of
an erection. Seminal vesicle is incorrect. It produces secretions that
contribute to the seminal fluid and is also not involved in the process of an
erection. Vas deferens is incorrect. It is a cord-like structure that transports
sperm from the tail of the epididymis to the urethra and also is not involved
in the process of an erection.
Reference: Bickley, Lynn S. Bates’ Guide to Physical Examination and
History Taking, 13th ed., Philadelphia: Wolters Kluwer, Chapter 20: Male
Genitalia.
2. A 29-year-old graduate student states that he is able to achieve an
erection and ejaculate during sexual intercourse; however, he does not
experience any pleasurable sensation of orgasm. He is otherwise healthy and
is not on any medications. What is the most likely cause of his problem?
Psychogenic
Rationale: Lack of orgasm with ejaculation is usually not a physiological or
structural issue, rather psychogenic in nature. It is fairly uncommon but does
occur, and clinicians should be aware of the problem and take a thorough
history to ascertain the roots of this disorder. Androgen insufficiency is
incorrect as it is more likely to cause a decrease in libido and problems with
erectile dysfunction (ED) rather than lack of orgasm. Endocrine dysfunction is