241 - Benign Male Genital Disorders Flashcards Preview

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Flashcards in 241 - Benign Male Genital Disorders Deck (25)
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1

Which two mullarian duct remnants can torse?

Appendix testis

Prostatic utricle

2

The internal spermatic fascia is an extension of which layer of the abdominal wall?

Transversalis fascia

 

ICE - TIE

 

3

Which nerve supplies motor fibers to the cremaster muscle?

Genitofemoral

4

What are the boundaries of Hesselbach's (aka the inguinal) triangle?

  • Inguinal ligament (inferior)
  • Inferior epigastric (lateral)
  • Rectus abdominus (medial)

 

5

The dartos and smooth muscle is an extension of which layer of the abdominal wall?

Scarpa's fascia

 

I think Scarpa's fascia anteriorly, and Colle's fascia closer to the perineum?

6

Which benign genital skin disorder may be associated with multi-segmented urethral stricture disease?

Balanitis Xerotica Obliterans

7

From which artery is the cremasteric artery derived?

Inferior epigastric artery

8

Why is surgery for torsion always bilateral?

If one torses, the other could too 

Anchor the dartos to the tunica vaginalis on both sides to prevent

9

List 5 characteristics that make a testis prone to torsion

  • Horizontal alignment
  • High-riding
  • Hypermobile
  • Bell clapper deformity
  • Undescended testis

 

10

What kind of varicocele warrants imaging of the retroperitneum?

Solitary right varicocele

 

Right varicocele = suspicion for tumor impeding venous drainage

Left varicocele: can be explained by normal anatomy (SMA crushes renal vein against abdominal aorta, backs up into renal ven -> gonadal vein)

11

What causes an indirect inguinal hernia?

Where is it located, relative to the inferiror epigastric vessels?

Patent processus vaginalis

Lateral to the inferior epigastric vessels in the inguinal triangle

12

Dysfunction in which structure results in a varicocele?

Pampiniform plexus of veins

Drains blood from the scrotum; if they are not draining, results in a varicocele

 

Left more common due to path of venous drainage

13

What are the differences between intravaginal and extravaginal testicular torsion?

  • Intravaginal
    • Tunica vaginalis not involved
    • Most common in early purberty
    • More common in general
    • Testes may be salvageable - hurry!
       
  • Extravaginal
    • Tunica vaginalis involved
    • Neonatal or perinatal event
    • Often does not cause dystress
    • Almost never salvageable

 

14

The cremasteric fascia is an extension of which layer of the abdominal wall?

Internal oblique

 

ICE - TIE

 

Lecture table has transversus abdominis as contributing to cremasteric fascia and muscle, but the main one is internal oblique; usually (according to Cochard) transversus abdomins doesn't do anything in the scrotum

15

The tunica vaginalis is an extension of which layer of the abdominal wall?

Peritoneum

16

Management of a hydrocele?

Observation if not bothersome, may resolve

Aspiration (but recurrence likely)

Surgery

17

Describe the management of intravaginal testicular torsion

  • Can diagnose on clinical suspician
    • Doppler US can confirm, but not sensitive
  • Pre-operative manual detorsion
    • Saves fertility if within 6h, Leydig cell fx if within 10h
  • Surgical fixation
    • Anchor tunica albuginia to dartos on both sides

 

18

The external spermatic fascia is an extension of which layer of the abdominal wall?

External oblique

 

ICE - TIE

 

19

A spermatocele can be derived from which structures? (4)

  • Rete testis
  • Efferent ductules
  • Head of epididymis
  • Body of epididymis

Vs. cyss, come from body or tail

20

What are the features of each grade of varicocele?

  • Grade 1: only perceptible with valsalva
  • Grade 2: perceptible w/o valsalva
  • Grade 3: visible through scrotal skin

 

21

How does the drainage of the left and right gonad differ?

Right gonad -> IVC

Left gonad -> left renal vein -> IVC

 

=> left renal vein can be compressed between abdominal aorta and superior mesenteric arteries

22

Which cells make the fluid found in a hydrocele?

Mesothelial cells

23

Which benign scrotal masses exhibit transillumination?

  • Hydrocele
  • Spermatocele
  • Epididymal cyst
  • Indirect inguinal hernia, if it contains fluid

 

24

Which branch of the internal iliac artery gives rise to the artery of the vas deferens?

Inferior vesical or superior vesical artery

 

Note: Artery to the vas is the most important collateral vessel to the gonad

25

What causes a diret inguinal hernia?

Where is it located, relative to the inferiror epigastric vessels?

Weakness in the transversalis fascia

Medial to the inferior epigastric vessels - sits in the middle of the inguinal triangle

 

Hesselbach's triangle = inguinal triangle