ABD Board-Scrotum Flashcards by miranda wilcox

fibrous casuple that surrounds the testicle

tunica albuginea

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multiple septations (septula) arise from the tunica albuginea to form the

mediastinum testis

echogenic linear line extending long within the testis

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the septula forms wedge shaped compartments that contain the

seminiferous tubules

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the seminiferous tubules converge to form the

tubuli recti AKA tubuli seminiferi recti)

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the tubuli recti (tubuli seminiferi recti) connect the

seminiferous tubule to the rete testis

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order of testi connections

seminiferous tubules 
to
tubuli recti
to 
rete testis
to
efferent ductules
to
ductus epididymis
to
vas deferens

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anastomosing network of delicate tubules located in the hilum of the testicle (mediastinum ttestis) that carries sperm to the epididymis. sperm is concentrated as fluid and reabsorbed within this network

rete testis

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carry the seminal fluid from the rete testis to the epididymis

efferent ductules

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composed of head body and tail, positioned parallet to the testicle

epididymis

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head of epididymis AKA

globus major

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head of epididimus is located

adjacent to the superior pole of the testis and is the largest part of epi

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the efferent ductules converge to form a single conconvoluted duct (ductus epididymis) in the

head (globus Major)

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form an acute angle and courses cephlad as the vas deferens (ductus deferens)

tail of epididymis

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appearance of epidydimis

slightly hyperechoic to testi or isoechogenic to testi

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a remnant of the mullerian duct, small ovoid structure located beneath the head of the epididymis

appendix testis

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blue dot sign

torsion of appendix testis occuring in boys 7-12 yrs old

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representing a detached efferent duct, is a small stalk projecting off the epididymis. Derived from the wolffian duct

appendix epididymis

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layer of muscle fibers, lying beneath the scrotal skin and dividing the scrotum into 2 chambers

darto

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the division of the 2 scrotal chambers is called

scrotal raphe

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saccular extension of the peritoneum into the scrotal chambers

tunica vaginalis

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inner or visceral layer of the tunica vaginalis covers the

testis and epididymis

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the outer or parietal layer of the tunica vaginalis lines the

scrotal chamber

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testicular blood flow is supplied by the

deferential artery

cremasteric (external spermatic) artery

testicular artery

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testicular artery divides into

capsular and centripetal (intratesticular) branches

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the centripetal arteries course along the septula converging on the

mediastiinum testis

spermatic cord consists of the

vas deferents creasteric, deferential, testicular arteries pampiniform plexus of veins lymphatic nerves

most extratesticular masses are

benign

majority of intratesticular lesions are

malignant

most malignant testicular neoplasms are

hypoechic compared to the normal testicular parenchyma

testicular neoplasms are the most common malignancy in men ages

15 to 35 yrs

most common testicular cancers

germ cell

germ cell tumors are classified as either

seminoma (50%) or nonseminoma (50%)

most common germ cell type found in both pure seminoma and mixed germ cell testicular masses

seminoma | radiosensitive so good prognosis

risk factors of seminoma

cryptorchidism (undescended testicles) infertility klinefelter syndrome (XXY) down syndrome smokeing white race

seminoma spreads by

draining lymph nodes in the retroperitoneum. Paraaortic region should be evaluated

seminoma tumor markers

beta HCG AFP LDH

masses that are not pure seminomas and consist of other cell types

nonseminomas considered mixed tumor and nonseminomatous germ cell tumor

other cells types found in nonseminomas

embryonal carcinomas teratomas yolk sac tumors (endodermal sinus tumors)** choriocarcinomas

treatment for nonseminomatous germ cell

radical (inguinal) orchiectomy

alpha fetoprotein is associated with

nonseminomas

most common testicular tumor in infants and young children

yolk sac tumors AKA endodermal sinus tumor

rare stromal (non germ cell) tsticular tumor occuring in boys 5 - 10 yrs and men 30 - 60 yrs

leydig cell tumors can also be mixed always benign in children but can be malignant in adults can also be in ovaries and usually malignant

leydig cell tumors produse

testosterone resulting in presosious puberty may also produce estrogen resluting in feminizing symtpons

elevated alpha fetoprotein is not found in

seminomas

levels of high serum tumor markers indicate

poor prognosis

two types of benign testicular cysts

cysts of the tunica albuginea intratesticular cysts

intratesticular cysts are normally located near the

mediastinum testis and probably originate from the rete testis

benign tumor of germ cell origin. well circumscribed solid tumors lying beneath the tunica albuginea. Filled with a cheesy white keratin. Appearas as a solid, hypoechic mass with an echogenic capsule or onion ring pattern formed by multiple layers of heratin

epidermoid cysts bow tie, central echogenic pattern

usually a complication of epididymo orchitis appears with an enlarged testicle containing a predominantly fluid filled mass with hypoechic or mixed echogenic areas

testicular abscess

called scrotal pearls and may be located within or between the layers of the tunica vaginalis

scrotal calcifications microlithiasis we don't know much about these and follow up exams will be ordered

uncommon event typically with an udetermined cause typically present as a triangular shaped avascular intratesticular lesion

testicular infarct

appearance of testicular infarct

depends on age of infacrtion initially produces a focal or diffuse hypoechoic testicle with time the testicle decreases in size and develops areas of increased echogenicity representing fibrosis or calcifications

a serous fluid that accumulates within the tunica vaginalis or between the layers of the tunica vaginalis (visceral and parietal layers)

hydrocele

most hydroceles are ____ and are noted in boys 1-2 yrs old. They are caused by failed closure of the ____ _____ at the _____ _____

congenital processus vaginalis internal ring

schronically acquired or secondary hydroceles usually occur in men older than 40 yrs. They may be idiopathic or the result of

trauma torsion neoplasms epididymitis orchitis

when blood fills the scrotal chamber assiciated with trauma

hematocele

_____ may be seen within a hydrocele

low level echoes from fibrin or cholesterol crystal

a dilatation of the pampiniform venous plexus of the testicular veins which drain in the testicle

varicocele

90% of varicoceles are on the ___ side

left due to the length of the left testiclular vein as it drains into the left renal vein

varicoceles should distend when a patient

is standing with valsalva ABD pressure

unilateral scrotal pain may be a result of

torsion epididymitis varicocele thrombosis

the most common cause of correctable male infertility

varicoceles

result from bowel protruding through the inguinal canal into the tunica vaginalis of the scrotum

scrotal hernia peristalsis confirms (bowel movement) small inguinal hernia can be seen by using valsalva

extratesticular tumors usually involve

the epididymis

most common extratesticular tumor

adenomatoid tumor

cystic masses of the epididymis that result from dilatation of the epididymal tubules

spermatoceles (composed of milky fluid containing spermatozoa) epididymal cysts (composed of clear fluid) both are a result of epididymitis

spermatoceles are ____ common than epididymal cysts

spermatoceles usually are at the

epididimal head

both spermatoceles and epididymal cysts appear as

anechoic well defined masses

most common condition that causes acute scrotal pain

epididymitis

acute epididymitis usually caused by

STD in older men urinary tract infection in kids

epididymitis may spread into the testicle causing

orchitis

appearance of epididymitis

enlarged hypoechioc epididymitis increased blood flow (hyperemia) reactive hydrocele scrotal wall thickening

appearance of orchitis

enlarged hypoechoic testicle increased blood flow (hyperemia) decreased arterial resisitence

bell clapper deformity AKA intravaginal testicular torsion only happens in infants

testicle is not attached to the tunica vaginalis and can rotate freely on the spermatic cord causing torsion

appearance of torsion

enlarged hypoechoic testicle duration of pain

hidden testicle and generally resfers to an undescended testicle

cryptorchidism

congenital absence is rare and accounts for only 4% of patients who present with cryptorchidism, it's called

anorchia

treatment of choice for cryptorchidism

orchioplexy

ABD Board-Scrotum Flashcards

(79 cards)