Chapter 13: The Male Pelvis Flashcards
(116 cards)
1
Q
a protein produced by the fetal yolk sac, fetal gastrointestinal tract, and the fetal liver; may also be produced by some malignant tumors
A
alpha-fetoprotein
2
Q
the testicular appendage located at the head of the epididymis
A
appendix epididymis
3
Q
the testicular appendage located between the head of the epididymis and the superior pole of the testis
A
appendix testis
4
Q
the testicular appendage located between the body and tail of the epididymis
A
appendix vas
5
Q
the condition in which the patient lacks the normal posterior fixation of the testis and epididymis to the scrotal wall
A
“bell-clapper” deformity
6
Q
the appearance of a torsed testicular appendage that can be observed as a blue dot just under the skin surface
A
“blue dot” sign
7
Q
gland that secretes preejaculate fluid that lubricates the penile urethra prior to ejaculation
A
bulbourethral gland
Cowper gland
8
Q
the muscle that raises the testicle
A
cremaster muscle
9
Q
the tube that connects the epididymis to the seminal vesicles
A
ductus (vas) deferens
10
Q
a coiled structure that is attached to the testicle and the posterior scrotal wall that is responsible for storing sperm
A
epididymis
11
Q
inflammation of the epididymis and testis
A
epididymoorchitis
12
Q
a type of neoplasm derived from germ cells of the gonads; may be found outside of the reproductive tract
A
germ cell tumor
13
Q
hormone produced by the trophoblastic cells of the early placenta; may also be used as a tumor marker in nongravid patients and males
A
human chorionic gonadotropin (hCG)
14
Q
a fluid collection within the scrotum; most often found between the two layers of the tunica vaginalis
A
hydrocele
15
Q
a condition in which a male has an extra X chromosome; characteristic features include small testicles, infertility, gynecomastia, long legs, and abnormally low intelligence
A
Klinefelter syndrome
16
Q
the structure that separates the scrotum into two compartments externally
A
median raphe
17
Q
the structure that is formed by the tunica albuginea and contains the rete testis
A
mediastinum testis
18
Q
the surgery that moves an undescended testis into the scrotum
A
orchiopexy
19
Q
inflammation of the testis or testicles
A
orchitis
20
Q
the group of veins in the scrotum
A
pampiniform plexus
21
Q
the largest zone of the prostate and most common location for prostatic cancer
A
peripheral zone
22
Q
a network of tubules that carry sperm from the seminiferous tubules to the epididymis
A
rete testis
23
Q
an extratesticular calculi
A
scrotal pearl
24
Q
a fluid that contains secretions from the testicles, seminal vesicles, and prostate gland
A
semen
25
small glands located superior to the prostate gland and posterior to the base of the bladder, which secrete an alkaline-based fluid
seminal vesicles
26
the location of spermatogenesis within the testicles
seminiferous tubules
27
the most common malignant neoplasm of the testicles
seminoma
28
the structure that travels through the inguinal canal and contains blood vessels, nerves, lymph nodes, and the cremaster muscle
spermatic cord
29
a common cyst that is found most often in the head of the epididymis that is composed of nonviable sperm, fat, cellular debris, and lymphocytes
spermatocele
30
the prostatic zone that is the most common site for benign prostatic hypertrophy
transitional zone
31
the dense connective tissue that is closely applied to each testicle
tunica albuginea
32
the structure that separates the scrotum into two separate compartments internally
tunica dartos
33
the paired serous coatings of the testis; hydroceles are most often found between these two layers
tunica vaginalis
34
an elevated area within the prostatic urethra at which the ejaculatory ducts meet the urethra
verumontanum
35
testicles descend into the pelvis at the ___ week of gestation
4th
36
the testicles descend into the scrotum at __ weeks gestation
28
37
where does spermatogenesis occur?
within the seminiferous tubules
38
endocrine function of the testicles
produce testosterone
39
exocrine function of the testicles
produce sperm
40
3 parts of the epididymis
head
body
tail
41
2 roles of the epidiymis
stores sperm in order for them to mature
| transports sperm into the ductus (vas) deferens
42
the ductus (vas) deferens is a tube that connects the epididymis to the _________________
seminal vesicles
43
the testicles receive most of their blood supply from the what?
testicular arteries
44
testicular arteries are branches of what?
abdominal aorta
45
testicular venous drainage is performed by what?
pampiniform plexus
46
the right testicular vein drains into the _________ and the left testicular vein drains into the _________
IVC
| left renal vein
47
5 components of the spermatic cord
```
testicular artery
pampiniform plexus
lymph nodes
nerves
cremaster muscle
```
48
normal scrotal wall thickness
2-8 mm
49
normal adult testicles measurements
3-5 cm in length
2-4 cm in width
3 cm in thickness
50
normal epididymis head measurement
10-12 mm
51
cryptorchidism is found in _____% of full-term births
3-4
52
an undescended testis will appear ___________ to a normal testis
hypoechoic
53
Clinical findings:
| one or both testicles not palpable within the scrotum
cryptorchidism
54
Sonographic findings:
testis located outside of the scrotum
the cryptorchid testis will appear hypoechoic to the normal testis
cryptorchidism
55
ages testicular torsion occurs most often
12-18 years old
56
testicle salvage rates range from 80-100% if the patient with testicular torsion is treated within _ hours of symptom onset
6
57
a torsed testicle is usually not salvageable after _ hours
24
58
Clinical findings:
acute onset of testicular pain (often during sleep)
possible pain within the lower abdomen and inguinal region
swollen testis/scrotum
nausea and vomiting
higher-positioned, painful testis with a horizontal position
acute testicular torsion
59
Sonographic findings:
enlargement of the spermatic cord, epididymis, and testis
thickened scrotal wall
hypoechoic or heterogeneous testis
reactive hydrocele
no intratesticular flow
decreased intratesticular flow (as compared with the asymptomatic testis)
acute testicular torsion
60
Sonographic findings:
enlargement of the spermatic cord, epididymis, and testis
no intratesticular flow
hyperemic flow around the testis
heterogeneous testis with areas of necrosis
chronic testicular torsion
61
most common cause of acute scrotal pain in prepubertal boys
torsion of the appendix testis
62
3 appendages of the testis
appendix testis
appendix epidiymis
appendix vas
63
Clinical findings:
acute testicular pain
pain localized to the superior pole of the testis
"blue dot" sign
torsion of the testicular appendage
64
```
Sonographic findings:
normal intratesticular flow
small, avascular, hypoechoic or hyperechoic mass adjacent to the superior pole of the testis
reactive hydrocele
scrotal wall thickening
```
torsion of the testicular appendage
65
Clinical findings:
transilluminates light
painless scrotal swelling
may present with pain when found in the presence of scrotal infections, testicular torsion, trauma, or a tumor
hydrocele
66
Sonographic findings:
simple fluid anterior to the testis
scrotal wall thickening
chronic hydroceles may have internal debris and septations
hydrocele
67
spermatoceles are most commonly found where?
head of the epidiymis
68
Clinical findings:
if large enough, they may be palpable
typically not painful
spermatocele, epidiymal cyst, tunica albuginea cyst
69
Sonographic findings:
round, anechoic mass with acoustic enhancement
may contain some layering debris
spermatocele, epididymal cyst, tunica albuginea cyst
70
what do incompetent or abnormal valves within the pampiniform plexus cause?
varicoceles
71
most common cause of correctable male infertility
varicoceles
| cause excess blood within scrotum, extra heat, overheat the sperm
72
2 types of varicoceles and where they are found
primary - most often found on the left
secondary - found on the right (promptly investigate kidneys and retroperitoneum due to their association with hydronephrosis, hepatomegaly, and retroperitoneal neoplasm)
73
Clinical findings:
palpable extratesticular mass
possible infertility
varicocele
74
Sonographic findings:
a group of anechoic, tubular structures located outside of the testis
distended veins that fill with color flow when the Valsalva maneuver is performed
dilated veins that measure greater than 2 mm
possible associated with hydronephrosis, hepatomegaly, or a retroperitoneal neoplasm if found on the right
varicocele
75
Sonographic findings:
| extremely echogenic, mobile extratesticular structure that produces acoustic shadowing
scrotal pearl
76
most common cause of acute testicular pain in adults
epididymitis
77
most common cause of epididymitis in young men
chlamydia
78
```
Clinical findings:
acute testicular pain
fever
dysuria
urethral discharge
skin wall edema
```
epididymitis or epididymoorchitis
79
Sonographic findings:
enlargement of the entire epididymis (diffuse)
enlargement of only part of the epidiymis (focal)
hypoechoic echotexture of the affected section(s) of the epididymis
hyperemia within the epididymis and/or testis
thickened scrotal wall
epididymitis or epididymoorchitis
80
what typically causes a testicular abscess?
untreated epididymoorchitis
81
Clinical findings:
painful, swollen scrotum
fever
elevated white blood cell count
testicular abscess
82
Sonographic findings:
complex intratesticular mass
mass that has no flow centrally but increased flow around its margins
may have a co-existing pyocele
testicular abscess
83
Sonographic findings:
complex fluid collection within the scrotum
scrotal wall thickening
may be seen in conjunction with rupture of a testicular abscess
pyocele
84
_____testicular masses are often considered malignant until proven otherwise, while the majority of _____testicular masses are typically benign
intra
| extra
85
an elevation in _____ levels is found in conjunction with malignant intratesticular tumors 60% of the time
hCG
86
3 things an elevated AFP level can indicate in a male
embryonal cell carcinoma
adult teratoma
yolk sac tumor
87
6 germ cell tumors of the testicles
```
pure seminoma
teratoma
embryonal cell carcinoma
yolk sac tumor
choriocarcinoma
burned-out germ cell tumor
```
88
2 sex cord-stromal tumors of the testicles
Leydig cell tumor
| Sertoli cell tumor
89
the seminoma is a ________ tumor that is typically found in males between __ and __ years of age
germ cell
30
50
90
Clinical findings:
painless scrotal mass
hardening of the testis
elevated hCG
seminoma
91
Sonographic findings:
| solid, hypoechoic intratesticular mass
seminoma
92
Clinical findings:
trauma to the scrotum resulting in acute scrotal pain
low hematocrit
scrotal trauma
93
Sonographic findings:
possible fracture line
indistinct testicular margins
hematocele
scrotal trauma
94
Clinical findings:
trauma to the pelvis or scrotum
recent pelvic or scrotal surgery
low hematocrit
hematocele
95
Sonographic findings:
complex fluid collection within the scrotum
scrotal wall thickening
hematocele
96
Clinical findings:
persistent or intermittent scrotal swelling
may have abdominal pain and blood in stool
inguinal hernia
97
Sonographic findings:
heterogeneous mass within the scrotum that moves (peristalsis)
mass may contain air and fluid
hydrocele may be present
inguinal hernia
98
the prostate is a retroperitoneal gland that produces and secretes an ________ fluid that constitutes between __ and __% of the semen
alkaline
13
30
99
4 zones of the prostate
peripheral zone
central zone
transitional zone
periurethral glandular zone
100
a protein produced by the prostate
prostate-specific antigen (PSA)
101
the most common cancer in men
prostate cancer in the form of adenocarcinoma
102
Clinical findings:
elevated PSA
enlarged prostate
blood in the urine or semen
back pain, pelvic pain, hip or thigh pain
impotence
decrease in the amount of ejaculated fluid
prostate cancer
103
Sonographic findings:
varying sonographic appearance
hypoechoic mass in prostate
may be hypervascular
prostate cancer
104
```
Clinical findings:
nocturia
increased urinary frequency
sense of urinary urgency
constant feeling of having a full bladder
elevated PSA
```
benign prostatic hypertrophy
105
```
Sonographic findings:
enlargement of the inner prostate
can lead to hypoechoic areas within the prostate
calcifications within the prostate
diffusely heterogeneous prostate
cystic changes within the prostate
```
benign prostatic hypertrophy
106
```
Secondary varicoceles are associated with all of the following except:
A. left-sided location
B. right-sided location
C. hepatomegaly
D. renal mass
```
left-sided location
107
```
The most common location of benign prostatic hypertrophy is the:
A. peripheral zone
B. transitional zone
C. central zone
D. verumontanum
```
transitional zone
108
```
Primary varicoceles are associated with all of the following except:
A. left-sided location
B. retroperitoneal mass
C. infertility
D. palpable extratesticular mass
```
retroperitoneal mass
109
```
The exocrine function of the testicles is to produce:
A. testosterone
B. human chorionic gonadotropin
C. alpha-fetoprotein
D. sperm
```
sperm
110
The most common location of a hydrocele is:
A. superior to the testis
B. within the scrotal wall
C. between the two layers of the tunica vaginalis
D. between the tunical vaginalis and tunica albuginea
between the two layers of the tunica vaginalis
111
Dilated veins of a varicocele will measure:
A. >8 mm
B. >4 mm
C. 2 mm
>2 mm
112
```
The endocrine function of the testicles is to produce:
A. testosterone
B. human chorionic gonadotropin
C. alpha-fetoprotein
D. sperm
```
testosterone
113
```
The most common germ cell tumor of the testis is the:
A. yolk sac tumor
B. embryonal cell carcinoma
C. seminoma
D. teratoma
```
seminoma
114
```
The most common location of a varicocele is:
A. the right side of the scrotum
B. the left side of the scrotum
C. the inguinal canal
D. within the testis
```
the left side of the scrotum
115
```
The most common location of prostatic cancer is the:
A. peripheral zone
B. transitional zone
C. central zone
D. verumontanum
```
peripheral zone
116
```
What is the most common sonographic appearance of a seminoma?
A. hyperechoic
B. anechoic
C. heterogeneous with calcifications
D. hypoechoic
```
hypoechoic
