module 10 testicular disorders

Question 1

varicocele patho

Answer 1

abnormal dilation of spermatic veins in the spermatic cord

• multifactorial process
• incompetent valves
• > backflow of blood and pooling

Question 2

epididymitis patho

Answer 2

acute or chronic inflammation of the epididymis
- cause: bacterial, viral, parasitic, chemical, trauma induced
2 most common: chlamydia, gonorrhoeae
> 35: r/t urinary tract pathogens, structural abnormalities, and urologic procedures

Question 3

Orchitis patho

Answer 3

systemic, blood-borne infection 
-> acute inflammation of one or both testicles 
Cause: 
- systemic viral infections (mumps)
- complication of syphilis
- mycobacterial infections
- fungal infections 
2 most common: trachomatis, gonorrhoeae

Question 4

spermatocele patho

Answer 4

benign, painless sperm filled cyst of the epididymis

between the head of epididymis and the testes

Question 5

hydrocele patho

Answer 5

accumulation of fluid within the tunica vaginalis surrounding the testicle

Question 6

hematocele patho

Answer 6

collection of blood in the tunica vaginalis of the testes and manifests as a mass
- usually precipitated by trauma

Question 7

testicular torsion patho

Answer 7

obstruction of blood flow to the testes because of a twisting of the arteries and veins in the spermatic cord

Question 8

extravaginal torsion

Answer 8

occurs with the twisting of the spermatic cord, testis, and process vaginalis

Question 9

intravaginal torsion

Answer 9

failure of the testis to adhere to the scrotal wall, creating a “bell clapper deformity”

Question 10

scrotal-inguinal hernia patho

Answer 10

segment of the bowel slips through the internal inguinal ring

• result of a defcct in the anterior abd. wall
• patent process vaginalis

Question 11

strangulation

Answer 11

suspected with

• tender mass
• redness
• N/V

Question 12

elephantiasis patho

Answer 12

causes by filariasis (parasitic) that affects the scrotum

-> massive scrotal lymphedema

Question 13

Varicocele s/s

Answer 13

• no visible s/s
• blue color through light-colored scrotal skin
• dull pain, ache, or heaviness
• enlargement in a testicle that decreases in supine position

Question 14

epididymitis s/s

Answer 14

low grade fever, chills
heavy sensation
sudden onset severe pain 
- partially relieved by elevating scrotum 
blood in semen
penile discharge
low abd. pain 
groin pain 
lump in testicle
pin with intercourse or ejaculation

Question 15

orchitis s/s

Answer 15

gradual onset of acute or moderate pain
testicular swelling
fever

Question 16

spermatocele s/s

Answer 16

painless, cystic mass that is separate from testis
general movable, firm, painless
distint corders
visible on transillumination

Question 17

hydrocele s/s

Answer 17

painless, may come and go
marked edema
uncomfortable r/t added wt

Question 18

hematocele s/s

Answer 18

painful scrotum, tender to palpation

not visible on transillumination

Question 19

testicular torsion s/s

Answer 19

sudden onset, extremely painful 
abd. pain 
N/V
poss. fever
testicle rides high in scrotum 
absent cremasteric reflex

Question 20

torsion of appendix testis s/s

Answer 20

gradual onset of unilateral testicular pain
edema
tenderness over head of testicle
blue dot sign: noted on transillumination

Question 21

scrotal-inguinal hernia s/s

Answer 21

swelling
mild to moderate pain on straining
scrotal heaviness
presence of a bulge
edema inc. with standing erect 
dec. edema when recumbent

Question 22

testicular tumor s/s

Answer 22

palpable mass
edema
sensation of fullness or heaviness
back or abd. pian
nausea
anorexia
bowel and bladder symptoms 
poss. retroperitoneal lymph involvement

Question 23

elephantiasis s/s

Answer 23

massive scrotal lymphedema
thickened scrotal skin
skin ulcerations

Question 24

varicocele exam

Answer 24

bag of worms on palpation

smaller when the pt is supine

Question 25

epididymitis exam

Answer 25

``` scrotum is red, enlarged, and extremely tender - may be difficult to distinguish from testis intact cremasteric refelx pain relief with elevation (Prehn sign) pain along upper pole of testicle fever inc. HR UTI s/s inflammation of testis (orchitis) ```

Question 26

orchitis exam

Answer 26

``` testicular edema - difficult to distinguish the testes from epididymis swollen, tense testes painful fever - occurs 4-7 days after viral infection ```

Question 27

spermatocele exam

Answer 27

small, non-tender, freely movable mass able and behind the testis - transillumination

Question 28

hydrocele exam

Answer 28

painless mass that appears easily on transillumination | smooth, tense scrotal mass

Question 29

hematocele exam

Answer 29

scrotal swelling - no transillumination may be tender to palpation

Question 30

testicular torsion exam

Answer 30

``` edematous erythematous higher position swollen spermatic cord, extremely tender epididymis felt anteriorly absent cremasteric reflex ```

Question 31

scrotal inguinal hernia exam

Answer 31

enlarged hemiscrotum or bulge in the goin area | - may spontaneously reduce when pt is supine or with manual reduction