Scrotal Powerpoint

Question 1

Scrotum

Answer 1

skin pouch, supports the testes outside the body for survival of sperm
Divided by a septum into 2 compartments
Each compartment contains a testis, epididymis, spermatic cord and ductus deferens.

Question 2

Testes

Answer 2

2 male reproductive glands, produces sperm and testosterone
Size 3-5 cm in length
3cm in height
3x3x5

Question 3

Seminal vesicles

Answer 3

2 sac-like structures located posterior to the bladder, store sperm

Question 4

Tunica albuginea

Answer 4

Dense fibrous capsule surrounding the testes

Question 5

Tunica vaginales

Answer 5

2 serous layers covering the testes

A potential space between the 2 layers exists for a hydrocele to form

Question 6

Septal raphe

Answer 6

fibrous tissue dividing the scrotum into 2 separate compartments
prevents infections on one side from passing to the opposite testicle

Question 7

Mediastinum testes

Answer 7

a vertical septum which provides support for the testicular vessels and ducts to enter and exit

Question 8

Epididymis

Answer 8

elongated structure along the posterolateral aspect of the testis
Head,body,tail
Stores sperm

Question 9

Appendix testis

Answer 9

seen in 80% of patients, a small oval structure on the superior pole, remnant of the mullerian duct

Question 10

Pampiniform plexus

Answer 10

plexus of veins in the spermatic cord that drain into the right and left testicular veins; when a varicocele is present, dilatation and tortuosity may develop

Question 11

Spermatic cord

Answer 11

structure made up of the vas deferens, testicular artery,cremasteric artery, and pampiniform plexus that suspends the testis in the scrotum

Question 12

SONOGRAPHICALLY TESTE IS

Answer 12

SMOOTH, MEDIUM GRAY STRUCTURE WITH FINE ECHOTEXTURE

Question 13

Normal Rete Testies

Answer 13

THE AREA IN THE TESTIS WHERE THE SEMINIFEROUS TUBULES CONVERGE BEFORE DRAINING IN THE HEAD OF THE EPIDIDYMIS

Question 14

Normal Mediastinum Testis- Transverse Image

Answer 14

THE VERTICAL SEPTUM IN THE TESTIS FORMED BY THE MULTIPLE FOLDS OF DENSE, FIBROUS TISSUE THAT COMPLETELY COVERS THE TESTE KNOWN AS THE TUNICA ALBUGINEA

Question 15

Normal Mediastinum Testis- Sagital Image

Answer 15

HELPS TO SUPPORT THE VESSELS & DUCTS THAT COURSE THRU THE TESTES
SEEN ON US AS A BRIGHT, HYPERECHOIC LINE

Question 16

Normal Septal Raphe- Transverse Image

Answer 16

THIS FIBROUS TISSUE IS A MIDLINE STRUCTURE THAT CAN BE MISTAKEN BY THE PATIENT AS A NEW “PALPABLE NODULE”

Question 17

Normal Appendix Testis

Answer 17

A SMALL STRUCTURE ATTACHED TO THE UPPER POLE LOCATED BETWEEN THE TESTE AND EPIDIDYMIS
90% UNILATERAL OCCURANCE RATE
NOT TO BE CONFUSED WITH THE EPIDIDYMIS HEAD
IT IS ISOECHOIC WITH THE TESTE AND IS BEST SEEN WITH A HYDROCELE

Question 18

Appendix Epididymis

Answer 18

IS A SMALL PROTUBANCE FROM THE EPI HEAD WITH ONLY A 34% OCCURANCE RATE

Question 19

Epididymis location and size

Answer 19

beginning superiorly and then coursing posterolater to the test

is 6 to 7 cm

Question 20

Epididymis Head- measurement and location

Answer 20

largest part
6 to 15 mm in width
superior to upper pole of testis

Question 21

Normal Epididymis Appearence

Answer 21

isoechoic or hypoechoic compared with the testis, although the echo texture is coarser
SHOULD BE IMAGED ON ALL SCROTAL US EXAMS IN LONG AND TRANS PLANES

Question 22

Epididymis Head ductules

Answer 22

CONTAINS 10-15 DUCTULES COMING FROM THE RETE TESTE TO FORM A SINGLE DUCT IN THE HEAD & BODY OF THE EPIDIDYMIS

Question 23

BODY OF EPIDIDYMIS

Answer 23

COURSES ALONG THE POSTEROLATERAL ASPECT OF THE TESTE-SMALLER THAN THE HEAD AND TAIL
DIFFUCULT TO IMAGE WHEN NORMAL

Question 24

Tail of Epididymis

Answer 24

POSTERIOR TO THE LOWER POLE OF THE TESTE

Question 25

Body and Tail of Epididymis

Answer 25

BOTH STRUCTURES CONTAIN A SINGLE DUCT KNOWN AS THE DUCTUS EPIDIDYMIS WHICH BECOMES THE VAS DEFERENS IN THE SPERMATIC CORD

Question 26

Blood Supply- Testicular Arteries

Answer 26

primary blood supply, arise from the abd aorta below the level of the renal arteries

Question 27

Blood Supply- Testicular Arteries Doppler

Answer 27

Normal Doppler signals are low velocity, low resitive flow Helpful in determing torsion or tumor vascularity Power doppler may also be helpful.

Question 28

Arterial Vessels of the Teste

Answer 28

AORTA—TESTICULAR ARTERY—CAPSULAR ARTERY—CENTRIPETAL ARTERY—RECURRENT RAMI

Question 29

50% of men have a

Answer 29

TRANSMEDIASTINAL ARTERY (& ACCOMPANYING VEIN) THAT COURSES THRU THE MEDIASTINUM TOWARDS THE TESTIS CASPSULE

Question 30

COLOR FLOW IN THE TMA WILL BE

Answer 30

OPPOSITE OF THE CENTRIPETAL ARTERIES

Question 31

FLOW IN THE CMA IS _____ FROM THE MEDIASTINUM

Answer 31

away

Question 32

FLOW IN THE CENTRIPETAL ARTERIES IS ______ THE MEDIASTINUM

Answer 32

towards

Question 33

Normal Color demonstrates

Answer 33

BLOOD FLOW IN CENTRIPETAL ARTERIES

Question 34

Spectral Doppler demonstrates

Answer 34

NORMAL LOW-RESISTANCE WAVEFORM

Question 35

Resistive Index

Answer 35

PEAK SYSTOLE MINUS PEAK DIASTOLE DIVIDED BY PEAK SYSTOLE (S-D/S=RI

Question 36

RI values

Answer 36

WILL DIFFER SLIGHTLY DEPENDING ON THE ORGAN AVERAGE RANGE IS BETWEEN 0.4-0.8 HIGHER VALUES INDICATE DECREASED PERFUSION

Question 37

ARTERIES WITH LOW-RESISTIVE (LOW IMPEDANCE) BLOOD FLOW SUPPLY

Answer 37

ORGANS THAT NEED CONTINUOUS PERFUSION (LIVER, KIDNEYS, TESTES, UMBILICAL CORD)

Question 38

Testis Benign Pathology- Tubular Ectasia Of the Rete Testes

Answer 38

> age 45

Question 39

Testis Benign Pathology- Intratesticular

Answer 39

located near mediastinum testis

Question 40

Testis Benign Pathology- Abscess

Answer 40

normally from epidiymo-orchitis

Question 41

Testis Benign Pathology- Hydrocele

Answer 41

an abnormal accumulation of serous fluid between the layers of the tunica vaginalis Most common cause of painless scrotal swelling Congenital or acquired (trauma,epididymitis,or torsion)

Question 42

Testis Benign Pathology- Henatoceles

Answer 42

trauma,surgery,torsion,diabetes, or arterosclerosis

Question 43

Testis Benign Pathology- Pyoceles

Answer 43

occurs when an abscess ruptures into an existing hydrocele | Normally have septations or scrotal skin thickening

Question 44

Testis Benign Pathology- Varioceles

Answer 44

enlargement of the veins of the spermatic cord most commonly left side < 25 years of age

Question 45

Hydrocele is associated with

Answer 45

neoplasms, tends to be smaller

Question 46

Is it normal for a small amount of hydrocele to excist?

Answer 46

Yes