Scrotum Flashcards
(149 cards)
1
Q
Pediatric testes measure approximately…
A
1 cm.
2
Q
From age 8 to puberty testes increase in size to about…
A
4 cm.
3
Q
Adult testes measure about…
A
3-5 cm long, 2-4 cm wide, 3 cm AP
4
Q
Scrotal u/s is best performed with a…
A
linear 7.5-12 MHz transducer.
5
Q
What maneuver should be performed when evaluating varicoceles?
A
valsalva
6
Q
This fibrous capsule surrounds the testicle.
A
tunica albuginea
7
Q
The tunica albuginea is continuous with the __ that divide the testis into about __.
A
septa, 250 lobules
8
Q
This contains a thin film of serous fluid between its layers and supports the testes in the scrotal sac.
A
tunica vaginalis
9
Q
The inner layer of the tunica vaginalis that covers the testis and epididymis is called the…
A
visceral layer
10
Q
The outer layer of the tunica vaginalis that lines the scrotal chamber.
A
parietal layer
11
Q
The tunica vaginalis is attached to the __ wall of the testis preventing each testis from rotation within the scrotum.
A
posterior
12
Q
Multiple septations arise from the tunica albuginea to form the…
A
mediastinum testis
13
Q
Sonographically, the mediastinum testis appears as…
A
a echogenic linear band extending longitudinally within the testis.
14
Q
This forms the support for the entering and exiting testicular vessels and ducts.
A
mediastinum
15
Q
This forms wedge-shaped compartments containing seminiferous tubules.
A
septa
16
Q
Where is the sperm produced?
A
in the seminiferous tubules
17
Q
This courses centrally to form 20-30 larger ducts called the tubuli recti.
A
seminiferous tubules
18
Q
This enters the mediastinum testis formed a network of channels called the rete testis.
A
tubuli recti
19
Q
The rete terminate in…
A
10-15 efferent ductules.
20
Q
These carry the seminal fluid from the rete testis to the epididymis.
A
efferent ductules
21
Q
The epididymis is composed of a…
A
head, body, and tail.
22
Q
The head of the epididymis is called…
A
globus major.
23
Q
This is the largest part of the epididymis, adjacent to the superior pole of the testis.
A
globus major
24
Q
This is where the efferent ductules converge to form a single convoluted duct called the ductus epididymis.
A
globus major
25
The tail of the epididymis is also known as...
globus minor
26
The globus minor courses cephalad and becomes known as the...
vas deferens or the ductus deferens
27
The epididymal head measures __ in length and lies at the __ pole of the testis.
5-12 mm, superior
28
The epididymal body and tail run __ to the testis.
posterior
29
Four testicular appendages that are remnant of embryonic ducts include...
1. appendix testis
2. appendix epididymis
3. vas aberrans
4. paradidymis
30
This is a remnant of the mullerian duct that 92% of men have.
appendix testis
31
This represents a detached efferent duct and is a small stalk projecting off the epididymis that 34% of men have.
appendix epididymis
32
These are derived from the wolffian duct and are blind ending tubules that project from the head and tail of the epididymis.
vas aberrans
33
Also known as the organ of Giraldes, this is a rarely identified appendage of the epididymis.
paradidymis
34
This is a layer of smooth muscle fibers that lies beneath the scrotal skin and divides the scrotum into two chambers.
dartos muscle
35
The division of the two scrotal chambers is called the...
scrotal raphe.
36
This consists of the vas deferens, arteries, pampiniform plexus of veins, lymphatic, and nerves.
spermatic cord
37
This is a tube that connects the epididymis to the seminal vesicle.
vas deferens
38
This joins the duct at the seminal vesicles to form the ejaculatory duct.
vas deferens
39
This is where sperm are manufactured in the scrotum.
testes
40
This is a long coiled structure topping the testis that receives immature sperm and stores it for several days.
epididymis
41
The three main arteries to the testis are...
1. testicular artery
2. deferential artery
3. cremasteric artery (aka external spermatic)
42
This provides the main supply of blood to the testicles and epididymis.
testicular artery
43
This provides the main supply of blood to the ductus deferens.
deferential artery
44
This joins the testicular artery just before it enters the testis, after supplying the cremaster muscle and the spermatic cord.
cremasteric artery
45
About 12 veins drain the testicles by forming an anastomotic network called the ...
pampiniform plexus.
46
This is a major portion of the spermatic cord forming a spiraling vine-like plexus covering the ductus deferens and arteries within the cord.
pampiniform plexus
47
Normal scrotal skin measures __ in thickness.
2-8 mm
48
Most extratesticular masses are...
benign.
49
Most intratesticular lesions are...
malignant.
50
Three kinds of benign intratesticular lesions are...
1. cysts
2. abscesses
3. calcifications
51
These testicular cysts are located within the tunica.
tunica albuginea cysts
52
These testicular cysts are usually solitary, well-defined and may be multiple or multilocular, mean age is 40 yrs.
tunica albuginea cysts
53
These testicular cysts are well-defined anechoic lesions located near the mediastinum, most likely originating from the rete testis.
intratesticular cyst
54
These are benign testicular cysts that are well circumscribed and of a germ cell origin.
epidermoid cysts
55
Epidermoid cysts can occur at any age but most commonly during...
2nd and 4th decades.
56
Abscesses are usually a complication of...
epididymo-orchitis.
57
Sonographically, a testicular abscess presents with an __ testicle containing a predominantly __ mass with __echoic areas.
enlarged, fluid-filled, hypo-
58
Testicular calcifications are also known as...
scrotal pearls.
59
T/F? Testicular calcifications are frequently seen in malignant conditions.
FALSE, not proven
60
This is an abnormal collection of serous fluid between the layers of the tunica vaginalis.
hydrocele
61
This is the most common cause of painless scrotal swelling, congenital or acquired.
hydrocele
62
Blood in the tunica vaginalis is called...
a hematocele.
63
Hematocele is caused by direct __, torsion, or invasion by a __.
trauma, tumor
64
This is an abnormal collection of pus in the tunica vaginalis.
pyelocele
65
This is a collection of abnormally dilated, tortuous and elongated veins of the pampiniform plexus located posterior to the testis in the spermatic cord.
varicocele
66
The pampiniform plexus veins normally range from __ in diatmeter, with a main draining vein up to __.
.5-1.5 mm, 2 mm
67
The two types of testicular varicoceles are...
1. primary (idiopathic)
| 2. secondary
68
With a testicular varicoceles, a characteristic increase in diameter is seen during a...
valsalva maneuver.
69
Testicular variococeles typically involve which side?
the left
70
The most common extratesticular tumor is...
a benign adenomatoid tumor.
71
T/F? Extratesticular tumors are common and usually involves the epididymis.
FALSE, rare
72
T/F? Extratesticular tumors are rare and usually involves the vas deferens.
FALSE, epididymis
73
T/F? Extratesticular tumors may occur at any age, but is commonly found in men between 20-50 yrs old.
true
74
Generally, extratesticular tumors are __lateral, solitary, __ defined, round/oval and measure __.
uni-, well, less than 5 cm
75
This is a common paratesticular mass and may contain small bowel or colon.
scrotal hernia
76
The three kinds of epididymal lesions are...
1. cysts
2. spermatoceles
3. sperm granuloma
77
This kind of testicular cyst is found in the epididymis usually in the head.
epididymal cyst
78
Epididymal cysts are composed of __ fluid.
clear
79
This is a cyst in the epididymis that has an accumulation of sperm within it.
spermatocele
80
Spermatoceles are composed of __ fluid.
thick milky
81
Epididymal cysts and spermatoceles result from prior episodes of...
epididymitis.
82
A sperm granuloma occurs in 15-40% of men who undergo __.
vasectomy
83
This is a mass that develops as a result of the body's immune reaction to sperm leaking from the cut end of the vas.
sperm granuloma
84
Hydroceles are treated by...
aspiration.
85
Sperm granulomas are treated by...
anti-inflammatories or (worst case) surgery.
86
The two most common causes of acute scrotal pain are..
1. epidiymitis/orchitis
| 2. torsion of the spermatic cord
87
This is the most common condition that causes acute scrotal pain.
epididymitis
88
This testicular condition is usually caused by sexually transmitted diseases in men under 35 and UTIs in men older than 35 or trauma.
epididymitis
89
Typically patients with this testicular condition present with the insidious onset of pain, which increases over 1-2 days.
Epididymitis. Fever, dysuria and discharge may also be present.
90
This is an infection of the testicle.
orchitis
91
Sonographically, orchitis is seen as an __ testicle with __ blood flow.
enlarged hypoechoic, increased
92
Sonographically, epididymitis is seen as an __ epididymis, __ blood flow, __ hydrocele, and __ thickening.
enlarged hypoechoic, increased, reactive, scrotal wall
93
This is when the testicle can rotate freely on the spermatic cord due to the lack of attachment in the tunica vaginalis.
bell clapper deformity
94
T/F? Bell clapper deformity is congenital.
true
95
The testicular salvage rate in torsion is 80-100% if surgery is performed within __.
5-6 hours of the onset of pain.
96
Testicular torsion more often involves the __ testicle.
left
97
Sonographically, testicular torsion is seen as an __ testicle that is inhomogenous compared to the contralateral testicle.
enlarged hypoechoic
98
More than 50% of testicular ruptures occur during...
sporting events.
99
9-17% of testicular injuries are from...
MVAs.
100
Trauma presents physically as...
scrotal edema and ecchymosis.
101
Approximately 90% of ruptured testicles can be saved if surgery is performed within..
the first 72 hours.
102
Sonographically, testicular rupture is seen as __ of altered echogenicity and __ formation in 1/3rd of the patients.
focal areas, hematocele
103
Testicular infarct commonly results from...
torsion and trauma.
104
Sonographically, a new testicular infarct produces a focal or diffuse __.
hypoechoic testicle
105
Sonographically, an old testicular infarct __ in size and develops areas of __ representing fibrosis or calcifications.
decreases, increased echogenicity
106
This is a condition of undescended testis.
cryptorchidism
107
This is one of the most common genitourinary anomalies in male infants.
cryptorchidism
108
The testicles form near the __ and then __ into the scrotum.
kidneys, descend
109
Complete descent is necessary for full testicular...
maturation.
110
Most undescended testes are palpable lying around the level of the..
inguinal canal.
111
Malpositioned testes may be located anywhere along the...
pathway of descent from the retroperitoneum to the scrotum.
112
These are the complications of cryptorchidism.
infertility and cancer (in both testes)
113
The increased risk of cancer in cryptorchidism is due to..
hormonal deficiency
114
Sonographically, the undescended testis is often __ and slightly less __ than the normally descended testis.
smaller, echogenic
115
T/F? Cryptorchidism and hydrocele are not associated.
true
116
Most primary testicular tumors are of __ origin and are generally __.
germ cell, highly malignant
117
The most common germ cell tumor in adults (either gender) is...
seminoma.
118
Less common testicular tumors include...
teratoma
choriocarcinoma
mixed tumors
119
Most malignant testicular neoplasms are more __echoic.
hypo-
120
Hemorrhage, necrosis, calcification or fatty changes can produce areas of __ in testicular tumors.
increased echogenicity
121
The highest risk factors for testicular cancer is...
being a white male between 15-35.
122
Most testicular cancer patients present with...
painless unilateral testicular masses or diffuse testicular enlargement.
123
The most common tumor in the epididymis is...
adenomatoid, tends toward the tail
124
Malignant lesions of the scrotal wall are usually __ in origin.
epididymal
125
The most common malignant paratesticular tumor in infants and children is...
rhabdomyosarcoma.
126
Seminomas tend to happen when men are...
in their 4th or 5th decades.
127
Seminomas are less __ than others and are commonly confined to the __.
aggressive, tunica albuginea
128
T/F? Seminomas have a favorable prognosis.
true
129
Whenever an intratesticular mass is discovered, the __ should be evaluated for lymph nodes.
para-aortic
130
The most common prepubertal testicular tumor is...
the yolk sac tumor.
131
This is a germ cell tumor usually in males under age two with an increased level of AFP.
yolk sac tumor
132
T/F? Testicular yolk sac tumors have a favorable prognosis.
FALSE, poor
133
The second most common testicular tumor in children is...
teratoma.
134
T/F? Teratomas in children are usually benign.
true
135
T/F? Teratomas in adults are usually benign.
FALSE, malignant
136
Sonographically, testicular teratomas are seen as __ masses with __ and __ components including __ representing bone.
well defined, cystic, solid, echogenic foci
137
These represent the most lethal and least common form of germ cell tumor.
choriocarcinoma
138
Choriocarcinoma metastasizes via __, thus patients present with distal mets.
hematogenous routes
139
Choriocarinoma presents with an increase in this lab value.
beta-hCG
140
The majority of testicular gonadal-stromal tumors are...
Leydig cell.
141
Testicular Sertoli cell tumors are __ and may cause symptoms of __.
rare, feminization
142
Testicular serotli cell tumors are __, __geneous, __echoic, and often __lateral.
small, homo-, hypo-, bi-
143
The most common metastatic testicular tumors are...
lymphoma and leukemia.
144
The most common secondary testicular neoplasm is...
malignant lymphoma.
145
Half of bilateral testicular neoplasms are..
malignant lymphomas.
146
Most malignant lymphomas of the testicle are of the __ type.
non-Hodgkin's
147
Primary testicular leukemia is...
rare.
148
These can create a normal cosmetic appearance for a man or child with a testicular condition.
implants
149
These patients are not appropriate candidates for a testicular implants.
1. untreated cancer
2. infection
3. radiotherapy
4. some forms of therapy
