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Flashcards in Scrotum Deck (39):
1

What is the testicle surrounded by?

Tunica albuginea

2

What do the multiple septations in the tunica albuginea form?

Mediastinum testis

3

What is a Rete testis?

Anastomosing network of delicate tubules located in the hilum of the testicle (mediastinum testis) that carries sperm to the epididymis.

4

What are the sections of the epididymis?

Head, Body, Tail

5

Where is the Epididymis in relation to the testicle?

-Parallel to testicle
- Head is adjacent to superior pole of teste ( largest portion of epi.)

6

What is an appendix teste?

Remnant of Mullerian ducts
- small ovoid structure beneath the head of epi.
- torsion may occur known as "Blue dot sign"

7

What is the tunica vaginalis?

- saccular extension of the peritoneum into the scrotal layers

8

What are the layers of the tunica vaginalis?

- Visceral layer (Inner): Covers testes and Epi
- Parietal layer ( outer): Lines scrotal chamber

9

What is the blood flow to the testes?

- deferential artery
- Cremasteric (external spermatic) artery
- Testicular artery

10

What does the testicular artery divide into?

- capsular
- centripetal (intratesticular) branches

11

What does the spermatic cord consist of?

- vas deferens
- cremasteric, deferential, testicular arteries
- pampiniform plexus of veins
- lymphatics
- nerves

12

Know about testicular masses...

- most extratesticular masses are benign, majority of intratesticular lesions are malignant

13

What is a Seminoma?

- Most common germ cell type found in both pure seminoma and mixed germ cell testicular masses
-** Cryptorchidism
- Spread through draining lymph nodes in the retroperitoneum

14

What labs are associated with tumor markers?

- Beta HCG
- AFP
- LDH

15

What is a nonseminoma?

- masses that are not "pure seminomas" and consist of other cell types: Embryonal carcinomas, teratomas, yolk sac tumors, choriocarcinoma

16

What type of lab is associated with nonseminomas?

Alpha fetoprotein

17

What lab will you see in both seminomas and nonseminomas?

Serum beta HCG

18

What is the most common testicular tumor in infants and young children?

Yolk sac tumors
- high AFP

19

What is a Leydig Cell tumor?

- rare stromal testicular tumor
- always benign in children, malignant variants in adults
- Tumor produces testosterone resulting in Precocious puberty
- Labs are normal in Leydig cell

20

What are the two types of benign cysts?

- cysts of tunica albuginea
- Intratesticular cysts
--------normally located near the mediastinum testis and probably originate from the rete testis

21

What is an Epidermoid cysts?

- benign tumor of germ cell origin
- lie beneath the tunica albuginea
- "Bow tie" central echogenic pattern

22

What is a Testicular Abscess?

- complication of epididymo-orchitis
- enlarged testicle seen with fluid filled mass

23

What are scrotal calcifications?

Calcs ("Scrotal Pearls") may be located within the testicle or between the layers of the tunica vaginalis
- AKA: Microlithiasis
- a definite but minimal risk of testicular germ cell tumor

24

What is a testicular infarct?

present as a triangular-shaped avascular intratesticular lesion
- can produce a focal or diffuse hypoechoic testicle

25

What is a hydrocele?

Serous fluid that accumulates within the tunica vaginalis or between the layers of the tunica vaginalis (parietal or visceral layer)

26

What are hydroceles caused by?

Failed closure of the vaginalis at the internal ring

27

What is a hematocele?

blood fills the scrotal chamber from trauma

28

What is a varicocele?

- dilatation of the pampiniform venous plexus of the testicular veins which drain the testicle
- 90% of varicoceles are on the LEFT side

29

What is the most common cause for male infertility?

Varicoceles

30

What is the technique we use to diagnose a varicocele?

Valsalva

31

What is a scrotal hernia?

bowel protruding through the inguinal canal into the tunica vaginalis of the scrotum
- ** presence of peristalsis confirms diagnosis

32

What is the most common extratesticular tumor?

adenomatoid tumor

33

What is a Spermatocele?

- AKA: Epididymal cyst
- cystic masses of the epididymis that result from dilatation of the epididymal tubules

34

What is the difference between spermatocele and epididymal cyst?

- Spermatocele: filled with thick milky fluid containing spermatozoa
- Epididymal cyst: Clear fluid

35

What are the main causes for acute scrotal pain?

- Torsion
- Epididymitis / Orchitis

36

What is the most common condition that causes acute scrotal pain?

Epididymitis
- usually caused by sexually transmitted organisms
- can cause infection to testicle causing orchitis

37

What testicular torsion?

without attachment to the tunica vaginalis, the testicle can rotate freely on the spermatic cord (Bell clapper deformity)
- venous and arterial occlusion
- becomes enlarged and hypoechoic

38

What is Cryptorchidism?

- Hidden testicle
- AKA Undescended testicle
- infertility and cancer are complications
- Patients who has cryptorchidism have increased risk of developing malignancy

39

What is the most common location for undescended testis?

Inguinal canal