Scrotum

Question 1

What is the fibrous capsule surrounding the testicle?

Answer 1

tunica albuginea

E 112

Question 2

What does the mediastinum testis appear as sonographically?

Answer 2

echogenic linear band extending longitudinally within the testis
E 112

Question 3

What is the rete testis?

Answer 3

network of delicate tubules located at the mediastinum testis that carries sperm to the epididymis
E 113

Question 4

What is the appendix testis?

Answer 4

remnant of the Mullerian duct, small ovoid structure located beneath the head of the epididymis
E 113

Question 5

What is the appendix epididymis?

Answer 5

derived from the Wolffian duct, small stalk projecting off the epididymis
E 113

Question 6

What is the tunica vaginalis?

Answer 6

saccular extension of the peritoneum into the scrotal sac
visceral layer is the inner layer surrounds testis and epididymis
parietal layer is the outer layer lines scrotal chamber
E 114

Question 7

What is consisted in the spermatic cord?

Answer 7

vas deferens
arteries-testicular, deferential, and cremasteric
pampiniform plexus of veins
lymphatics
nerves
E 114

Question 8

What age group is the most common for malignant testicular neoplasms?

Answer 8

15-35 years

E 115

Question 9

What is the most common testicular cancer?

Answer 9

seminoma

E 115

Question 10

What are the risk factors for testicular neoplasm?

Answer 10

cryptorchidism
family hx
infertility
Klinefelter syndrome
Down syndrome
smoking
white race
E 115

Question 11

What should be evaluated if a testicular mass is seen?

Answer 11

lymph nodes in the paraaortic region
lab values - hCG, AFP, LDH
E 115

Question 12

What lab value may be elevated in a nonseminoma?

Answer 12

AFP

E 116

Question 13

What lab value may be elevated in both seminomas and nonseminomas?

Answer 13

beta-hCG

E 116

Question 14

What is the most common testicular tumor in children?

Answer 14

yolk sac tumors aka endodermal sinus tumor

E 116

Question 15

What lab value may be elevated in yolk sac tumors?

Answer 15

AFP

E 116

Question 16

What age groups are affected by Leydig Cell tumors?

Answer 16

5-10 years of age
30-60 years of age
E 117

Question 17

Why can Leydif cell tumors cause early puberty?

Answer 17

secrete testosterone

E 117

Question 18

Where do intratesticular cysts typically develop?

Answer 18

near the mediastinum testis

E 118

Question 19

How do testicular abcesses present on ultrasound?

Answer 19

enlarged testicle containing a predominantly fluid-filled mass with mixed echogenic areas
E 118

Question 20

What is another term for a scrotal calcification?

Answer 20

scrotal pearl

E 119

Question 21

How does a testicular infarct appear on ultrasound?

Answer 21

triangular shaped avascular intratesticular lesion
initially diffusely hypoechoic, with time it develops areas of calcifications
E 119

Question 22

Between which layers does a hydrocele form?

Answer 22

between the parietal and visceral layers of the tunica vaginalis
E 120

Question 23

What is a varicocele?

Answer 23

dilatation of the testicular veins

E 121

Question 24

Which side is it more common to have a varicocele?

Answer 24

left (90%) due to the longer length to the vein to reach the left renal vein
E 121

Question 25

What happens when a valsalva maneuver is performed during a scrotal ultrasound?

Answer 25

a varicocele will distend | E 121

Question 26

What are varicoceles associated with?

Answer 26

aching pain after standing for a long time or heavy lifting infertility E 121

Question 27

What is a scrotal hernia?

Answer 27

bowel protruding through the inguinal canal into the tunica vaginalis E 122

Question 28

What confirms the diagnosis of a scrotal hernia?

Answer 28

bowel peristalsis | E 122

Question 29

What is the most common extratesticular tumor?

Answer 29

adenomatoid tumor | E 122

Question 30

What is a spermatocele?

Answer 30

cystic masses of the epididymal tubules aka epididymal cyst E 123

Question 31

What is the most common reason for acute scrotal pain?

Answer 31

epididymitis | E 124

Question 32

What are the sonographic findings of epididymitis?

Answer 32

``` enlarged hypoechoic epididymis increased vascularity hydrocele, possible scrotal wall thickening E 124 ```

Question 33

What are the sonographic findings of orchitis?

Answer 33

enlarged hypoechoic testicle increased vascularity E 124

Question 34

What are the sonographic findings of testicular torsion?

Answer 34

no vascularity enlarged and hypoechoic after several hours E 125

Question 35

What is another name for undescended testicle?

Answer 35

cryptorchidism | E 126

Question 36

What are complications with cryptorchidism?

Answer 36

infertility cancer E 126

Question 37

Where is the most common location for an undescended testicle?

Answer 37

inguinal canal | W 126