Testicular Flashcards Preview

Abdomen > Testicular > Flashcards

Flashcards in Testicular Deck (51)
Loading flashcards...
0

What is the appendix testis

Ruminant of the mullerian duct. A small ovoid structure near head of epididymis.

1

What is the appendix epididymis

A detached efferent duct. It's seen as a small soft projection off the epididymis.

2

What is the tunica albuginea and tunica vaginalis

Albuginea: fibrous capsule that surrounds the testicle

Vaginalis:
the inner/visceral layer. It covers the testicle and epididymis.
The outer/parietal layer lines the walls of the scrotal chamber. A small amount of fluid is commonly seen in this space.

3

Hydrocele

Collection of fluid in tunica vaginalis

Fluid collection surrounding the testicle.

Congenital/acquired

MC fluid collection in scrotum
MC in newborns

Idiopathic, trauma, infection, infarct, torsion, neoplasm

Fluid collection, enhancement, wall thick, scrotal pearls, septations with old hemorrhage/infection

4

Varicocele

Dilated tortuous veins of the pampiniform plexus located posterior to the testis and assoc with male infertility.

Caused by incompetent valves of the internal spermatic vein

MC on left, distend when valsalva or abd compression

Pamp plexus > 2 mm

Infertility, warm temp scrotum, tubular serpiginous veins, > 2 mm, inc with valsalva in upright position.

5

Difference between epididymal cyst and spermatocele

Both result from dilatation of the epididymal tubules

Epi cyst are composed of clear fluid.

Spermatoceles are filled with thick milky fluid containing spermatozoa

6

2 MC causes of acute scrotal pain

Torsion, epididymalorchitis

7

Torsion of spermatic cord

Enlg hetero and hypo when compared to contralateral testis

Enlg epididymis, skin thickening, reactive hydrocele

Prescience of blood flow does not exclude partial torsion
At least 540 degrees of torsion is necessary to completely occlude testicular blood flow.

8

Acute epididymitis

Enlg Epi, dec echoes, hetero, hydrocele, skin thickening

9

Cryptorchidism / undescended testicle

At or below inguinal canal

May cause infertility or cancer

10

2 complications of undescended testicle

Infertility and inc risk of cancer even on the normal testicle with an orchiopexy

11

Orchiopexy

Surgery to move undescended testicle into scrotum

12

Hematocele

Blood collection in tunica vaginalis

Trauma

13

Pyocele

Pus collection in tunica vaginalis

Infection
Echogenic debri

14

Endocrine

Testosterone (sex hormones)

15

Exocrine

Spermatogenesis

16

Spermatic cord

Arteries veins nerves lymphatics vas deferens

Vas deferens connects epididymis to seminal vesicles.

17

Blood supply

Testicular artery, cremasteric artery, deferential arteries
Pampiniform plexus-> spermatic vein -> ivc on rt and left renal vein to ivc on left.

18

Sperm travels

Epididymis
Vas deferens
Seminal vesicles
Ejaculatory Duct
Urethra

19

Epididymis

Stores sperm

20

Layers

Tunica vaginalis: double sac covering testis, prevents abdomen contents from herniating into sac

Tunica albuginea: fibrous capsule covering testis

Mediastinum: invagination of tunica albuginea. Echogenic line

Appendix testis: fibrous band sup to testis

21

Testis & epididymis meas

Testis 3-5 cm L, 2-4 W, 3 AP

Scrotal wall 2-8 mm

Epi head 6-15 mm, body 2-4, tail 2-5 mm

22

Epididymis

Head / Globus Major
Body / Corpus
Tail / Globus Minor

Patients with vasectomy, inc size of epi & may see cyst

23

Congenital Anomalies

Testicular Ectopia

Anorchia: rare, only 1 testis, vasc problem in utero

Polyorchidism: very rare

24

Rupture

Torn capsule, rare, assoc with trauma, early dx & tx critical

Irreg capsule, Hematocele, intratesticular hematoma/infarct, wall thick, absent/dec flow, liquefaction after 3 days

25

Torsion

Twisting of testis. "Bell clapper" deformity.
Young males
Resting

Severe sudden pain, when at rest, n/v, radiating pain, may mimic epididymitis.

5-6 hrs can save.

Absent Doppler, inc size, hypo/hetero, skin thickening, hydrocele, necrosis/hemorrhage/infarct

Chronic: small hypo testis, large epi

26

Epididymitis

Inflammation of epi.
Bacterial, trauma, idiopathic
Focal or diffuse (head body tail)
Can lead to epididymalorchitis and abscess

Fever, pain urine, tense tender epi/scrotum, Palp hard cord

Skin thickening, hydrocele
Acute: enlg epi, hypo, hypervascular
Chronic: hyper, ca+

27

Spermatocele

Retention cyst of sperm containing tubules
MC in epi head

Cystic mass, displace testis ant, septations, indistinguishable from
Epididymal cyst

Spermatocele more common than epididymal cyst & is milky fluid

28

Scrotal hernia

Inguinal hernias descended into scrotum.
Assoc with patency of vaginalis and heavy lifting.

Extratesticular mass, bowel, peristalsis unless bowel stuck.

abd pain, blood in stool, constipation

29

Granulomatous Disease

TB spread, unilateral, initially involves epi but can spread to testis.

Acute: focal hypo mass
Chronic: blending of epi and testis. Ca+