Flashcards in Testicular Deck (51)
What is the appendix testis
Ruminant of the mullerian duct. A small ovoid structure near head of epididymis.
What is the appendix epididymis
A detached efferent duct. It's seen as a small soft projection off the epididymis.
What is the tunica albuginea and tunica vaginalis
Albuginea: fibrous capsule that surrounds the testicle
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.
Collection of fluid in tunica vaginalis
Fluid collection surrounding the testicle.
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
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.
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
2 MC causes of acute scrotal pain
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.
Enlg Epi, dec echoes, hetero, hydrocele, skin thickening
Cryptorchidism / undescended testicle
At or below inguinal canal
May cause infertility or cancer
2 complications of undescended testicle
Infertility and inc risk of cancer even on the normal testicle with an orchiopexy
Surgery to move undescended testicle into scrotum
Blood collection in tunica vaginalis
Pus collection in tunica vaginalis
Testosterone (sex hormones)
Arteries veins nerves lymphatics vas deferens
Vas deferens connects epididymis to seminal vesicles.
Testicular artery, cremasteric artery, deferential arteries
Pampiniform plexus-> spermatic vein -> ivc on rt and left renal vein to ivc on left.
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
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
Head / Globus Major
Body / Corpus
Tail / Globus Minor
Patients with vasectomy, inc size of epi & may see cyst
Anorchia: rare, only 1 testis, vasc problem in utero
Polyorchidism: very rare
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
Twisting of testis. "Bell clapper" deformity.
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
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+
Retention cyst of sperm containing tubules
MC in epi head
Cystic mass, displace testis ant, septations, indistinguishable from
Spermatocele more common than epididymal cyst & is milky fluid
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