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Testis Flashcards

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1
Q

Covering of TESTIS

A
  1. Tunica albuginea
  2. Visceral layer of Tunica Vaginalis
  3. Parietal layer of Tunica Vaginalis
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2
Q

Pathway of SPERMS
🧠⚡SEVEN UP ⚡

A
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3
Q

Testicular Artery is a branch of

A

Abdominal AORTA

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4
Q

Which sided TESTICULAR VEIN drains directly to IVC

🧠⚡RIVer⚡

A

Right ➡️ IVC
All RIGHT Sided Veins directly drain into IVC
✨ Right TESTICULAR VEIN
✨ Right Suprarenal Vein
✨ Right Inferior Phrenic Vein

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5
Q

Left TESTICULAR VEIN drains into

A

Left Renal Vein
⬇️
IVC

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6
Q

Lymphatic Drainage of TESTIS

A
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7
Q

Descent of TESTIS

A
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8
Q

Which Testis has HIGHER CHANCE of Being UNDESCENDED?

A

Right Testis

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9
Q

Which Testis Descends EARLIER

A

Left Side

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10
Q

Descent of TESTIS can occur upto

A

4-5 months after BIRTH

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11
Q

Difference between UNDESCENDED TESTIS & CRYPTORCHIDISM

A

Cryptorchidism: B/L UNDESCENDED TESTIS

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12
Q

⚡⚡ MOST COMMON SITE OF UNDESCENDED TESTIS

⚡⚡ MOST COMMON SITE OF ECTOPIC TESTIS

A

⚡⚡ MOST COMMON SITE OF UNDESCENDED TESTIS
🎯 INGUINAL CANAL

⚡⚡ MOST COMMON SITE OF ECTOPIC TESTIS
🎯 SUPERFICIAL INGUINAL POUCH

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13
Q

💊💉 MANAGEMENT of ECTOPIC TESTIS

A

Orchidopexy

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14
Q

COMPLICATIONS of UNDESCENDED TESTIS

🧠⚡TESTIS⚡

A
  1. Torsion
  2. Epididymo-orchitis
  3. Sterility
  4. Trauma
  5. Indirect Inguinal Hernia
  6. Seminoma (ITGCN)
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15
Q

Which cells are MOST AFFECTED in TESTIS due to non-descent?

A

Sertoli cells
⬇️
Spermatogenesis is affected

⭐ LEYDIG cells are affected Less ➡️ Testosterone is NORMAL ➡️ NORMAL 2° SEXUAL Characteristics

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16
Q

HIGHER UP THE TESTIS in UNDESCENDED TESTIS, MORE IS THE

A

Histological CHANGES
(Abdominal > Inguinal)

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17
Q

Clinical Features of UNDESCENDED TESTIS

A
  1. Missing Testis in scrotum
  2. Testis palpable in INGUINAL REGION: INGUINAL canal
  3. Testis non-palpable in INGUINAL REGION: Abdominal
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18
Q

🩺 IOC for INTRA-ABDOMINAL TESTIS

A

Diagnostic LAPAROSCOPY

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19
Q

💊💉 MANAGEMENT of UNDESCENDED TESTIS

A
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20
Q

Cause of VANISHING TESTIS Syndrome

A

INTRA-UTERINE TORSION of Testis

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21
Q

ORCHIDOPEXY: Types

🧠⚡S²K ⚡

A
  1. Stephan Fowler Technique
  2. Silbar Procedure
  3. Keetley Torek Procedure
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22
Q

BEST ORCHIDOPEXY technique

A

SILBAR’S TECHNIQUE

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23
Q

2 STAGE ORCHIDOPEXY Procedure

A

Stephen Fowler Technique

✨ 1st STAGE: High LIGATION of TESTICULAR Vessels & Position Testis in Inguinal Canal

✨ 2nd STAGE: Place Testis into SCROTUM

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24
Q

Limiting Factor for ORCHIDOPEXY IN STEPHEN FOWLER TECHNIQUE

A

Length of Testicular Vessels

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25
How Testis survives when TESTICULAR ARTERY is ligated?
Testis has DUAL BLOOD SUPPLY ⬇️ Also gets blood supply from CREMASTRIC VESSELS
26
Ideal Time to do ORCHIDOPEXY
6-12 months
27
Microvascular anastamosis of vessels with BRANCHES of INTERNAL ILIAC VESSELS in SILBAR'S technique is done with
Pro line Suture
28
Whenever you do ORCHIDOPEXY, Also do
HERNIOTOMY
29
Why INDIRECT INGUINAL HERNIA is common with UNDESCENDED TESTIS
When Testis comes down, it pulls down PROCESSUS Vaginalis with it ⬇️ Processus vaginalis communicates with the PERITONEAL CAVITY ⬇️ BRINGS LOOP of BOWEL with it
30
⚡⚡ MOST COMMON COMPLICATION OF UNDESCENDED TESTIS
Indirect Inguinal Hernia
31
What is RETRACTILE TESTIS?
Testis present in the SCROTUM but occasionally it jumps into the INGUINAL CANAL
32
How to differentiate RETRACTILE TESTIS & UNDESCENDED TESTIS
✨ RETRACTILE TESTIS: Scrotal Rugosities ➕ ✨ UNDESCENDED TESTIS: Scrotal Rugosities ⛔
33
💊💉 MANAGEMENT of RETRACTILE TESTIS
-Reassurance -After walking 30-45 mins, it comes back again into SCROTUM
34
⚒️ RISK FACTORS for TESTICULAR TORSION
1. Bell Clapper Testis 2. Testicular Inversion 3. Undescended TESTIS 4. Torsion of CYST of MORGAGNI
35
⚡⚡ MOST COMMON CAUSE OF TESTICULAR TORSION
⭐ Bell Clapper Testis High INVESTMENT of TUNICAL VAGINALIS
36
BLUE DOT SIGN on Doppler is seen in
Torsion of CYST of MORGAGNI
37
🧑🏻‍⚕️ Clinical Features of TESTICULAR TORSION
1. Young Male 3. ACUTE SCROTAL PAIN & SWELLING 2. PATIENT wakes up in EARLY MORNING DUE TO: Pain 4. Erythema 5. Nausea & Vomiting Twisted Cord can be SOMETIMES be palpated
38
⚡⚡ MOST IMPORTANT 🚦DIFFERENTIAL DIAGNOSIS FOR TESTICULAR TORSION
Acute EPIDIDYMO-ORCHITIS
39
How to differentiate EPIDIDYMO-ORCHITIS & TESTICULAR TORSION 🧠⚡PAD ⚡
1. Prehn test 2. Angell's SIGN 3. Deming's Sign: Spasm of Cre master muscle DUE TO: Twisting of spermatic cord causes affected testis to be positioned higher than NORMAL testis 4. Cremastric Reflex: Absent on side of affected testis
40
PREHN'S test 🧠⚡PIT ⚡
On manually lifting the Testis ⭐ Pain Increases in TORSION ⭐ Pain decreases in EPIDIDYMO-ORCHITIS
41
DEMING SIGN
Testis with TORSION: Lies at HIGHER Level EPIDIDYMO-ORCHITIS: Lies at NORMAL level
42
ANGELL SIGN
Testis which has UNDERGONE Torsion is TRANSVERSELY placed
43
Causes of TESTICULAR PAIN 🧠⚡ TO THE⚡
1. Torsion 2. Orchitis 3. Trauma 4. Hernia (Indirect Inguinal) 5. EPIDIDYMO-ORCHITIS
44
🩺 IOC for TESTICULAR TORSION
Clinical examination ⬇️ Doppler
45
💊💉 MANAGEMENT of TESTICULAR TORSION
Immediate Exploration on both SYMPTOMATIC & ASYMPTOMATIC side
46
Testis remains viable in TORSION till
6 hours
47
ORCHIDOPEXY in TESTICULAR torsion is done with
3 Point FIXATION
48
⚡⚡ MOST COMMON CAUSE OF EPIDIDYMO-ORCHITIS in CHILDREN (Age < 40 years) 🧠⚡ CN: Cartoon Network⚡
1. Chlamydia 2. Neisseria Gonorrhea
49
⚡⚡ MOST COMMON CAUSE OF EPIDIDYMO-ORCHITIS in ADULTS (Age > 40 years) 🧠⚡EPididymis⚡
1. E. coli 2. Pseudomonas
50
Spread of INFECTION in ⭐ TB ⭐ SYPHILIS 🧠⚡STD⚡
⭐ TB: Epididymis ➡️ ➡️ TESTIS ⭐ Syphilis: Testis ➡️ ➡️ epiDiDymis
51
💊💉 MANAGEMENT of EPIDIDYMO-ORCHITIS
1. Antibiotics 2. Analgesics 3. Scrotal Support: Lifting the Scrotum
52
Beaded VAS DEFERENS ➕ FIRM ENLARGEMENT OF EPIDIDYMIS Seen in
Tubercular EPIDIDYMIS
53
HYDROCELE meaning
Fluid accumulation in TUNICA VAGINALIS
54
Types of HYDROCELE 🧠⚡VICE ⚡
1. Vaginal 2. Infantile 3. Congenital 4. Encysted (OR) Hydrocele of the Cord
55
⚡⚡ MOST COMMON TYPE OF HYDROCELE
Primary Vaginal HYDROCELE
56
Difference BETWEEN 1° & 2° VAGINAL HYDROCELE
57
⚡⚡ MOST COMMON CAUSE of 2° VAGINAL HYDROCELE 🧠⚡ET³⚡
EPIDIDYMO-ORCHITIS Others: 1. Torsion 2. Tumour 3. Trauma
58
FLUCTUATIONS ➕ Meaning
Any fluid filled swelling, which when pressed on 1 side, it expands from other site
59
Transilluminant swellings 🧠⚡CREaM H ⚡
• Cystic hygroma • Ranula • Epididymal cyst • Meningocele • Hydrocele
60
FLUCTUATION SIGN ➕
✨ HYDROCELE
61
💊💉 MANAGEMENT of VAGINAL HYDROCELE
Surgery ⭐ JABOULAY'S Procedure: Large Hydrocele ⭐ LORD'S plication: Small Hydrocele
62
Which HYDROCELE presents as INGUINOSCROTAL Swelling?
Infantile HYDROCELE
63
💊💉 MANAGEMENT of INFANTILE HYDROCELE
Excision of EXCESS SAC ➕ Eversion of SAC
64
PATENT PROCESSUS VAGINALIS synonyms
Congenital Hydrocele
65
💊💉 MANAGEMENT of CONGENITAL HYDROCELE
Herniotomy @ 2-3 years of age
66
💊💉 MANAGEMENT of ENCYSTED HYDROCELE OF CORD
Excise the SWELLING without DAMAGING the CORD
67
Difference BETWEEN Spermatocele vs EPIDIDYMAL CYSTS
68
⭐ Cause of production of SPERMATOCELE ⭐ Cause of production of EPIDIDYMAL CYSTS
⭐ Cause of production of SPERMATOCELE 🎯 swelling of EPIDIDYMAL HEAD ⭐ Cause of production of EPIDIDYMAL CYSTS 🎯 CYSTIC DEGENERATION of EPIDIDYMIS
69
Chinese LATTERN Pattern is seen in
EPIDIDYMAL CYSTS
70
VARICOCELE meaning
Dilated TORTUOUS Pampiniform plexus of VEINS
71
Varicocele is MORE COMMON in which side
Left side > Right Side
72
Why LEFT Sided VARICOCELE more common than RIGHT side?
✨ Left TESTICULAR Vein is LONGER ✨ Left TESTICULAR Vein drains at RIGHT ANGLE to Left Renal Vein ✨ Sigmoid Colon can press on LEFT TESTICULAR Vein ✨ Left ADRENAL VEIN opens OPPOSITE to LEFT TESTICULAR VEIN (Left ADRENAL VEIN releases Catecholamines ➡️ Vasoconstriction )
73
Recent ACUTE ONSET LEFT SIDED VARICOCELE ⚡⚡ MOST COMMON CAUSE
Left RENAL CELL CARCINOMA ⬇️ RCC can spread to RENAL VEIN & BLOCK THE VEIN
74
Why INFERTILITY occurs in VARICOCELE?
When VARICOCELE occurs ➡️ Temperature of SCROTUM ⬆️⬆️ (maintained by Counter Current mechanism in scrotum) ⬇️ Spermatogenesis affected
75
🧑🏻‍⚕️ Clinical Features of VARICOCELE
1. Asymptomatic 2. Dull Pain in SCROTUM 3. Swelling in SCROTUM 4. INFERTILITY
76
BAG OF WORM consistency seen in MEDICINE
1. VARICOCELE 2. ADENOIDS 3. ORBITAL VARICES
77
🩺 IOC for VARICOCELE
DUPLEX Scan (OR) DOPPLER
78
Grading of VARICOCELE
Grade I: Inpalpable , but detected on DOPPLER Grade II: Palpable, detected on DOPPLER Grade III: VISIBLE
79
💊💉 MANAGEMENT of VARICOCELE
Asymptomatic: No treatment Asymptomatic in IAS & Army: SURGERY Symptomatic: SURGERY ⭐ EMBOLIZATION of VEINS ⭐ VARICOCELECTOMY: Ligation of Vessels
80
VARICOCELECTOMY: TYPES 🧠⚡PIN ⚡
1. Paloma's approach: Retroperitoneal route: Laparoscopic 2. Ivanisevich procedure: Open INGUINAL approach 3. NOTES: Transvesical route
81
VARICOCELE recurrance is very HIGH, despite SURGERY Why?
Dual Blood Supply
82
Sperm count improvement after VARICOCELE Surgery is seen in
30-40%
83
Identify
Fournier's GANGRENE ⬇️ Necrotizing Fasciitis involving PERINEAL Region
84
⭐ Necrotizing Fasciitis involving PERINEAL Region is known as ⭐ Necrotizing Fasciitis involving PERINEAL ➕ ABDOMINAL Region is known as
⭐ Necrotizing Fasciitis involving PERINEAL Region is known as 🎯 FOURNIER'S GANGRENE ⭐ Necrotizing Fasciitis involving PERINEAL ➕ ABDOMINAL Region is known as 🎯 MELENEY'S GANGRENE
85
Fournier's GANGRENE starts as
TRIVIAL TRAUMA ✨ Shaving of HAIR ✨ Removal of BOIL ✨ Catheterization
86
🧑🏻‍⚕️ Clinical Features of Fournier's GANGRENE
1. Pain 2. Fever 3. Swelling 4. Foul smelling odour 5. Shock 6. High Mortality rate
87
⚒️ RISK FACTORS for Fournier's GANGRENE
1. Immunocompromised 2. DM 3. ELDERLY
88
💊💉 MANAGEMENT of FOURNIER'S GANGRENE
1. IV FLUIDS 2. IV ANTIBIOTICS: Aerobic ➕ Anaerobic coverage 3. ANALGESICS 4. SHOCK Management 5. AGGRESIVE DEBRIDEMENT
89
Which structures are SPARED in Fournier's GANGRENE Why?
Testis & Urethra ⬇️ Dual Blood Supply
90
Identify
Scrotal Sebaceous Cyst ⬇️ ✨ Blocked Hair Follicle Ducts ✨ Punctum ±
91
Management of SEBACEOUS CYST IN SCROTUM
Excision
92
1st STAGE OF STEPHEN FOWLER'S ORCHIOPEXY
Testicular Vessels are ligated ⬇️ Clipping of Testicular artery promotes neo-vasculogenesis along the vas deferens ⬇️ 2nd stage is performed after SEVERAL MONTHS
93
Shameful Exposure of Testis
Fournier's Gangrene
94
USG of Hydrocele
Anechoic reflection DUE TO: fluid collection

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