AB-Scrotum

Question 1

What is the diameter of a varicocele?

Answer 1

More than 2mm pg. 619

Question 2

What is the fibrous capsule called that surrounds the testicle?

Answer 2

Tunica albuginea pg. 606

Question 3

What is the length, the width, and height of a testicle?

Answer 3

3-5 cm in length 2-4 cm width approximately 3 cm in height pg. 604

Question 4

Normal echo characteristics of the testicle

Answer 4

Smooth, medium gray with fine echo textures Pg. 604

Question 5

What is the mediastinum testis?

Answer 5

Posterior aspect of the tunica albuginea reflects into the teste to form the mediastinum, a vertical septum. It supports the vessels and ducts in the testis. It appears as a bright, hyperechoic line coursing craniocaudad within the testis. Pg. 606

Question 6

Where is the epididymis located in reference to the testicle?

Answer 6

Beginning superiorly and coursing posteriolateral to the testis. The head is superior to the upper pole of the testis. The tail is posterior to the lower pole of the testis. Pg. 604n

Question 7

Know all about undescended testes

Answer 7

Also cryptochidism. A condition where the testis as not descended into the scrotum and cannot be brought into the scrotum with external manipulation. Most often located in the inguinal cavity but may also be located in the abdominal canal or other locations as well. Pg. 628 Undescended testis are 10x more likely to torse. Pg. 616

Question 8

What is the most common cause of acute scrotal pain in adolescents?

Answer 8

Torsion Pg. 616

Question 9

Know about hydroceles and reasons why they would occur

Answer 9

Contains serous fluid and is the most common cause of painless scrotal swelling. May have an unknown cause (idiopthic), but are commonly associated with epididymo-orchitis and torsion, may also be found in patients following trauma or development of a neoplasm. Hydroceles associated with neoplasms tend to be smaller than those associated with other causes pg. 621

Question 10

Know all about varicoceles

Answer 10

Abnormal dilation of the veins of the pampiniform plexus in the spermatic cord. More common in infertile men. Primary: Caused by incompetent venous valves in the spermatic vein, typically on the left side. Secondary: Caused by pressure on the spermatic vein due to renal hydronephrosis, abdominal mass or liver cirrhosis. Pg. 618

Question 11

Know about spermatoceles, specifically where they are located

Answer 11

Cystic dilations of the efferent ductules of the epididymis. They are always located in the epididymal head. They contain proteinaceous fluid and spermatozoa. May be seen more often following vasectomy pg. 618

Question 12

What is the most common cause of acute scrotal pain in adults?

Answer 12

Epididymo-Orchitis Pg. 615

Question 13

What is orchitis?

Answer 13

Inflammation of the testis. Testicular infarction may occur due to severe orchitis. Orchitis is enlarged hypoechoic testis

Question 14

What is epididymitis?

Answer 14

Enlarged, hypoechoic gland. May contain focal hyperechoic areas if secondary to hemorrhage. Sonographically will show increased flow. Pg. 615

Question 15

What is tubular ectasia of the rete testis associated with?

Answer 15

Spermatocele, epididymal or testicular cysts or other epididymal obstruction Pg. 624

Question 16

What does seminoma look like under ultrasound?

Answer 16

A seminoma is the most common germ cell tumor. It appears as a homogenous or hypoechoic lesion with smooth, well defined borders. Pg. 626

Question 17

What is the common reason for the occurrence of epididymo-orchitis?

Answer 17

Results from the spread of a lower urinary tract infection via the spermatic cord pg. 615

Question 18

Who do sperm granulomas happen to most and why do they happen?

Answer 18

Most frequently seen in patients with a history of vasectomy. Occur as a chronic inflammatory reaction to extravasation of spermatozoa pg. 621

Question 19

What is the primary source of blood flow to the testicle?

Answer 19

The right and left testicular arteries pg. 606

Question 20

Intratesticular cysts have an association with what? (in men over 40)

Answer 20

Extratesticular Spermatoceles Pg. 624

Question 21

Microlithiasis of the testes is associated with what? How often should be patient be followed up?

Answer 21

Associated with: Testicular malignancy, cryptorchidism, Klinefelter’s Syndrome, Infertility, Vericoceles, Testicular Atrophy, and Male pseudohermaphroditism. Patient should be followed up with annually. Pg. 625

Question 22

Where is the appendix testis located?

Answer 22

A small protuberance from the head of the epididymis pg. 605 — this is the appendix of the epididymis Upper pole of testis, between testis and epididymis pg. 605

Question 23

Layers of tissue in the testes and between what layers does a hydrocele develop?

Answer 23

The tunica vaginalis lines the inner walls of the scrotum. It has 2 layers. The parietal layer is the inner lining of the scrotal wall. The visceral layer surrounds the testis and epididymis. Hydroceles develop in the space between the visceral and parietal layers of the tunica vaginalis Pg. 620

Question 24

What is the rete testis? (location)

Answer 24

Located at the hilum of the testis where the mediastinum resides. Pg. 623

Question 25

What is the difference in echo characteristics between the epididymis and testicle?

Answer 25

The epididymis appears isoechoic or hyperechoic compared with the testis, although the echo texture is coarser. Pg. 605