ABD Board-Scrotum Flashcards

1
Q

fibrous casuple that surrounds the testicle

A

tunica albuginea

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2
Q

multiple septations (septula) arise from the tunica albuginea to form the

A

mediastinum testis

echogenic linear line extending long within the testis

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3
Q

the septula forms wedge shaped compartments that contain the

A

seminiferous tubules

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4
Q

the seminiferous tubules converge to form the

A

tubuli recti AKA tubuli seminiferi recti)

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5
Q

the tubuli recti (tubuli seminiferi recti) connect the

A

seminiferous tubule to the rete testis

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6
Q

order of testi connections

A
seminiferous tubules 
to
tubuli recti
to 
rete testis
to
efferent ductules
to
ductus epididymis
to
vas deferens
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7
Q

anastomosing network of delicate tubules located in the hilum of the testicle (mediastinum ttestis) that carries sperm to the epididymis. sperm is concentrated as fluid and reabsorbed within this network

A

rete testis

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8
Q

carry the seminal fluid from the rete testis to the epididymis

A

efferent ductules

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9
Q

composed of head body and tail, positioned parallet to the testicle

A

epididymis

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10
Q

head of epididymis AKA

A

globus major

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11
Q

head of epididimus is located

A

adjacent to the superior pole of the testis and is the largest part of epi

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12
Q

the efferent ductules converge to form a single conconvoluted duct (ductus epididymis) in the

A

head (globus Major)

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13
Q

form an acute angle and courses cephlad as the vas deferens (ductus deferens)

A

tail of epididymis

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14
Q

appearance of epidydimis

A

slightly hyperechoic to testi or isoechogenic to testi

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15
Q

a remnant of the mullerian duct, small ovoid structure located beneath the head of the epididymis

A

appendix testis

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16
Q

blue dot sign

A

torsion of appendix testis occuring in boys 7-12 yrs old

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17
Q

representing a detached efferent duct, is a small stalk projecting off the epididymis. Derived from the wolffian duct

A

appendix epididymis

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18
Q

layer of muscle fibers, lying beneath the scrotal skin and dividing the scrotum into 2 chambers

A

darto

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19
Q

the division of the 2 scrotal chambers is called

A

scrotal raphe

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20
Q

saccular extension of the peritoneum into the scrotal chambers

A

tunica vaginalis

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21
Q

inner or visceral layer of the tunica vaginalis covers the

A

testis and epididymis

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22
Q

the outer or parietal layer of the tunica vaginalis lines the

A

scrotal chamber

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23
Q

testicular blood flow is supplied by the

A

deferential artery

cremasteric (external spermatic) artery

testicular artery

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24
Q

testicular artery divides into

A

capsular and centripetal (intratesticular) branches

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25
Q

the centripetal arteries course along the septula converging on the

A

mediastiinum testis

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26
Q

spermatic cord consists of the

A

vas deferents

creasteric, deferential, testicular arteries

pampiniform plexus of veins

lymphatic

nerves

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27
Q

most extratesticular masses are

A

benign

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28
Q

majority of intratesticular lesions are

A

malignant

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29
Q

most malignant testicular neoplasms are

A

hypoechic compared to the normal testicular parenchyma

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30
Q

testicular neoplasms are the most common malignancy in men ages

A

15 to 35 yrs

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31
Q

most common testicular cancers

A

germ cell

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32
Q

germ cell tumors are classified as either

A

seminoma (50%)

or

nonseminoma (50%)

33
Q

most common germ cell type found in both pure seminoma and mixed germ cell testicular masses

A

seminoma

radiosensitive so good prognosis

34
Q

risk factors of seminoma

A

cryptorchidism (undescended testicles)

infertility

klinefelter syndrome (XXY)

down syndrome

smokeing

white race

35
Q

seminoma spreads by

A

draining lymph nodes in the retroperitoneum. Paraaortic region should be evaluated

36
Q

seminoma tumor markers

A

beta HCG
AFP
LDH

37
Q

masses that are not pure seminomas and consist of other cell types

A

nonseminomas

considered mixed tumor and nonseminomatous germ cell tumor

38
Q

other cells types found in nonseminomas

A

embryonal carcinomas

teratomas

yolk sac tumors (endodermal sinus tumors)**

choriocarcinomas

39
Q

treatment for nonseminomatous germ cell

A

radical (inguinal) orchiectomy

40
Q

alpha fetoprotein is associated with

A

nonseminomas

41
Q

most common testicular tumor in infants and young children

A

yolk sac tumors AKA endodermal sinus tumor

42
Q

rare stromal (non germ cell) tsticular tumor occuring in boys 5 - 10 yrs and men 30 - 60 yrs

A

leydig cell tumors

can also be mixed

always benign in children but can be malignant in adults

can also be in ovaries and usually malignant

43
Q

leydig cell tumors produse

A

testosterone resulting in presosious puberty

may also produce estrogen resluting in feminizing symtpons

44
Q

elevated alpha fetoprotein is not found in

A

seminomas

45
Q

levels of high serum tumor markers indicate

A

poor prognosis

46
Q

two types of benign testicular cysts

A

cysts of the tunica albuginea

intratesticular cysts

47
Q

intratesticular cysts are normally located near the

A

mediastinum testis and probably originate from the rete testis

48
Q

benign tumor of germ cell origin. well circumscribed solid tumors lying beneath the tunica albuginea. Filled with a cheesy white keratin. Appearas as a solid, hypoechic mass with an echogenic capsule or onion ring pattern formed by multiple layers of heratin

A

epidermoid cysts

bow tie, central echogenic pattern

49
Q

usually a complication of epididymo orchitis

appears with an enlarged testicle containing a predominantly fluid filled mass with hypoechic or mixed echogenic areas

A

testicular abscess

50
Q

called scrotal pearls and may be located within or between the layers of the tunica vaginalis

A

scrotal calcifications

microlithiasis

we don’t know much about these and follow up exams will be ordered

51
Q

uncommon event typically with an udetermined cause

typically present as a triangular shaped avascular intratesticular lesion

A

testicular infarct

52
Q

appearance of testicular infarct

A

depends on age of infacrtion

initially produces a focal or diffuse hypoechoic testicle

with time the testicle decreases in size and develops areas of increased echogenicity representing fibrosis or calcifications

53
Q

a serous fluid that accumulates within the tunica vaginalis or between the layers of the tunica vaginalis (visceral and parietal layers)

A

hydrocele

54
Q

most hydroceles are ____ and are noted in boys 1-2 yrs old. They are caused by failed closure of the ____ _____ at the _____ _____

A

congenital

processus vaginalis

internal ring

55
Q

schronically acquired or secondary hydroceles usually occur in men older than 40 yrs. They may be idiopathic or the result of

A

trauma

torsion

neoplasms

epididymitis

orchitis

56
Q

when blood fills the scrotal chamber assiciated with trauma

A

hematocele

57
Q

_____ may be seen within a hydrocele

A

low level echoes from fibrin or cholesterol crystal

58
Q

a dilatation of the pampiniform venous plexus of the testicular veins which drain in the testicle

A

varicocele

59
Q

90% of varicoceles are on the ___ side

A

left

due to the length of the left testiclular vein as it drains into the left renal vein

60
Q

varicoceles should distend when a patient

A

is standing

with valsalva

ABD pressure

61
Q

unilateral scrotal pain may be a result of

A

torsion

epididymitis

varicocele thrombosis

62
Q

the most common cause of correctable male infertility

A

varicoceles

63
Q

result from bowel protruding through the inguinal canal into the tunica vaginalis of the scrotum

A

scrotal hernia

peristalsis confirms (bowel movement)

small inguinal hernia can be seen by using valsalva

64
Q

extratesticular tumors usually involve

A

the epididymis

65
Q

most common extratesticular tumor

A

adenomatoid tumor

66
Q

cystic masses of the epididymis that result from dilatation of the epididymal tubules

A

spermatoceles (composed of milky fluid containing spermatozoa)

epididymal cysts (composed of clear fluid)

both are a result of epididymitis

67
Q

spermatoceles are ____ common than epididymal cysts

A

more

68
Q

spermatoceles usually are at the

A

epididimal head

69
Q

both spermatoceles and epididymal cysts appear as

A

anechoic

well defined masses

70
Q

most common condition that causes acute scrotal pain

A

epididymitis

71
Q

acute epididymitis usually caused by

A

STD in older men

urinary tract infection in kids

72
Q

epididymitis may spread into the testicle causing

A

orchitis

73
Q

appearance of epididymitis

A

enlarged hypoechioc epididymitis

increased blood flow (hyperemia)

reactive hydrocele

scrotal wall thickening

74
Q

appearance of orchitis

A

enlarged hypoechoic testicle

increased blood flow (hyperemia)

decreased arterial resisitence

75
Q

bell clapper deformity AKA intravaginal testicular torsion

only happens in infants

A

testicle is not attached to the tunica vaginalis and can rotate freely on the spermatic cord causing torsion

76
Q

appearance of torsion

A

enlarged hypoechoic testicle

duration of pain

77
Q

hidden testicle and generally resfers to an undescended testicle

A

cryptorchidism

78
Q

congenital absence is rare and accounts for only 4% of patients who present with cryptorchidism, it’s called

A

anorchia

79
Q

treatment of choice for cryptorchidism

A

orchioplexy