ARRT abdomen 13 Flashcards
The cremaster and deferential arteries supply:
walls and ducts of scrotum and testicles
The ____ drains the testes.
pampiniform plexus
The pampiniform plexus drains into the:
testicular veins (spermatic veins)
The right testicular vein drains into:
IVC
The left testicular vein drains into:
left renal vein
The longest pelvic vein is:
left testicular vein
The testes are surrounded by _____ and _____
tunica albuginea
tunica vaginalis
The _____ of the scrotum appears as an echogenic focus in transverse and linear in sagittal.
mediastinum
Can be seen when prominent as a hypoechoic line running through the middle of the mediastinum
transmediastinal (or centripetal) vessel
The head of the epididymis is imaged ____ to the testes
Superior
The epididymis measures approximately ___ mm
12
The body of the epididymis runs ____ to the testes
Posteriorly
The tail of the epididymis runs ____ to the testes
Inferiorly
Excess fluid located between layers of the tunica vaginalis
Hydrocele
A hydrocele is excess fluid located between layers of the tunica vaginalis. This area is called _____
Cavum vaginale
Most common acute scrotal pain in prebuscent boys
Appendix testes torsion
The _____, _____, and ____ are all appendages of the testes and can twist, cutting off blood supply.
Appendix testes
Epididymis
Vas deferens
Clinical symptoms of appendix testes torsion
Acute pain
Blue dot sign
What is the blue dot sign in appendix testes torsion?
Visible blue dot on skin surface
Sonographic signs of appendix testes torsion
Avascular mass adjacent to testicle
Normal intratesticle flow
Reactive hydrocele
Most common cause of acute scrotal pain in adolescents
Testicular torsion
Testicular torsion is also known as:
Spermatic cord torsion
Arterial blood supply cut off due to twisting of the testicle
Testicular torsion
When does testicular torsion most often happen?
During sleep, awakened in night by pain
Testicular torsion is fixed by:
Orchioplexy
After ___, the testicles are not salvageable in testicular torsion
24 hours
No posterior fixation of testicle to posterior wall, higher risk of torsion and may be bilateral
Bell-Clapper deformity
Clinical symptoms of testicular torsion
Acute pain
Scrotal swelling
Nausea and vomiting
Sonographic appearance of testicular torsion
Enlarged hypoechoic or heterogeneous testicle with decreased (incomplete) or absent (complete) intratesticular flow
Most common cause of acute scrotal pain in adults
Epididymitis
Most common reason for epididymitis
STDs
Clinical symptoms of epididymitis
Acute pain
Infection signs (fever, leukocytosis, swelling)
Dysuria
Sonographic appearance of epididymitis
Enlarged hypoechoic epididymis with hyperemia
If extended into testicle (orchitis), then also enlarged, hypoechoic, and hyperemic
Reactive hydrocele
Complications of epididymitis
Abscess
Pyocele
Complex intratesticular mass with peripheral flow only
Abscess
Complex hydrocele containing pus
Pyocele
Most common in prebuscents
Enlarged extratesticular mass with no flow
Appendix testes torsion
Most common in adolescents
Enlarged testicle and epdidymis with no flow
Testicular torsion
Most common in adults
Enlarged epididymis and testicle with lots of flow
Epididymitis/orchitis
Types of testicular trauma
Intraparenchymal hemorrhage
Hematoma
Rupture
Fracture
In testicular trauma, assess for interruption of the _____
Tunica albuginea
Complex or Echogenic hydrocele filled with blood
Hematocele
Undescended testicles
Cryptorchidism
Most common location of cryptorchidism
Inguinal canal
Surgical correction of cryptorchidism
Orchiopexy
Cryptorchidism has an increased risk of developing what kind of cancer?
Seminoma
Most common scrotal mass
Spermatocele
Spermatoceles are most often found in:
Epididymal head
An ___ cyst can be found anywhere in the epididymis
Epididymal
A _____ cyst is found along the periphery of the testicle
Tunica albuginea
Dilated venous collaterals within scrotum
Varicoceles
Varicoceles are dilated collaterals of more than __mm
2
In a varicocele, the ____ is “backed up”
Pampiniform plexus
Varicoceles are found ____ to testicles
Lateral
Most common cause of correctable male infertility due to heating of sperm
Varicocele
The _____ or ____ will increase abdominal pressure and cause venous blood to reflux back indicating a varicocele.
Valsalva maneuver
Standing
A primary Varicocele is caused by:
Incompetent valves
A primary varicocele is most likely on the ____ since this testicular vein is longer
Left
A secondary varicocele is caused by:
Other pathology in abdomen/pelvis
When a varicocele is on the right, it warrants investigation of:
Renal or retroperitoneum
Mobile calcification within tunica vaginalis
Scrotal pearl
A scrotal pearl is:
Remnant of torsed appendage
An ______ may descend into scrotum
Indirect Inguinal hernia
The _____ will push hernia further into scrotal sac
Valsalva maneuver
An Inguinal-scrotal hernia may be seen as ___ or ____ superior to testicles
Fat
Bowel
Types of extratesticular cysts
Spermatocele
Epididymal cyst
Tunica albuginea cyst
Varicoceles
Scrotal pearl
Visible, dilated rete testes along mediastinum, usually seen as a cluster along side of testes
Tubular ectasia of rete testes
Tubular ectasia of rete testes may be seen in patients that had had:
Vasectomy
Cyst that has an onion layer or “whorled” appearance
Epidermoid cyst
Diffuse microcalcifications within testicles, asymptomatic, increased risk of testicular cancer
Microlithiasis
Types of intratesticular cysts
Tubular ectasia of rete testes
Epidermoid cysts
Microlithiasis
Solid masses of testicle are most likely:
Malignant germ cell tumors
What labs are most likely elevated in testicular cancer?
HcG and/or AFP
Most common testicular malignancy
Seminoma
Risk factors of Seminoma
History of cryptorchidism
Microcalcifications
Clinical signs of testicular cancer
Palpable mass
Elevated HcG
Sonographic appearance of testicular cancer
Solid, hypoechoic or heterogeneous intratesticular mass
A _____ of the testicle has elevated AFP only
Yolk sac tumor
_____ of the testicle has elevated HcG only.
Choriocarcinoma
______ of the testicle has elevated HcG and AFP.
Embryonal cell carcinoma
Dense fibrous covering of the penis
Buck fascia
The penis is made up of paired _____ (dorsal) covered by ____
Corpus cavernosa
Tunica albuginea
The singular corpus spongiosum (ventral) that contains the ____
Urethra
Arterial blood for the penis is supplied by the:
Internal pudendal artery
Fibrous plaque (hard tissue) and scarring of tunica albuginea causing painful curvature of penis
Peyronie disease
Penile fracture caused by blunt force trauma
Penile trauma
In penile trauma, the ____ may be hemorrhaged
Corpus cavernosum
In penile trauma it is important to evaluate the ____ for irregularity.
Tunica albuginea
Arterial insufficiency caused by proximal arterial stenosis or venous incompetence caused by venous leak in the penis
Vasculogenic impotence
The prostate is a ___peritoneal organ.
Retro
The prostate is an ___ gland.
Exocrine
The prostate is responsible for:
Making semen
Protein produced by prostate
Protein-specific antigen (PSA)
_____ (vas deferens) ascends from the scrotum and goes to seminal vesicles.
Deferent duct
The deferent duct (vas deferens) ascends from scrotum and goes to:
Seminal vesicles
The ____ secretes fluid and then turns into the ejaculatory duct.
Seminal vesicles
The seminal vesicles secretes fluid and then becomes the _____
Ejaculatory duct
The _____ travels to the prostate where it meets with urethra at verumontanum.
Ejaculatory duct
The ejaculatory duct travels to the _____ where it meets with urethra at veromontanum
Prostate
The ejaculatory duct travels to the prostate where it meets with the ____ at the verumontanum.
Urethra
