Chapter 13 The Male Pelvis Flashcards
What would be the most likely sonographic appearance of a seminoma?
Hypoechoic
What is the most common cancer found in men?
Prostate cancer
Sonographic feature of testicular abscess:
Hyperemic flow around the abscess but not within it
The most common location of prostatic cancer is the:
Peripheral zone
The most common location of a varicocele is:
The left side of the scrotum
The most common germ cell tumor of the testis is the:
Seminoma
The term cryptorchidism denotes:
One or both testicles have not descended into the scrotum
Spermatogenesis occur within the:
Seminiferous tubules
The endocrine function of the testicles is to produce:
Testosterone
____techniques is useful for providing sonographic evidence of a varicocele
Valsalva maneuver
The lack of the normal fixation of the testis to the posterior scrotal wall is:
Bell-clapper deformity
Dilated veins of a varicocele will measure:
> 2mm
Zinner syndrome consists of unilateral renal agenesis, ejaculatory duct obstruction and:
Seminal vesicle cysts
Acute onset of testicular pain at rest is a common clinical finding with:
Testicular torsion
The most common location of a hydrocele is:
Between the two layers of the tunica vaginalis
The exocrine function of the testicles is to produce:
Sperm
Painful curvature of the penis and impotence is?
Peyronie disease
What is the most common malignancy of the penis?
Squamous cell carcinoma
A simple fluid collection surrounding the testis is:
Hydrocele
What is the most common correctable cause of male infertility?
Varicocele
_____houses the male urethra?
Corpus spongiosum
The blue dot sign is indicative of:
Torsion of the testicular appendage
What lab value can be assessed as a tumor marker to evaluate a patient for testicular malignancy?
Alpha-fetoprotein
What scrotal abnormality is caused by incompetent valves within the pampiniform plexus?
Varicocele
A common cyst most often seen in the head of the epididymis that contains nonviable sperm is the:
Spermatocele
Primary varicocele are associated with:
- Left-sided location
- Infertility
- Palpable extratesticular mass
A dilated group of veins found within the scrotum is called?
Varicocele
Describe a spermatocele:
A cyst, found within the head of epididymis, that may contain debris
_____is a benign intratesticular mass that typically has a whorled or onion skin sonographic appearance?
Epidermoid cyst
Enlargement of the prostate in older men is most often caused by:
Benign prostatic hypertrophy
During a sonographic exam of the right testis, you visualize multiple small cysts located along the mediastinum testis:
Tubular ectasia of the rete testis
The most common location of BPH is the:
Transitional zone
Secondary varicoceles are most likely associated with:
- Right-sided location
- Hepatomegaly
- Renal mass
What is the most common malignancy of the testicules?
Seminoma
Components of the spermatic cord?
- Testicular artery
- Cremaster muscle
- Lymph nodes
______extends posteriorly and enters each testicle to help form the mediastinum tests
Tunica albuginea
Beneath the layers of the tunica vaginalis, the testis is also intimately, surrounded by a dense fibrous layer called:
Tunica albuginea
The tunica vaginalis consists of:
Parietal and closely applied visceral covering
Each testis is surrounded by a double layer of tissue called the:
Tunica vaginalis
_____occurs within the seminiferous tubules that are found throughout each testicle
Spermatogenesis
Internally the scrotum is divided by the:
Tunica dartos
The scrotum is externally divided at the midline into two compartments by a structure known as:
Median Raphe
When descending, the testicles may become trapped anywhere along this path and consequently never completely descend is known as:
Cryptorchidism
By _____weeks, the testicles descend into the scrotum
28
_____is responsible for storing sperm in order for them to mature and transports sperm into the ductus (VAS) deferens
Epididymis
The _____is attached to the testicle and the posterior scrotal wall
Epididymis
The ejaculatory ducts are formed by the union of the:
Seminal vesicles and Ductus deferens
Clinical findings of peyronie disease
- Impotence
- Painful erections
- Area of scar tissue can typically be palpated
- Marked curvature of the penis
______surrounds the corpus cavernosa and partially covers the corpus spongiosum
Tunica albugenia
The male urethra is housed within the _____which is situated ventrally
Corpus spongiosum
The penis is covered with skin and subsequently a dense fibrous tissue termed:
Back fascia
The ____is a tube that connects the epididymus to the seminal vesicles
Ductus (VAS) deferens
The seminomas is a germ tumor that is typically found in:
Males between 30 and 50 years of age
An elevated AFP level is most often associated with:
*Embryonal cell carcinoma
*Teratomas
*Yolk sac tumors
_____are caused by the migration of adrenal tissue with gonadal tissue during fetal development
Adrenal rests
An abscess that occurs within the testicle is typically the results of untreated:
Epididymo-orchitis
The combination of an infection within the epididymis and testis is termed:
Epididymo-orchitis
Inflammation of the testis is called:
Orchitis
_____is an extratesticular calculus
Scrotal pearl
______ varicoceles are most often found on the left and are palpable during a physical exam
Primary
Varicoceles are caused by:
Incompetent or abnormal valves within the pampiniform plexus
A dilated group of veins found within the scrotum is termed :
Varicocele
Tunica albuginea cysts are located anywhere along the periphery of the:
Testicle within the tunica albugunea
_____is a cyst found most often in the head of the epididymis
Spermatocele
A simple fluid collection within the scrotum is referred to as:
Hydrocele
_____describes the appearance of the torsed appendage as a blue dot just under the skin surface
Blue dot sign
_____occurs in the neonatal period or in utero and is related to torsion of the spermatic cord within the inguinal canal
Extravaginal torsion
_____is a congenital abnormality describes the situation in which the patient lacks the normal posterior fixation of the testis and epididymis to the scrotal wall
Bell-clapper
With _____, the testis, which is not affixed to the scrotal wall, is permitted to migrate and twist freely within the scrotum
Intravaginal torsion
Blood that is present within the scrotum is called?
Hematocele
____is the buildup of fibrous plaque (scar tissue) and calcifications within the penis that results in a painful curvature
Peyronie disease
The _____ is a retroperitoneal gland that produces and secretes an alkaline fluid that constitutes between 13 and 30% of the volume of semen
Prostate
The higher the PSA level, the more likely the patient will have:
Prostate cancer
The most common location for prostate cancer is within the :
Peripheral zone
BPH is most often located within the:
Transitional zone
The benign enlargement of the prostate gland is termed:
Benign prostatic hypertrophy (BPH)
________occurs when the arterial blood supply to the testicle is cut off secondary to the twisting of the testicular axis
Testicular torsion
Surgical correction of an undescended testis is called:
Orchiopexy
_____is the most common cancer found in an undescended testis
Seminoma
The normal head of the epididymis measures approximately _____in size
10 to 12mm
Adult testicular measure ______in length, _____in width, and _____in thickness
*3 to 5cm
*2 to 4cm
*3cm
The normal mediastinum testis will be noted as an ______in sagittal plane
Echogenic linear structure
The normal mediastinum testis will be noted as a ______ in the transverse plane
Triangular structure
The scrotal wall thickness ranges between:
2-8mm
The left testicular vein drains into the:
Left renal vein
The right testicular vein drains into the:
IVC
Testicular arteries emanate from the:
Anterior abdominal aorta just below the level of the renal arteries
The testicles receive most of their blood supply from the:
Testicular arteries
The spermatic cord enters the scrotum through the ______and contains essential structures including the vascular supply and venous drainage for testicles
Inguinal canal
The ______, secretes pre-ejaculate fluid that lubricates the penile urethra prior to ejaculation
Bulbourethral gland
Sonographic findings of a pyocele
- Complex fluid collection within the scrotum
- Scrotal wall thickening
- May be seen in conjunction with rupture of a testicular abscess
Sonographic findings of a testicular abscess
- Complex intratesticular mass
- Mass that has no flow centrally but increased flow around its margins
- May have a coexisting pyocele
Sonographic findings of epididymitis and epididyoorchitis
- Enlargement of the entire epididymis (diffuse)
- Enlargement of only part of the epididymis (focal)
- Hypoechoic echotexture of the affected sections of the epididymis
- Hypoechoic testis
- Hyperemia
- Thickened wall
- Scrotal wall edema
Sonographic findings of a scrotal pearl
- Extremely echogenic, mobile extratesticular structure that produces acoustic shadowing
Sonographic findings of a varicocele
- A group of anechoic, tubular structures located outside of the testis
- Distended veins that fill with color flow when the valsalva maneuver is performed
- Dilated veins measure greater than 2mm
Sonographic findings of a spermatocele, epididymal cyst, and tunica albuginea cyst
- Round, anechoic mass with acoustic enhancement
- May contain some layering debris
Sonographic findings of a hydrocele
- Simple fluid anterior to the testis
- Scrotal wall thickening
- Chronic hydroceles may have internal debris and septations
Sonographic findings of torsion of the testicular appendage
- Normal intratesticular flow
- Small, avascular, hypoechoic or hyperechoic mass adjacent to the superior pole of the testis
- Reactive hydrocele
- Scrotal wall thickening
Sonographic appearance of testicular torsion
- Enlarged and hypoechoic or heterogeneous
- No detectable intratesticular vascularity when completely torsed
- Enlarged epididymis and reactive hydrocele
- Areas of necrosis
- Hyperemic flow in testis
Sonographic findings of seminal vesicle cysts
- Anechoic or complex cystic structures in the area of the seminal vesicles
Sonographic findings of prostatitis
- Enlarged, hypoechoic prostate
- Hypermia evident with color doppler
Sonographic findings of benign prostatic hypertrophy
- BPH will show an enlargement of the inner gland
- Can lead to hypoechoic areas within the gland
- Calcifications within the gland
- Diffusely heterogenous gland
- Cystic changes within the gland
Clinical findings of benign prostatic hypertrophy
- Nocturia
- Increased urinary freuency
- Sense of urinary urgency
- Constant feeling of having a full bladder
- Elevated PSA
Sonographic findings of prostate cancer
- Varying sonographic appearances
- Hypoechoic mass
- May be hypervascular
Sonographic findings of cryptorchidism
- Testis located outside of the scrotum (most likely in the inguinal canal)
- The cryptorchid testis will appear hypoechoic to the normal testis
Sonographic findings of penile trauma
- An irregular hypoechoic or hyperechoic defect at the site of rupture
Sonographic findings of an inguinal hernia
- Heterogeneous mass within the scrotum that moves (peristalsis)
- Mass may contain air and fluid
- Hydrocele may be present
Sonographic findings of a hematocele
- Complex fluid collection within the scrotum
- Scrotal wall thickening
Sonographic findings of scrotal trauma
- Possible fracture line
- Indistinct testicular margins
- Hematocele
Sonographic findings of a seminoma
- Solid, hypoechoic intratesticular mass
- Large seminomas may become heterogenous
Sonographic findings of Adrenal rests
- Bilateral, round, hypoechoic, intratesticular masses (most commonly near the mediastinum testis)
Clinical findings of a seminoma
- Painless scrotal mass
- Hardening of the testis
- Elevated hCG
Clinical findings of scrotal trauma
- Trauma to the scrotum resulting in acute scrotal pain
- Low hematocrit
Clinical findings of a hematocele
- Trauma to the pelvis or scrotum
- Recent pelvic or scrotal surgery
- Low hematocrit (possible)
Clinical findings of an inguinal hernia
- Persistent or intermittent scrotal swelling
- May have abdominal pain and blood in stool
Clinical findings of penile trauma
- History of hearing an audible popping sound during intercourse (corpus cavernosa)
- Subcutaneous bleeding area
Clinical findings of prostate cancer
- Elevated PSA
- Enlarged prostate
- Blood in the urine or semen
- Back pain, pelvic pain, hip or thigh pain
- Impotence
- Decrease in the amount of ejaculated fluid
Clinical findings of prostatitis
- Hematospermia
2.Painful ejaculation - Perineal pain
- Dysuria
Clinical findings of seminal vesicle cysts
- Asymptomatic
- May be associated with zinner syndrome (perineal pain, recurrent prostatitis, painful ejaculation and infertility)
Clinical findings of a varicocele
- Typically painless (large varicoceles can cause discomfort)
- Palpable extratesticular mass
- Possible infertility
Clinical findings of a spermatocele, epididymal cyst, and tunica albuginea cyst
- If large enough, they may be palpable
- Typically not painful
Clinical findings of a hydrocele
- Transilluminates light
- Painless scrotal swelling
- May present with pain when found in the presence of scrotal infection, testicular torsion, trauma, or a tumor
Clinical findings of torsion of the testicular appendage
- Acute testicular pain
- Pain localized to the superior pole of the testis
- “Blue dot” sign
Clinical findings of a testicular abscess
- Painful, swollen, scrotum
- Fever
- Leukocytosis
Clinical findings of cryptorchidism
- One or both testicles not palpable within the scrotum
Clinical findings of adrenal rests
- History of congenital adrenal hyperplasia
- Elevated adrenocticotropic hormone
Clinical findings of epididymitis and epididymoorchitis
- Acute testicular pain
- Leukocytosis
- Fever
- Dysuria
- Urethral discharge
- Scrotal wall edema
The _______ gland secretes a pre-ejaculated fluid that lubricates the penile urethra prior to ejaculation
Bulbourethral gland
