Chapter 5. Male Reproductive

Question 1

The appendix testis is a remnant of the —. Torsion of this structure results in a —-. Located beneath the head of the epididymis.

Answer 1

Mullerian remnant. Blue dot sign

Question 2

Remnant of the Wolffian duct, projecting off the epididymis

Answer 2

Appendix epididymis

Question 3

A layer of muscle fibers lying beneath the scrotal skin, dividing the scrotum into two separate chambers

Answer 3

Dartos muscle

Question 4

The division of the two scrotal chambers

Answer 4

Scrotal raphe

Question 5

Describe the blood flow in the testicles

Answer 5

Aorta
Gonadal/Testicular artery
Capsular artery
Centripetal aka intratesticualr artery

Question 6

List the structures found within the spermatic cord…

Answer 6

L-ymphatics
P-ampiniform plexus of veins
N- erves
C- remasteric, deferential, testicular arteries
V- as deferens

“late prenatal care, V!”

Question 7

What is the most common type of testicular cancer?

Answer 7

Germ cell tumors are the most common testicular cancers. They can be classified as either seminoma or nonseminoma.

Question 8

What is the most common germ cell tumor type?

Answer 8

Seminoma is the most common germ cell type

Question 9

What is the most common testicular tumor in infants and young children?

Answer 9

Yolk sac tumors are the most common testicular tumor in infants and young children

Question 10

Yolk sac tumors are highly associated with an elevation in what lab value?

Answer 10

yolk sac tumors are associated with an increase in AFP values

Question 11

A rare tumor that produces testosterone resulting in precocious puberty, always benign in children, normal AFP, bHCG, and LDH levels

Answer 11

Leydig cell tumors

Question 12

What three lab values are helpful in the diagnosis of testicular malignancies?

Answer 12

AFP, LDH and bHCG

Question 13

An increase of AFP is an indicator of what type of testicular tumor?

Answer 13

An increase in AFP is an indicator of a NONseminoma tumor.
Elevated AFP is NOT found with seminoma testicular tumors

Question 14

In the case of an intratesticular mass, what is the procedure to establish histologic confirmation of malignancy?

Answer 14

Inguinal orchiectomy. Biopsies on intratesticualr masses are NOT recommended.

Question 15

A benign tumor that has the sonographic appearance of an onion ring or bow tie pattern as a result of multiple layers of keratin

Answer 15

Epidermoid cysts

Question 16

What is the sonographic appearance of a segmental testicular infarction?

Answer 16

Triangular shaped AVASCULAR intratesticular lesion

Question 17

Where do hydroceles occur?

Answer 17

Between the visceral and parietal layers of the tunica vaginalis

Question 18

90% of varicoceles occur in which testicle? Why is this?

Answer 18

90% of varicoceles occur in the left testicle. This is because of the length of the left testicular vein as it drains into the left renal vein

Question 19

What is the most common correctable cause of male infertility?

Answer 19

Varicoceles

Question 20

What is the most common extratesticular tumor?

Answer 20

Adenomatoid tumors are the most common extratesticular tumors

Question 21

What are spermatoceles and where are they located?

Answer 21

Spermatoceles are cystic masses that are filled with sperm , they are seen in the epidydimal head

Question 22

A rare benign entity having a typical appearance of a cluster of small anechoic structures adjacent to the mediastinum testis

Answer 22

Tubular ectasia of the rete testis

Question 23

What is the most common condition that causes acute scrotal pain?

Answer 23

Acute epididymitis is the most common cause of acute scrotal pain

Question 24

What is the most common cause of epididorchitis in men < 35 and in men >35

Answer 24

Men with epididorchitis that are >35 years OR are pre-pubertal typically contacted the infection from a UTI.

Men with epididorchitis that are <35 typically contracted the infection from STD’s

Question 25

What condition puts the patient at a higher risk of testicular torsion?

Answer 25

Bell clapper deformity

Question 26

Intravaginal testicular torsion primarily occurs in men of what age?

Answer 26

adolescents and neonates. males <30 years, mostly aged 12-18

Question 27

List the times and corresponding salvage rate for testicular torsion

Answer 27

<6 hours - 90-100% salvage rate
12-24 hours - 20-50% salvage rate
>24 hours - 0-10%

Question 28

Type of testicular torsion that occurs exclusively in NEWBORNS

Answer 28

extravaginal testicular torsion

Question 29

Treatment of choice for cryptorchisism

Answer 29

Orchioplexy

Question 30

The key structure that guides the testicles into descent out of the abdomen and into the scrotum

Answer 30

Gubernaculum

Question 31

The most common location of cryptorchidism is the…

Answer 31

Inguinal canal

Question 32

Explain the correct anatomical position for penile anatomy

Answer 32

The penis is considered to be erect and pointing upward
The dorsal or posterior side is the side touching the belly
The ventral or anterior side is the scanning surface

Question 33

While scanning in the correct anatomical position, what penile structure lies directly underneath the transducer?

Answer 33

Corpus spongiosum

Question 34

An erection that lasts for more than 4 hours and is usually painful is known as…

Answer 34

Priaprism

Question 35

A condition in which scar tissue called plaque forms inside the penis causing it to be bent rather than straight when erect

Answer 35

Peyronies disease

Question 36

Penile trauma is defined as the traumatic rupture of the…

Answer 36

Corpus cavernosum