Lecture 7 - Pathology of the Scrotum and Foreskin Flashcards

1
Q

What is the scrotum?

A
  • Protective pouch (for testes) devoid of fat and rich in sebaceous and sweat glands.
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2
Q
A
  • Median Raphe
  • Divides scrotum into 2 compartments
  • Each compartment contains a testis
  • Continues forward to underside of penis, and backward along middle line of perineum to anus.
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3
Q

Temperature in Scrotum

A
  • 3 degrees lower than core body temperature
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4
Q

Where does scrotal lymph drain?

A
  • Inguinal nodes
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5
Q
A
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6
Q

What is the tunica vaginalis?

A
  • Pouch of serous membrane that covers the testis
  • Derived from the vaginal process of the peritoneum, which in the fetus precedes the descent of the testes from the abdomen into the scrotum.
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7
Q

What is the spermatic cord?

A
  • Suspends testis
  • Contains structures that run to and from testis:
  • Arteries, nerves, vas deferens, pampniform plexus, tunica vaginalis, lymphatic vessels
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8
Q
A
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9
Q
A
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10
Q

What are leydig cells?

A
  • Found adjacent to the seminiferous tubules in the testicle.
  • Produce testosterone in the presence of luteinizing hormone (LH).
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11
Q

What are sertoli cells?

A
  • Part of seminiferous tubules
  • Nourish developing sperm cells through spermatogenesis
  • Stimulated by FSH
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12
Q

What are the Chronic Benign Scrotal Masses?

A
  • Hydrocele-infantile or adult (1º or 2º)
  • Epididymal cyst or spermatocele
  • Varicocele
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13
Q

What are the Acute Benign Scrotal Masses?

A
  • Inflammatory (epididymo-orchitis, orchitis, epididymitis, scrotal abscess)
  • Traumatic (haematoma, rupture)
  • Torsion
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14
Q

What are the Malignant Scrotal Masses?

A
  • Tumours
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15
Q

What is a hydrocele?

A
  • Swelling scrotum when serous fluid collects in tunica vaginalis surrounding testis.
  • Below age of 1, they resolve spontaneously.
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16
Q

Diagnosis of a Hydrocele

A
  • Transilluminate
  • Soft and painless
  • Testis usually can’t be felt
  • Able ‘to get above’ of swelling (feel upper border of it as opposed to a hernia)
  • Ultrasound scan
17
Q

Treatment of a Hydrocele

A
  • Reassurance about nature of swelling
  • Aspiration
  • Surgery
18
Q

What is an Epididymal Cyst / Spermatocele?

A
  • Arise from epididymal ducts
  • Contain either serous fluid or sperm
19
Q

Diagnosis of an epididymal cyst / spermatocele

A
  • Painless
  • Cystic
  • Transilluminant
  • Separates from testis (unless large)
  • Ultrasound
20
Q

Treatment of an epididymal cyst

A
  • Reassurance
  • Surgical excision if symptomatic
21
Q

What is a Varicocele?

A
  • Dilated and tortuous pampniform plexus - bag of worms
22
Q

Features of a varicocele

A
  • Common on left side (due to venous drainage)
  • Many are asymptomatic
  • Can: lump, pain, reduction in testicular size and infertility
23
Q

Diagnosis of a Varicocele

A
  • Ultrasound
  • Semenalysis
  • Grades 1-3
24
Q

Treatment of a Varicocele?

A
  • Conservative
  • Embolization (briefly blocking veins)
  • Surgical Ligation
25
Q

What is epididymo-orchitis?

A
  • Painful swelling
  • Dysuria