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.
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.
3
Q
Temperature in Scrotum
A
- 3 degrees lower than core body temperature
4
Q
Where does scrotal lymph drain?
A
- Inguinal nodes
5
Q
A
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.
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
8
Q
A
9
Q
A
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).
11
Q
What are sertoli cells?
A
- Part of seminiferous tubules
- Nourish developing sperm cells through spermatogenesis
- Stimulated by FSH
12
Q
What are the Chronic Benign Scrotal Masses?
A
- Hydrocele-infantile or adult (1º or 2º)
- Epididymal cyst or spermatocele
- Varicocele
13
Q
What are the Acute Benign Scrotal Masses?
A
- Inflammatory (epididymo-orchitis, orchitis, epididymitis, scrotal abscess)
- Traumatic (haematoma, rupture)
- Torsion
14
Q
What are the Malignant Scrotal Masses?
A
- Tumours
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.
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
