Scrotum

Question 1

What divides the scrotum into 2 compartments externally?

Answer 1

Raphe

Question 2

What merges centrally to form internal scrotal septum internally?

Answer 2

Dartos tunica

Question 3

What is the scrotum lined by?

Answer 3

Tunica vaginalis (2 layers):
-parietal
-visceral

Question 4

What is normal scrotal was thickness?

Answer 4

2-8mm

Question 5

Fibrous layer surrounding testes

Answer 5

Tunica albuginea

Question 6

Invaginations of the tunica albuginea divide testicles into what? What do these contain?

Answer 6

Lobules, lobules contain seminiferous tubules

Question 7

Converging of seminiferous tubules at the mediastinum join to form?

Answer 7

Efferent ducts

Question 8

What do efferent ducts do?

Answer 8

Carry seminal fluid to the epididymis

Question 9

Where the testes are tethered to the scrotal wall by the visceral layer of the tunica vaginalis

Answer 9

Bare area

Question 10

Remnant of the Müllerian duct

Answer 10

Appendix testes

Question 11

Where does the tail of the epididymis

Answer 11

Vas deferens

Question 12

Another name for the head of the epididymis

Answer 12

Globus major

Question 13

Remnant of the Wolffian (mesonephric) duct

Answer 13

Appendix epididymis

Question 14

What connects the testes to the pelvis/abdomen?

Answer 14

Spermatic cord

Question 15

What does the spermatic cord contain?

Answer 15

Vas deferens, arteries, pampiniform plexus, lymphatics and nerves

Question 16

What is venous drainage route?

Answer 16

Via pampiniform plexus
RT drains into IVC
LT drains into left renal vein

Question 17

What is the mediastinum on u/s?

Answer 17

The hyperechoic area in the middle of the testicle

Question 18

Where in the testicle is it mostly benign and malignant?

Answer 18

Extratesticular- benign
Intratesticular- malignant

Question 19

Undescended testicle

Answer 19

Cryptorchidism

Question 20

The structure that guides and anchors the testis during descent into the scrotal sac

Answer 20

Gubernaculum

Question 21

Testicular duplication

Answer 21

Polyorchidism

Question 22

Absent testicle

Answer 22

Anorchia, more common on left

Question 23

Most common cause of painless scrotal swelling

Answer 23

Hydrocele

Question 24

Collection of fluid between the tunica vaginalis layers

Answer 24

Hydrocele

Question 25

Are large hydrocele associated with neoplasms?

Answer 25

No, but small ones are seen in 60% of patients with testicular tumors

Question 26

Blood in scrotal sac

Answer 26

Hematocele

Question 27

Pus in the scrotal sac

Answer 27

Pyocele

Question 28

Dilated veins in the pampiniform plexus >2mm

Answer 28

Varicocele

Question 29

What are scrotal hernias typically associated with?

Answer 29

Heavy lifting

Question 30

Is a ruptured testicle a surgical emergency?

Answer 30

Yes

Question 31

Spermatic cord twists, cutting off blood supply

Answer 31

Torsion

Question 32

Testis rotate freely within the tunica vaginalis

Answer 32

Intravaginal torsion

Question 33

Both tunica vaginalis & spermatic cord undergo torsion as a unit

Answer 33

Extravaginal torsion

Question 34

Sonographic appearance of acute torsion (name 3)

Answer 34

-enlarged testicle/epi -testicle more hypoechoic -absent flow -reactive hydrocele -scrotal skin thickening

Question 35

Most common cause of acute scrotal pain in adults

Answer 35

Epididymitis

Question 36

Inflammation of the testis

Answer 36

Orchitis

Question 37

Mobile calcifications on tunica or within scrotal sac

Answer 37

Scrotal pearls

Question 38

Retention cyst, dilated epididymal tubules filled with nonviable sperm

Answer 38

Spermatocele

Question 39

Are non-germ cell (gonadal stromal) tumors benign? Name the 2

Answer 39

Majority are benign -Sertoli cells -Leydig cells

Question 40

Most common extratesticular tumour

Answer 40

Adenomatoid tumour (benign)

Question 41

Calcifications within seminiferous tubules

Answer 41

Microlithiasis

Question 42

<5 micro calcs per transducer field

Answer 42

Benign

Question 43

Signs/symptoms of malignant pathologies

Answer 43

-painless scrotal enlargement - unilateral -hypoechoic -increased vascularity -reactive hydrocele (sometimes)

Question 44

Germ cell tumours

Answer 44

Seminoma Non-seminomatous -embryonal -yolk sac -choriocarcinoma -teratoma -mixed germ call

Question 45

Most common germ cell tumour

Answer 45

Seminoma

Question 46

May cause BhCG to be elevated

Answer 46

Seminoma

Question 47

Least aggressive malignant tumour

Answer 47

Seminoma

Question 48

2nd most common testicular malignancy

Answer 48

Embryonal cell

Question 49

Most aggressive cancer

Answer 49

Embryonal cell

Question 50

Infantile form of embryonal cell

Answer 50

Yolk sac tumour

Question 51

AFP is always elevated with this one

Answer 51

Yolk sac tumor

Question 52

Highly malignant and aggressive, serum BhCG always elevated

Answer 52

Choriocarcinoma

Question 53

Low frequency, typically benign in children and malignant in adults

Answer 53

Teratoma