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Small Parts > Scrotum > Flashcards

Scrotum Flashcards

1
Q

Pediatric testes measure approximately…

A

1 cm.

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2
Q

From age 8 to puberty testes increase in size to about…

A

4 cm.

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3
Q

Adult testes measure about…

A

3-5 cm long, 2-4 cm wide, 3 cm AP

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4
Q

Scrotal u/s is best performed with a…

A

linear 7.5-12 MHz transducer.

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5
Q

What maneuver should be performed when evaluating varicoceles?

A

valsalva

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6
Q

This fibrous capsule surrounds the testicle.

A

tunica albuginea

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7
Q

The tunica albuginea is continuous with the __ that divide the testis into about __.

A

septa, 250 lobules

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8
Q

This contains a thin film of serous fluid between its layers and supports the testes in the scrotal sac.

A

tunica vaginalis

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9
Q

The inner layer of the tunica vaginalis that covers the testis and epididymis is called the…

A

visceral layer

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10
Q

The outer layer of the tunica vaginalis that lines the scrotal chamber.

A

parietal layer

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11
Q

The tunica vaginalis is attached to the __ wall of the testis preventing each testis from rotation within the scrotum.

A

posterior

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12
Q

Multiple septations arise from the tunica albuginea to form the…

A

mediastinum testis

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13
Q

Sonographically, the mediastinum testis appears as…

A

a echogenic linear band extending longitudinally within the testis.

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14
Q

This forms the support for the entering and exiting testicular vessels and ducts.

A

mediastinum

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15
Q

This forms wedge-shaped compartments containing seminiferous tubules.

A

septa

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16
Q

Where is the sperm produced?

A

in the seminiferous tubules

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17
Q

This courses centrally to form 20-30 larger ducts called the tubuli recti.

A

seminiferous tubules

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18
Q

This enters the mediastinum testis formed a network of channels called the rete testis.

A

tubuli recti

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19
Q

The rete terminate in…

A

10-15 efferent ductules.

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20
Q

These carry the seminal fluid from the rete testis to the epididymis.

A

efferent ductules

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21
Q

The epididymis is composed of a…

A

head, body, and tail.

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22
Q

The head of the epididymis is called…

A

globus major.

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23
Q

This is the largest part of the epididymis, adjacent to the superior pole of the testis.

A

globus major

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24
Q

This is where the efferent ductules converge to form a single convoluted duct called the ductus epididymis.

A

globus major

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25
Q

The tail of the epididymis is also known as…

A

globus minor

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26
Q

The globus minor courses cephalad and becomes known as the…

A

vas deferens or the ductus deferens

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27
Q

The epididymal head measures __ in length and lies at the __ pole of the testis.

A

5-12 mm, superior

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28
Q

The epididymal body and tail run __ to the testis.

A

posterior

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29
Q

Four testicular appendages that are remnant of embryonic ducts include…

A
  1. appendix testis
  2. appendix epididymis
  3. vas aberrans
  4. paradidymis
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30
Q

This is a remnant of the mullerian duct that 92% of men have.

A

appendix testis

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31
Q

This represents a detached efferent duct and is a small stalk projecting off the epididymis that 34% of men have.

A

appendix epididymis

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32
Q

These are derived from the wolffian duct and are blind ending tubules that project from the head and tail of the epididymis.

A

vas aberrans

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33
Q

Also known as the organ of Giraldes, this is a rarely identified appendage of the epididymis.

A

paradidymis

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34
Q

This is a layer of smooth muscle fibers that lies beneath the scrotal skin and divides the scrotum into two chambers.

A

dartos muscle

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35
Q

The division of the two scrotal chambers is called the…

A

scrotal raphe.

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36
Q

This consists of the vas deferens, arteries, pampiniform plexus of veins, lymphatic, and nerves.

A

spermatic cord

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37
Q

This is a tube that connects the epididymis to the seminal vesicle.

A

vas deferens

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38
Q

This joins the duct at the seminal vesicles to form the ejaculatory duct.

A

vas deferens

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39
Q

This is where sperm are manufactured in the scrotum.

A

testes

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40
Q

This is a long coiled structure topping the testis that receives immature sperm and stores it for several days.

A

epididymis

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41
Q

The three main arteries to the testis are…

A
  1. testicular artery
  2. deferential artery
  3. cremasteric artery (aka external spermatic)
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42
Q

This provides the main supply of blood to the testicles and epididymis.

A

testicular artery

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43
Q

This provides the main supply of blood to the ductus deferens.

A

deferential artery

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44
Q

This joins the testicular artery just before it enters the testis, after supplying the cremaster muscle and the spermatic cord.

A

cremasteric artery

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45
Q

About 12 veins drain the testicles by forming an anastomotic network called the …

A

pampiniform plexus.

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46
Q

This is a major portion of the spermatic cord forming a spiraling vine-like plexus covering the ductus deferens and arteries within the cord.

A

pampiniform plexus

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47
Q

Normal scrotal skin measures __ in thickness.

A

2-8 mm

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48
Q

Most extratesticular masses are…

A

benign.

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49
Q

Most intratesticular lesions are…

A

malignant.

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50
Q

Three kinds of benign intratesticular lesions are…

A
  1. cysts
  2. abscesses
  3. calcifications
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51
Q

These testicular cysts are located within the tunica.

A

tunica albuginea cysts

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52
Q

These testicular cysts are usually solitary, well-defined and may be multiple or multilocular, mean age is 40 yrs.

A

tunica albuginea cysts

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53
Q

These testicular cysts are well-defined anechoic lesions located near the mediastinum, most likely originating from the rete testis.

A

intratesticular cyst

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54
Q

These are benign testicular cysts that are well circumscribed and of a germ cell origin.

A

epidermoid cysts

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55
Q

Epidermoid cysts can occur at any age but most commonly during…

A

2nd and 4th decades.

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56
Q

Abscesses are usually a complication of…

A

epididymo-orchitis.

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57
Q

Sonographically, a testicular abscess presents with an __ testicle containing a predominantly __ mass with __echoic areas.

A

enlarged, fluid-filled, hypo-

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58
Q

Testicular calcifications are also known as…

A

scrotal pearls.

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59
Q

T/F? Testicular calcifications are frequently seen in malignant conditions.

A

FALSE, not proven

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60
Q

This is an abnormal collection of serous fluid between the layers of the tunica vaginalis.

A

hydrocele

61
Q

This is the most common cause of painless scrotal swelling, congenital or acquired.

A

hydrocele

62
Q

Blood in the tunica vaginalis is called…

A

a hematocele.

63
Q

Hematocele is caused by direct __, torsion, or invasion by a __.

A

trauma, tumor

64
Q

This is an abnormal collection of pus in the tunica vaginalis.

A

pyelocele

65
Q

This is a collection of abnormally dilated, tortuous and elongated veins of the pampiniform plexus located posterior to the testis in the spermatic cord.

A

varicocele

66
Q

The pampiniform plexus veins normally range from __ in diatmeter, with a main draining vein up to __.

A

.5-1.5 mm, 2 mm

67
Q

The two types of testicular varicoceles are…

A
  1. primary (idiopathic)

2. secondary

68
Q

With a testicular varicoceles, a characteristic increase in diameter is seen during a…

A

valsalva maneuver.

69
Q

Testicular variococeles typically involve which side?

A

the left

70
Q

The most common extratesticular tumor is…

A

a benign adenomatoid tumor.

71
Q

T/F? Extratesticular tumors are common and usually involves the epididymis.

A

FALSE, rare

72
Q

T/F? Extratesticular tumors are rare and usually involves the vas deferens.

A

FALSE, epididymis

73
Q

T/F? Extratesticular tumors may occur at any age, but is commonly found in men between 20-50 yrs old.

A

true

74
Q

Generally, extratesticular tumors are __lateral, solitary, __ defined, round/oval and measure __.

A

uni-, well, less than 5 cm

75
Q

This is a common paratesticular mass and may contain small bowel or colon.

A

scrotal hernia

76
Q

The three kinds of epididymal lesions are…

A
  1. cysts
  2. spermatoceles
  3. sperm granuloma
77
Q

This kind of testicular cyst is found in the epididymis usually in the head.

A

epididymal cyst

78
Q

Epididymal cysts are composed of __ fluid.

A

clear

79
Q

This is a cyst in the epididymis that has an accumulation of sperm within it.

A

spermatocele

80
Q

Spermatoceles are composed of __ fluid.

A

thick milky

81
Q

Epididymal cysts and spermatoceles result from prior episodes of…

A

epididymitis.

82
Q

A sperm granuloma occurs in 15-40% of men who undergo __.

A

vasectomy

83
Q

This is a mass that develops as a result of the body’s immune reaction to sperm leaking from the cut end of the vas.

A

sperm granuloma

84
Q

Hydroceles are treated by…

A

aspiration.

85
Q

Sperm granulomas are treated by…

A

anti-inflammatories or (worst case) surgery.

86
Q

The two most common causes of acute scrotal pain are..

A
  1. epidiymitis/orchitis

2. torsion of the spermatic cord

87
Q

This is the most common condition that causes acute scrotal pain.

A

epididymitis

88
Q

This testicular condition is usually caused by sexually transmitted diseases in men under 35 and UTIs in men older than 35 or trauma.

A

epididymitis

89
Q

Typically patients with this testicular condition present with the insidious onset of pain, which increases over 1-2 days.

A

Epididymitis. Fever, dysuria and discharge may also be present.

90
Q

This is an infection of the testicle.

A

orchitis

91
Q

Sonographically, orchitis is seen as an __ testicle with __ blood flow.

A

enlarged hypoechoic, increased

92
Q

Sonographically, epididymitis is seen as an __ epididymis, __ blood flow, __ hydrocele, and __ thickening.

A

enlarged hypoechoic, increased, reactive, scrotal wall

93
Q

This is when the testicle can rotate freely on the spermatic cord due to the lack of attachment in the tunica vaginalis.

A

bell clapper deformity

94
Q

T/F? Bell clapper deformity is congenital.

A

true

95
Q

The testicular salvage rate in torsion is 80-100% if surgery is performed within __.

A

5-6 hours of the onset of pain.

96
Q

Testicular torsion more often involves the __ testicle.

A

left

97
Q

Sonographically, testicular torsion is seen as an __ testicle that is inhomogenous compared to the contralateral testicle.

A

enlarged hypoechoic

98
Q

More than 50% of testicular ruptures occur during…

A

sporting events.

99
Q

9-17% of testicular injuries are from…

A

MVAs.

100
Q

Trauma presents physically as…

A

scrotal edema and ecchymosis.

101
Q

Approximately 90% of ruptured testicles can be saved if surgery is performed within..

A

the first 72 hours.

102
Q

Sonographically, testicular rupture is seen as __ of altered echogenicity and __ formation in 1/3rd of the patients.

A

focal areas, hematocele

103
Q

Testicular infarct commonly results from…

A

torsion and trauma.

104
Q

Sonographically, a new testicular infarct produces a focal or diffuse __.

A

hypoechoic testicle

105
Q

Sonographically, an old testicular infarct __ in size and develops areas of __ representing fibrosis or calcifications.

A

decreases, increased echogenicity

106
Q

This is a condition of undescended testis.

A

cryptorchidism

107
Q

This is one of the most common genitourinary anomalies in male infants.

A

cryptorchidism

108
Q

The testicles form near the __ and then __ into the scrotum.

A

kidneys, descend

109
Q

Complete descent is necessary for full testicular…

A

maturation.

110
Q

Most undescended testes are palpable lying around the level of the..

A

inguinal canal.

111
Q

Malpositioned testes may be located anywhere along the…

A

pathway of descent from the retroperitoneum to the scrotum.

112
Q

These are the complications of cryptorchidism.

A

infertility and cancer (in both testes)

113
Q

The increased risk of cancer in cryptorchidism is due to..

A

hormonal deficiency

114
Q

Sonographically, the undescended testis is often __ and slightly less __ than the normally descended testis.

A

smaller, echogenic

115
Q

T/F? Cryptorchidism and hydrocele are not associated.

A

true

116
Q

Most primary testicular tumors are of __ origin and are generally __.

A

germ cell, highly malignant

117
Q

The most common germ cell tumor in adults (either gender) is…

A

seminoma.

118
Q

Less common testicular tumors include…

A

teratoma
choriocarcinoma
mixed tumors

119
Q

Most malignant testicular neoplasms are more __echoic.

A

hypo-

120
Q

Hemorrhage, necrosis, calcification or fatty changes can produce areas of __ in testicular tumors.

A

increased echogenicity

121
Q

The highest risk factors for testicular cancer is…

A

being a white male between 15-35.

122
Q

Most testicular cancer patients present with…

A

painless unilateral testicular masses or diffuse testicular enlargement.

123
Q

The most common tumor in the epididymis is…

A

adenomatoid, tends toward the tail

124
Q

Malignant lesions of the scrotal wall are usually __ in origin.

A

epididymal

125
Q

The most common malignant paratesticular tumor in infants and children is…

A

rhabdomyosarcoma.

126
Q

Seminomas tend to happen when men are…

A

in their 4th or 5th decades.

127
Q

Seminomas are less __ than others and are commonly confined to the __.

A

aggressive, tunica albuginea

128
Q

T/F? Seminomas have a favorable prognosis.

A

true

129
Q

Whenever an intratesticular mass is discovered, the __ should be evaluated for lymph nodes.

A

para-aortic

130
Q

The most common prepubertal testicular tumor is…

A

the yolk sac tumor.

131
Q

This is a germ cell tumor usually in males under age two with an increased level of AFP.

A

yolk sac tumor

132
Q

T/F? Testicular yolk sac tumors have a favorable prognosis.

A

FALSE, poor

133
Q

The second most common testicular tumor in children is…

A

teratoma.

134
Q

T/F? Teratomas in children are usually benign.

A

true

135
Q

T/F? Teratomas in adults are usually benign.

A

FALSE, malignant

136
Q

Sonographically, testicular teratomas are seen as __ masses with __ and __ components including __ representing bone.

A

well defined, cystic, solid, echogenic foci

137
Q

These represent the most lethal and least common form of germ cell tumor.

A

choriocarcinoma

138
Q

Choriocarcinoma metastasizes via __, thus patients present with distal mets.

A

hematogenous routes

139
Q

Choriocarinoma presents with an increase in this lab value.

A

beta-hCG

140
Q

The majority of testicular gonadal-stromal tumors are…

A

Leydig cell.

141
Q

Testicular Sertoli cell tumors are __ and may cause symptoms of __.

A

rare, feminization

142
Q

Testicular serotli cell tumors are __, __geneous, __echoic, and often __lateral.

A

small, homo-, hypo-, bi-

143
Q

The most common metastatic testicular tumors are…

A

lymphoma and leukemia.

144
Q

The most common secondary testicular neoplasm is…

A

malignant lymphoma.

145
Q

Half of bilateral testicular neoplasms are..

A

malignant lymphomas.

146
Q

Most malignant lymphomas of the testicle are of the __ type.

A

non-Hodgkin’s

147
Q

Primary testicular leukemia is…

A

rare.

148
Q

These can create a normal cosmetic appearance for a man or child with a testicular condition.

A

implants

149
Q

These patients are not appropriate candidates for a testicular implants.

A
  1. untreated cancer
  2. infection
  3. radiotherapy
  4. some forms of therapy

Small Parts (6 decks)

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