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ABD Boards! > Scrotum > Flashcards

Scrotum Flashcards

1
Q

What is the testicle surrounded by?

A

Tunica albuginea

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2
Q

What do the multiple septations in the tunica albuginea form?

A

Mediastinum testis

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3
Q

What is a Rete testis?

A

Anastomosing network of delicate tubules located in the hilum of the testicle (mediastinum testis) that carries sperm to the epididymis.

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4
Q

What are the sections of the epididymis?

A

Head, Body, Tail

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5
Q

Where is the Epididymis in relation to the testicle?

A
  • Parallel to testicle

- Head is adjacent to superior pole of teste ( largest portion of epi.)

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6
Q

What is an appendix teste?

A

Remnant of Mullerian ducts

  • small ovoid structure beneath the head of epi.
  • torsion may occur known as “Blue dot sign”
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7
Q

What is the tunica vaginalis?

A
  • saccular extension of the peritoneum into the scrotal layers
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8
Q

What are the layers of the tunica vaginalis?

A
  • Visceral layer (Inner): Covers testes and Epi

- Parietal layer ( outer): Lines scrotal chamber

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9
Q

What is the blood flow to the testes?

A
  • deferential artery
  • Cremasteric (external spermatic) artery
  • Testicular artery
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10
Q

What does the testicular artery divide into?

A
  • capsular

- centripetal (intratesticular) branches

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11
Q

What does the spermatic cord consist of?

A
  • vas deferens
  • cremasteric, deferential, testicular arteries
  • pampiniform plexus of veins
  • lymphatics
  • nerves
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12
Q

Know about testicular masses…

A
  • most extratesticular masses are benign, majority of intratesticular lesions are malignant
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13
Q

What is a Seminoma?

A
  • Most common germ cell type found in both pure seminoma and mixed germ cell testicular masses
  • ** Cryptorchidism
  • Spread through draining lymph nodes in the retroperitoneum
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14
Q

What labs are associated with tumor markers?

A
  • Beta HCG
  • AFP
  • LDH
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15
Q

What is a nonseminoma?

A
  • masses that are not “pure seminomas” and consist of other cell types: Embryonal carcinomas, teratomas, yolk sac tumors, choriocarcinoma
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16
Q

What type of lab is associated with nonseminomas?

A

Alpha fetoprotein

17
Q

What lab will you see in both seminomas and nonseminomas?

A

Serum beta HCG

18
Q

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

A

Yolk sac tumors

- high AFP

19
Q

What is a Leydig Cell tumor?

A
  • rare stromal testicular tumor
  • always benign in children, malignant variants in adults
  • Tumor produces testosterone resulting in Precocious puberty
  • Labs are normal in Leydig cell
20
Q

What are the two types of benign cysts?

A
  • cysts of tunica albuginea
  • Intratesticular cysts
  • ——-normally located near the mediastinum testis and probably originate from the rete testis
21
Q

What is an Epidermoid cysts?

A
  • benign tumor of germ cell origin
  • lie beneath the tunica albuginea
  • “Bow tie” central echogenic pattern
22
Q

What is a Testicular Abscess?

A
  • complication of epididymo-orchitis

- enlarged testicle seen with fluid filled mass

23
Q

What are scrotal calcifications?

A

Calcs (“Scrotal Pearls”) may be located within the testicle or between the layers of the tunica vaginalis

  • AKA: Microlithiasis
  • a definite but minimal risk of testicular germ cell tumor
24
Q

What is a testicular infarct?

A

present as a triangular-shaped avascular intratesticular lesion
- can produce a focal or diffuse hypoechoic testicle

25
Q

What is a hydrocele?

A

Serous fluid that accumulates within the tunica vaginalis or between the layers of the tunica vaginalis (parietal or visceral layer)

26
Q

What are hydroceles caused by?

A

Failed closure of the vaginalis at the internal ring

27
Q

What is a hematocele?

A

blood fills the scrotal chamber from trauma

28
Q

What is a varicocele?

A
  • dilatation of the pampiniform venous plexus of the testicular veins which drain the testicle
  • 90% of varicoceles are on the LEFT side
29
Q

What is the most common cause for male infertility?

A

Varicoceles

30
Q

What is the technique we use to diagnose a varicocele?

A

Valsalva

31
Q

What is a scrotal hernia?

A

bowel protruding through the inguinal canal into the tunica vaginalis of the scrotum
- ** presence of peristalsis confirms diagnosis

32
Q

What is the most common extratesticular tumor?

A

adenomatoid tumor

33
Q

What is a Spermatocele?

A
  • AKA: Epididymal cyst

- cystic masses of the epididymis that result from dilatation of the epididymal tubules

34
Q

What is the difference between spermatocele and epididymal cyst?

A
  • Spermatocele: filled with thick milky fluid containing spermatozoa
  • Epididymal cyst: Clear fluid
35
Q

What are the main causes for acute scrotal pain?

A
  • Torsion

- Epididymitis / Orchitis

36
Q

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

A

Epididymitis

  • usually caused by sexually transmitted organisms
  • can cause infection to testicle causing orchitis
37
Q

What testicular torsion?

A

without attachment to the tunica vaginalis, the testicle can rotate freely on the spermatic cord (Bell clapper deformity)

  • venous and arterial occlusion
  • becomes enlarged and hypoechoic
38
Q

What is Cryptorchidism?

A
  • Hidden testicle
  • AKA Undescended testicle
  • infertility and cancer are complications
  • Patients who has cryptorchidism have increased risk of developing malignancy
39
Q

What is the most common location for undescended testis?

A

Inguinal canal

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