Scrotum Flashcards
role of sonography in evaluating the scrotum
Differentiate between intratesticular and extratesticular masses, Differentiate between cystic and solid masses, Evaluation of suspected testicular torsion, Evaluation of suspected testicular infection
shape of testis
Symmetric, oval shaped glands residing in the scrotum
size of testis
3 to 5 cm x 2 to 4 cm x 3 cm
Testis is divided into _____ conical lobules containing the seminiferous tubules
> 250 to 400
where is sperm created
seminiferous tubules
seminiferous tubules converge at apex of each lobule and anastomose (join) to form _______
rete testis in mediastinum.
Rete testis drains into ______ through efferent ductules
head of epididymis
sonographic appearance of testis
Smooth, medium gray structures with fine echo texture
Protrusion off the upper pole of the testis, located between the testis and the epididymis
appendix testis
size of epididymis
6 to 7 mm
Shape of epididymis
Tubular structure.
epididymis divided into
head, body, and tail
location of epididymis
Superior to upper pole of testis.
epididymis runs ________ to testis
superiorly posterolaterally
epididymis contains 10 to 15 efferent ductules from rete testis, which converge to form _________
single duct in body and tail, known as ductus epididymis.
ductus epididymis becomes _______
vas deferens and continues in spermatic cord
largest portion of epididymis
head
Smaller than the head of epididymis, Can be difficult to see sonographically. and Follows posterolateral aspect of testis from upper to lower pole
body of epididymis
Slightly larger than the body of epididymis and Positioned posterior to lower pole of testis
tail of epididymis
Small protuberance from head of epididymis
appendix epididymis
sonographic appearance of epididymis
Isoechoic or hypoechoic compared with testis, Echo texture coarser than testis
Dense, fibrous tissue that completely covers the testis
tunica albuginea
Posterior aspect of tunica albuginea reflects into testis to form vertical septum known as ________-
mediastinum testis
Multiple septa, or divisions, (known as the __________) are formed from tunica albuginea at mediastinum
septa testis
septa within testis separate it into _______
lobules
Mediastinum supports _______ coursing within testis
vessels and ducts
sonographic appearance of mediastinum testis
Bright, hyperechoic line coursing craniocaudad within testis
Lines the inner walls of scrotum, covering each testis and epididymis.
tunica vaginalis
tunica vaginalis consists of two layers: _______
parietal (inner lining of scrotal wall) and visceral (surrounds testis & epi)
bare area located where
posteriorly
________is the point where the testicle is against the scrotal wall, preventing torsion
bare area
________ travel through bare area
Blood vessels, lymphatics, nerves, spermatic ducts
where do hydroceles form
Between the layers of the tunica vaginalis.
A continuation of the ductus epididymis
vas deferens
vas deferens dilates where
at terminal portion near seminal vesicles, known as the ampulla
Vas deferens joins the duct of seminal vesicles to form _______, which empties into urethra
the ejaculatory duct
Urethra courses from ______ to ________
bladder to end of penis
In men, urethra transports _______ outside body.
both urine and semen
Extends from scrotum through inguinal canal and internal inguinal rings to pelvis.
spermatic cord
spermatic cord consist of
Vas deferens, testicular arteries, venous pampiniform plexus, lymphatics, autonomic nerves, and fiber of cremaster
function of spermatic cord
suspends the testes in the scrotum
Primary source of blood flow to testis
right and left testicular arteries
testicular arteries arise from
abdominal aorta
testicular arteries descend in the retroperitoneum and enter the ______
spermatic cord
testicular arteries course along posterior surface of testis and pierce ________
tunica albuginea
testicular arteries form or give rise to ________
capsular arteries
centripetal arteries course
from testicular surface toward mediastinum along the septa
centrifugal arteries branch further into ________
arterioles and capillaries
capsular arteries give rise to
centripetal arteries
Before reaching the mediastinum, centripetal arteries curve backward forming _______
recurrent rami (centrifugal arteries)
capsular and centrifugal arteries show a _________ waveform
low resistance
__________ Accompany testicular artery within spermatic cord to supply extratesticular structures
cremasteric and deferential
__________ Have anastomoses with testicular artery and may provide some flow to testis
cremasteric and deferential
venous drainage of testis occurs through
veins of pampiniform plexus
Pampiniform plexus exits from _________ and courses in spermatic cord
mediastinum testis
prep for sonographic evaluation of scrotum
none
transducer to use for evaluation of scrotum
High-frequency (8 to 12 MHz) linear-array
Scrotum is often painful & swollen with ________
scrotal trauma
scrotal trauma is often the result of ______
MVA, Athletic injury, Direct trauma to scrotum, Straddle injury
goal of sonography in evaluating a patient with scrotal trauma
Determine if rupture is present.
_____ of testicular ruptures can be saved if surgery is within 72 hours
90%
________ of testicular ruptures can be saved after 72 hours
45%
complication of scrotal trauma include
Hydrocele and hematocele
sonographic appearance of scrotal trauma/rupture
Focal alteration of testicular parenchymal pattern, Interruption of tunica albuginea, Irregular testicular contour, Scrotal wall thickening, Hematocele
sonographic appearance of hematocele
Varies with age
sonographic appearance of acute hematocele
echogenic with numerous, highly visible echoes that can be seen to float or move in real time
sonographic evaluation of hematocele that ages over time
low-level echoes and develop fluid-fluid levels or septations
Heterogeneous areas within scrotum that may be large and cause displacement of the associated testis, may involve testis or epididymis or contained within scrotal wall
hematoma
color doppler can be useful to distinguish areas of hematoma, especially when involving testis, because color doppler will show _____
no flow