Scrotum and Prostate - Part 4 Flashcards

1
Q

Cryptorchidism

A

Undescended testis

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2
Q

Where are 80% of undescended testis located?

A

In the inguinal canal

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3
Q

What is cryptorchidism associated with? (4)

A
1. Herniated scrotal
sac
2. Increased risk of infertility
3. Torsion
4. Malignancy
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4
Q

When should normal testis descend?

A

At 6 months of age

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5
Q

What are the clinical findings for cryptorchidism? (2)

A
  1. Absence of testis in the scrotum

2. Palpable inguinal mass

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6
Q

What is the US appearance for cryptorchidism? (4)

A
  1. Absence of testis in the scrotum
  2. Oval-shaped hypo echoic mass in the inguinal canal, pelvis, or retroperitoneum
  3. Smaller than a normal testis
  4. Generally mobile
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7
Q

What are 3 differential diagnosis of cryptorchidism?

A
  1. Lymph node
  2. Hematoma
  3. Bowel
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8
Q

Polyorchidism

A

Presence of more than two testes

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9
Q

What is polyorchidism associated with? (3)

A
  1. Inguinal hernia
  2. Testicular torsion
  3. Malignancy
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10
Q

What are the clinical findings of the polyorchidism? (3)

A
  1. Asymptomatic
  2. Enlarged scrotum
  3. Palpable scrotal mass
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11
Q

What is the US appearance of polyorchidism?

A

Small echogenic extratesticular mass similar to the testis

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12
Q

What are 3 differential diagnosis of polyorchidism?

A
  1. Epididymal neoplasm
  2. Testicular neoplasm
  3. Epididymitis
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13
Q

Where is polyorchidism usually located?

A

In the superior medial aspect of the scrotum

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14
Q

Agenesis of the seminal vesicles

A

Absence of seminal vesicles

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15
Q

What is agenesis of the seminal vesicles associated with?

A

Ipsilateral renal agenesis

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16
Q

What are the clinical findings of agenesis of the seminal vesicles? (3)

A
  1. Asymptomatic
  2. Urinary retention
  3. Perirenal pain
17
Q

What is the US appearance for agenesis of the seminal vesicles?

A

Absence of the hypo echoic seminal vesicles

18
Q

What are 2 differential diagnosis of agenesis of the seminal vesicles?

A
  1. Technical error

2. Epididymal neoplasm

19
Q

What is the US appearance of a scrotum? (2)

A
  1. Thin hyper echoic wall measuring 2-8mm in thickness

2. Small amount of anechoic fluid surrounds each testis

20
Q

What is the US appearance of testes? (2)

A
  1. Homogeneous parenchyma demonstrating a medium-level to low-level echo pattern
    - hypo echoic parenchyma is demonstrated in infants and children
  2. Intratesticular Doppler blood flow should be symmetrical
21
Q

What is the shape of testes?

A

Oval

22
Q

How does the mediastinum of the testis appear on US?

A

Hyper echoic linear structure located in the

medial and posterior aspect of each testis

23
Q

What is the blood resistance of the testis?

A

Low-resistance, low-velocity intratesticular blood flow demonstrating continuous
flow throughout diastole

24
Q

What is the US appearance of the epididymis? (3)

A
  1. Homogeneous structure demonstrating a medium-level to low-level echo pattern
  2. Isoechoic to hypo echoic when compared to the normal testis
  3. Minimal or no discernible internal blood flow
25
Q

What is the US appearance of the spermatic cord? (2)

A
  1. Hypo echoic to isoechoic structure superior to the testicles
  2. Multiple linear strands in sagittal orientation
26
Q

What is the shape of the spermatic cord on US in the transverse orientation?

A

Round or oval

27
Q

What is the US appearance for the prostate?

A

Homogeneous structure demonstrating a medium-level echo pattern

28
Q

What do the peripheral zones appear as compared to the central zone of the prostate?

A

Uniform in texture and slightly more echogenic

29
Q

What separates the peripheral and central zones of the prostate?

A

Hyper echoic band

- surgical capsule

30
Q

How do you prep for a prostate exam? (2)

A
  1. Fill bladder for a transabdominal exam

2. Empty bladder for a transrectal exam

31
Q

What are the indications a scrotal exam? (7)

A
  1. Scrotal pain
  2. Scrotal trauma
  3. Enlarged scrotum
  4. Palpable scrotal mass
  5. Infertility
  6. Undescended testis
  7. Evaluate mass from previous medical imaging study
    - eg) CT
32
Q

What are the indications a prostate exam? (7)

A
  1. Enlarged prostate
  2. Decreased urine output
  3. Urinary frequency
  4. Urinary urgency
  5. Dysuria
  6. Elevated PSA leve
  7. Infertility
33
Q

When is the prostate routinely starting to be scanned?

A

At the age of 50

34
Q

What is the normal PSA level?

A

4 ng/mL

35
Q

Where is PSA produced?

A

From the prostate

36
Q

What is elevation of 20% of PSA in 1 year indicate?

A

Carcinoma

37
Q

What is elevation of 0.75ng/mL of PSA in 1 year indicate?

A

Carcinoma