Test Chapters 22&23 Flashcards
What is the diameter of a varicocele?
More than 2mm
pg. 619
What is the fibrous capsule called that surrounds the testicle?
Tunica albuginea
pg. 606
What is the length, the width, and height of a testicle?
3-5 cm in length
2-4 cm width
approximately 3 cm in height
pg. 604
Normal echo characteristics of the testicle
Smooth, medium gray with fine echo textures
Pg. 604
What is the mediastinum testis?
Posterior aspect of the tunica albuginea reflects into the teste to form the mediastinum, a vertical septum. It supports the vessels and ducts in the testis. It appears as a bright, hyperechoic line coursing craniocaudad within the testis.
Pg. 606
Where is the epididymis located in reference to the testicle?
Beginning superiorly and coursing posteriolateral to the testis. The head is superior to the upper pole of the testis. The tail is posterior to the lower pole of the testis.
Pg. 604n
Know all about undescended testes
Also cryptochidism. A condition where the testis as not descended into the scrotum and cannot be brought into the scrotum with external manipulation. Most often located in the inguinal cavity but may also be located in the abdominal canal or other locations as well.
Pg. 628
Undescended testis are 10x more likely to torse.
Pg. 616
What is the most common cause of acute scrotal pain in adolescents?
Torsion
Pg. 616
Know about hydroceles and reasons why they would occur
Contains serous fluid and is the most common cause of painless scrotal swelling. May have an unknown cause (idiopthic), but are commonly associated with epididymo-orchitis and torsion, may also be found in patients following trauma or development of a neoplasm. Hydroceles associated with neoplasms tend to be smaller than those associated with other causes
pg. 621
Know all about varicoceles
Abnormal dilation of the veins of the pampiniform plexus in the spermatic cord. More common in infertile men.
Primary: Caused by incompetent venous valves in the spermatic vein, typically on the left side.
Secondary: Caused by pressure on the spermatic vein due to renal hydronephrosis, abdominal mass or liver cirrhosis.
Pg. 618
Know about spermatoceles, specifically where they are located
Cystic dilations of the efferent ductules of the epididymis. They are always located in the epididymal head. They contain proteinaceous fluid and spermatozoa. May be seen more often following vasectomy
pg. 618
What is the most common cause of acute scrotal pain in adults?
Epididymo-Orchitis
Pg. 615
What is orchitis?
Infection of the epididymis and testis. The result of the spread of a lower urinary tract infection via the spermatic cord.
Pg. 615—-this describes epididymo-orchitis
Orchitis is enlarged hypoechoic testis
What is epididymitis?
Enlarged, hypoechoic gland. May contain focal hyperechoic areas if secondary to hemorrhage. Sonographically will show increased flow.
Pg. 615
What is tubular ectasia of the rete testis associated with?
Spermatocele, epididymal or testicular cysts or other epididymal obstruction
Pg. 624
What does seminoma look like under ultrasound?
A seminoma is the most common germ cell tumor. It appears as a homogenous or hypoechoic lesion with smooth, well defined borders.
Pg. 626
What is the common reason for the occurrence of epididymo-orchitis?
Results from the spread of a lower urinary tract infection via the spermatic cord
pg. 615
Who do sperm granulomas happen to most and why do they happen?
Most frequently seen in patients with a history of vasectomy. Occur as a chronic inflammatory reaction to extravasation of spermatozoa
pg. 621
What is the primary source of blood flow to the testicle?
The right and left testicular arteries
pg. 606
Intratesticular cysts have an association with what? (in men over 40)
Extratesticular Spermatoceles
Pg. 624
Microlithiasis of the testes is associated with what? How often should be patient be followed up?
Associated with: Testicular malignancy, cryptorchidism, Klinefelter’s Syndrome, Infertility, Vericoceles, Testicular Atrophy, and Male pseudohermaphroditism.
Patient should be followed up with annually.
Pg. 625
Where is the appendix testis located?
A small protuberance from the head of the epididymis
pg. 605 — this is the appendix of the epididymis
Upper pole of testis, between testis and epididymis
pg. 605
Layers of tissue in the testes and between what layers does a hydrocele develop?
The tunica vaginalis lines the inner walls of the scrotum. It has 2 layers. The parietal layer is the inner lining of the scrotal wall. The visceral layer surrounds the testis and epididymis.
Hydroceles develop in the space between the visceral and parietal layers of the tunica vaginalis
Pg. 620
What is the rete testis? (location)
Located at the hilum of the testis where the mediastinum resides.
Pg. 623
What is the difference in echo characteristics between the epididymis and testicle?
The epididymis appears isoechoic or hyperechoic compared with the testis, although the echo texture is coarser.
Pg. 605
What does the thyroid gland regulate? (metabolic function)
Metabolism, growth and development
Pg. 588
How many lobes make up the thyroid gland?
2
Pg. 589
What are the dimensions of the thyroid gland?
Adults: L: 40-60 mm W: 15-20 mm AP: 20-30 mm Isthmus: AP: 4-6 mm Children: L: 20-30 mm W: 10-15 mm AP: 12-15 Pg. 589
What are the lobes of the thyroid gland connected by?
Isthmus
Pg. 589
Know all the muscles that surround the thyroid gland
Anterior:
Sternothyroid
Omohyoid, Sternohyoid (Appear thin, hypoechoic)
Sternocleidomastoid (Large, Oval, located anterior and lateral)
Posterior:
Longus colli (Hypoechoic, Triangular, located posterior and lateral)
Pg. 589
What is the sonographic description of thyroid tissue?
Fine, homogenous echotexture. Slightly more echogenic than surrounding muscles.
Pg. 592
What is the pyramidal lobe, and where is it located?
The pyramidal lobe arises from the isthmus and tapers superiorly just anterior to the thyroid cartilage. It may be seen in the pediatric population but usually atrophies in the adults. It is found in 15-30% of patients.
Pg. 589
What vascular structures are used as landmarks to find the thyroid gland?
Common Carotid Artery, Trachea and Jugular Vein
Pg. 592
Other surrounding anatomy includes Vagus Nerve, Larynx, Inferior Pharynx, Esophagus, Parathyroid glands and anastomosis.
Pg. 589
What characteristic is found in 20% of solitary thyroid nodules?
Cystic
What is the most common cause of thyroid disorders worldwide?
Iodine Deficiency
Pg. 593
Disorders associated with hypERthyroidism
Common (99% of cases):
Diffuse toxic hyperplasia (Graves Disease), Toxic multi nodular goiter and toxic adenoma.
Uncommon:
Acute or subacute thyroiditis, hyper functioning thyroid cancer, choriocarcinoma or hydatidiform mole, TSH-secreting pituitary adenoma and neonatal thyrotoxicosis associated with maternal Graves disease.
Pg. 590 —-these are for HYPERthyroidism
What are the sonographic features of a thyroid adenoma?
Broad spectrum ranging from anechoic to hyperechoic. Typically have a peripheral halo or thin echo lucent rim surrounding the lesion that may present edema of the compressed normal thyroid or the capsule of the adenoma. Blood may surround the lesion as well.
If an adenoma contains anechoic areas it is a result of cystic degeneration and they usually lack well rounded margins.
Calcifications may appear along the rim along with acoustic shadowing.
Pg. 596
The parathyroid glands produce a hormone that affects what structures?
Parathyroid glands produce Parathyroid Hormone (PTH) which acts on bone, kidney, and intestines to enhance calcium absorption.
Pg. 600
Where are parathyroid glands located, how big are they and how many are there?
Located on posterior medial surface of thyroid gland
Typically there are 4 parathyroid glands but there may be 3 or 5.
2 are located posterior to each superior pole, 2 are located posterior to each inferior pole. They have been found in ectopic places like the neck and mediastinum.
They each measure 5mm x 3mm x 1mm.
Pg. 600
Solitary thyroid nodule with lymphadenopathy on the same side might indicate what?
Malignancy
Pg. 596
What is the most common cause for primary hyperparathyroidism?
Adenoma
Pg. 601
What is a thyroglossal ductal cyst?
Congenital anomalies that appear in the midline of the neck anterior to the trachea. They are oval or spherical and rarely larger than 2-3 cm.
A remnant of the tubular development of the thyroid gland may persist between the base of the tongue and the hyoid bone. This narrow, hollow tract, which connects the thyroid lobes to the floor of the pharynx, normally atrophies in the adult. Failure to atrophy creates the potential for cystic masses to form.
Pg. 602
What is primary hyperplasia of the parathyroid glands?
The hyper function of all the parathyroid glands for no known reason. 1 or all glands may be enlarged. Typically includes all glands but may include just 2 or 3. They rarely exceed 1 cm. Increased size makes it difficult to separate lesions.
Pg. 601
Thyroid Inferno
Increased vascularity on color doppler
Pg. 600
What is the most common cause of thyroid malignancy?
Causes: Age, Family History and Radiation Exposer. per google
Most common thyroid malignancy is Papillary Carcinoma
pg 596
What is the appearance of an abnormal lymph node?
The more rounded, the increased risk of malignancy.
Low level echogenicity of well circumscribed masses. They may also appear echo free. Inflammatory processes may also exhibit a cystic nature.
Pg. 603
The cystic formation lateral to the thyroid gland is called what?
Branchial Cleft Cysts
Pg. 602
normal prostate measurements
2x4x3
what is BPH?
Benign prostate hypertrophy
what lab test is done … and if it’s elevated, what does that usually mean?
PSA (blood test)
An Increased # of prostate cells that increased over 50% from normal amount can result in cancer.
malignant cells usually lie in what lobe?
periphery
