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UROLOGY > Testis > Flashcards

Testis Flashcards

1
Q

Covering of TESTIS

A
  1. Tunica albuginea
  2. Visceral layer of Tunica Vaginalis
  3. Parietal layer of Tunica Vaginalis
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2
Q

Pathway of SPERMS
🧠⚡SEVEN UP ⚡

A
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3
Q

Testicular Artery is a branch of

A

Abdominal AORTA

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4
Q

Which sided TESTICULAR VEIN drains directly to IVC

🧠⚡RIVer⚡

A

Right ➡️ IVC
All RIGHT Sided Veins directly drain into IVC
✨ Right TESTICULAR VEIN
✨ Right Suprarenal Vein
✨ Right Inferior Phrenic Vein

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5
Q

Left TESTICULAR VEIN drains into

A

Left Renal Vein
⬇️
IVC

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6
Q

Lymphatic Drainage of TESTIS

A
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7
Q

Descent of TESTIS

A
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8
Q

Which Testis has HIGHER CHANCE of Being UNDESCENDED?

A

Right Testis

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9
Q

Which Testis Descends EARLIER

A

Left Side

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10
Q

Descent of TESTIS can occur upto

A

4-5 months after BIRTH

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11
Q

Difference between UNDESCENDED TESTIS & CRYPTORCHIDISM

A

Cryptorchidism: B/L UNDESCENDED TESTIS

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12
Q

⚡⚡ MOST COMMON SITE OF UNDESCENDED TESTIS

⚡⚡ MOST COMMON SITE OF ECTOPIC TESTIS

A

⚡⚡ MOST COMMON SITE OF UNDESCENDED TESTIS
🎯 INGUINAL CANAL

⚡⚡ MOST COMMON SITE OF ECTOPIC TESTIS
🎯 SUPERFICIAL INGUINAL POUCH

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13
Q

💊💉 MANAGEMENT of ECTOPIC TESTIS

A

Orchidopexy

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14
Q

COMPLICATIONS of UNDESCENDED TESTIS

🧠⚡TESTIS⚡

A
  1. Torsion
  2. Epididymo-orchitis
  3. Sterility
  4. Trauma
  5. Indirect Inguinal Hernia
  6. Seminoma (ITGCN)
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15
Q

Which cells are MOST AFFECTED in TESTIS due to non-descent?

A

Sertoli cells
⬇️
Spermatogenesis is affected

⭐ LEYDIG cells are affected Less ➡️ Testosterone is NORMAL ➡️ NORMAL 2° SEXUAL Characteristics

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16
Q

HIGHER UP THE TESTIS in UNDESCENDED TESTIS, MORE IS THE

A

Histological CHANGES
(Abdominal > Inguinal)

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17
Q

Clinical Features of UNDESCENDED TESTIS

A
  1. Missing Testis in scrotum
  2. Testis palpable in INGUINAL REGION: INGUINAL canal
  3. Testis non-palpable in INGUINAL REGION: Abdominal
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18
Q

🩺 IOC for INTRA-ABDOMINAL TESTIS

A

Diagnostic LAPAROSCOPY

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19
Q

💊💉 MANAGEMENT of UNDESCENDED TESTIS

A
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20
Q

Cause of VANISHING TESTIS Syndrome

A

INTRA-UTERINE TORSION of Testis

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21
Q

ORCHIDOPEXY: Types

🧠⚡S²K ⚡

A
  1. Stephan Fowler Technique
  2. Silbar Procedure
  3. Keetley Torek Procedure
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22
Q

BEST ORCHIDOPEXY technique

A

SILBAR’S TECHNIQUE

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23
Q

2 STAGE ORCHIDOPEXY Procedure

A

Stephen Fowler Technique

✨ 1st STAGE: High LIGATION of TESTICULAR Vessels & Position Testis in Inguinal Canal

✨ 2nd STAGE: Place Testis into SCROTUM

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24
Q

Limiting Factor for ORCHIDOPEXY IN STEPHEN FOWLER TECHNIQUE

A

Length of Testicular Vessels

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25
Q

How Testis survives when TESTICULAR ARTERY is ligated?

A

Testis has DUAL BLOOD SUPPLY
⬇️
Also gets blood supply from CREMASTRIC VESSELS

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26
Q

Ideal Time to do ORCHIDOPEXY

A

6-12 months

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27
Q

Microvascular anastamosis of vessels with BRANCHES of INTERNAL ILIAC VESSELS in SILBAR’S technique is done with

A

Pro line Suture

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28
Q

Whenever you do ORCHIDOPEXY, Also do

A

HERNIOTOMY

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29
Q

Why INDIRECT INGUINAL HERNIA is common with UNDESCENDED TESTIS

A

When Testis comes down, it pulls down PROCESSUS Vaginalis with it
⬇️
Processus vaginalis communicates with the PERITONEAL CAVITY
⬇️
BRINGS LOOP of BOWEL with it

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30
Q

⚡⚡ MOST COMMON COMPLICATION OF UNDESCENDED TESTIS

A

Indirect Inguinal Hernia

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31
Q

What is RETRACTILE TESTIS?

A

Testis present in the SCROTUM but occasionally it jumps into the INGUINAL CANAL

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32
Q

How to differentiate RETRACTILE TESTIS & UNDESCENDED TESTIS

A

✨ RETRACTILE TESTIS: Scrotal Rugosities ➕

✨ UNDESCENDED TESTIS: Scrotal Rugosities ⛔

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33
Q

💊💉 MANAGEMENT of RETRACTILE TESTIS

A

-Reassurance
-After walking 30-45 mins, it comes back again into SCROTUM

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34
Q

⚒️ RISK FACTORS for TESTICULAR TORSION

A
  1. Bell Clapper Testis
  2. Testicular Inversion
  3. Undescended TESTIS
  4. Torsion of CYST of MORGAGNI
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35
Q

⚡⚡ MOST COMMON CAUSE OF TESTICULAR TORSION

A

⭐ Bell Clapper Testis
High INVESTMENT of TUNICAL VAGINALIS

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36
Q

BLUE DOT SIGN on Doppler is seen in

A

Torsion of CYST of MORGAGNI

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37
Q

🧑🏻‍⚕️ Clinical Features of TESTICULAR TORSION

A
  1. Young Male
  2. ACUTE SCROTAL PAIN & SWELLING
  3. PATIENT wakes up in EARLY MORNING DUE TO: Pain
  4. Erythema
  5. Nausea & Vomiting
    Twisted Cord can be SOMETIMES be palpated
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38
Q

⚡⚡ MOST IMPORTANT 🚦DIFFERENTIAL DIAGNOSIS FOR TESTICULAR TORSION

A

Acute EPIDIDYMO-ORCHITIS

39
Q

How to differentiate EPIDIDYMO-ORCHITIS & TESTICULAR TORSION

🧠⚡PAD ⚡

A
  1. Prehn test
  2. Angell’s SIGN
  3. Deming’s Sign: Spasm of Cre master muscle DUE TO: Twisting of spermatic cord causes affected testis to be positioned higher than NORMAL testis
  4. Cremastric Reflex: Absent on side of affected testis
40
Q

PREHN’S test

🧠⚡PIT ⚡

A

On manually lifting the Testis

⭐ Pain Increases in TORSION

⭐ Pain decreases in EPIDIDYMO-ORCHITIS

41
Q

DEMING SIGN

A

Testis with TORSION: Lies at HIGHER Level

EPIDIDYMO-ORCHITIS: Lies at NORMAL level

42
Q

ANGELL SIGN

A

Testis which has UNDERGONE Torsion is TRANSVERSELY placed

43
Q

Causes of TESTICULAR PAIN
🧠⚡ TO THE⚡

A
  1. Torsion
  2. Orchitis
  3. Trauma
  4. Hernia (Indirect Inguinal)
  5. EPIDIDYMO-ORCHITIS
44
Q

🩺 IOC for TESTICULAR TORSION

A

Clinical examination
⬇️
Doppler

45
Q

💊💉 MANAGEMENT of TESTICULAR TORSION

A

Immediate Exploration on both SYMPTOMATIC & ASYMPTOMATIC side

46
Q

Testis remains viable in TORSION till

A

6 hours

47
Q

ORCHIDOPEXY in TESTICULAR torsion is done with

A

3 Point FIXATION

48
Q

⚡⚡ MOST COMMON CAUSE OF EPIDIDYMO-ORCHITIS in CHILDREN (Age < 40 years)

🧠⚡ CN: Cartoon Network⚡

A
  1. Chlamydia
  2. Neisseria Gonorrhea
49
Q

⚡⚡ MOST COMMON CAUSE OF EPIDIDYMO-ORCHITIS in ADULTS (Age > 40 years)

🧠⚡EPididymis⚡

A
  1. E. coli
  2. Pseudomonas
50
Q

Spread of INFECTION in

⭐ TB
⭐ SYPHILIS
🧠⚡STD⚡

A

⭐ TB: Epididymis ➡️ ➡️ TESTIS

⭐ Syphilis: Testis ➡️ ➡️ epiDiDymis

51
Q

💊💉 MANAGEMENT of EPIDIDYMO-ORCHITIS

A
  1. Antibiotics
  2. Analgesics
  3. Scrotal Support: Lifting the Scrotum
52
Q

Beaded VAS DEFERENS
➕
FIRM ENLARGEMENT OF EPIDIDYMIS

Seen in

A

Tubercular EPIDIDYMIS

53
Q

HYDROCELE
meaning

A

Fluid accumulation in TUNICA VAGINALIS

54
Q

Types of HYDROCELE

🧠⚡VICE ⚡

A
  1. Vaginal
  2. Infantile
  3. Congenital
  4. Encysted (OR) Hydrocele of the Cord
55
Q

⚡⚡ MOST COMMON TYPE OF HYDROCELE

A

Primary Vaginal HYDROCELE

56
Q

Difference BETWEEN 1° & 2° VAGINAL HYDROCELE

A
57
Q

⚡⚡ MOST COMMON CAUSE of 2° VAGINAL HYDROCELE

🧠⚡ET³⚡

A

EPIDIDYMO-ORCHITIS

Others:
1. Torsion
2. Tumour
3. Trauma

58
Q

FLUCTUATIONS ➕
Meaning

A

Any fluid filled swelling, which when pressed on 1 side, it expands from other site

59
Q

Transilluminant swellings
🧠⚡CREaM H ⚡

A

• Cystic hygroma
• Ranula
• Epididymal cyst
• Meningocele

• Hydrocele

60
Q

FLUCTUATION SIGN ➕

A

✨ HYDROCELE

61
Q

💊💉 MANAGEMENT of VAGINAL HYDROCELE

A

Surgery
⭐ JABOULAY’S Procedure: Large Hydrocele
⭐ LORD’S plication: Small Hydrocele

62
Q

Which HYDROCELE presents as INGUINOSCROTAL Swelling?

A

Infantile HYDROCELE

63
Q

💊💉 MANAGEMENT of INFANTILE HYDROCELE

A

Excision of EXCESS SAC ➕ Eversion of SAC

64
Q

PATENT PROCESSUS VAGINALIS
synonyms

A

Congenital Hydrocele

65
Q

💊💉 MANAGEMENT of CONGENITAL HYDROCELE

A

Herniotomy @ 2-3 years of age

66
Q

💊💉 MANAGEMENT of ENCYSTED HYDROCELE OF CORD

A

Excise the SWELLING without DAMAGING the CORD

67
Q

Difference BETWEEN Spermatocele vs EPIDIDYMAL CYSTS

A
68
Q

⭐ Cause of production of SPERMATOCELE

⭐ Cause of production of EPIDIDYMAL CYSTS

A

⭐ Cause of production of SPERMATOCELE
🎯 swelling of EPIDIDYMAL HEAD

⭐ Cause of production of EPIDIDYMAL CYSTS
🎯 CYSTIC DEGENERATION of EPIDIDYMIS

69
Q

Chinese LATTERN Pattern is seen in

A

EPIDIDYMAL CYSTS

70
Q

VARICOCELE
meaning

A

Dilated TORTUOUS Pampiniform plexus of VEINS

71
Q

Varicocele is MORE COMMON in which side

A

Left side > Right Side

72
Q

Why LEFT Sided VARICOCELE more common than RIGHT side?

A

✨ Left TESTICULAR Vein is LONGER
✨ Left TESTICULAR Vein drains at RIGHT ANGLE to Left Renal Vein
✨ Sigmoid Colon can press on LEFT TESTICULAR Vein
✨ Left ADRENAL VEIN opens OPPOSITE to LEFT TESTICULAR VEIN (Left ADRENAL VEIN releases Catecholamines ➡️ Vasoconstriction )

73
Q

Recent ACUTE ONSET LEFT SIDED VARICOCELE

⚡⚡ MOST COMMON CAUSE

A

Left RENAL CELL CARCINOMA
⬇️
RCC can spread to RENAL VEIN & BLOCK THE VEIN

74
Q

Why INFERTILITY occurs in VARICOCELE?

A

When VARICOCELE occurs ➡️ Temperature of SCROTUM ⬆️⬆️ (maintained by Counter Current mechanism in scrotum)
⬇️
Spermatogenesis affected

75
Q

🧑🏻‍⚕️ Clinical Features of VARICOCELE

A
  1. Asymptomatic
  2. Dull Pain in SCROTUM
  3. Swelling in SCROTUM
  4. INFERTILITY
76
Q

BAG OF WORM consistency seen in MEDICINE

A
  1. VARICOCELE
  2. ADENOIDS
  3. ORBITAL VARICES
77
Q

🩺 IOC for VARICOCELE

A

DUPLEX Scan (OR) DOPPLER

78
Q

Grading of VARICOCELE

A

Grade I: Inpalpable , but detected on DOPPLER

Grade II: Palpable, detected on DOPPLER

Grade III: VISIBLE

79
Q

💊💉 MANAGEMENT of VARICOCELE

A

Asymptomatic: No treatment
Asymptomatic in IAS & Army: SURGERY

Symptomatic: SURGERY
⭐ EMBOLIZATION of VEINS
⭐ VARICOCELECTOMY: Ligation of Vessels

80
Q

VARICOCELECTOMY: TYPES

🧠⚡PIN ⚡

A
  1. Paloma’s approach: Retroperitoneal route: Laparoscopic
  2. Ivanisevich procedure: Open INGUINAL approach
  3. NOTES: Transvesical route
81
Q

VARICOCELE recurrance is very HIGH, despite SURGERY
Why?

A

Dual Blood Supply

82
Q

Sperm count improvement after VARICOCELE Surgery is seen in

A

30-40%

83
Q

Identify

A

Fournier’s GANGRENE
⬇️
Necrotizing Fasciitis involving PERINEAL Region

84
Q

⭐ Necrotizing Fasciitis involving PERINEAL Region is known as

⭐ Necrotizing Fasciitis involving PERINEAL ➕ ABDOMINAL Region is known as

A

⭐ Necrotizing Fasciitis involving PERINEAL Region is known as
🎯 FOURNIER’S GANGRENE

⭐ Necrotizing Fasciitis involving PERINEAL ➕ ABDOMINAL Region is known as
🎯 MELENEY’S GANGRENE

85
Q

Fournier’s GANGRENE starts as

A

TRIVIAL TRAUMA
✨ Shaving of HAIR
✨ Removal of BOIL
✨ Catheterization

86
Q

🧑🏻‍⚕️ Clinical Features of Fournier’s GANGRENE

A
  1. Pain
  2. Fever
  3. Swelling
  4. Foul smelling odour
  5. Shock
  6. High Mortality rate
87
Q

⚒️ RISK FACTORS for Fournier’s GANGRENE

A
  1. Immunocompromised
  2. DM
  3. ELDERLY
88
Q

💊💉 MANAGEMENT of FOURNIER’S GANGRENE

A
  1. IV FLUIDS
  2. IV ANTIBIOTICS: Aerobic ➕ Anaerobic coverage
  3. ANALGESICS
  4. SHOCK Management
  5. AGGRESIVE DEBRIDEMENT
89
Q

Which structures are SPARED in Fournier’s GANGRENE

Why?

A

Testis & Urethra
⬇️
Dual Blood Supply

90
Q

Identify

A

Scrotal Sebaceous Cyst
⬇️
✨ Blocked Hair Follicle Ducts
✨ Punctum ±

91
Q

Management of SEBACEOUS CYST IN SCROTUM

A

Excision

92
Q

1st STAGE OF STEPHEN FOWLER’S ORCHIOPEXY

A

Testicular Vessels are ligated
⬇️
Clipping of Testicular artery promotes neo-vasculogenesis along the vas deferens
⬇️
2nd stage is performed after SEVERAL MONTHS

93
Q

Shameful Exposure of Testis

A

Fournier’s Gangrene

94
Q

USG of Hydrocele

A

Anechoic reflection DUE TO: fluid collection

UROLOGY (12 decks)

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