The Male Pelvis (Scrotum and Testis, Penis, and Prostate) Flashcards
Location of the Male Organs
_____= a sac of cutaneous tissue supporting the testes posterior to the penile shaft.
_____= male gonads (endocrine and exocrine glands) within the scrotum that produce (endo function) sperm which is stored and transported through a network of ducts (exo function)
_____ Vesicles and _____= accessory organs posterior to bladder which add secretions called semen to the sperm
_____= shaft with connection to bladder, testicles and prostate which releases urine from the bladder and sperm and seminal fluid from the prostate gland
scrotum testicles seminal prostate penis
Testicular Assessment
Testicular cancer is the most common cancer found in young men between the ages of __-__ years, however it can develop at any age.
Risk Factors;
- -Men aged between ___-__ years
- -Testes that are undescended - _____ risk to one in 44
- -Early _____
- -A _____ history
- -_____ - white males are 6 times more likely to develop TA than black males
- -Lack of regular _____
- -Regularly wearing clothing that is _____ fitting
Early diagnosis of testicular cancer allows for correct treatment to be given to ensure that the disease is prevented from spreading. Modern treatment for testicular cancer is extremely successful, as ___% of cases will be treated effectively.
15 49 15 49 increases puberty family race exercise tight 90
Examination Technique
–A _____ frequency, _____ (7.5-10 MHz) or _____ linear transducer (for enlarged testicle) should be utilized to obtain optimal resolution with multiple focal zones in place.
–The patient lies _____ with the legs slightly apart and a rolled towel placed underneath the scrotum for support. the penis and upper thighs are covered with towels.
–The right and left _____ and _____ are examined separately in both the sagittal and transverse planes. the transverse images include the superior, middle, and inferior portions. A measurement is obtained at the _____ diameter. One image demonstrating both testes for comparison of echogenicity and scrotal skin _____. The sagittal images include the medial and lateral borders. the epididymal head may be measured in three planes. Compare the echogenicity of the epididymal head to the testes.
–_____ flow and _____ wave doppler of both testes and epididymal heads are performed when a patient presents with scrotal pain. The symptomatic side is compared to the asymptomatic side. In the normal testis and epididymis, the blood flow is symmetrical.
–In patients with dilated veins (varicoceles), measure the veins with and without a _____ maneuver. _____ doppler is used to document the presence and direction of flow. Additional views with the patient standing can be obtained.
high linear curved supine testis epididymis widest thickness color pulse valsalva color
–2 ovoid organs located in the scrotal sac.
–Primary Function = _____ production and secretion of _____
– _____ which determines male sex characteristics
–Develop between the _____ abdominal wall and the peritoneum then descend into scrotum by the 5th month
–Normal size : At birth = ____ cm L x ___ cm W
At puberty/adult = ___ x ___ x ___ cm; _____ in size with age
SONO appearance:
Infants: Hypoechoic, Homogeneous
Between ages of 9-16 years:
–Increase in echogenicity due to growth of seminiferous tubules
–Homogeneous texture similar to liver and thyroid
–smooth surface
sperm hormones testosterone posterior 1.5 1.0 4 2 3 decrease
Scrotum and Contents
Scrotum
–Pouch of skin continuous with abdomen, suspended from base of male pelvis between _____ and _____
–_____ Raphe - a median ridge that divides it externally into lateral portions; seen on US
–Tunica _____ - a septum that divides it internally into anterior and posterior portions
_____ Muscle - surrounds each testicle and extends over the spermatic cord; contractions of this regulates testicular temperature
Contents
- _____
- _____
- Vas _____
peritoneum penis median dartos cremaster testicles epididymis deferens
Inter-Testicular Anatomy
_____= radiates into the testicle; separates into 200-300 lobules
–Each Lobule contains:
-convulted seminiferous tubule -
produce _____ - “spermatogenesis”
-siminiferous tubule empty spermatozoa into _____ Testis located within the mediastinum; this network connects/exits through the mediastinum as a series of coiled _____ ducts
Sono appearance of Mediastinum:
–a bright linear echo in the mid portion of the testicle in a sagittal and transverse planes
mediastinum
sperm
rete
efferent
Coverings of the Testicles
Tunica Albuginea and Tunica Vaginalis
– 2 serous layers that cover each testicle except on the posterior aspect called the “_____ area” - is at the spermatic cord area where the vessels can travel
Sono Findings:
- a layer normally seen as one layer
- bright echoes around testicles
Layers may be separated by a potential space which bowel (scrotal hernia), amounts of serous fluid (hydrocele), and blood (hematocele) can accumulate in this space
bare
Epididymis
- Small, oblong body that lies along _____ aspect of the testicle
- Extends _____ and _____
- Composed of three parts
–_____ = At the upper pole, round or pyramid shaped; 6mm-15mm Width
–_____ = 2-4 mm diameter
–_____ = 2-5mm diameter
Sono appearance:
-Echogenicity (normal) is homogeneous, and greater than or equal to the testis but coarser
- Normal color flow is very slight flicker flow or no flow
- Post-vasectomy changes - epididymis may be enlarged, may have cysts; inhomogeneous echo pattern; may mimic epididymitis
posterolateral superiorly inferiorly head body tail
Vas Deferens
-small tube that transports the sperm from each testis to the prostatic _____
Doppler: Arterial Vascular Anatomy
Arteries within the spermatic cord supply testicle with blood:
1) _____ Artery - Posterior cord/testicle
2) _____ Artery - Anterior cord/testicle
3) _____ Artery - Mid and travels towards mediastinum of testicle
Testicular Artery
–arises from the _____ aspect of the aorta, just below the level of the _____ arteries
–As the testicular artery reaches the tunica albuginea, it becomes the _____ artery
–When the capsular passes the tunica albuginea, the _____ arteries arise
urethra differential cremasteric testicular anterior renal capsular centripetal
Doppler of the Testicle
Doppler imaging with US is a technique for demonstrating the blood flow to the _____ and _____.
_____ imaging of the testis for ischemia is achieved when images are acquired at early suspicion of ischemia. The effectiveness diminishes as reactive scrotal inflammation occurs in conditions like torsion.
It is important for the sonographer to know the appearance of a normal Doppler waveform for blood flow to the _____.
- Testicular artery = _____ resistance
- Differential artery = _____ resistance
- Cremasteric arteries = _____ resistance
testis epididymis Doppler testicles low high high
Doppler: Venous Flow (Pampiniform Plexus)
-Venous outflow from the scrotum is via the paminiform plexus, which empties into the _____ veins
testicular
Seminal Vesicles
Two sac-like structures that lie _____/_____ to the bladder and store the sperm
Ejaculatory Duct
paired structures in male anatomy formed by the union of the vas deferens with the duct of the seminal vesicle
They pass through the _____, and open into the _____ at the Colliculus seminalis
During ejaculation, semen passes through the _____ gland, enters the _____ and exits the body via the tip of the _____
posterior inferior prostate urethra prostate urethra penis
Laboratory Values
–No specific laboratory values have been identified for _____ disease. A _____ in sperm count may occur in patients with male infertility.
scrotal
decrease
