Chapter 23. Scrotum

peak incidence of torsion is age _. sudden onset of scrotal _ with swelling on _ side. may cause nausea and vomiting.

14 pain affected

testicular cancer occurs most frequently between the ages of _ -_ years.

20 34

the _ _ anomaly occurs when the tunica vaginalis completely surrounds the testis, epididymis, and distal spermatic cord, allowing them to move and rotate freely within the scrotum.

bell clapper

omental hernias appear _ _ because of the omental fat.

brightly echogenic

undescended testis also called _ may be located in abd, _ canal, or ectopic locations. usually found in _ _ . SA: _ in size and _ echogenic than normal testis, usually _ shape.

cryptorchidism inguinal inguinal canal smaller less oval

_ are more common in men over 40 yo. they are associated with _ spermatoceles located near mediastinum.

cysts extratesticular

identify the abnormality in these images, pg 190?

dilation of rete testis -spermatocele

hematomas associated with trauma may be large and cause _ of testis. they appear as _ areas within scrotum. they become more _ with time, developing cystic components. they may involve testis, epi, or be within scrotal _.

displacement heterogeneous complex wall

embryonal cell carcinoma is _ and less well circumscribed. areas of _ echogenicity from calcification, hemorrhage or fibrosis.

heterogeneous increased

rete testis is located at _ of testis where mediastinum resides. _ _ of rete testis is uncommon, benign condition.

hilum tubular ectasia

seminomas tend to be _ hypoechoic masses with a _ border. normally _ calcification or cystic components.

homogeneous no

a _ contains serous fluid and is the most common cause of painless scrotal swelling.

hydrocele

a potential space between the visceral and parietal layers of tunica vaginalis is where _, pyocele, and hematocele develop.

hydrocele

describe the sonographic findings on this image of the tunica vaginalis, pg 191?

hydrocele -between parietal and visceral layers

the space between the layers of the tunica vaginalis is where _ can form.

hydroceles

_ contain serous fluid. they are _ common cause of painless scrotal swelling.

hydroceles most

secondary varicoceles are caused by _ pressure on spermatic vein. result of hydronephrosis, abd mass, or liver _.

increased cirrhosis

testicular _ may occur in severe cases of orchitis. swollen testis confirmed within rigid tunica _. the excessive swelling can cause obstruction to blood supply.

infarction albuginea

the epi is _ or hypoechoic compared with testis. echo texture is _.

isoechoic coarser

during fetal growth, testes first appear near _. testes should descend into scrotum from _ canal shortly before or after birth.

kidneys inguinal

primary tumor may originate from prostate or _. metastasis to testicle is bilateral with _ lesions. both hypoechoic and _.

kidneys multiple hyperechoic

anorchia is most common on _ side. intrauterine testicular torsion which caused _ vascular supply causes it.

left decreased

normal epi shows _ flow with color Doppler.

little

determine mass _, differentiate between _ and solid. extratesticular masses usually _ and intratesticular masses usually _.

location cystic benign malignant

malignant _ is most common bilateral secondary neoplasm. _ is next most common secondary neoplasm.

lymphoma leukemia

blood flow disruption across surface of testis indicates _.

rupture

the most important goal of the ultrasound examination in testicular trauma is to determine if _ has occurred.

rupture

US is done for scrotal trauma to determine if there's a _. if surgery done within 72 hrs, up to _% of testes can be saved, but only _% can be saved after 72 hrs.

rupture 90 45

the testes are symmetric, oval-shaped glands residing in the _.

scrotum

the vas deferens dilates at the terminal portion near _ _ .

seminal vesicles

each testis is divided into > 250-400 conical lobules containing the _ tubules. these converge at the _ of each lobule to form _ testis in mediastinum. these drain into the head of the _.

seminiferous apex rete epididymis

_ occurs as result of abnormal mobility of testis within scrotum. testis and epi twist and cut off _ supply. _ flow affect first, causing swelling. if torsion continues, _ flow obstructed and ischemia follows.

torsion blood venous arterial

varicocele shows numerous _tubes of varying sizes within spermatic cord near epi head. may contain _ that move. they measure >_ mm. increase diameter with _ maneuver.

tortuous echoes > 2 mm Valsalva

the testis is completely covered by a dense, fibrous tissue termed the _ _ .

tunica albuginea

testes are covered by dense, fibrous tissue termed _ _ . the posterior aspect reflects into testis to form vertical septum known as _ testis. which is seen as bright _ line coursing craniocaudad within testis.

tunica albuginea mediastinum hyperechoic

_ _ lines inner walls of scrotum. it has _ layers. the _ layer lines scrotal walls and _ layer surrounds testis and epididymis.

tunica vaginalis 2 parietal visceral

testicular cancer is _. one of most _ forms of cancer. occurs between ages of _ --.

uncommon curable 20-34

patients with _ testes are 2.5 to 8 times more likely to develop cancer.

undescended

a _ is an abnormal dilation of veins of pampiniform plexus (within spermatic cord). caused by incompetent venous _ within spermatic vein. more common on the _.

varicocele valves left

choriocarcinoma has _ appearance bc of mixed cell types with _ borders.

varied irregular

torsion is the most common cause of acute scrotal pain in _.

adolescents

hydroceles are found around the _ aspect of the testis.

anterolateral

small protuberance from head of epididymis is the _ of the epididymis.

appendix

what is the arrow pointing to, pg 190?

arrow pointing to stalk connecting the cyst to the epididymal head -epididymal cysts

a small _ area is posterior, and testicle is against scrotal wall preventing _. this is the site of _.

bare torsion hydroceles

_ _ deformity occurs when tunica vaginalis completely surrounds testis, epi, distal spermatic cord, allowing them to move and rotate freely within scrotum.

bell clapper

acute hematocele is _ with numerous, highly visible echoes that can be seen to float or move in real time. with time, hematoceles show low-level echoes and develop fluid-fluid levels or _. this does not confirm rupture though.

echogenic septations

_ cysts are small, clear cysts containing serous fluid located within the epi.

epididymal

the _ is a 6-7 cm tubular structure beginning superiorly and then coursing posteriolaterally to testis. it has _ parts. and the _ is the largest which is located superior to the upper pole of _. it contains 10-15 efferent ductules from rete testis and converges to form a _ duct in the body/tail called the _ epididymis. which becomes the vas _.

epididymis 3, head/body/tail head testis single ductus deferens

the most common cause of acute scrotal pain in adults is _-_ infection of the epididymis and testis.

epididymo-orchitis

infection of epididymis and testis is _ -_. most commonly results from ___ via spermatic cord. this is most common cause of acute scrotal pain in adults. SA: epididymitis appears as enlarged, _ gland. hyperemic flow confirmed with color Doppler.

epididymo-orchitis UTI hypoechoic

most scrotal cysts are _ found in tunica albuginea or epididymis and include spermatoceles, epididymal cysts, tunica albuginea cysts.

extratesticular

these masses called _ are usually benign, whereas _ masses are most likely to be malignant.

extratesticular intratesticular

_ cell tumors associated with elevated levels of human _ gonadotropin and alpha-fetoprotein. highly _.

germ chorionic malignant

tumors categorized as _ cell or _-_ cell tumors.

germ cell non-germ cell

sperm _ occur as chronic inflammatory reaction to extravasation of spermatozoa. most frequently seen with patients who had _. located _ within epi and vas deferens.

granuloma vasectomy anywhere

the largest part of the epididymis is the _, measuring 6 to 15 mm in width.

head

_ are collections of blood associated with trauma, surgery, neoplasms, or torsion.

hematoceles

scrotal _ occur when bowel, omentum, or other structures herniate into scrotum. _ is the most common structure to come down followed by _.

hernia bowel omentum

_ of the spermatic cord occurs as a result of abnormal mobility of the testis within the scrotum.

torsion

_ are microcalcifications which are < _ mm, usually _ condition. associated with cryptorchidism, klinefelter's syndrome, infertility, varicoceles, testicular atrophy.

microlithiasis 3 bilateral

with scrotal rupture; focal alteration of testicular _ pattern, interruption of _ _ , irregular testicular contour, scrotal wall thickening, and hematocele.

parenchymal tunica albuginea

_ is testicular duplication.

polyorchidism

severe cases of epididymo-orchitis have _. this occurs when pus fills space between layers of tunica _. contains _ septations and loculations and debris.

pyocele vaginalis internal

_ is a collection of pus. occur with _ infection or when _ ruptures into space between layers of tunica vaginalis.

pyocele untreated abscess

testicular ectopia is a very _ condition. they _ be manipulated into correct path of descent. most common site is superficial _ pouch.

rare cannot inguinal

_ are cystic dilatations efferent ductules of epididymis. _ located in epi head. contain proteinaceous fluid and spermatozoa.

spermatoceles always

testes are _, _-shaped glands residing in the scrotum.

symmetric oval-shaped

which anatomic structure does the arrow point to? pg 189.

testis mediastium