Scrotum

What is generally caused by STI in men under 35?

epididymitis/orchitis

Why do varicoceles occur most often on the patient's left side?

the length of the left testicular vein is longer; it drains into left renal vein

The blue dot sign is indicative of

torsion of the testicular appendage

What are the 3 layers of the scrotum

tunica vaginalis visceral layer parietal layer

The presence of peristalsis confirms the diagnosis and is a result from bowel protruding through the inguinal canal into the tunica vaginalis of the scrotum with what pathology?

scrotal hernia

The most common germ cell tumor of the testis is the

seminoma

What artery branches off of the AO?

testicular artery

A simple fluid collection surrounding the testis is referred to as a:

hydrocele

The epididymis body/tail ______ to testis. (color and location)

hypoechoic and lateral

The epididymis head is _____ to testis. (color and location)

isoechoic and superior

What is caused by failed closure of the processes vaginalis at the internal ring OR by trauma, torsion, or dpididymitis/orchitis?

hydrocele

What is the most common malignancy in men 15-35?

testicular neoplasms

The endocrine function of the testicles is to produce

testosterone

Which technique is useful for providing sonographic evidence of a varicocele?

valsalva

A 23y/o man has a hx of infertility. Which of the following is associated with male infertility? a. spermatocele b. choriocarcinoma c. varicocele d. hydrocele

varicocele

A dilated group of veins found within the scrotum

varicocele

What inner layer of the tunica vaginalis covers testis and epididymis

visceral layer

What is the most common testicular tumor in infants and young children?

yolk sac tumor (endodermal sinus tumor) [type of nonseminoma]

Which of the following best describes a spermatocele? a. the most common malignant neoplasm of the scrotum b. a benign intratesticular cyst c. a cyst, found within the head of the epididymis, that may contain debris d. a dilated group of veins found within the scrotum

a cyst, found within the head of the epididymis, that may contain debris

which of the following would most likely resemble a solid intratesticular mass and be associated with Cushing syndrome? a. choriocarcinoma b. epidermoid cyst c. intratesticular varicocele d. adrenal rest

adrenal rest

What laboratory value can be assessed as a tumor marker to evaluate a patient for testicular malignancy?

alpha-fetoprotein

A small, stalk-like projection representing a detached efferent duct is called

appendix epididymis

What type of torsion occurs outside the tunica vaginalis when testis and gubernaculum can rotate freely?

extravaginal testicular torsion

Which is consistent with the sonographic features of testicular abscess? a. hyperemic flow around the abscess but not within b. onion skin sonographic appearance and hyperemic epididymis c. hyperemic flow within the anechoic mass d. hyperemic flow within the abscess but not around it

hyperemic flow aroudn the abscess but not within it

All of the following are sonographic findings consistent with the diagnosis of testicular torsion except: a. hyperemic flow within the testis b. hypoechoic testis c. reactive hydrocele d. decreased intratesticular flow (compared with the asymptomatic testis)

hyperemic flow within testis

What would be the most likely sonographic appearance of a seminoma?

hypoechoic

What is the most common location for an undescended testicle to be found?

inguinal canal

What type of cyst originates from rete testis and located near mediastinum?

intratesticular cysts

All of the following are sonographic findings consistent with torsion of the testicular appendage except: a. no intratesticular flow b. small hyperechoic mass adjacent to the testis c. reactive hydrocele d. scrotal wall thickening

no intratesticular flow

AFP lab value elevation is more specific to what type of germ cell tumor?

nonseminomas

The term cryptorchidism denotes

one or both of the testicles has not descended into the scrotum

What is performed on 2-10 y/o males with cryptorchidism?

orchioplexy

What arteries supply the penis?

pundendal arteries, which branch off of the internal iliacs

Primary varicoceles are associated with all of the following except: a. left sided location b. retroperitoneal mass c. infertility d. palpable extratesticular mass

retroperitoneal mass

What is the scrotal division called

scrotal raphe

Testicular tumors has a 10-15% of being identified after

scrotal trauma

Zinner syndrome consists of unilateral renal agenesis, ejaculatory duct obstruction, and

seminal vesicle cysts

Speratogenesis occurs within the

seminiferous tubules

What is the order of testis anatomy

seminiferous tubules tubuli recti rete teste efferent ductules ductus epididymis vas deferens

What are seminiferous tubules formed by?

septula

The exocrine function of the testicles is to produce

sperm

What artery divides into capsular and centripetal (intratesticular) branches?

testicular artery

You see a triangular shaped, avascular intratesticular lesion within a teste. What does this denote?

testicular infarction

What pathology is shown?

testicular microlithiasis

Acute onset of testicular pain at rest is a common clinical finding with

testicular torsion

What layer of the scrotum is a saccular extension of peritoneum into scrotal chambers?

tunica vaginalis

Remnants of the Mullerian duct cause what?

uterus abnormalities in females; testes remnants in males

Wolffian duct remnants causes

vaginal issues in females; epididymis issues in males

You visualize an echogenic area located within the testical or between the layers of the tunica vaginalis. What is this called?

Scrotal Pearls/ calcification

What layer of muscle fibers lie beneath the scrotal skin and divides the scrotum into two chambers

dartos

A dilation of the pampiniform venous plexus of the testicular veins which drain the testicle is called?

varicocele

What is associated with heavy lifting and infertility?

varicocele

What is the most common correctable cause of male infertility?

varicocele

What scrotal abnormality is caused by incompetent valves within the pampiniform plexus?

varicocele

What causes males to have positive pregnancy tests?

B-HCG seen in testicular cancers

What joins together to create the ejaculatory duct?

Vas deferens and seminal vesicles

Extratesticular tumors are mostly _______

benign

What type of torsion leads to venous and arterial occulsion?

intravaginal testicular torsion

the most common location of a varicocele is

The left side of the scrotum

What germ cell tumor contains embryological cells?

Nonseminomas

What carries seminal fluid from rete testis to epididymis

efferent ductules

What cyst lays within the outer "film" layer of the testes?

tunic albuginea cyst

The teste is surrounded by a fibrous capsule called the

tunica albuginea

What separates the 3 corpora?

tunica albuginea

The most common location of a hydrocele is

between the 2 layers of the tunica vaginalis

A common cyst most often seen in the head of the epididymis that contains nonviable sperm is the:

spermatocele

What are the 3 main arteries of the testes?

-Deferential -Cremasteric (external spermatic) -Testicular

What is the spermatic cord composed of?

-vas deferens -3 arteries of the testes -pampiniform plexus of veins -lymphatics -nerves

A 7-12 male has a small ovoid structure located beneath the head of the epididymis, and sonographically, you see the "blue dot" sign. What does this denote?

Appendix testis

Superfiscial to the tunica albuginea is a thick fibrous envelope and a loosely applied covering of skin, called______.

Buck's fascia

What is the most common testicular cancer?

Germ Cell (seminoma and nonseminoms)

What is the largest part of the epididymis; also called globus major?

Head

What results in precocious puberty and produces estrogen and normal levels of LDH?

Leydig Cell tumor

What appears as an echogenic linear band extending within the testes?

Mediastinum testis

What is an anastomosing network of tubules located within the hilum of the mediastinum testis?

Rete testis

A white male with a history of cryptorchidism, infertility, and family testicular cancer has a higher chance for what type of testicular malignancy?

Seminoma

What germ cell testicular tumor can be treated with radiation and chemotherapy?

Seminoma

What part of the epididymis forms acute angle and courses cephalad as the vas deferens?

Tail also called the globus minor

What is a usual complication of epididymo-orchitis?

Testicular abscess

What connects seminiferous tubule to the rete testi?

Tubuli recti (tubuli seminiferi recti)

What is the most common extratesticular tumor?

adenomatoid tumor

The lack of the normal fixation of the testis to the posterior scrotal wall is referred to as

bell-clapper deformity

The two corpus cavernosa is located _____ on the penis

dorso-laterally

Efferent ductules converge to form a single convoluted duct called

ductus epidiymis

What germ cell origin cyst is filled with keratin, showing a "bow tie" pattern?

epidermoid cyst

What outer layer of the tunica vaginalis lines scrotal chamber

parietal layer

What is the treatment for nonseminomas?

radical orchiectomy

A 7y/o goes to ER with acute testicular pain localized to the superior pole of his right testis. What is likely diagnosis?

torsion of the testicular appendage

Cystic dilation of rete testis is called

tubular ectasia of rete testis

What results from partial or complete obliteration of the efferent ductus, is usually benign, and often associated with spermatoceles?

tubular ectasia of rete testis

During a sonographic exam of the right testes, you visualize multiple small cyst located along the mediastinum testis. What is the most likely diagnosis?

tubular ectasia of the rete testis

The 1 corpus spongiosum is located ____ on the penis and contains the urethra.

midventral

Which of the following is a benign intratesticular mass that typically has a whorled or onion skin sonographic appearance? a. seminoma b. teratoma c. epidermoid cyst d. adrenal rest

epidermoid cyst

Dilated veins of a varicocele will measure:

greater than 2mm