SCROTAL U.S

Testicular neoplasms are the most common malignancy in men ___to___ years of age.

15-35 years of age

The degree of torsion varies between ___ -___ degrees.

180 - 540 degrees

________, literally means hidden testicle, and generally refers to an undescended testicle.

Cryptorchidism

A _____ is seen when blood fills the scrotal chamber associated with trauma

Hematocele

A _______ is a serous fluid that accumulates within the tunia vaginalis or between the layers of the tunica vaginalis 9visceral & parietal layers).

Hydrocele

______ & ______ are complications of Cryptorchidism.

Infertiliy & Ca

90% of varicoceles are on which side?

Left -This is due to the length of the testicular vein as it drains into the left renal vein.

Exam(?) ______ are rare stromal (non-germ cell) testiculars ocurring in boys (5-10 yrs typically benign) & men (30-60 yrs may be malignant).

Leydig Cell Tumors

______ are masses that are not "pure-seminomas" and consist of other cell types such as: -Embryonal Ca's -Teratomas -Yolk Sac Tumors (endodermal sinus tumors) -Choriocarcinoma

Nonseminomas

What is the most common correctable cause of male infertility?

Varicocele

What describes Anorchia?

a congential absence, which is rare and accounts for only 4% of patients who present with cryptorchidism.

The ______, representing a detached efferent duct, is a small stalk projecting off the epididymis.

appendix epididymis

The______, a remnant of the Nullerian Duct, is a small ovoid structure located beneath the head of the epididymis.

appendix testis

The______ is a layer of muscle fibers, lying beneath the scrotal skin & dividing the scrotum into two chambers. The division of the two scrotal chambers is called the ______.

dartos scrotal raphe

Abscesses are usually a complication of ________. Sonographically present with an enlarged testicle containing a predominantly fluid-filled mass with hypoechoic or mixed echogenic areas.

epididymo-orchitis

Leydig cell tumors may also secrete______ resulting in feminizing symptoms.

estrogen

The septula forms wedge-shaped compartments that contain the ________.

seminiferous tubules

Exam(?) The_____is a saccular extension of the peritoneum into the scrotal chambers. The inner or_____ layer of the tunica_______, covers the testis & epididymis. The outer or ______ layer of the _____, lines the scrotal chamber.

tunica vaginalis visceral tunica vaginalis parietal tunica vaginalis

The Tubuli Recti enter the mediastinum testis forming a network of channels called the _________.

rete testis

Tesicular torsion is observed in males younger than_____years of age, with most aged ___-___. The patient typically presents with a sudden onset of several unilateral scrotal pain.

- <30 years of age. - 12-18 years of age.

Exam(?) Risk factors from Seminoma's include:

-***Cryptorchidism (undescended test.) -Family Hx of Testicular Ca -Infertility -Klinefelter Sundrome (XXY) -Down Syndrome -Smoking -Caucasion

Bell Clapper in a _______ anomaly which can be found in ____% of males, allows the testicle to twist, causing testicular torsion.

-Congenital -12%

Exam(?) Seminoma spreads initially to ____________.

-Draining lymph nodes in retroperitoneum. When an intratesticular mass is discovered, the paraaortic region should be evaluated for lymph nodes. Seminoma has better prognosis because lyphatics move slower.

Sonographically, Epididymitis is associated with?

-Enlarged hypoechoic epidiymis -Hypoechoic testicle -Incread blood flow (hyperemia) -Reactive hydrocele -Scrotal wall thickening

Tesicular ____________ leads to venous occlusion and arterial ischemia causing infarction of the testicle. Torsion more often involved the _____ side.

-Torsion -Left

Most extratesticular masses are _____, but the Majority of intratesticular lesions are _______.

-benign -malignant

Spermatoceles are more common than epididymal cysts. Epididymal cysts are composed of ________ whereas spermatoceles are filled with __________ containing________. Both lesions result from prior episodes of epididymitis.

-clear fluid -thick milky fluid -spermatozoa

What are the two types of benign testicular cysts?

-cysts of the tunica albuginea -intratesticular cysts (normally near the mediastinum testis & probably originate from the rete testis.

Typically, the testicle is attached to the ___________, without this attachment, the testicle can rotate freely on the spermatic cord, this anomaly is known as:_______.

-tunica vaginalis -Bell Clapper deformity

_______ are the Most common testicular cancers.

Cerm cell tumors -classified as either Seminoma (approx 50%) or non-seminoma (approx. 50%), based on their histology.

Testicular blood flow is supplied by the :

Differential artery Cremasteric artery (external spermatic) artery Testicular artery

The Epidermoid Cyst is a benign tumor of germ cell origin. These leasions are well-circumscribed solid tumors lying beneath the tunica albuginea. The cyst is filled with cheesy-white keratin. what are the sonographic findings?

Epidermoid cysts are well-defined, solid, hypoechoic masses with an echogenic capsule or onion ring pattern formed by multiple layers of keratin.

Exam(?) Acute______ is THE Most common condition that causes acute scrotal pain.

Epididymitis

What are the two most common causes of scrotal pain?

Epididymitis / orchitis Spermaticord torsion

Exam(?) ________ are benign tumors that usually involve the epididymis. The most common ______ tumor is the adenomatiod tumor. May also be lipomas.

Extratesticular

This results from bowel protruding through the inguinal canal into the tunica caginalis of the scrotum.

Scrotal Hernia -The presence of parastalsis confirms the diagnosis. Small inguinal hernias can be visualized by using the valsalva maneuver.

Serum beta-hCG is assoc. with which testicular tumors?

Seminomas & nonseminomas

Acute Epididymitis is usually caused by?

Sexually transmitted diseases in men under 35 years of age & UTI's in men older than 35 years of age. -Patients present with acute scrotal pain which may be associated with fever & pyuria. -infection may extend into the testicle causing orchitis.

Exam(?) The ________ consists of the: -Vas Deferens Cremasteric, deferential, testicular arteries: -Pampiniform plexus of veins -Lymphatics -Nerves

Spermatic cord

________ are cystic masses of the epididymis that result from dilatation of the epididymal tubules.

Spermatoceles (Epididymal Cysts)

The seminiferous tubules converge to form the _____

Tubuli Recti

Exam(?) The testicular artery divides into _____ &_______ (intratesticular) branches. The ______ arteries course along the septula converging on the mediastinum testis.

capsular centripetal

The ________ carry the seminal fluid from the rete testis to the ______.

efferent ductules epididymis

_______ is associated with what testicular tumors?

nonseminomas

Leydig Cell tumors produce testosterone resulting in?

percocious puberty

Testicular infarction commonly result from what?

torsion or trauma

The testicle is surrounded by a fibrous capsule, the _____. Mulitiple septations arise from the ______ to form the _______ which is sonographically seen as an echogenic linear band extending longitudinally within the testes.

tunica albuginea tunica albuginea mediastinum testes

A ______ is a dilatation of the pampiniform venous plexus of the testicular veins which drain the testicle.

varicocele