Superficial Structures: Chapter 23 - Scrotum

pudendal artery

the internal and external _____ arteries partially supply the scrotal wall and epididymis and occasionally the lower pole of the testis

visceral and parietal tunica vaginalis

Hydrocele fluid is located between which two layers?

inguinal canal

If the physician's request is for evaluation of cryptorchidism, the sonographer should pay particular attention to which area?

between the two layers of the tunica vaginalis

The most common location of a hydrocele is:

hypoechoic

What is the most common sonographic appearance of a seminoma?

hyperechoic

What is the sonographic appearance of the testicular mediastinum?

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

You have been asked to perform a study to rule out crytorchidism. The term cryptorchidism denotes:

epididymal cyst

cyst filled with clear, serous fluid located in the epididymis

testicle

male gonad that produces hormones that induce masculine features and spermatozoa

pampiniform plexus

plexus of veins in the spermatic cord that drain into the right and left testicular veins; when a varicocele is present, dilation and tortuosity may develop

vas deferens

tube that connects the epididymis to the seminal vesicle

torsion

A patient presents with acute scrotal pain and unilateral enlargement. A sonographic examination is performed and the testicular parenchyma is hyperechoic with decreased vascular flow. This is consistent with which of the following?

low resistive with broad systolic peaks

Normal testicular artery flow is considered:

retroperitoneal mass (What IS associated with primary varicoceles would be left sided location, infertility, and palpable extratesticular mass)

Primary varicoceles are associated with all of the following except:

left sided location (what IS associated with secondary varicoceles is right sided location, hepatomegaly, and renal mass)

Secondary varicoceles are associated with all of the following except:

seminiferous tubules

Spermatogenesis occurs within the:

torsion of the testicular appendage

The blue dot sign is indicative of:

testosterone

The endocrine function of the testicles is to produce:

sperm

The exocrine function of the testicles is to produce:

bell clapper deformity

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

seminoma

The most common germ cell tumor of the testis is the:

the left side of the scrotum

The most common location of a varicocele is:

varicocele

What is the most common correctable cause of male infertility?

seminoma

What is the most common malignancy of the testicle?

varicocele

What is the term for enlargement of the veins in the spermatic cord?

varicocele

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

7.5 MHz to 10 MHz linear

What type of transducer is best for a scrotal sonographic examination?

all of the above: - power Doppler - a higher frequency transducer - adjusting filters to lowest settings

When evaluating color flow in the testicles, which of the following will help demonstrate perfusion?

teratoma

Which intratesticular tumor is more prevalent in the pediatric age group?

WBC

Which lab value can help determine an inflammatory process in the scrotum?

c. a simple-appearing cyst, found within the head of epididymis, that may contain debris

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

all of the above: - palpable mass - swelling - infertility

Which of the following is an indication for a scrotal sonographic examination?

cremasteric muscle

an extension of the internal oblique muscle that descends to the testis with the spermatic cord; contraction of this muscle shortens the spermatic cord and elevates the testis

epididymis

anatomic structure formed by the network of ducts leaving the mediastinum testis that combine into a single, convoluted epididymal tubule; located on the posterolateral aspect of the testis; consists of the head, the body, and the tail; spermatozoa mature and accumulate within

deferential artery

arises from the vesicle artery (a branch of the internal iliac artery) and supplies the vas deferens and epididymis

testicular artery

artery arising from the aorta just distal to each renal artery; it divides into two major branches, supplying the testis medially and laterally

mediastinum testis

central linear structure formed by the convergence of multiple thin septations within the testicle; the septations are invaginations of the tunica albuginea

ejaculatory ducts

connect the seminal vesicle and the vas deferens to the urethra at the verumontanum

spermatocele

cyst in the vas deferens containing sperm

varicocele

dilated veins in the pampiniform plexus caused by obstruction of the venous return from the testicle

hydrocele

fluid formed between the visceral and parietal layers of the tunica vaginalis

tunica albuginea

inner fibrous membrane surrounding the testicle

verumontanum

junction of the ejaculatory ducts with the urethra

tunica vaginalis

membrane consisting of a visceral layer (adherent to the testis) and a parietal layer (adherent to the scrotum) lining the inner wall of the scrotum; a potential space between these layers is where hydroceles may develop

septa testis

multiple septa formed from the tunica albuginea that course toward the mediastinum testis and separate the testicle into lobules

rete testis

network of channels formed by the convergence of the straight seminiferous tubules in the mediastinum testis; these channels drain into the head of the epididymis

pyocele

pus located between the visceral and parietal layers of the tunica vaginalis

seminal vesicles

reservoirs for sperm located posterior to the bladder

scrotum

sac containing the testes and epididymis

cremasteric artery

small artery arising from the inferior epigastric artery (a branch of the external iliac artery), which supplies the peritesticular tissue, including the cremasteric muscle

urethra

small membranous canal that extends from the bladder to the end of the penis

spermatic cord

structure made up of vas deferens, testicular artery, cremasteric artery, and pampiniform plexus that suspends the testis in the scrotum

recurrent rami

terminal ends of the centripetal (intratesticular) arteries that curve backward toward the capsule

testicular vein

the pampiniform plexus forms each testicular vein; the right testicular vein drains directly into the inferior vena cava, whereas the left testicular vein drains into the left renal vein

varicocele

A 23-year-old man presents to the ultrasound department with a history of infertility. Which of the following is associated with male infertility?

seminoma

A 30-year-old male presents with unilateral testicular enlargement and no pain. This is characteristic of which of the following?

torsion of the testicular appendage

A 7-year-old boy presents to the emergency department with acute testicular pain localized to the superior pole of his right testis. What is the most likely diagnosis?

spermatocele

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

varicocele

A dilated group of veins found within the scrotum is defined as a:

epididymitis

A hydrocele is secondary to:

>2 mm

Dilated veins of a varicocele will measure:

benign prostatic hypertrophy

Enlargement of the prostate in older men is most often caused by:

transitional zone

The most common location of benign prostatic hypertrophy is the:

peripheral zone

The most common location of pancreatic cancer is the:

head, body, and tail

What does the epididymis consist of?

prostate cancer

What is the most common *cancer* found in men?

cryptorchidism

also called undescended testes; testicles remain within the abdomen or groin and fail to descend into the scrotal sac

hematocele

blood located between the visceral and parietal layers of the tunica vaginalis

epididymitis

inflammation of the epididymis

no intratesticular flow (What ARE sono findings of torsion of testicular appendage would be small hyperechoic mass adjacent to testis, reactive hydrocele, and scrotal wall thickening)

All of the following are sonographic findings consistent with torsion of the testicular appendage except:

testicular torsion

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

hyperemic flow within the testis (What is consistent with testicular torsion is hypoechoic testis, reactive hydrocele, decreased intratesticular flow)

All of the following are sonographic findings consistent with the diagnosis of testicular torsion except:

centripetal artery

terminal intratesticular artery arising from the capsular arteries

hydrocele

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

valsalva maneuver

Which of the following techniques is useful at providing sonographic evidence of a varicocele?

choriocarcinoma

Which of the following tumors corresponds to an elevated HCG in males?