Scrotal Sonography Study Guide PDF

What is the average size of testicles? (length, width and height) [3-5cm Length, 2-4cm wide, and 3cm height] [The mediastinum testes] is seen as a hyperechoic line within the testis. It supports vessels and ducts coursing within the testis. The Epididymis is composed of a [head, body] and [tail] t...

What is the average size of testicles? (length, width and height) [3-5cm Length, 2-4cm wide, and 3cm height] [The mediastinum testes] is seen as a hyperechoic line within the testis. It supports vessels and ducts coursing within the testis. The Epididymis is composed of a [head, body] and [tail] that lie along the postero-lateral surface of the testis. What carries sperm from the epididymis up into the pelvic cavity to the seminal vesicles? [Vas deferns (ductus deferens)] The [testicular] artery, which Is the main blood supply to the testicles branches off the aorta inferior to the renal arteries. What venous network drains the testes and joins to form the testicular veins? [The pampiniform plexus of veins] The Vas Deferens, Testicular arteries, Pampiniform Plexus of veins, Lymphatic's, and Nerves are all structures contained in the [spermatic cord] In patient preparation for a scrotal sonogram, the patient should be instructed to remove all clothing from the [waist down.] The [testicular artery] and [testicular vein] should have pulsed Doppler applied to them as part of the scrotal ultrasound protocol. The tunica vaginalis and tunica albuginea are not usually seen unless the patient has a [Hydrocele]. (fluid collection between the layers of the tunica vaginalis. [Crytorchidism] refers to a testicle that fails to descend into the scrotum from the pelvis, through the inguinal canal. 80% of patients with cryptorchidism are found in the [inguinal canal]. [Orichioplexy] is the surgical correction of cryptorchidism. If surgery is not performed to correct an undescended testicle at an early age, what 3 things are the testis at a greater risk for? [Infertility (due to warm environment of the abdomen), developing testicular cancer, testicular torsion]\_ 16. [Polyorchidism] refers to having more than two testicles. 17. What is Bilateral Anorchia ? [absence of both testis.] 18. [Epididymitis] is the inflammation of the epididymis. 19. Epididymitis­­­­­­­ is the most common cause of [scrotal pain and tenderness.] 20. Describe the sonographic appearance of epididymitis: (3 characteristics): [Enlargement of the epididymis ( especially the head), Hypoechoic and hypervascular (hyperemia)] 21. Focal orchitis cannot be sonographically distinguished from a [tumor] 22. Elevated [white blood cell count (leukocytosis)] and a fever can be good clinical clues that the patient may have orchitis. 23. A collection of blood within the scrotal sac is called a [Hematocele or a Hematoma.] The appearance varies with the [age] of injury. The condition can occur due [trauma, surgery, torsion, or tumor] 24. Fracture of the testicle or testicular [rupture] due to trauma is a surgical emergency. 25. Surgery within hours of injury causing rupture can save 90% of the affected testicles. 26. [Testicular torsion] results when the testis and the epididymis twist within the scrotum, cutting off the vascular supply within the spermatic cord. 27. [Bell Clapper Defomity] is the most common cause of testicular torsion. 28. With torsion there will be lack of flow in the [testicle] but normal flow in the epididymis. 29. Increased [extratesticular] flow is indicated with chronic torsion. 30. [Hydrocele] is a collection of fluid between the layers of the tunica vaginalis. 31. Hydrocele is the most common cause of [painless scrotal swelling]. 32. It is normal to have [1 to 2] ml of serous fluid in the scrotal sac. 33. Pyocele refers to [pus] in the scrotal sac, which is caused by abscess rupture between the layers of the tunica vaginalis. 34. Varicocele is an abnormal dilation of the [pampiniform plexus of veins], and is most common on the [left] side. 35. Describe the sonographic appearance of a varicocele: [Tortuous tubular anechoic structures outside the testicle in the scrotal sac.] 36. A scrotal hernia results in [bowel] herniating through the inguinal canal into the [scrotum]. 37. How is a scrotal hernia usually diagnosed? (3 possible symptoms) 38. Less than [5%]% of all solid scrotal masses are benign. 39. Dermoid cysts also known as Teratoma contain [Fat, Teeth and Hair].(and possibly bone) 40. [Microlithiasis] are multiple tiny calcifications scattered though the testis that are associated with tumor, sterility and cryptorchidism. 41. The majority of intratesticular lesions are [malignant]. 42. Testicular cancer is typically a young man's disease, with a peak incidence at age's [15 to 35.] 43. [Seminoma] is the most common germ cell tumor and has the [best] prognosis of testicular malignancies. 44. [Embryonal cell carcinoma] is associated with increased Beta-HCG and is more aggressive than seminoma. It accounts for 25% of all testicular tumors. 45. The Yolk sac/endodermal sinus tumor is the most common germ cell tumor found in [infants]. 46. The Yolk sac tumor is associated with increased [Alphafetoprotein (AFP).] 47. Teratoma's in children are usually [benign] while teratoma's in adults are usually [malignant]. 48. [Lymphoma] affects men between the ages of 60-80 years old and is the most common [bilateral] testicular tumor. 49. [95%] of all testicular tumors are germ cell tumors and are malignant. 50. Only [tissue samples] can make the diagnosis of a tumor being malignant vs. benign. 51. Most physicians will perform an [orhiectomy] when a solid mass is found within the testis. 52. If metastasis to the testicles occurs the primary is usually [prostate or renal]\_. 53. What are 2 symptoms associated with malignant testicular masses? [Acute scrotal pain (10-50%) or a painless palpable scrotal mass] 54. List the pathway of the sperm from the scrotum (6 total structures): [Semineferous tubules, tubuli recti, rete testis, efferent ductules, ductus epididymis, vas deferens]