scrotum

what are three major structures contained in scrotum?

spermatic cord, epididymis, testes

what are three parts of epididymis?

head, body, tail

the scrotum is a ___ sac

fibromuscular

the skin of the scrotum is more ____ pigmented than the rest of the body

heavily

smooth muscle and superficial fascia that wrinkles the scrotal skin

dartos fascia and muscle

fascial layer derived from external oblique muscle

external spermatic fascia

suspender muscle consisting of bands of sk muscle

derived from fascia of internal oblique muscle

cremasteric fascia

derived from peritoneum. double layer composed of parietal and visceral layer

tunica vaginalis

outer layer of tunica vaginalis that lines walls of scrota sac

parietal

inner layer of tunica vaginalis that covers testis, epididymis, lower portion of spermatic cord

visceral

what are the three accessory sex glands?

seminal vesicles, prostate, bulbourethral glands

dense fibrous capsule covering testis. extends inwards

the ___ produce sperm by spermatogenesis

seminiferous tubules

seminiferous tubules converge to form ___.

rete testis

the rete testis are located in the _____ (middle)

testicular mediastinum

remnant tissue after paramesonephric duct degenerates. small portion at cranial end

appendix testis

muscular cord designed to pump sperm into prostatic segment of urethra

ductus vas deferens

___ connect vas deferens to form ejaculatory duct

seminal vesicle

supporting tube of testes. contains blood vessels, nerves, lymph nodes, cremaster muscle.

spermatic cord

comma shaped structure that curves along posterior border of testis

epididymis

how many parts does the epididymis have

5

what are the five parts of the epididymis simple terms?

head, body, tail, appendix, efferent ductules

what are five parts of epididymis scientific names?

globulus major, corpus, globulus minor, appendix epidydimis, efferent ductules

most focus is on the ___ when imaging the epidydimis

head

normal size diameter epi head

10-12 mm

normal size diameter epi body

less than 4 mm

normal size diameter epi tail

less than 4 mm

normal testes length

4-5 cm

normal testes width

normal testes AP

left testicular vein drains into

LRV

arterial blood supply to testes

aorta, testicular artery, retroperitoneum to spermatic cord, capsular arteries, centripetal arteries

testes have __ resistance to arterial flow

low

arterial supply to scrotum and epi

inf epigastric,

unique nuclear division that occurs in gonads

meiosis

final trigger for spermatogenesis

testosterone

once testosterone hits bloodstream, it inhibits ___ release

hypothalmic

the amount of testosterone and sperm produced by testes reflect a balance among three sets of hormones:

gonadotropins, GnRH, testicular hormones

supporting structure for testes that regulates temperature and sperm can mature

scrotum

site for sperm maturation and site for storage

epi

testes function as an ____ and _ gland

endocrine, exocrine

HCG

human chorionic gonadotropin

produced by tumor which can raise its levels in blood

HCG

HCG elevated in

seminoma, embryonic cell tumors

main androgen secreted by leydig cells

testosterone

testosterone elevated in

testicular tumor, adrenal hyperplasia, dfssffs

orchiectomy

removal of testis

testosterone decreased in

orchiectomy, testicular/prostate cancer, fasiljf

normal US appearance of testes

homogenous, medium-level echoes, smooth walls

small ovoid structure beneath head of epi

appendix epi

wall/scrotal layers of scrotum typically how thick?

2-8mm

epi will have ___ flow around it

peripheral

cryptorchidism

undescended testis

normally, testis descend in scrotal sac at

8 months

ectopic locations of cryptorchidism in child and adult

inguinal canal

acute painful scrotum etiology

common in children and adults

commonly caused by epididymitis or orchitis

torsion cannot be ruled out

twisting of spermatic cord that results in loss of blood supply to testis and blocks venous drainage.

testicular torsion

bell clapper deformity

ischemia

tissue death

signs and symptoms acute testicular torsion

sudden onset extreme test pain.

50% nausea and vomiting

low grade fever

acute torsion on US after ischemia

enlarged, decreased echogenicity, inhomogenous

acute torsion on doppler

no blood flow

chronic torsion etiology

complete cessation of blood flow

classified after 10 days

severe pain but didn’t come in until too late

chronic torsion on US

heterogenous appearance of testes

peripheral rim around tissue

testicle atrophies and gets smaller

torsion-detorsion signs and symptoms

acute and intermittent sharp test pain and scrotal swelling

long asymptomatic intervals

torsion-detorsion on US

torsion of appendages etiology

loss of blood supply to appendix testis

7-14 years old

torsion of appendages on US

testes normal on color doppler

jlkjsd

testicular rupture etiology

rare, occurs when capsule (tunica albuginea) torn by trauma

athletic injuries, industrial, car accidents

testicular rupture on US

contour abnormality due to irregular fibrous tunica albuginea

extrusion of testicular contents

dskjf

epidydimitis etiology

most common cause of acute scrotal illness/pain

retrograde spread of bacterial infection from bladder of prostate

associated with prostatitis

sexual transmission common cause

epididymitis signs and symptoms

slight fever

chills

saf

acute epidydimitis on US

enlarged, hypoechoic epi

mainly involves head

chronic epidydimitis on US

orchitis etiology

orchitis signs and symptoms

chronic orchitis on US

thickened tunica albuginea

acute orchitis on US

epididymoorchitis

benign scrotal masses

hydrocele

dsjkf

most common cause of painless scrotal swelling

hydrocele

hydrocele etiology

hydrocele on US

anechoic fluid collection, enhanced through transmission,

scrotal pearls etiology

scrotal pearls on US

echogenic free-floating calcifications

posterior shadowing

spermatocele etiology

spermatocele signs and symptoms

usually asymptomatic

\

spermatocele on US

spermatocele diff diagnosis

loculated hyrocele, hernia,

epidydimal cyst etiology

epidydimal cyst signs and symptoms

tubular ectasia etiology

tubular ectasia of epi normally seen in

post-vasectomy patients

appears as cluster of hypoechoic, small cystic spaces in epidydimal area

tubular ectasia

varicocele etiology

varicoceles are typically larger on the ___ side

left

varicoceles are typically larger on the left side because left testicular vein is ___ and enters _ at right angle

longer, LRV

secondary varicocele etiology

varicocele on US