Small parts - ch 23 - scrotum, penis, prostate

what is most common cause of torsion

bell clapper deformity

what is bell clapper deformity

tunica vaginalis surrounds testical organs which allows them to move freely within scrotum

undescended testis are ____ times more likely to have torsion

10

what are 3 phases of torsion

acute 24 hours, subacute 1-10 days, chronic >10 days

what is peak age of torsion

14 YO

what is most common extratesticular mass

epididymal cyst

what is most common cause of infertility in men

varicocele

what is a vericocele

dilation of veins of pampiniform plexus (within spermatic cord)

where do vericoceles occur more commonly

left due to venous drainage into left renal vein

what is most common fluid collection in scrotum

hydrocele, common in newborns

what is symptom of hydrocele

scrotum enlargement/mass

what is sperm granuloma

a chronic inflammatory reaction from spermatozoa or extravasation - most common w/vasectomy

what does extravasation and spermatozoa mean

leakage of sperm cord

are intratesticular or extratesticula masses more likely malignant

intratesticular

what is most common extratesticular tumor

adenomatoid tumor - 20-50 YO

what side are extratesticular tumors usually on

left

sono of scrotal hernia

echogenic and anechoic areas respresenting air, and fluid filled bowel loops (which can be traced to inguinal canal)

what is most common malignancy in men 15-35 YO

testicular cancer

undescended testes are also called

cryptoorchid

what pathology looks like onion skin or whorled appearance

epidermoid cyst

what is most common testicular cancer

seminoma

sono of seminoma

hypoechoic, smooth well defined borders

what is most aggresive and 2nd most common testicular cancer

embryonal cell carcinoma

what is primary sites of metastases

prostate and kidney

sono of embryonal cell carcinoma

irregular, hetero/hypo, calcs, irregular borders

what malignancy is most common in men 15-25YO

malignant neoplasms

what testicular malignancy is more common in older men

lymphoma and leukemia

the epididymis, vas deferens, and seminal vesccles are formed from _____

Wolfian duct

what does the spermatic cord do

suspends testis in scrotum - bilateral

what is tunica albuginea

fibrous tissue surrounding testes - forms mediastinum testes

what is tunica vaginalis

lines inner wall of scrotum, covers each testi and epididymis

where do hydroceles occur

between parietal and visceral layers of tunica vaginalis

where does spermatic cord attach

posterior border of testis

what joins to form ejaculatory duct

spermatic cord and seminal vesicle duct

what is the vas deferens/seminal duct

muscular cord to pump sperm from epididymus to prostate portion of urethra

where is the vas deferens/semianl duct

ascends along posterior border of testis

what are seminal vesicle fluids rich in

fructose

sono of epididymis

homogenous, slow or no flow

what sono of testicles

homogenous, similar to liver and thyroid, medium echos

what is purpose of testis

production of sperm, secrete hormones (testosterone)

where are testis

in scrotum

size of testis

3-4 × 3 × 2-3 (w) cm - 4 × 3 × 3

what is function of mediastinum testis

supporting system for vasculature and lymph

sono of mediastinum testis

echogenic line within testis (hilum)

what is rete teste

the anastomosis of tubules/lobules at mediastinum teste

what is the appendix testis called

Hydatid of Morgagni

what is the appendix testis a remnant of

mullerian duct

where is appendix testis

superior aspect of testi, beneath epididymal head

what is cryptorchidism

undescended testicle

what is arterial vasculature of scrotum

testicular arteries descend to spermatic cord, then posterior testis into tunical albuginea.

what is venous vasculature of scrotum

occurs through pampiniform plexus, ascends as testicular veins through inguinal canal. Right drains into IVC, left into LRV

what mainly supplies the vas deferense and epididymis

deferential artery (arises from vesicle artery, from internal iliac)

what artery supplies scrotal wall

branches of pudendal artery

what is orchiectomy

removal of testi(s)

testi measurements taken in where

2 in trans-w & a/p, 1 in long-L

what is median raphe

fibrous band of tissue that divides scrotal sac into 2 pouches

how many hours before surgery may a testi be saved

72 hours

what is most common reason for pain and inflammatory process of scrotum

epididmitis

what usually causes epidimitis

bacterial infection

what kind of blood flow can be expected post vasectomy

little/no flow

how might a spermatocele displace testicle

anteriorly

what is noral/abnormal scrotal wall thickness

normal is 2-8 mm, > 10 mm abnormal

what size is epididymal head

5-12 mm

sono of epididymal head

equal or slighly more echos than testis, slightly more coarse

infection of the testes

orchitis

20-30 year olds

testicular tumors , germ cell tumors are 95%

blood flow of penis

internal iliac, pudendal, dorsal, carvernous bulbourehtral arteries; deep and superficial dorsal vein, pudendal plexus & vein

what is peyronie’s disease

calcified or fibrous tissue on dorsal penis that causes a bend

what velocities should cavernosal artery in penis have

>30 cm/sec; <25 cm/sec after injection is poor

where is prostate located

posterior, inferior to bladder

size of prostate

3-4 (L) × 2-3 cm (H & W)

what lab valus is increased with enlarged prostate

PSA prostate specific antigen

what are lobes of prostate

anterior (fibromuscular), middle, posterior, lateral (2)

what are the prostate regions

central (CZ), peripheral (PZ) (mostly glandular tissue), transitional (TZ), anterior fibromuscular stroma (fibrous and muscular tissue, no glandular tissue)

what is purpose of prostate

releases alkaline fluid into prostatic urethra to aid in sperm motility

what’s best way to check prostate function

calculate prostate specific antigen density

what age is common for BPH - benign prostate hypertrophy

>70 YO

what is TURP

treatment for BPH - trasnurethral resection of prostate

where does prostatitis usually occur

peripheral zone