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140 Cards in this Set
- Front
- Back
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An abnormal accumulation of serous fluid in the tunica vaginalis is known as a _____.
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hydrocele
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What is a hydrocele usually due to?
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epididymitis
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A hydrocele can be either ____ or ____.
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congenital or idiopathic
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When is a hydrocele often seen?
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in male infants (fluid will reabsorb by 1st year of life)
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Blood in the scrotal sac is called a ____.
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hematocele
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When there is pus in the scortal sac it is known as a ____.
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pyocele
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Hydrocele's are usually found around the _____ aspect of the testis.
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anterolateral
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What is the appearance of a hydrocele?
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may appear anechoic (w/ low level echoes) or complex (thick septations & low level echoes)
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With a hydrocele the ____ & ____ are surrounded by fluid.
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testis and epididymis
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What does a pyocele usually contain?
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internal septations, loculations, and debris
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A ____ is always located in the head of the epididymis.
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spermatocele
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What is a spermatocele?
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cystic dilatation (tumor) of the epididymis containing sperm
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When are spermatoceles more often seen?
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following a vasectomy
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What is the sonographic appearance of a spermatocele?
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superior to teste, smooth walls, posterior acoustic enhancement, may have internal echoes/septations
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Enlarged veins of the spermatic cord are known as _____.
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varicoceles
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What is the other name for a varicocele?
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pampinform plexus varicocele
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What is the most common cause of male infertility?
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varicoceles
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The majority of varicoceles occur on the ____ side. Why is this?
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left- because of venous drainage into the LRV.
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Right sided varicoceles may be associated with a ____ ____.
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renal tumor
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What is the sonographic appearance of a varicocele?
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numerous anechoic tortuous structures that lie posterior and superior to the testis and epi
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With varicoceles the dilated veins are greater than ____ mm.
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4 mm
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What patient positions help with dilating the veins when examing for varicoceles?
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having the patient stand up or doing the valsalva maneuver
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Reversal of flow occurs when intra-abdominal pressure ____ & there is ____ of valves in the veins
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increases, absence/damage
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A cyst containing lymph within the teste is known as a ____.
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lymphocele
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Uncomplicated lymphoceles are ____.
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anechoic
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What is seen within a complicated lymphocele?
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septations & floating debris due to hemorrhage or infection
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Some lymphoceles may require ____ ____.
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percutaneous aspiration
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Small, clear cysts containing serous fluid that can be seen anywhere in the epi are known as _____ _____.
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epididymal cysts
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Sometimes small cysts are seen between the layers of the teste and are known as ____ ____ cysts.
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tunica albuginea cysts
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What are 3 types of benign testicular conditions?
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ectasia of rete testis, testicular cysts, microlithiasis
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What is ectasia?
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a swelling or dilation of a part of the body
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Microlithiasis is an _____ condition.
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uncommon
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Tiny calcifications within the testis is known as _____.
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microlithiasis
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The calcifications with microlithiasis are less than ____ mm.
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3 mm
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What is microlithiasis associated with?
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cryptorchidism, klinefelter's syndrome, infertility, varicoceles, and testicular atrophy
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Multiple small grouped calcifications are highly suggestive of _____.
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malignancy
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Extratesticular calcifications are mostly benign due to underlying ____ ____.
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chronic inflammation
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Calcifications in the testis are known as "____ ____"
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scrotal pearls
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Sudden painful swelling of the scrotal contents is known as:
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acute scrotum
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What are some common causes of acute scrotum?
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epididymitis, torsion of testis, trauma, strangulated inguinal hernia, torsion of appendix teste/epi
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An infection of the epididymis and testes is known as ____ ____.
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epididymo-orchitis
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What is a common cause of epididymo-orchitis?
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spread of lower UTI via the spermatic cord
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Less common causes of epididym-orchitis include:
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mumps, syphilus, TB, trauma
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The ____ is the organ primarily involved with infection with ____% of cases spread to the teste.
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epididymis, 20-40%
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What is acute epididymitis?
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inflammation of the epididymis
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The most common cause of acute scrotal pain is:
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acute epididymis
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Acute epididymitis is usually caused by a ____.
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UTI
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What are the clinical findings of acute epididymitis?
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pain increasing over a 1-2 day period, fever, infertility, dysuria, urethral discharge
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Specific epididymitis stems from what 4 things?
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gonorrhea, syphilis, mumps, and TB
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Non-specific epididymitis usually occurs from a ____.
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UTI
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What is the US appearance of epididymitis?
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enlarged epi, scrotal skin thickening ( 2-8 mm), decreased echogenicity, heterogeneous pattern, increased flow
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Orchitis is inflammation of the ____.
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testis
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What 4 things can cause orchitis?
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trauma, mets, mumps, infection
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What is the most common cause of orchitis?
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chlamydia
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Orchitis is almost always secondary to ____.
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epididymitis
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What is the sonographic appearance of orchitis?
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enlarged teste, less echogenic, increased color flow
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In patients with dilated veins (variococeles), measure the veins w/ and w/o the _____ maneuver.
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valsalva
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A decrease in sperm count may occur in patients with ____.
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infertility
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Testicular torsions cause ____.
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edema
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If the testicular torsion lasts longer than 12 hours, ____ ____ of the testicle will result.
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complete infarction
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What are the indications for a testicular torsion?
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acute scrotal pain w/ nausea and vomiting
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With a torsion the teste is free to move around on its ____ ____.
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vascular pedicle
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What are the two peaks of incidence that occur?
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first- 1 yr of age
second- puberty |
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What are the different stages of torsion?
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acute: 1-24 hrs
subacute: 1-10 days chronic: > 10 days |
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What is the sonographic appearance of a testicular torsion?
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variably & non-specific, scrotal wall thickening (variable), possible hyrdocele, decreased/no arterial flow
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With acute torsion the ____ & ____ are enlarged with decreased _____.
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testicle & epididymal head, echogenicity
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If a partial torsion is present blood flow will be _____ & there may be increased flow in the ____ ____ ____.
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decreased, peritesticular soft tissue
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Complete torsions do not have any ____ ____.
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blood flow
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A small heterogeneous testicle due to areas of infarct & necrosis is known as ____ ____.
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chronic torsion
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Observation of the _____ side of the testes must be observed and documented.
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contralateral
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When there is trauma to the testis, the primary goal of US is to see if ____ has occured.
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rupture
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If there is a rupture, surgery within 72 hours can save up to ____% of testes.
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90%
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After 72 hours of rupture, surgery can save up to ____% of testes.
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45%
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What are 2 complications associated with trauma?
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hyrdocele & hematocele
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A focal alteration of the testicular parenchymal pattern is known as a ____ ____.
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scrotal rupture
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Scrotal ruptures involve interruption of the ____ ____.
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tunica albuginea
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What type of testicular hematoma is more common?
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intratesticular
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Hematoma's are associated with ____.
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trauma
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Herniation of abdominal contents into the scrotal sac is known as a ____ ____.
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inguinal hernia
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What is the sonographic appearance of an inguinal hernia?
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mass with peristalsis, echogenic foci w/ dirty shadow due to bowel
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What are the 3 less common causes of acute scrotum?
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acute hydrocele, hematocele, hemorrhage or infarction in a testicular neoplasm
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With chronic epididymitis there is a thickened ____ and it is very ____.
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epididymis, echogenic
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What are the 2 types of malpositions of the testes?
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cryptorchidism & ectopic teste
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Cryptorchidism is also known as _____ _____.
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undescended testes
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Cryptorchidism is more common in ____ ____.
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premature babies
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Where are the testes usually located when they are undescended?
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abdomen, inguinal canal or other
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Approx. ____% of undescended testes are palpable & located in the region of the ____ ____.
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80%, inguinal canal
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Bilateral undescended testes are found in approx. ____% of all cases.
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20%
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Cryptorchidism can prohibit ____ % result in ____.
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spermatogenesis, infertility
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When someone has cryptorchidism you are more likely to develop ____ ____.
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testicular cancer
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The surgical treatment of an undescended testicle is known as _____.
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orchiopexy
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What is the sonographic appearance of cryptorchidism?
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small & less echogenic, and oval w/ homogeneous texture
(the mediastinum is rarely ever seen) (testicles in the abdomen are hard to see) |
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A very rare condition of the testicles is ____ ____.
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testicular ectopia
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T or F. Testicular ectopia cannot be manipulated into the correct path of descent.
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TRUE
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What is the most common site for ectopic testes?
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superficial inguinal pouch
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What is an absent teste called?
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anorchia
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When there is unilateral absent testicles it is known as _____.
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monoorchidism
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Monoorchidism is found in ____% of patients with non-palpable testes & is more common on the ____ side.
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4%, left
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Bilateral absent testicles is found in ____% of patients with non-palpable testes.
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0.6 - 1%
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Testicular duplication is known as _____.
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polyorchidism
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Polyorchidism is very ____ with ____ cases reported.
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rare, 80
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Polyorchidism is more common on the ____ side and is found to be bilateral is ____% of cases.
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left, 5%
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Polyorchidism is usually found in the scrotum but has also been found in the ____ ____ or _____.
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inguinal canal or retroperitoneum
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A testicular abscess is more commonly caused by untreated ____ or ____.
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epididymitis or orchitis
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What are the symptoms of abscess?
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pain, fever, and swelling
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What is the appearance of a testicular abscess on US?
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sonolucent/complex mass w/ increased blood flow are periphery & no flow in the mass
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What are the 2 types of testicular tumors?
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non-germ cell tumors (generally benign) & germ cell tumors (generally malignant)
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A germ cell is the cell that leads to the production of ____.
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gametes
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The most common extratesticular tumor is the _____ tumor.
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adenomatoid
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What are 4 types of non-germ cell tumors?
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leydig cell tumors, sertoli tumor, cystadenoma, dermoid cyst
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Testicular cancer is known to be ____ and makes ____% of cancer in men.
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uncommon, 1%
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If someone does have testicular cancer though, it is known to be the most common _____ in men ages 15-35
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malignancy
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Testicular cancer occurs most frequently in men between ages _____.
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20 - 34
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T or F. Testicular cancer is one of the most curable forms of cancer.
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TRUE
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Undescended testes are ____ times more likely to develop cancer.
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2.5 - 8
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Usually testicular cancer has no symptoms but when it does it involves:
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painless unilateral lump or enlargement & minor scrotal discomfort
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Extratesticular masses are usually ____.
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benign
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What type of masses are more likely to be malignant?
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intratesticular
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Germ cell tumors are highly ____ & comprise ____% of all testicular tumors.
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malignant, 95%
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What are germ cell tumors associated with?
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elevated HCG & AFP
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What is the most common type of germ cell tumor?
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seminoma
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What are 4 types of germ cell tumors?
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seminoma, embryonal carcinoma, teratoma, choriocarcinoma
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The least aggressive malignant tumor in men age 30-40 is a ____.
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seminoma
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Seminoma's are usually found in the ____ ____ and account for ____% of all testicular cancers.
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tunica albuginea, 30-40%
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When a patient has a seminoma, they have elevated _____ _____ hormone levels.
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follicle stimulating
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What is the sonographic appearance of a seminoma?
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solid, homogeneous, hypoechoic, masses w/ smooth borders
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Embryonal carcinoma (cell tumor) is more ____ & produces ill-defined _____ & _____ lesions.
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invasive, heterogeneous & hypoechoic
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Another name for teratoma is "____ ____".
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monstrous tumor
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Definitive diagnosis of a teratoma is based on its ____.
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histology
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Teratomas are usually benign and have tissue components resembling all 3 ____ ____.
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embryonic (germ) layers
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What is the appearance of a teratoma on US?
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well-defined complex masses w/ possible areas of hemorrhage, necrosis, or calcifications
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The type of germ cell cancer containing trophoblast cells is known as ______.
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choriocarcinoma
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Choriocarcinoma's appear as a ____ ____ w/ ____ borders.
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complex lesion, heterogeneous
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With stomal tumors ____% are malignant.
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10%
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What is considered rare that occurs later in life w/ multiple bilateral lesions?
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metastases
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Lymphoma makes up ____% of all testicular tumors.
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1 - 7%
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What is the most common bilateral secondary testicular tumor affecting men over the age of 60?
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lymphoma
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What is the imaging modality of choice for infertility?
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ultrasound
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____ is known as the gold standard for visualizing the male reproducrtive tract but is invasive.
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vasography
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What are 5 scrotal US findings in infertile men?
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absence, atrophy, cryptorchidism, ectopic location, obstruction
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