Term
| What is the lymphatic drainage of the scrotum? |
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Definition
| Superficial inguinal nodes |
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Term
| What is the arterial supply of the scroutm? |
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Definition
| Perineal and pudendal arteries |
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Term
| What is the dartos muscle? |
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Definition
| Muscle associated with skin – responsible for wrinkling scrotum when cold (thickens skin & reduces surface area) |
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Term
| What is the cremaster muscle and fascia? |
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Definition
| Continuous with fascia of internal oblique muscle in abdomen – draws testicles in in cold/during exercise to maintain temperature/prevent damage |
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Term
| Where is the internal spermatic fascia? |
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Definition
| Associated closely with spermatic chord/testicle |
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Term
| What is the tunic vaginalis? |
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Definition
| Double layered serous membrane covering testicle anteriorly, laterally, superiorly & inferiorly (epididymis, & vascular access posteriorly) – derived from peritoneum embryologically |
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Term
| What is the lymphatic drainage of the testicles? |
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Definition
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Term
| What is the arterial supply of the testicles? |
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Definition
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Term
| What is the venous drainage of the testicles? |
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Definition
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Term
| What is the role of the tunica albuguinea? |
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Definition
| Connective tissue, white in colour, covers testicle. |
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Term
| What is the role of the seminiferous tubules? |
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Definition
| Make sperm and testosterone |
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Term
| What cell types are associated with the seminiferous tubules? |
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Definition
Germ cells- develop into sperm
Sertollis cells- epithelial cells encouraging sperm development by secretions (FSH)
Leydig cells- Between tuubles, secrete testosterone. |
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Term
| What is the role of the straight tubules? |
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Definition
| link seminiferous tubules and rete testis. |
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Term
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Definition
| Tubular network where fluid is reabsorbed , sperm is stored and sperm is matured. |
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Term
| What is the role of the epididymis? |
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Definition
| Where sperm is stored and matured |
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Term
| What is the epididymis made up of? |
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Definition
Head - Coiled ends of 12-14 ductules (efferent tubules) joining epididymis from rete testis
Body - Convoluted duct of epididymis
Tail - Continuous with ductus deferens |
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Term
| What is the Vas deferens? |
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Definition
| Muscular tubes carrying sperm from epididymis, through spermatic cord, inguinal canal and behind the bladder then dilates into the ampullae of duct. |
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Term
| What is the ampullae of duct? |
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Definition
| Ducti deferens dilate before it is joined by seminal vesicle outflow tract |
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Term
| What is the role of the seminal vesicles? |
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Definition
| Secrete a think alkaline fluid (neutralise acidic vagina)containing nutrients etc into ejaculatory duct. |
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Term
| What is the role of the ejaculatory ducts? |
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Definition
| Union of ductus deferens and seminal outflow tracts. Passes through prostate to open into urethra. |
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Term
| What is the role of the prostate gland? |
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Definition
| Secretes further alkaline fluid into urethra at the junction of the ejaculatory ducts. |
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Term
| What are the four parts of the urethra? |
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Definition
Pre-prostatic
Prostatic
Intermediate (membranous) urethra- into which bulbourethral glands secrete lubricating fluid.
Spongy (penile) urethra |
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Term
| What structures run along the dorsal surface? |
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Definition
| Dorsal arteries, nerves, superficial and deep veins. |
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Term
| What does the corpus spongiosum expand to form? |
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Definition
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Term
| Whats the incidence of testicular cancer? |
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Definition
| Peak incidence ~30 YO, most common cancer in young men but overall 1% of all cancers. |
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Term
| What are the risk factors for testicular cancer? |
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Definition
| Cryptorchidism, family history, caucasians, infertility, past infection (mumps), intersex state |
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Term
| What are the types of testicular cancer? |
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Definition
Germ cell Tumours (95%)- non seminomas (50% including teratomas) seminomas (45%)
Non germ cell tumours (5%) May arise from connective tissue or as secondaries. |
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Term
| What are the symptoms of testicular cancer? |
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Definition
Lump (97%) – usually asymptomatic
Often less tender than normal testis
Pain (31%)
Heaviness/Dragging (30%)
Metastases & associated symptoms
Lymph drains to deep retroperitoneal nodes th. rarely palpable unless huge
Gynaecomastia (5%) – development of female breast tissue |
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Term
| What investigations would you carry out to diagnose testicular cancer? |
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Definition
| USS, Tmour markers, MRI/CT abdo(staging) |
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Term
| What tumour markers would be present in testicular cancer? |
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Definition
| αFP (α-Feta-Protein),βhCG (β-human Chorionic Gonadotrophin and LDH (Lactate DeHydrogenase) |
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Term
| What are the management options for testicular cancer? |
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Definition
Surgery – Inguinal Orchidectomy, Removes testis & spermatic cord, Offer contralateral testis removal if – atrophied, cryptorchid or <30 y.o.
Radiotherapy- Early stage seminoma
Chemotherapy-Non Seminomas & late stage seminomas
Surveillance |
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Term
| What is the prognosis for testicular cancer? |
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Definition
| Very good, low mortality even with metastases. Very responsive to radio/chemotherapy. |
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