Scrotum and Prostate Review

A hydrocele is defined as an abnormal fluid collection between the:

two layers of the tunica vaginalis

Bell clapper" is another term used to describe which of the following abnormalities?

testicular torsion

Normal testes will descend into the scrotal sac by:

6 months of age

Carcinoma of the prostate gland most commonly develops in the:

peripheral zone

Which of the following arteries gives rise to the testicular arteries?

anteriour aspect of the abdominal aorta

A fibrous sheath enclosing the testis describes which of the following structures?

tunica albuginea

What is considered a responsibility of the prostate gland?

produces ejaculation fluid

The thickened portion of the tunica albuginea is termed the:

mediastinum testis

What structure supports the posteriour border of the testes?

spermatic cord

Indications for a scrotal ultrasound may include all of the following EXCEPT:
groin pain
palpable mass
undescended testis
decreased urine output

decreased urine output

An anechoic structure arising from the rete testes describes what structure?


What structure transports sperm from the testes to the prostatic urethra?

vas deferens

A spermatic vein is considered dilated once the diameter exceeds:

4 mm

The scrotum is divided into two separate compartments by the:

median raphe

A 35-year-old patient presents with a palpable scrotal mass. He is afebrile and denies any scrotal pain. On the basis of this clinical history, the sonographic finding is most suspicious for what abnormality?

testicular carcinoma

An 85-year-old patient presents with intermittent scrotal swelling. He states that the swelling "comes and goes." On the basis of this clinical history, the sonographic finding is most suspicious for:

scrotal hernia

What complication is associated with the diagnosis of varicocele?


A patient presents with a history of scrotal swelling and tenderness. He denies any scrotal trauma. On the basis of this clinical history, the sonographic findings are most consistent with a:


The echogenic structure superior to the testis most likely represents the:

epididymal head

Epididymitis is most commonly caused by what condition?

bladder infection (UTI)

What region in the prostate most commonly develops benign prostatic hypertrophy (BPH)?

transitional zone

Twisting of the spermatic cord upon itself is a predisposing factor of what abnormality?

testicular torsion

A 30-year-old patient presents with a low-grade fever and acute testicular pain. An enlarge hypoechoic right testis is demonstrated within the testis on colour Doppler imaging. On the basis of this clinical history, the sonographic findings are most suspi


Sudden onset of severe scrotal pain in an adolescent patient is most suspicious for:

testicular torsion

The epididymis connects to the testis by what structure?

rete testis

What is considered a function of the seminal vesicles?

produce ejaculatory fluid

The majority of blood supplied to the prostate gland is through the:

capsular artery

A 45-year-old patient presents with acute scrotal pain after a mountain biking trip. On the basis of this clinical history, the sonographic findings are most suspicious for what abnormality?


An echogenic mass is identified superiour to the testis and outlined by the calibers. This most likely represents what structure?

head of the epididymis

A 76-year-old patient presents with a history of a palpable mass in the superiour portion of the right scrotal sac. A nonvascular cystic mass is identified in the medial portion of the testis. This mass is most suspicious for what abnormality?

tubular ectasia of the rete testis

The contralateral testis in a patient with tubular ectasia of the rete testis will most likely demonstrate a:

tubular ectasia of the rete testis

An asymptomatic patient presents with a palpable right scrotal mass discovered during a recent physical examination. The sonographic finding is most consistent with what abnormality?

spermatocele (big w/ echoes)
(epi head cyst is small w/ echoes)

A patient presents with a history of hematuria and elevated prostate specific antigen (PSA). The neoplasm identified by the arrows is located in which region of the prostate gland?

peripheral zone

The male urethra is divided into proximal and distal segments by what structure?


The normal monoclonal level of prostate specific antigen (PSA) should not exceed:

4 ng/mL

Decreased urine output is most commonly linked with an abnormality in what structure?

prostate gland

The location of the epididymis is most accurately described as:

posterior and lateral to the testis

Blood is supplied directly to the epididymis through what artery?


What vein receives the left testicular vein?

left renal vein

What pathology is the most common cause of acute scrotal pain?


What accurately describes the echogenicity and location of the seminal vesicles?

hypoechoic structures located superiour to the prostate gland

What artery is contained in the spermatic cord?


A 60-year-old patient presents with a history of urinary frequency and a decrease in urinary output. These clinical symptoms are most commonly associated with:

benign prostatic hypertrophy (BPH)

Cryptorchism is associated with an increased risk in developing:

testicular torsion

Which region of the prostate gland comprises only 5% of the glandular tissue?

transitional zone

The prostatic urethra is lined by what structures?

periurethral glands

The lobes of the prostate gland are termed the:

anteriour, middle, posteriour, and two lateral

The sonographic appearance of the mediastinum testis is best described as a(n):

hyperechoic linear structure located in the posterior medial aspect of the testis

The mediastinum testis is identified sonographically as:

prominent echogenic linear echo in the middle of the testis

What condition would show hyperemic flow on colour Doppler?


A large complex hydrocele is most commonly associated with what?


The most common germ cell testicular tumour is:


You are performing an ultrasound of a patient with a known "bell clapper" deformity. This deformity is associated with what condition?


The capsular artery of the testis is a branch of what artery?


The testicular artery is a branch of what artery?

abdominal aorta

You are performing a Doppler evaluation of the testis. What describes the waveform you will see within an artery of the testicular parenchyma if the testis is normal?

low resistance

You are performing Doppler analysis of the spermatic cord. What artery or structure is found within the spermatic cord?

vas deferens
testicular artery
cremasteric artery
deferential artery

The intratesticular arteries that arise from the capsular artery are known as:

centripetal arteries

The left testicular vein drains into what vein?

left renal vein

You are performing an ultrasound exam on an adolescent male to rule out testicular torsion. How should you adjust the system colour Doppler parameters to achieve the greatest sensitivity to slow flow?

low PRF, low filter, high gain, high packet size

You are performing an ultrasound study on a 27-year-old male with scrotal pain to rule out epididymo-orchitis versus torsion. What finding is most consistent with epididymitis?

increased flow by colour Doppler

A 33-year-old male has been referred for a scrotal ultrasound as a part of an infertility work-up. You will tailor your exam to include an evaluation for what?


You have identified a hydrocele during a scrotal ultrasound. Hydrocleles form in what potential space?

between the two layers of the tunica vaginalis

The rete testis is located in the:

mediastinum testis

What artery shows a low-resistance waveform:

testicular artery

What artery courses within the testicular parenchyma?

centripetal artery

You detect a mass within the left testis on a 43-year-old male. What is a sign indicative of malignancy?

irregular shape of testis
intratesticular location of mass

In performing scrotal sonography, you should tailor your exam to include colour Dopple analysis in what conditions?


The most common germ cell tumour of the testis is:


You are imaging a patient presenting with trauma, pain, and scrotal swelling. You detect a large hydrocele with prominent internal echoes. This most likely represents:


You have detected a transtesticular artery during scrotal sonography. Which of the following is true regarding this finding?

it is a common variant
it courses in the opposite direction of the centripetal arteries
it enters the testicular parenchyma at the mediastinum testis
a large vein frequently accompanies it

You are performing a scrotal ultrasound exam on a 38-year-old male with acute scrotal pain to rule out orchitis. Which finding would NOT be associated with orchitis?
hypoechoic testis
hyperemic testicular flow
enlargement of testis
thickened scrotal wall


You are performing a scrotal ultrasound on a 21-year-old male with acute scrotal pain. You do not detect flow with colour Doppler in the painful testis. This finding is most consistent with:


Which structure would you image posterior to the prostate gland?


You are performing a prostate sonogram to evaluate a patient with known prostate cancer. Which anatomic zone is most likely involved with the cancer?

peripheral zone

You are imaging a patient with suspected benign prostatic hypertrophy (BPH). Which zone is most commonly involved?

transition zone

You have been asked to identify the seminal vesicles. What is their anatomic relation to the prostate gland?

posterior and superior

What describes the most common patient positioning for performance of a transrectal prostate ultrasound?

left lateral decubitus

What lab test is most helpful in screening patients for prostate cancer?

prostate specific antigen

A patient has been referred for transrectal sonography due to symptoms of prostatism. What are the msot common patient symptoms of prostatism?

difficult initiation of voiding, nocturia, and small stream

Which of the following is an indication for transrectal ultrasound for the prostate?

abnormal digital rectal exam
abnormal laboratory test results indicative of prostate cancer
guidance for directed sonographic biopsy
monitor response to treatment of prostate cancer

A referring physician has asked if your department uses colour Doppler during transrectal prostate sonography. What is the role of colour Doppler in this procedure?

Color Doppler allows improved perception of pathologic vessels associated with cancer

What is the sonographic appearance of prostate cancer?

hypoechoic lesions
isoechoic lesions
hyperechoic lesions

You are aiding a physician in a transrectal biopsy of the prostate. What patient preparation is required?

a cleansing enema is performed immediately prior to the procedure;
antibiotics are administered prior to and following the examination

Which anatomic classification is most commonly used to describe the prostate during sonongraphic evaluation?

zonal anatomy

The prostaticovesical arteries that supply the prostate are branches from which artery?

internal iliac

What describes the most widely used conventional display of the prostate using transrectal sonography?

the rectum is shown at the bottom of the screen

You are performing a transrectal prostate ultrasound in a sagittal plane. The most lateral images of the gland show which tissue?

peripheral zone

You have been asked to perform a transrectal prostate ultrasound exam. What frequency transducer is best suited for this study?

7-8 MHz

What describes the most common appearance of the seminal vesicles by transrectal prostate sonography?

hypoechoic, symmetrical, irregularly shaped structures

You have been requested to perform a transrectal ultrasound of the prostate in a patient with suspected benign prostatic hyperplasia (BPH). What is the ultrasound appearance of this condition?

enlarged prostate gland which may be diffuse or focal

You are performing a prostate ultrasound in a patient having an infertility work-up. Which cyst may be associated with infertility?

ejaculatory duct cysts

You are performing a transrectal ultrasound in a patient with acute prostatitis. An anechoic mass is seen within the prostate. This most likely represents:


You have been asked to perform a transrectal ultrasound of the prostate in a patient with metastasis of unknown origin. What are you looking for?

prostate cancer