MudPhud20XX

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A 20 yr old man who is a football player is brought to the emergency dept b/c of a suddent onset of severe testicular pain during a game. Physical exam shows significant scrotal edema on the Rt. side and significant tenderness to palpation. Stroking of the medial thigh does not cause elevation of the testis. Doppler flow studies reveal decreased arterial flow to the right testis. Compromised flow through a direct branch of which of the following vessels is most likely responsible for this pt's condition?

(Please with explanation!)

A. Aorta
B. External iliac artery
C. Inf. epigastric artery
D. Internal iliac artery
E. Internal pudendal artery
 

dfib slim

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Aug 20, 2012
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A 20 yr old man who is a football player is brought to the emergency dept b/c of a suddent onset of severe testicular pain during a game. Physical exam shows significant scrotal edema on the Rt. side and significant tenderness to palpation. Stroking of the medial thigh does not cause elevation of the testis. Doppler flow studies reveal decreased arterial flow to the right testis. Compromised flow through a direct branch of which of the following vessels is most likely responsible for this pt's condition?

(Please with explanation!)

A. Aorta
B. External iliac artery
C. Inf. epigastric artery
D. Internal iliac artery
E. Internal pudendal artery
Testicular artery is a branch off the aorta. Think about it this way, the testicles form in the abdomen then descend into the pelvis so it makes sense that none of the pelvic arteries supply them.
 

Transposony

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Nov 10, 2011
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Dagobah
Testicular artery is a branch off the aorta. Think about it this way, the testicles form in the abdomen then descend into the pelvis so it makes sense that none of the pelvic arteries supply them.
Just for completion sake that same goes for the venous drainage. nerve supply (radiating pain) as well as the lymphatics (para-aortic nodes are involved in testicular malignancy etc).
 
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Aug 2, 2014
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I do understand the rest of the case, but I was wondering about how stroking the inner thigh does not cause elevation of the testis. The cremaster muscle is supplied by the cremasteric artery, a branch of the inferior epigastric artery which comes from the external iliac artery. So how does compromised blood flow through the testicular artery affecting the cremaster muscle?
 

Transposony

Do or do not, There is no try
7+ Year Member
Nov 10, 2011
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Dagobah
I do understand the rest of the case, but I was wondering about how stroking the inner thigh does not cause elevation of the testis. The cremaster muscle is supplied by the cremasteric artery, a branch of the inferior epigastric artery which comes from the external iliac artery. So how does compromised blood flow through the testicular artery affecting the cremaster muscle?
Do you mean --How stroking the inner thigh does not cause elevation of the testes ?
That would be Cremasteric reflex

But if you are asking --Why the cremasteric reflex may be absent with testicular torsion.
Then it is due to the involvement of the afferent sensory fibers from both the L1-2 spinal nerves (genitofemoral nerve).
 
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