A client arrives in the emergency department complaining of severe testicular pain associated with nausea and vomiting. Their pulse rate is 120 beats/minute. Physical exam reveals an enlarged testis that is painful to palpation. The nurse suspects:

Question

A) Inguinal hernia
B) Cancer of the scrotum
C) Testicular aneurysm
D) Testicular torsion

Answer 1

Ans: D
Feedback:
With testicular torsion, the testis rotates about the distal spermatic cord, obstructs perfusion through the testicular arteries and spermatic veins, and obstructs nerve conduction. The torsion obstructs venous drainage, with resultant edema and hemorrhage, and subsequent arterial obstruction. The dartos muscle separates the two testes and responds to changes in temperature by contracting when cold and relaxing when warm. Most squamous cell cancers of the scrotum occur after 60 years of age and are linked to poor hygiene, chronic inflammation, exposure to ultraviolet A radiation, or human papilloma virus (HPV). After descent of the testes, the inguinal canal normally closes almost completely; failure of this canal to close predisposes to the development of an inguinal hernia later in life.