422.The answer is d.(Moore and Dalley, pp 225–226.)The newborn boy
has congenital hydrocele. As the testicles migrate from the posterior abdom-
inal wall to the anterior abdominal wall through the inguinal canal, they
bring a process of the peritoneal lining, the processes vaginalis, which is
filled with fluid and is connected to the peritoneal cavity. Normally, this
process vaginalis disconnects from the abdominal cavity and forms the
tunica vaginalis. Sometimes due to the late migration of the testis, the
process vaginalis does notlose its connection with the peritoneal cavity, so
that during straining and coughing or crying the scrotum swells. Normally
this condition spontaneously corrects itself a few months after birth. Cryp-
torchidism (answer a)is the failure of the testis to migrate down into the
scrotum, but the physical exam indicated the testes were in the scrotum. A
direct inguinal hernia (answer b)is very rare in newborns. Congenital
varicocele(answer c)would generally appear bluish and would feel like a
bag of worms. Klinefelter’s newborn (answer e)would have normal-sized
testicles and is notrelated to a hydrocele.
423.The answer is d.(Moore and Dalley, pp 441–442.)The blood from
straddle injuries is generally limited to the superficial perineal space which
is bound by the superficial membranous fascia (superficially; including
Scarpa’s fascia on the anterior abdominal wall, dartos fascia on penis and
scrotum, and Colles’ fascia on the urogenital triangle) and the deep per-
ineal membrane (deep). The superficial membranous fascia is attached to
deep structures at the following locations: superiorly the superficial mem-
branous fascia attaches to the deep fascia of the anterior abdominal mus-
cles about half way between the pubic symphysis and the umbilicus;
attaches to the inguinal ligament, and the fascia lata, laterally; and attaches
to the posterior edge of the perineal membrane just anterior to the anus.
Camper’s fascia (answer a)is the fatty layer on the anterior abdominal
wall, which extends beyond the umbilicus. Transversalis fascia (answer
b)is the fascia just deep to the peritoneal lining in the abdomen. Dartos
fascia(answer c)only covers the scrotum and penis. The inferior fascia
of the pelvic diaphragm (answer e)is deep to the perineal membrane.
424.The answer is d.(Kierszenbaum, pp 557–558.)The thick secretion
from the seminal vesicles contributes substantially to the ejaculate volume
that conveys the spermatozoa. The high fructose content of secretions of
the seminal vesicles provides the primary metabolic energy source for
Pelvis Answers 549