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  #1  
Old 01-18-2012
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A man comes to your office because he thinks he has bilateral hernias and bilateral pain in the inguinal area. Upon physical examination he does not have a direct nor indirect inguinal hernia, but does have bilateral palpable superficial inguinal lymph nodes, which are tender. You formulate a differential diagnosis of locations from which lymph drains into the superficial inguinal lymph nodes. Which anatomical region or structure does not drain into the superficial inguinal lymph nodes and thus should be excluded from your differential diagnosis list?
A.
Penis

B.
Scrotum

C.
Testicles

D.
Anus

E.
Epididymides
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  #2  
Old 01-18-2012
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C) Testicles .. they drain into the Lumbar (para-aortic) lymph nodes.
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  #3  
Old 01-18-2012
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C.
Testicles
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  #4  
Old 01-19-2012
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Lymph drains from the testicles to preaortic nodes, because remember that the blood supply for the testicles comes directly off the abdominal aorta, where the testicles first develop, prior to their inferior migration into the scrotum. All the other pelvic structures: penis (answer a), scrotum (answer b), anus (answer d), and epididymides (answer e) can drain lymphatics to the superficial inguinal nodes. The anus and rectum have drainage to three sites: superficial inguinal nodes, internal iliac nodes, and inferior mesenteric preaortic nodes.
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