USMLE Step 1 Question 361

Question:

A 25 year old man comes to the emergency room complaining of acute onset of fever and testicular pain. He also noted that his scrotum had begun to swell and had a moderate amount of erythema. On physical exam, he is found to be febrile to 40 degrees Celsius and has significant bilateral swelling of the scrotum and bilateral testicular tenderness on palpation. Lab values were significant for leukopenia with relative lymphocytosis and a slightly elevated amylase. A high degree of suspicion for mumps prompted antibody testing. The patient was found to be IgM positive for the mumps antibody. What is the primary lymphatic drainage of the testes?

Correct Answer: E.  Para-aortic nodes

The primary lymphatic drainage for the testes and ovaries are the para-aortic lymph nodes (choice E) located in the lumbar region of the abdominal aorta. The para-aortic lymph nodes are sometimes referred to as the retroperitoneal lymph nodes.

External iliac lymph nodes (choice B) drain external genitalia, vagina, and cervix. Internal iliac lymph nodes (choice D) drain the cervix, prostate, and rectum. The common iliac lymph nodes (choice A) receive afferents from both external and internal iliac groups.

Inguinal lymph nodes (choice C) drains the lower part of the anal canal as well as part of the external genitalia.