American Board of Pathology (ABPath) Practice Test

In the case of a torsed testicle, the venous flow is typically the first to be cut off. Testicular torsion occurs when the spermatic cord twists, leading to obstruction of blood flow. The anatomy of the testicular blood supply plays a critical role in understanding this phenomenon.

When torsion occurs, the twisting of the spermatic cord compresses the veins that drain the testis, resulting in a backflow of blood. This impeded venous return can lead to increased pressure in the testicle, swelling, and ultimately, ischemia. Since the arterial blood supply still may be partially maintained initially, the compromised venous return is what leads to the rapid onset of symptoms such as severe pain and swelling. If treatment is not administered promptly, the arterial supply can eventually be compromised as well, leading to irreversible damage to the testicle.

Thus, understanding the flow dynamics in testicular torsion highlights why recognizing the initial cut-off of venous flow is critical in managing this acute surgical emergency effectively.