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15. Reproductive > 4. Anatomy of the Male Reproductive System and Osteology of the Pelvis > Flashcards

4. Anatomy of the Male Reproductive System and Osteology of the Pelvis Flashcards

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1
Q

What is the scrotum?

A

A cutaneous fibro-muscular sac for the testes and associated structures.

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2
Q

Where is the scrotum?

A

Posteroinferior to the penis and inferior to the pubic symphysis.

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3
Q

What is the scrotal raphe?

A

The mid-line which is continuous with the penile raphe and indicates the bilateral embryonic formation of the scrotum.

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4
Q

What are the two compartments of the scrotum?

A

One for each testis diving by the septum of the scrotum.

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5
Q

What are the testes?

A

Male gonads. Paired, ovoid reproductive glands that produce spermatozoa and male hormones.

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6
Q

Where are the testes?

A

Suspended in the scrotum by spermatic cords.

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7
Q

What are the tests covered by?

A

Visceral layer of tunica vaginalis. Parietal layer of tunica vaginalis adjacent to internal spermatic fascia. Fluid in between two layer, small amount for free movement of the testis in the scrotum.

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8
Q

What is the tunica albuginea?

A

The tough, fibrous outer surface of the testes that thickens into a ridge on internal, posterior aspect as mediastinum of testis.

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9
Q

How are seminiferous tubules joined?

A

By rete testis = network of canals in the mediastinum of the testis.

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10
Q

What are Sertoli cells associated with and what do they do?

A

Seminiferous tubules, spermatozoa development.

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11
Q

Where are Leydig cells and what do they do?

A

Cells in the interstitial tissue (hence aka interstitial cells) and they secrete testosterone.

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12
Q

Where do the testes arise?

A

In the mesonephric ridge in the upper lumbar regions, at the lower pole of the kidneys. They’re tethered to labioscrotal folds, by the gubernaculum.

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13
Q

How do the testes descend?

A

As the body grows, the testis becomes relatively more caudal. A musculo-fascial layer evaginates into the scrotum as it develops with peritoneal membrane to form the processes vaginalis.

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14
Q

What do the testes cross and exit in their descent?

A

Inguinal canal and exit the anterolateral abdominal wall.

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15
Q

What forms the spermatic cord?

A

The fascia and peritoneum become closely apposed. So fascial layers, obliterated stem of processus vaginalis, vas deferens, testicular vessels and nerves.

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16
Q

What occupies the inguinal canal in males?

A

The spermatic cord.

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17
Q

What is the scrotal ligament?

A

The vestigial remnant of the gubernaculum.

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18
Q

What is the arterial supply to the testes?

A

Direct from the abdominal aorta. The long, testicular arteries arise just inferior to the renal arteries.

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19
Q

What is the course of testicular arteries?

A

Pass retroperitoneally and cross over the ureters and the inferior part of the external iliac arteries to reach the deep inguinal rings. They then pass through the inguinal canal, emerge through superficial inguinal rings, and enter spermatic cords.

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20
Q

What is the venous drainage of the testes?

A

Asymmetrical. Veins from testis and epididymis form pampiniform venous plexus, the veins converge superiorly to form right and left testicular veins.
Right testicular vein -> inferior vena cava.
Left testicular vein -> left renal vein.

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21
Q

What is an action of the pampiniform venous plexus?

A

Thermoregulatory system of the testis, it cools blood from the abdominal aorta as it passes through testicular artery as the testicular vein wraps around it.

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22
Q

What are the segment of the epididymis?

A

Head (caput), body (corpus), and tail (caudal) segments.

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23
Q

Where is the epididymis?

A

On the superior and psoterolateral surface of the testis.

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24
Q

What are the functions of the epididymis?

A

It connects to the seminiferous tubule via efferent ductules and rete testis. Functions: sperm transport, maturation, and storage.

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25
What is the innervation of the testes and scrotum?
Lumbar plexus for anterior surface and sacral plexus for posterior and inferior surfaces.
26
What is the lymphatic drainage of the testes and scrotum?
Testes: drain to paraaortic nodes. Scrotum: drains to superficial inguinal nodes.
27
What is the ductus (vas) deferens?
A straight muscular tube that emerges from the caudal epididymis and is contained within the spermatic cord.
28
What is the function of the ductus deferens?
To transport the sperms rapidly to the prostatic urethra.
29
How are the contents of the vas deferens propelled towards the ejaculatory duct?
Rich autonomic innervation permits rapid contractions of the muscular tube.
30
What does the ductus deferens do in ejaculation?
It and the duct of the seminal vesicle dilate to facilitate entry of sperms and seminal gland secretions into prostatic urethra.
31
What does the spermatic cord contain?
The structures running to and from the testes - neurovascular and duct systems. Neurovascular - testicular artery, cremasteric artery, artery to vas, pampiniform plexus, genital branch of genitofemoral nerve. Vas deferens. Lymphatics. Processus vaginalis.
32
Where does the spermatic cord run?
From the deep inguinal ring, lateral to the inferior epigastric vessels to the posterior border of the testis via the inguinal canal and superficial inguinal ring.
33
What are the coverings of the spermatic cord?
From the anterolateral abdominal wall. External spermatic fascia - aponeurosis of external oblique. Cremasteric muscle and fascia - internal oblique and transversalis. Internal spermatic fascia - transversalis fascia.
34
What is the seminal vesicle?
Two small glands that lie posterior to the prostate, between the bladder and rectum.
35
What makes up the gland body of the seminal vesicle?
Single, highly convoluted tube that joins the ampulla of the ductus deferens to form the ejaculatory duct.
36
What does the mucous membrane of the seminal vesicle form?
An elaborate system of thin, branched, anastomosing folds that project into the lumen, which contains coagulated secretion.
37
What are the components of ejaculate?
70-80%: secretions from the seminal vesicles. | 30%: secretions from the prostate gland.
38
What are the anatomical relations of the prostate?
Base - neck of bladder. Apex - urethral sphincter and deep perineal muscles. Muscular anterior surface - urethral sphincter. Posterior - ampulla of rectum. Inferior-lateral - levator ani.
39
How is the prostate gland separated into alveolar glands?
Fibro-muscular capsule surrounds the glands and branching septae divides it into the compound glands.
40
What is the importance of the compound alveolar glands of the prostate?
The excretory ducts originate from there and open independently into the prostatic urethra.
41
What characterises the septae of the prostate?
Discrete bundles of smooth muscle fibres interweaving with connective tissues.
42
What are the secretions of the prostate gland?
Prostaglandins, proteolytic enzymes, and citric acid.
43
What is the bulbourethral gland?
Glands within the urogenital diaphragm that contain tubular and alveolar-type glands.
44
What is the production of bulbourethral glands?
Clear water secretion to lubricate the urethra prior to ejaculation.
45
What are the parts of the penis?
Root, body, and glans.
46
What are the internal structures of the penis?
Pair of corpoa cavernosa dorsally and a single corpus spongiosum ventrally, through which the urethra runs.
47
What is the arterial supply to the penis?
Branches of the internal pudendal arteries (from abdominal aorta -> common iliac -> internal iliac -> anterior division -> internal pudendal).
48
What is the venous drainage of the penis?
Drains into venous plexus that joins deep dorsal vein of the penis, drains into prostatic venous plexus, drains prostatic venous plexus, then into internal iliac vein, then common iliac vein and inferior vena cava. Venous plexus -> deep dorsal -> prostatic venous plexus -> internal iliac -> inferior vena cava.
49
What is the bulbospongiosus?
Helps to expel last drops of urine and maintain erections.
50
What is the ischiocavernosus?
Compresses veins, therefore helps maintain erections.
51
What are the parts of the male urethra?
Pre-prostatic (short, neck of bladder), prostatic, membranous (least distensible, greatest risk of trauma in catheterisation), spongy.
52
What is hydrocoele?
Serous fluid in tunica vaginalis.
53
What is haematocoele?
Blood in tunica vaginalis.
54
What is varicocoele?
Varicosities of the pampiniform plexus.
55
What is spermatocoele?
Retention cyst within epididymis, aka epididymal cyst.
56
What is epididymitis/
Inflammation of the epididymal cyst.
57
What is a direct inguinal hernia?
Hernia directly into the inguinal area, medial to the inferior epigastric vessels.
58
What is an indirect inguinal hernia?
Hernia indirectly into the inguinal area, via the inguinal canal, lateral to inferior epigastric vessels. Reopening of the processus vaginalis gives potential continuity between peritoneal cavity and tunica vaginalis.
59
What is testicular torsion?
Twisting of spermatic cord, giving the risk of necrosis of the testis. Usually just above the upper pole of testis.
60
How is the lymphatic drainage of the testes and scrotum relevant?
It is different so relevant in malignancy spread.
61
Where does benign prostatic hyperplasia occur?
Mainly in the central zone, next to the urethra hence it causes dysuria, nocturia, and urgency.
62
Where does prostatic malignancy occur?
In the peripheral zone of the prostate so has to be very large before presenting by compressing the urethra.
63
Where does prostatic malignancy metastasise?
Via lymphatic route to internal iliac and sacral nodes and venous route to internal vertebral plexus to vertebrae and brain.
64
What elevates prostatic-specific antigen (PSA)?
Normal or abnormal prostatic epithelial cells in prostatic disorders. Can differentiate between prostatic hyperplasia, prostatitis, and carcinoma.
65
How can the prostate be examined?
Digital rectal examination.
66
What are the three bones of the pelvic girdle?
Right and left hip bones (ilium, ischium, pubis), and sacrum (from fusion of five sacral vertebrae).
67
Where do the hip bones articulate?
With the sacrum at the sacroiliac joint and with each other at pubic symphysis.
68
What makes a good pelvis for childbirth?
Round inlet, straight side walls, ischial spines not too prominent, well-rounded greater sciatic notch, well-curved sacrum, sub-pubic arch >90 degrees.
69
What forms the pelvic inlet?
Promontory and ala of sacrum posteriorly (superior surface of lateral part, adjacent to body of sacrum), and right and left linea terminalis anteriorly (arcuate line on inner surface of ileum, pectineal line and pubic crest).
70
What is the anatomic conjugate?
Measured from sacral promontory to superior border of pubic symphysis.
71
What is the obstetric conjugate?
Measured from sacral promontory to midpoint of pubic symphysis. Minimum diameter of canal as it's where pubic bone is thickest.
72
What is the diagonal conjugate?
Measured from sacral promontory to inferior border of pubic symphysis.
73
What forms the pelvic outlet?
Pubic arch anteriorly, ischial tuberosities laterally, inferior margin of sacrotuberous ligament posterolaterally, tip of coccyx posteriorly.
74
How does pregnancy affect the sacrotuberous ligament?
Progesterone makes it softer to increase the size of the pelvic outlet to aid childbirth.
75
What is the greater pelvis?
Superior to pelvic inlet, bounded by iliac alae posterolaterally, bounded by anterosuperior aspect of S1 vertebra posteriorly, occupied by abdominal viscera.
76
What is the lesser pelvis?
Bony canal which is solid and immovable between pelvic inlet and outlet. It's bounded by pelvic surfaces of hip bones, sacrum, and coccyx.

15. Reproductive (12 decks)

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