6. Male Reproductive System Flashcards
What is the septum of the scrotum
Divides scrotum into 2 components for each testis
Deep to scrotal raphe
What is the innervation of the testis & scrotum
Anterior surface: Lumbar plexus
Posterior & inferior surfaces: Sacral plexus
What is the lymphatic drainage of the testis & scrotum
Testis: para aortic nodes
Scrotum: superficial inguinal nodes
How are the testes suspended in the scrotum
Spermatic cords
What are the 2 main layers of the testes
Tunica vaginalis: visceral & parietal layers
Tunica albuginea: tough, fibrous outer layer
Describe the 2 sublayers of the tunica vaginalis in the testes
Visceral later:
covers each testes
except where attaches to epididymis & spermatic cord
Parietal layer:
adjacent to internal spermatic fascia
More extensive than visceral
Extends superiorly for short distance onto distal part of spermatic cord
Describe the descent of the testis
Arise in Mesonephric ridge @ lower pole of kidneys
Tethered to labioscrotal folds (genital swellings: future scrotum) by gubernaculum (future scrotal ligament)
As body grows, relative position of testis becomes more caudal
Musculo-fascial layer evaginates into scrotum with peritoneal membrane, to form Processus Vaginalis
As descend, cross inguinal canal & exit anterolateral abdominal wall
Above testis, fascia & peritoneum become closely apposed;
Fascial layers obliterated
Stem of Processus vaginalis/vas deferens/testicular vessels/nerves forms spermatic cord, occupying inguinal canal
What are the 2 cells of the testis
What do they produce
Where are they found
Sertoli cells:
Spermatozoa development
Seminiferous tubules
Leydig (interstitial) cells:
Secrete testosterone
In interstitial tissue
Describe the arterial supply of the testis
Direct from abdominal aorta
Long testicular arteries arise inferior to renal arteries
Blood cooled in testicular artery, as wrapped in testicular vein
Pass retroperitoneally, cross ureters & inf part of iliac arteries to reach deep inguinal rings
Pass thru Inguinal canal, emerging thru superficial inguinal rings
Enter spermatic cords
Describe the venous drainage of the testis
Asymmetrical:
Veins emerging from testis & epididymis from Pampiniform Venous Plexus (part of testis thermoregulatory system)
Venous plexus converge, forming L & R testicular veins
R testicular vein drains to IVC
L testicular vein drains to L renal vein
What are the 3 segments of the epididymis
Head (caput)
Body (corpus)
Tail (caudal)
How does the epididymis connect to the seminiferous tubules
Via efferent ductules & the rete testis
What are the main functions of the epididymis
Sperm transport
House sperm from maturation
House sperm for storage (in tail segment)
Describe the course of the vas (ductus) deferens
Ascends in spermatic cord Traverses inguinal canal Passes around pelvic side wall Passes between bladder & ureter Forms dilated ampulla Opens into ejaculatory duct
What is the main function of the vas deferens
Transport sperms rapidly to prostatic urethra
What are the contents of the spermatic cord
Neurovascular: Testicular artery Cremasteric artery Artery to Vas Pampiniform plexus Genital branch of Genitofemoral Nerve
Duct system:
Vas deferens
Lymphatics
Processus vaginalis
What is the boundaries of the spermatic cord (what is its course)
From deep inguinal ring (lateral to inferior epigastric vessels)
To posterior border of testis
via inguinal canal & superficial Inguinal ring
What are the coverings of the spermatic cord
Where do they come from
From the anterolateral abdominal wall:
External spermatic fascia (transversalis fascia; remnant of aponeurosis of external oblique)
Cremasteric muscle & fascia (internal oblique & transversalis)
Internal spermatic fascia (transversalis fascia)
What is the seminal vesicle
Where is it found
2 small glands
Posterior to prostate, between bladder & rectum
Describe the structure of the seminal vesicle
Gland body has single, convoluted tube joining ampulla of vas deferens to form ejaculatory duct
Mucous membrane forms syste, of thin, branched, anastomosing folds projecting into the lumen
Where do the ejaculate contents originate from and in what proportions
Seminal vesicle: 70-80%
Prostate: 30%
Small amount from bulbourethral gland
What are the zones/lobes of the prostate
What areas of anatomy are they related to
Base: neck of bladder
Apex: urethral sphincter & deep perineal muscles
Muscular anterior surface: urethra, sphincter
Posterior: ampulla of rectum
Inferior-lateral: levator ani
What are the prostate secretions compressed of
Prostaglandins
Proteolytic enzymes
Citric acid
Where are the bulbourethral glands located
What do they produce & what is its function
Within urogenital diaphragm
Produce clear, watery solution just prior to ejaculation
May lubricate the urethra
What structural parts is the penis comprised of
Root
Body
Glans
What is the internal structure of the penis comprised of
2 Corpoa cavernosa (dorsally)
Single Corpus spongiosum (ventrally)
Describe the arterial supply to the penis
Branches of internal pudendal arteries
From anterior division of internal iliac
Describe the venous supply to the penis
Blood from cavernosus spaces drains into venous plexus that joins deep dorsal vein of penis
Drains into prostatic venous plexus
Which drains into internal iliac
Describe the 2 muscles of the male perineum & their function
Bulbospongiosus:
Helps expel last drops of urine
Helps maintain erection
Ischiocavernosus:
Compresses veins, helping to maintain erection
Describe the 4 parts of the male urethra
Pre-prostatic
(very short, at neck of bladder)
Prostatic
Membranous
(thru perineum & pelvic floor, least distensible, greatest risk of trauma in catheterisation)
Spongy (penile)
Define the following: Hydrocoele Haematocoele Variococoele Spermatocoele Epididymitis
Serous fluid in tunica vaginalis
Blood in tunica vaginalis
Varicosities of Pampiniform plexus
Retention cyst within epididymis (epididymal cyst)
Inflammation of epididymal cyst
Distinguish between a direct & indirect inguinal hernia
Direct:
Hernia directly into inguinal area
Media, to inferior epigastric vessels
Indirect:
Hernia indirectly into inguinal area, via inguinal canal
Lateral to inferior epigastric vessels
Reopening of Processus vaginalis = potential continuity btw peritoneal cavity & tunica vaginalis (abdomen -> scrotum)
Describe testicular torsion
Twisting of spermatic cord
risk necrosis of testis
Usually just above upper pole of testis
Where does Benign prostatic hyperplasia usually occur in the prostate
What can be a consequence
Central zone, close to urethra
Dysuria, nocturia, urgency
Where do prostate malignancies usually occur in the prostate
What is the usual presentation: how long until present
By what mechanisms can they metastasise
Peripheral zone
Present late: large before compress urethra & cause symptoms
Metastasise via: Lymphatic route (internal iliac & sacral nodes) Venous route (internal vertebral plexus to vertebrae & brain)
What can be detected in the blood in prostatic disorders
Prostatic-Specific Antigen (PSA)
Produced by abnormal & normal prostatic epithelial cells
Often elevated in prostatic disorders
Is one of diagnostic tests to differentiate BPA, prostatitis, carcinoma
What is the midline scrotal raphe
Remnant of Bilateral embryonic formation of scrotum
Continuous on ventral surface of penis with penile raphe
