Anat of Male Repro Tract

Question 1

What’s the lumbodorsal fascia?

Answer 1

Fascia originating from lumbar vertebrae that covers abdominal muscles posteriorly.
Encases the retroperitoneum

Question 2

Where are the renal arteries relative to the renal veins?

Answer 2

Posterior (runs behind the vein)

Question 3

Which gonadal vein drains to the IVC and which drains to a renal vein? What about the adrenals?

Answer 3

Right gonadal v.and Right adrenal vein drain to IVC directly.
Left gonadal v. and Left adrenal vein drain to left renal v.

Question 4

What is the “White Line of Toldt”?

Answer 4

Something you can cut through to access the retroperitoneal space laproscopic-ly.
(“marks of the site of peritoneal reflection where the colon is attached to the posterolateral wall”) - probs just trivia for now.

Question 5

What are 3 arteries that come off the posterior trunk of the internal iliac a.?

Answer 5

1) Iliolumbar a.
2) Superior gluteal a.
3) Lateral sacral a.

Question 6

What is “hypogastric” synonymous with?

Answer 6

Internal iliac

Question 7

What are 7 branches of the anterior trunk of the internal iliac a?

Answer 7

Sup. vesical a.
Middle rectal a.
Inf. vesical a.
Uterine a.
Int. pudendal a.
Obturator a.
Inf. gluteal a.

Question 8

What is the Space of Retzius?

Answer 8

aka. the retropubic space, it’s between the bladder/peritoneum and the pubic symphysis. It’s largely avascular.
(also trivia, until the surgeons pimp you on it)

Question 9

What’s the prostatic utricle? What landmark can you find it by surgically?

Answer 9

It’s where the ejaculatory ducts (vas deferens and seminal vesicles) drain into the prostatic urethra. It’s located at the “verumontanum” aka “seminal colliculus” - which is a bump you can pretty easily see.

Question 10

What’s the male version of “water under the bridge”?

Answer 10

The vas deferens crosses on top of and perpendicular to the ureter - right at about the point where the ureter joins the bladder.

Question 11

What’s the trigone of the bladder? What does it point you to?

Answer 11

Triangle thing in the bladder, with uteric openings at the two points.

Question 12

What’s the most important structure for urinary continence (at least when doing a prostatectomy)?

Answer 12

The external urethral sphincter. (the internal urethral sphincter is more important during ejaculation to prevent backflow)

Question 13

What must go away in order for the testes to begin to descend? What makes them go away? When does this begin?

Answer 13

The cranial suspensory ligament (CSL). Androgens make the CSL dissolve and the testes can then descend

Transabdominbal descent by 12th week in utero

Question 14

What layers surround the testis before it descends? (6 listed)

Answer 14

6) Skin
5) Scarpa’s fascia
4) Ext. abdominal oblique m.
3) Int. abdominal oblique m.
2) Transversus abdominus m.
1) Transversalis fascia
(testis housed in tunica albuginea and it’s in front of the peritoneum)

Question 15

What layers surround the descended testis? (name 5) What original layer does each correspond to?

Answer 15

5) Skin - skin
4) Dartos - Scarpa’s fascia
3) Ext. spermatic fascia - Ext. oblique m.
2) Cremaster m. - Int. oblique m.
1) Int. spermatic fascia - trasverse fascia

Question 16

What happens to the peritoneum that’s dragged down with the testis?

Answer 16

It becomes the tunica vaginalis, and should obliterate.

Question 17

What’s the pampiniform plexus for?

Answer 17

Countercurrent flow that keeps the testes and epididymis as cool and comfortable as possible.

Question 18

Where is a hydrocele?

Answer 18

Between the tunica vagnalis and the tunic albuginea of the testis (between TA and TV)

Question 19

What are 4 branches coming off the internal pudendal a. in the penis?

Answer 19

Bulbar a.
Circumflex cavernosal a.
Cavernosal a.
Dorsal a.
(and there are Circumflex aa. coming off the Dorsal a.)

Question 20

2 emphasized features of the venous drainage of the penis?

Answer 20

The deep dorsal vein and the periprostatic plexus.

Question 21

What does the tunica albuginea surround?

Answer 21

Really just the corpus cavernosums - not the corpus spongiosum.

Question 22

What are the layers between the skin and the corpus cavernosum?

Answer 22

Skin, dartos/superficial fascia, Deep/Buck’s fascia, Tunica Albuginea, corpus cavernosum.

Question 23

Can you break your dick?

Answer 23

Yeah. It’s called “penile fracture” when the tunica albuginea is ruptured. (always keep your adulterous spaces free of trip hazards)

Question 24

The ejaculatory duct is the union between WHAT 2 structures?

Answer 24

Ejaculatory duct is union of vas deferens and seminal vesicle ducts

Question 25

During the 7th-9th month- what aids inguino-scrotal descent?

Answer 25

Contraction of the gubernaculum under androgen control. Also helped by increased abdominal pressure.

Question 26

What is the GROSS ANATOMY pathway from testes to penis?

Answer 26

Testicle– Epididymis– Vas deferens– Up via inguinal canal- Crosses over bladder– Joins with Seminal Vesicles– drains into Prostate- out via penis

Question 27

REVIEW: What can causes hernia in babies?

Answer 27

Processus vaginalis that has not obliterated (remains open)–> get a hydrocele

Question 28

What important function does Cremasteric muscle do?

Answer 28

Retract the testes/ help them descend- for temperature regulation

Question 29

What are the the 3 sources of blood supply to the testicles (3 collaterals)?

Answer 29

1) Gonadal artery/ testicular artery
2) Vasal artery
3) Cremasteric artery

Question 30

What provides most of the blood supply to the penis? What other arteries are there?

Answer 30

1) Internal pudendal artery–> becomes dorsal artery
2) Circumflex arteries
3) Bulbar artery

Question 31

What are the 3 sources of penis drainage?

Answer 31

1) Cavernosal vein –> 2) Deep dorsal vein–> 3) Periprostatic plexus

Question 32

What is the function of the Corpus Cavernosa? Corpus Spongiosum? What tissue surrounds these 3 compartments?

Answer 32

• Bilateral Corpora Cavernosa (part that fills with blood during erection)
• Corpus Spongiosum surrounds urethra

WHOLE thing surrounded by Buck’s facia

Question 33

What’s the function of the tunica albuginea in erection?

Answer 33

• Soft and elastic when penis is flaccid

- When penis fills with blood– causes compression of venous drainage and helps maintain erection