Anatomy of the male and female reproductive systems

Question 1

What is meant by the perineum?

Answer 1

A shallow compartment/space that lies between the levator ani superiorly and the perineal skin inferiorly

Question 2

What are the contents of the perineum?

Answer 2

The distal ends of the pelvic organs passing to the exterior, the external genitalia, perineal muscles and the blood and nerve supply, venous and lymphatic drainage to all the contents

Question 3

Which structures pass through the levator ani in the male?

Answer 3

Rectum and urethra

Question 4

What is the function of the levator ani muscle?

Answer 4

Forms the roof of the perineum and floor of pelvis (along with its fascial coverings), provides support to the pelvic organs and assists in maintaining faecal and urinary continence

Question 5

What are the nerve roots of the pudendal nerve?

Answer 5

S2, 3, 4 - keeps your guts off the floor!

Question 6

What type of nerve fibres does the pudendal nerve contain?

Answer 6

Somatic motor (to the levator ani and muscles of the perineum) and somatic sensory from the perineum (there will also be sympathetic nerve fibres as there are in all spinal nerves)

Question 7

Why might a perianal abscess spread readily through the ischioanal space?

Answer 7

It is a relatively large space filled with fat and loose connective tissue. Fat has a relatively poor blood supply with few immune cells and so presents minimal barrier to spread of infection

Question 8

What is the nerve supply to the external urethral sphincter and the external anal sphincter?

Answer 8

Pudendal nerve

Question 9

Name a clinical procedure, in the female pelvis, in which the ureters may be damaged

Answer 9

Hysterectomy - ureter lies in close relationship with the uterine artery, so may be damaged during ligation of the uterine artery

Question 10

Where would lymph from the ovaries drain to?

Answer 10

Lumbar (aortic) lymph nodes

Question 11

Describe the route taken by gametes (sperm & ovum) from production through to fertilisation

Answer 11

Sperm - seminiferous tubules -> rete testis -> epididymis -> vas deferns -> ejaculatory duct -> prostatic urethra -> membranous urethra -> spongy urethra ->external urethral meatus -> vagina, cervix and uterine tube Ovum - ovary -> peritoneal cavity -> fimbriae -> infundibulum -> ampulla of uterine tube

Question 12

When a female patient is in anatomical position, excess fluid within the peritoneal cavity will collect in which pouch?

Answer 12

Rectouterine (Pouch of Douglas)

Question 13

How might fluid from the rectouterine pouch be drained?

Answer 13

Via a needle placed through the posterior fornix of the vagina

Question 14

Name the structure formed by a double layer of peritoneum, extending between the uterus and the lateral pelvic walls and floor?

Answer 14

Broad ligament

Question 15

How might uterine prolapse be caused?

Answer 15

Weakened pelvic support, increased intra-abdominal pressure

Question 16

What is a cystocele and a rectocele?

Answer 16

Cystocele - hernial protrusion of bladder into vaginal wall Rectocele - hernial protrusion of rectum into vaginal wall

Question 17

What is the function of the external urethral sphincter?

Answer 17

Final control of urination

Question 18

What are the components of fluid secreted by the seminal vesicles?

Answer 18

Proteins, enzymes, fructose, mucus, vitamin C, flavins, phosporylcholine and prostaglandin

Question 19

What is the main function of the fluid secreted by the prostate gland?

Answer 19

Activating sperm

Question 20

What are the functions of the fluid/mucus secreted by the bulbourethral glands?

Answer 20

Lubricates urethra and helps to neutralise acid in urethra

Question 21

What structures are located in the spermatic cord?

Answer 21

Vas deferens, testicular artery, pampiniform venous plexus, sympathetic nerve fibres, genital branch of genitofemoral nerve and lymphatics

Question 22

What is the route of the vas deferens?

Answer 22

Begins at tail of epididymis, ascends through the scrotum posterior to the testis and medial to the epidiymis, travels through the abdominal wall as part of the spermatic cord, crosses over the external iliac vessels to enter the pelvis, travels along the lateral wall of the pelvis and ends by joining the duct of the seminal gland to form the ejaculatory duct