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11: Urogenital System > Chapter 112 Penis and Prepuce > Flashcards

Chapter 112 Penis and Prepuce Flashcards

1
Q

What are the three parts of the penis?

A

Root, body and distal portion (aka glans)

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2
Q

What is the name of the penile tissue that surrounds the urethra (for the entirety of its length?

A

Corpus spongiosum

(bulb of penis is a bilobed extension of corpus spongiosum)

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3
Q

What anatomical areas make up body of penis?

A

Corpus spongiosum + corpus cavernosum

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4
Q

What anatomical areas make up distal penis/glans penis

A

Bulbus glandis

Pars longa glandis

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5
Q

What is another name for the os penis?

A

Baculum

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6
Q

What are the four paired extrinsic muscles of the penis?

A

Ischiourethralis

Ischiocavernosus

Bulbospongiosus

Retractor penis

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7
Q

Where do the retractor penis muscles arise from

A

Cd vertebrae 1 and 2, then blend with external anal sphincter

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8
Q

Where do bulbospongiosus muscles arise from?

A

Tunica albuginea and external anal sphicter (and fuse with retractor penis at insertion)

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9
Q

Label he diagram

A
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10
Q

What is the primary vessel supplying the penis

A

Artery of the penis (from internal pudendal)

  • Arteries of the bulb
  • Deep arteries of the penis
  • Dorsal artery of the penis
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11
Q

Label the diagram

A
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12
Q

What region does each of the main vessels of the penis supply?

A

Artery of the penis (branch of internal pudendal)

  • Artery of bulb: Corpus spongiosum, penile urethra, pars longa glandis (surprisingly as very dor away an dorsal surface…)
  • Deep artery of penis: Corpus cavernosum
  • Dorsal artery of penis: corpus spongiosum, bulbus glandis, pars longa glandis
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13
Q

What is the venous drainage of the penis?

A

Internal and external pudendal

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14
Q

What is the main sensory nerve innervating the penis?

A

Dorsal nerve of penis

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15
Q

In what % of cats is os penis readiographically visible?

A

40%

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16
Q

How soon after castration do spines of penis in cats regress?

A

6 weeks

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17
Q

What are the three layers of the prepuce?

A

External skin, inner layers are parietal and visceral epithelium (i..e outer layer of what i consider penis is actually viscera layer of prepuce)

18
Q

Which layer of prepuce has many lymph nodules and nodea

A

Parietal layer

19
Q

Where do the prepucial muscles originate from

A

Xiphoid (from cuaneous trunci)

20
Q

Label the diagram

A
21
Q

What are the two principal vessels supplying the parietal and viceral layers of the prepuce?

And the skin?

A

Dorsal artery of the penis and external pudendal

Skin = caudal superficial epigastric

22
Q

What are the two mechanisms –> erection

A
  1. Expansion of arteris and contraction of veins –> expansion of cavernous bodies
  2. Dorsal penile vein compressed against ischial arch by contraction of ischiocavernosus and bulbospongiosus
23
Q

Comment on relationship between penis and prepuce at birth

A

Pepucial and penile surfaces usually adherent + penile frenulum usually present

Separation of both with puberty

24
Q

What breed gets hypospadias?

A

Boston terrier

25
Q

What conditions are usually seen with hypospadia

A

Failure of fusion of prepuce

Underdevelopment of penis

26
Q

What is treatment for hypospadia?

A

Not usually reconstructed as often no urethra distal to anomaly.

Tx: excision of penile remnant + urethrostomy (poss via enlargement of existing opening) IF NECESSARY

27
Q

How are hypospadias classified?

A

Anal

Perineal

Scrotal

Penile

Glandular

28
Q

What are treatment options for os penis deformity (if necessary)

A

Fracture + realigment

partial penile amputation

29
Q

How is os penis fracture managed

A

Conservative, u cath or plate

(scrotal urethrostomy if callous –> urethral obstruction)

30
Q

Describe technique for shortening prepuce (e.g. if performed partial penile amputation)

A

Technique for shortening of the prepuce in conjunction with partial penile amputation.

A, A rectangular portion of ventral prepuce is excised.

B, A sliding skin flap facilitates retraction of the cranial prepuce (arrows).

C, The segments are apposed with two or three layers of suture.

31
Q

What clinical signs are seen with persistent penile frenulum?

A

Pain when penile extrusion attempted, licking, blanoprosthitis

32
Q

List 5 ddx for penile neoplasm

A

TVT, MCT, SCC, papilloma, HSA, OSA

33
Q

Describe technique for penile amp

A

Ablation of the external male genitalia.

A, The skin is incised around the sides or base of the prepuce and scrotum.

B, The penis is separated from the body wall, and its blood supply is temporarily occluded with a ligature or tourniquet proximal to the proposed transection site. The penile body is sharply severed.

C, After hemostasis has been achieved, the tunica albuginea is apposed over the end of the transected penis.

D-E, A urethrostomy is performed, and the remaining skin defect is closed.

34
Q

What type or urethrostomy hs been reported with subtotal peinle amputation?

What is the benefit?

A

Prepucial urethrostomy.

Doesnt –> skin irritation

35
Q

What is paraphimosis

A

Paraphimosis = penis protrudes from the preputial sheath and cannot be replaced to its normal position

36
Q

hat are tx options for paraphimosis?

A
  • Lube, hyperosmolar solution, local cooling

If not successful

  • U cath to avoid urethral obstruction
  • Prepucial enlargement (excision of dorsal V in dogs, ventral in cats)
  • Phallopexy (remove a dorsal or ventral strip of visceral and parietal prepuce and suture together
  • +- Prepucial advancement
37
Q

What is phimosis

A

Phimosis is the inability to protrude the penis beyond the preputial orifice.

May –> blanoprosthitis if urine pooling in prepuce

38
Q

How is blanoprosthitis managed

A
  • Flush with saline or dilute povodine-iodine or chlorhex
  • Curette lymphoid nodules
  • BReak down adhesions
  • Antimicrobial ointment

Px guarded asss often recurrs

39
Q

What are the 2 most common tumours of external genitalia/prepuce?

A

MCT and SCC

(ddx lympoma, TVT, perianal gland adenoma)

40
Q

What are the broad concepts necessary for prepucial reconstruction

A

Epihelial tissue i.e. skin (usually based on axial patttern flap from caudal superficial epigastric artery)

Mucosal tissue (free buccal graft)

41
Q

What amount of penile tissue protrusion (due to prepucial hypoplasia) can be managed wiht prepucial advancement?

A

1.5 cm

(usually unsuccessful if protrusion >1.5cm )

Phallopexy or partial amp if still a problem

11: Urogenital System (11 decks)

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