First Aid: Reproductive Anatomy Flashcards
Types of congenital penile abnormalities
- Hypospadias
- Epispadias
What is hypospadias?
Abnormal opening of penile urethra on ventral surface of penis due to failure of urethral folds to fuse
Hypospadias Mnemonic
Hypo is below
Congenital penile abnormalities epidemiology
Hypospadias is more common than epispadias
Hypospadias risk factors
Associated with inguinal hernia and cryptorchidism
Epispadias risk factors
Exstrophy of the bladder is associated with Epispadias
Epispadias Mnemonic
When you have Epispadias, you hit your Eye when you pEE
What is epispadias?
- Abnormal opening of the penile urethra on the dorsal surface of penis due to faulty positining of genital tubercle
Hypospadias and epispadias
What is the Gubernaculim?
Band of fibrous tissue
Gubernaculim male remnant
Anchors testes within scrotum
Gubernaculim female remnant
Ovarian ligament + round ligament of uterus
What is the Processus vaginalis
Evagination of peritoneum
Processus vaginalis male remnant
Forms tunica vaginalis
Processus vaginalis female remnant
Obliterated
Types of gonadal drainage
2 listed
- Venous drainage
- Lymphatic drainage
Describe venous gonadal drainage
Left ovary/testis → left gonadal vein → left renal vein → IVC
Right Ovary/testis → right gonadal vein → IVC
Describe gonadal lymphatic drainage
- Ovaries/testes → para-aortic lymph nodes
- Body of uterus/superior bladder → external iliac nodes
- Prostate/cervix/corpus cavernosum/proximal vagina → internal iliac nodes
- Distal vagina/vulva/scrotum/distal anus → superficial inguinal nodes
- Glans penis → deep inguinal nodes
Things to remeber regarding gonadal lymphatic and venous drainage
- “Left gonadal vein takes the Longest way”
- Because the left spermatic vein enters the left renal vein at a 90o angle, flow is less laminar on left than on the right → left venous pressure > right venous pressure → varicocele more common on the left
Identify female reporductive anatomy
Infundibulopelvic ligament function
Connects the ovaries to the lateral pelvic wall and contains the ovarian vessels
Ovarian vessels are contained in what ligament?
Infundibulopelvic ligament
Infundibulopelvic ligament AKA
Suspensory ligament of the ovary
Infundibulopelvic ligament notes
- Ligate vessels during oophorectomy to avoid bleeding
- Ureter courses retroperitoneally, close to gonadal vessels → at risk of injury during ligation of ovarian vessels
Cardinal ligament function
Connects the cervix to the side wall of pelvis and contains the uterine vessels
Cardinal ligament notes
Ureter at risk of injury during ligation of uterine vessels in hysterectomy
Female reproductive related ligaments
- Infundibulopelvic ligament
- Cardinal ligament
- Round ligament of the uterus
- Broad ligament
- Ovarian ligament
Round ligament of the uterus function
Connects the uterine horn to labia majora doesn’t contain anything
Round ligament of the uterus notes
- Derivative of gubernaculum
- Travels through round inguinal canal; above the artery of Sampson
Broad ligament function
Connects the Uterus, fallopian tubes and ovaries to pelvic side wall and contains ovaries, fallopian tubes, round ligaments of uterus
Broad ligament notes
Fold of peritoneum that comprises the mesosalpinx, mesometrium and mesovarium
Ovarian ligament function
Connects Medial pole of ovary to the uterine horn
Ovarian ligament notes
Derivative of gubernaculum
Ovarian Ligament Latches to Lateral uterus
Vagina histology
Stratified squamous epithelium, nonkeratinized
Ectocervix histology
Stratified squamous epithelium, nonkeratinized
Transformation zone hiistology
Squamocolumnar junction (most common area for cervical cancer)
What is the most common area for cervical cancer?
The transformation zone squamocolumnar junction
Endocervix histology
Simple columnar epithelium
Uterus histology
Simple columnar epithelium with long tubular glands in proliferative phase; coiled glands in secretory phase
Fallopian tube histology
Simple columnar epithelium, ciliated
Ovary, outer surface histology
Simple cuboidal epithelium (germinal epithelium covering surface of ovary)
Male reproductive anatomy
608
Urethral injury epidemiology
- Occurs almost exclusively in men
- Suspect if blood seen at urethral meatus
- Urethral catheterization is relatively contraindicated
Part of the urethra involved in anterior urethral injury
Bulbar (spongy) urethra
Part of the urethra involved in posterior urethral injury
Membranous urethra
Mechanism of anterior urethral injury
Perineal straddle injury
Mechanism of posterior urethral injury
Pelvic fracture
Location of urine leak/blood accumulation in Anterior urethral injury
Blood accumulates in scrotum
IF Buck fascia is torn, urine escapes into the perineal space
Location of urine leak/blood accumulation in Posterior urethral injury
Urine leaks into retropubic space
Presentation of Anterior urethral injury
Blood at urethral meatus and scrotal hematoma
Presentation of Posterior urethral injury
Blood at urethral meatus and high-riding prostate
Autonomic innervation of the male sexual response: processes innervated
- Erection
- Emission
- Ejaculation
Describe the Autonomic innervation of erection
- Parasympathetic nervous system (pelvic splanchnic nerves, S2-S4)
- NO → ↑ cGMP → smooth muscle relaxation → vasodilation → proerectile
- Norepinephrine → ↑ [Ca2+] → smooth muscle contraction → vasoconstriction → antierectile
Describe the autonomic innervation of Emission
Sympathetic nervous system (hypogastric nerve, TH-L2)
Describe the autonomic innervation of Ejaculation
Visceral and Somatic nerves (pudendal nerve)
Mnemonic of autonomic innervation of the male sexual response
PSS
Point
Squeeze
Shoot
Sildenafil moa in the male sexual response
PDE-5 inhibitors (eg sildenafil) ↓cGMP breakdown
