...genital sytem Flashcards
Differentiate btw male genetalia.
internal genetalia:
- testes + epidydimis
- ductus deferens + funiculus spermaticus
- accessory sex glands: prostate + gl. vesiculosa + gl. bulbourethralis (COWPER)
testes + epidydimus belong to int. genetalia bc they originate from abd. cavity, descended w/ peritoneal covering (cavitas serosa scroti) into scrotum
external genetalia:
- penis
- urethra
- scrotum
Briefly explain the function of the male genetalia.
- testes produce spermatozoa (∽ 74d)
- transported to epididymis → maturation (∽ 8-17d)
- pass through ductus deferens to urethra, sperms mixed with secretions of accessory sex glands
- leave body cavity through urethra
Describe the macroscopic structure of the testes.
- sup./inf. pole
-
epididymis
- 3 parts: caput, corpus, cauda
- fixed to sup. pole by lig. epididymis sup./inf.
- becomes ductus deferens at inf. pole
- covered by capsule = tunica albuginea
Briefly describe the microscopic structure of the testes.
What is their function?
seperated by septula testis into lobuli testes
→ contain seminiferous tubules
⇒ spermatozoa are produced in wall of seminiferous tubules
- in interstitium btw seminiferous tubules: LEYDIG cells → produce testosterone
Which remnants of embryological structures can be found in mature testes?
appendix testis:
- 3-4 mm wide at sup. pole
- remnant of MÜLLERIAN duct
appendix epididymis:
- at sup. pole of head of epidiymis
- remnant of WOLFFIAN duct
Which vessels supply/drain the testes?
Innervation?
supply:
-
a. testicularis (from aorta pars abdominalis)
orginate from lumbar region, follow during descencus
drainage:
-
plexus pampiniformis → unite in canalis inguinalis
→ v. testicularis dextra → v. cava inf.
→ v. testicularis sin. → v. renalis sin.
innervation:
- symph: plexus testicularis (rr. from plexus intermesentericus/renalis)
What is a varicocele and what might be the cause?
e. g. kidney tumors can grow into v. renalis → cause constriction of left v. testicularis →
* *dilation of plexus pampiniforis/vv. testicularis** → changes in blood circulation → reduced spermatic production
List the coats of the testes/scrotum from the innermost to the outermost layer.
-
tunica vaginalis = mesorchium
- epiorchium
- periorchium
- fascia spermatica int.
- m. cremaster
- fascia spermatica ext.
- scrotum - tunica DARTOS
- scrotum - skin
1 - 5
Which structures are formed by #2
No #4.
Another name for #3 and #5.
1) testes + epididymis
2) peritoneum → proc. vaginalis + deep ing. ring
3) epiorchium (visceral layer of tunica vaginalis)
5) periorchium (parietal layer of tunica vaginalis)
6 - 10
6) fascia transversalis abdominis
7) m. transv. abd.
8) m. obliq. int.
9) m. obliq. ext.
10) m. cremaster (prod. by #7 + #8)
11 - 16
11) fascia spermatica ext.
12) scrotum
13) tunica DARTOS
14) skin
15) cavitas serosa scroti
16) fascia spermatica int.
What is the function of tunica dartos?
movement of scrotal skin → temperature regulation (optimally 2 °C below body temperature)
Which structure can be found on the dorsal aspect in the middle of the scrotum?
raphe scroti = continuation of raphe perinei
What might be the reason for an innate inguinal hernia?
no obliteration of proc. vaginalis peritonei that forms tunica vaginalis testis
What is a hydrocele testis?
accumulation of fluid in cavitas serosa scroti → balloon-like enlargement
What can cause a testicular torsion and what are possible consequences?
thin mesorchium → testicular torsion → strangulation of blood vessels → irreversible damage to testes
What causes the cremaster reflex?
petting of inner surface of thigh → r. femoralis of n. genitofemoralis + cutaneous rr. of n. obturatorius → reflectory contraction of m. cremaster
What is cryptorchidism?
non-descent of testis into scrotum → stay in abd. cavity → high body temperature → damage to parenchyme of testes → no spermatic production
Which vessels supply/drain the scrotum?
Innervation?
supply:
- coats of testes: a. cremasterica (a. epigastrica inf.)
- scrotum: a. pudenda int.
drainage:
- v. pudenda ext. → v. saphena magna
- v. pudenda int. → v. iliaca int.
innervation:
- rr. scrotales of n. ilioinguinalis/n. pudendus
Which structures are connected by vas deferens?
How long is it, how thick?
Relate the structure of its wall to its function.
connects epididymis + urethra
- 35 - 40cm long
- 3mm thick
thick muscular layer → emission of sperms
What are the parts of vas deferens?
- pars epididymica ductus deferentis in inner aspect of epididymis
- pars funiculi spermatici in spermatic cord
- pars inguinalis in canalis inguinalis
- pars pelvica in lesser pelvis
then:
- ampulla ductus deferentis before entering prostate
- ductus ejaculatorius in prostate
- opens into colliculus seminalis of urethra
Which vessels supply/drain vas deferens?
Innervation?
supply:
- a. ductus deferentis (from a. umbilicalis)
drainage:
- plexus pampiniformis (cf. scrotal supply/innervation)
- *innervation:
- symph: plexus hypogastricus inf.
What are the layers of funiculus spermaticus?
from innermost to outermost
- fascia spermatica int
- m. cremaster
- fascia spermatica ext.
What are the contents of funiculus spermaticus?
-
vas deferens
- a. ductus deferentis
- plexus pampiniformis
- 2 aa. testiculares
- r. genitalis of n. genitofemoralis
- parasymph. fibers of plexus testicularis
- lymph vessels
<strong></strong><em>cf. histology flashcards</em>
Which structures accompany funiculus spermaticus?
- n. ilioinguinalis
- a. cremasterica
What are the 3 accessory sex glands in males?
What is their common function?
- paired gl. vesiculosa
- paired gl. bulbourethralis (COWPER)
- prostate
⇒ produce chief constituent of ejaculate
Where is gl. vesiculosa (= seminal vesical) located?
How big is it?
How much of the ejaculate is produced by it?
behind bladder, lateral to ampulla ductus deferentis
- 5cm long
- 1cm wide
- 1cm thick
⇒ produce 50-80% of ejaculate
How is gl. vesiculosa examined?
palpable via rectum
Which vessels supply/drain gl. vesiculosa?
supply:
- a. vesicalis inf.
- a. rectalis med.
- a. ductus deferentis
drainage:
- plexus venosus vesicalis/prostaticus
innervation:
- plexus hypogastricus inf.
<u>only difference btw supply/drainage innervation of gl. vesiculosa/prostate:</u><br></br>- <em>gl. vesiculosa:</em> a. ductus deferentis (since more cran.)<br></br>- prostate: a. pudenda int. (since more caud.)
What are the boundaries of the prostate?
How big is it, weight?
How much of the ejaculate is produced by it?
⇒ produces 15 - 30% of the ejaculate containing e.g. acid phosphatase
- 3cm long, 4cm wide, 2cm thick
- 20g
boundaries:
- ant: lig. puboprostaticum to pubic bone
- post: fascia rectoprostatica (DENONVILLIER) to rectum
- cran: base attaches to bladder
- caud: apex is sitting on pelvic diaphragm
Divide the prostate into zones.
- periurethral zone around urethra
- anteromedial zone anterior part of prostate (no glands)
- central zone encloses ductus ejaculatorii
- peripheral zone main mass laterally
- transitional zone btw central/peripheral zone
Why are the prostatic zones clinically relevant?
- benign prostate hyperplasia develops mainly in central/transitional zone (occurs in 50% of all men over 50)
- prostate carcinomas develop mainly in peripheral zone
⇒ impairs micturition due to occlusion of urethra
Which vessels supply/drain the prostate?
Innervation?
supply:
- a. rectalis med.
- a. vesicalis inf.
- a. pudenda int.
drainage:
- plexus vensosus vesicalis/prostaticus
innervation:
- plexus hypogastricus inf.
<u>only difference btw supply/drainage innervation of gl. vesiculosa/prostate:</u><br></br>- gl. vesiculosa: a. ductus deferentis (since more cran.)<br></br>- prostate: a. pudenda int. (since more caud.)
Where are gll. bulbourethrales located?
Another name?
COWPER glands on urogenital diaphragm
⇒ lubricate pars spongiosa of urethra
Which 2 structures attach the penis to the body?
- lig. fundiforme penis hooks around penis
- lig. suspensorium penis attaches at dorsum
⇒ both attach it to abd. wall / symphysis pubica
MNEMONIC: fundiforme = forms a fundus, “holds” penis
Where are the 3 constrictions of the penis?
- ostium urethrea int.
- pars membranacea
- ostium urethrae ext.
Which gll. can be found in urethra pars spongiosa?
What is their function?
gll. urethrales (LITTRE)
⇒ produce a colloid secretion containing glycosaminoglycans protecting the epithelium against urine
Which structures form ductus ejaculatorius?
ductus deferens (from epididymis) + ductus excretorius (from gl. vesiculosa)
1 - 5
1) urethra pars intramuralis
2) urethra pars prostatica
3) urethra pars membranacea
4) urethra pars spongiosa
5) ostium ureteris
6 - 10
Another name for #10.
6) trigonum vesicae
7) colliculus seminalis
8) prostate
9) ductuli prostatici
10) gll. bulbourethrales (COWPER)
11 - 15
11) crura of penis
12) ductus gll. bulbourothrales
13) corpus cavernosum
14) glans penis
15) preputium
16 - 20
16) fossa navicularis
17) ostium urethrae ext.
18) corpus bulbospongiosum
19) corona glandis
20) crista urethralis
21 - 23
Another name for #23.
21) openings of ductuli ejacultorii
22) ostium urethrae int.
23) openings of gll. urethrales (LITTRE)
How do you call the condition when the preputium cannot be fully retracted?
phimosis
Which vessels supply/drain the penis and the accompanied part of the urethra?
Innervation?
supply:
- a. dorsalis penis → skin, preputium, glans
- a. profunda penis → aa. helicinae → corpora cavernosa
- a. bulbi penis (from. a. prof. penis) → aa. urethrales → urethra, corpus spongiosum
drainage:
- v. dorsalis profunda → plexus venosus vesicalis/prostaticus
- 2 v. dorsalis superficialis → v. pudenda ext. → v. saphena magna
- v. bulbi penis → v. dorsalis prof.
innervation:
- sens: n. dorsalis penis (from n. pudendus)
- plexus hypogastricus inf.
1 - 5
1) corpus cavernosum
2) corpus spongiosum
3) urethra
4) septum penis
5) tunica albuginea
6 - 10
Another name for #6.
6) fascia penis (BUCK)
7) subcutis
8) cutis
9) a. prof. penis
10) v. dorsalis prof. penis
11 - 13
11) v. dorsalis sup. penis
12) a. dorsalis penis
13) a. bulbi penis
Explain the function of Viagra®.
Viagra® = inhibitor of phosphodiesterase
→ slower decomposition of cGMP
Explain the process of erection.
- stimulation of erection center in S3
- parasymp. innervation releases acteylcholine
- endothelial cells of a. helicinae/corpora cavernosa release NO → diffuses into smooth m.
- activates guanylate cyclase → production of cGMP
- relaxation of smooth m. of corpora cavernosa → vasodilation of aa. helicinae in corpora cavernosa
- filled corpora cause compression of v. dorsalis prof. penis against tunica albuginea → no venous drainage
- erection due to increasing pressure in corpora cavernosa (∽ 10x → 1,200 mmHg)
What is priapism?
What might be a cause?
condition where penis doesn’t return to its flaccid state
e.g some types of leucemia can cause problems in the blood circulation of the penis
Which nn. cause the emission of semen from vas deferens into the urethra?
symph. ejaculation center in L2/3
What is responsible for ejaculation?
rhythmic contraction of m. bulbospongiosus
1) parasymp. erection centers in S3→ erection<br></br>2) symp. emission centers in L2/3 → emission<br></br>3) <strong>n. pudendus</strong> → ejaculation
Differentiate btw 2 types of potency.
potentia coeundi = being able to have sex
potentia generundi = being able to reproduce
⇒ if both: fertile
Which structures belong to the external female genetalia?
Another name?
What is their common function?
also: vulva
- mons pubis
- labia majora pudendi
- labia minora pudendi
- clitoris
- vestibulum vaginae
- gll. vestibulares majores/minores
⇒ protection, sexual arousal, lubrication
Which structures belong to the internal female genetalia?
What is their function?
- vagina
- uterus
- ovaries
- tubae uterinae
⇒ reproduction, birth
Which structures are referred to as adnexa?
tubae uterinae + ovaries
Explain the structure of the clitoris.
similar to penis
- 2 corpora cavernosa covered by fascia clitoridis + m. ischiocavernosus
- form crura + corpus + glans clitoridis
- seperated by a septum
- attached to symphysis pubica by lig. suspensorium clitoridis
What do labia majora/minora consist of?
What are they continuous with?
labia majora pudendi:
- adipose tissue + venous plexuses
- contain ligg. teretes uteri (cf. female perineum)
- continuous w/ commissurae labiorum
labia minora pudendi:
- conn. tissue + sebaceous glands
- continuous w/ frenulum clitoridis → preputium clitoridis, frenulum labiorum
1 - 5
1) mons pubis
2) labium majus pudendi
3) labium minus pudendi
4) commissura labiorum ant.
5) commissura labiorum post.
6 - 10
6) frenulum labiorum pudendi
7) carunculae hymenales
8) rugae vaginales
9) crista urethralis vaginae
10) ostium urethrae ext.
11 - 14
Another name for #14.
11) frenulum clitoridis
12) glans clitoridis
13) preputium clitoridis
14) projection of gl. vestibularis maj. (BARTHOLIN)
Which structures open into vestibulum vaginae?
urethra + vagina + BARTHOLIN gll.
How do you call the opening to the vagina?
ostium/introitus vaginae
Which vessels supply/drain the vulva?
Innervation?
supply:
-
a. pudenda int.
- rr. labiales post. → labia minora
- a. bulbi vestibuli → bulbus vestibuli
- a. profunda clitoridis → crus clitoridis
- a. dorsalis clitoridis → glans clitoridis
- rr. labiales ant. → labia majora
drainage:
-
v. pudenda int.
- corpus/glans → v. dorsalis prof. clitoridis → plexus venosus vesicalis
-
v. pudenda ext.
- v. dorsalis sup. clitoridis
- vv. labiales ant.
innervation:
- sens: nn. labiales ant from n. ilioinguinalis, nn. labiales post./n. dorsalis clit. from n. pudendus
- plexus hypogastricus inf.
How do you call the part of the vagina surrounding the entrance to the uterus?
Why is it clinically relevant?
fornix vaginae
- pars ant.
- pars. post.
- pars lat.
⇒ excavatio rectuoterina (DOUGLAS pouch) is palpable via pars post. of fornix
Which vessels supply/drain the vagina?
Innervation?
supply:
- a. vaginalis (from a. iliaca int.)
- rr. vaginales (from a. uterina)
- a. vesicalis inf.
- a. rectalis med.
drainage:
- plexus venosus vagina → v. iliaca int.
innervation:
- sens: n. pudendus
- plexus uterovaginalis
Explain the peritoneal relation of the different parts of the uterus, tuba uterina, and ovary.
corpus = intraperitoneal
cervix = subperitoneal
tuba uterina = intraperitoneal
ovary = intraperitoneal
Differentiate btw peri-, para-, meso-, myo- and endometrium.
- mesometrium = part of lig. latum that attaches at margo uteri
- parametrium = fibrous structure connecting cervix to bladder, sacrum, wall of pelvis, inguinal canal
- perimetrium = peritoneum covering rest of uterus
- mesometrium = muscular layer of uterus
- endometrium = mucous membrane of uterus
1 - 5
Another name for #2.
What is the difference btw #4 and #5 besides their location?
1) excavatio vesicouterina
2) excavatio rectouterina (DOUGLAS pouch)
3) corpus uteri
4) cervix uteri - portio supravaginalis → attached to parametrium = paracervix
5) cervix uteri - portio vaginalis
6 - 10
Another name for #10.
6) endometrium
7) myometrium
8) perimetrium
9) fornix post. vaginae
10) ostium anatomicum uteri int. (= internal os)
11 - 15
Another name for #11, 13, 15.
11) ostium uteri (= external os)
12) cavitas uteri
13) spatium retropubicum (RETZIUS)
14) isthmus uteri
15) facies intestinalis/post.
16 - β
Another name for #16.
⍺ and β are pointing at the angles.
16) facies vesicalis/ant.
⍺) angle of anteflexio
β) angle of anteversio
1 - 5
1) lig. ovarii proprium
2) lig. teres uteri
3) mesometrium
4) mesovarium
5) mesosalpinx
6 - 10
6) lig. latum
7) lig. suspensorium ovarii
8) lig. cardinale
9) cervix portio supravaginalis
10) cervix portio vaginalis
11 - 15
Another name for #11.
11) pars uterina tubae (= intramural part)
12) isthumus tubae uterinae
13) ampulla tubae uterinae
14) infundibulum tubae uterinae
15) fimbriae
16 - 20
16) ureter
17) a./v. iliaca int.
18) a./v. uterina
19) r. vaginalis a. ut.
20) r. helicanus a. ut.
21 - 24
21) r. tubarius a. ut.
22) r. ovarius a. ut.
23) a./v. ovarica
24) plexus ovaricus
Describe the course of lig. teres uteri.
tubal angle → canalis inguinalis → labium majus
Which structure(s) mainly support(s) the uterus?
pelvic diaphragm, not ligg.
Which vessels supply/drain the uterus?
Innervation?
supply:
- rr. helicini of a. uterina
drainage:
- vv. uterinae → plexus venosus uterinus → vv. iliacae int.
innervation:
- plexus uterovaginalis (from plexus hypogastricus inf.) (= FRANKENHÄUSER’s ganglion)
What can happen in case of a tubal pregnancy?
What is a common cause?
inflammational stenosis in tuba → embryo remains in tuba → grows → rupture + critical bleedings
Where else does the tuba open into?
peritoneal cavity via ostium abdominale
Which vessels supply/drain the tuba uterina?
Innervation?
supply:
- a. ovarica
- r. tubarius (from a. uterina)
drainage:
- plexus venosus uterinus → v. iliaca int.
innervation:
- plexus ovaricus
- plexus hypogastricus
How are the superior/inferior pole, and ant. and post. border of the ovary called?
Does anything attach?
- superior pole = extremitas tubaria, lig. suspsensorium ovarii attached
- inferior pole = extremitas uterina, lig. ovarii proprium attached
- ant. border = margo liber
- post. border = margo mesovaricus, mesovarium attached
Which vessels/nerves lie adjacent to the ovary?
Why are they clinically relevant?
- ureter dorsally
- a. umbilicalis caudally
- a./n. obturatorius caudally
⇒ inflammation of ovary can radiate pain up to the inner surface of the thigh
Which vessels supply/drain the ovary?
Innervation?
supply:
- a. ovarica (via lig. suspensorium ovarii)
- r. ovaricus of a. uterina
drainage:
-
vv. ovaricae
- → left into v. renalis
- → right into v. cava inf.
innervation:
- plexus ovaricus
Explain the 4 phases of sexual reaction.
-
phase of sexual arousal:
- stimulation of clitoris
- gl. vestibulares lubricate introitus vag.
- corpora cav. + glans swell due to vasocongestion (filling w/ venous blood) + increase of muscle tone
-
plateau phase:
- widening of sup. portion of vagina
- orgasmic platform (due to vasocongestion) in inf. portion of vagina
-
orgasmic phase:
- contraction of orgasmic platform, uterus + pelvic diaphragm
-
phase of dissolution:
- organs return to initial state
