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RRPA Anatomy II > GUT Male Anatomy and Radiology (ClinMed & Commentary)) > Flashcards

GUT Male Anatomy and Radiology (ClinMed & Commentary)) Flashcards

1
Q

What muscles make up the Levator ani?

A
  • Iliococcygeus
  • Pubococcygeus
  • Puborectalis
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2
Q

What are all the muscles and structures in the Deep Perineal Pouch?

A
  • External urethral sphincter
  • Opening of urethra
  • Deep transverse perineal m
  • Deep perineal pouch lies inside the perineal membrane
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3
Q

Pelvic Fossa contents

A
  • Many blood vessels & nerves in area
  • Puboprostatic ligament = analagous to supportive ligament in females
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4
Q

What are the muscles and erectile tissues of the penis?

A
  • Corpora Cavernosum (2)
  • Corpus Spongiosum (attached to the Perineal Membrane)
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5
Q

Bladder Anatomy

A
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6
Q

Internal Bladder Anatomy

A
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7
Q

T/F: Urethral Catheterization will be gender specific?

A

True

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8
Q

What part of the urethra is surrounded by erectile tissue just below the Deep perineal pouch, is thin, angled, and vulnerable to injury?

A
  • Spongy urethra
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9
Q

The Prostatic Urethra curves slightly ___?

A

anteriorly

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10
Q

During filling of the bladder what state are the detrusor m and internal and external sphincters in?

A
  • Detrusor = relaxed
  • Internal sphincter = contracted
  • External sphincter = contracted
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11
Q

During filling of the bladder what is each muscle’s control mechanism?

A
  • Destrusor = sympathetic (B2)
  • Internal sphincter = sympathetic (a1)
  • External sphincter = voluntary
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12
Q

During emptying of the bladder what state are the detrusor m and internal and external sphincters in?

A
  • Detrusor = contracted
  • Internal sphincter = relaxed
  • External sphincter = relaxed
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13
Q

During emptying of the bladder what is each muscle’s control mechanism?

A
  • Detrusor = parasympathetic (M)
  • Internal sphincter = parasympathetic (M)
  • External sphincter = voluntary
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14
Q

Spermatic Cord contents

A
  • Ductus (Vas) deferens
  • Pampiniform Plexus
  • Genitofemoral n
  • Sympathetic and visceral afferent nn
  • Course of inguinal canal
  • Inguinal rings
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15
Q

The Pampiniform Plexus function

A

Heat exchanger

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16
Q

What muscle does the Genitofemoral N go to?

A

Cremasteric muscle

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17
Q

The Tunica vaginalis is comprised of what 3 layers?

A
  1. Parietal layer (outter layer)
  2. Cavity
  3. Visceral layer
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18
Q

What is the arterial supply of the penis?

A

Via Internal Pudendal AA –> branches to Dorsal A –> Perineal AA –> branches to Deep A & penile erectile tissues

*Remember PDPD - (Erectile Dysfunction)

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19
Q

What is the venous anatomy of the penis?

A

Dorsal V –> Prostatic Plexus –> Vesicle Plexus –> Internal Pudenal VV –> Internal Iliac VV

*DPV IPI

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20
Q

The Testicular AA arises from?

A

Abdominal Aorta (to scrotum via inguinal canal)

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21
Q

The Cremasteric AA comes from the ___ ___ to the Inferior Epigastric AA

A

External Iliac AA

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22
Q

Arterial supply of the scrotum is via?

A

Perineal AA

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23
Q

Venous anatomy of the scrotum

A
  • Drains via Testicular VV –> Internal Iliac –> Internal Saphenous
  • *drainage via multiple systems - think Plexes
  • Venous drainage can go into inguinal area - lymph nodes in that area

* you’re TIIIS‘ing out the blood

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24
Q

Lymphatics: Deep perineal drainage via ___ ___ vessels into Internal Iliac nodes

A

Internal Pudendal

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25
Q

Lymphatics: Superficial drainage via ___ ___ vessels mainly into Superificial Ingunal nodes

A

External Pudendal

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26
Q

Lymphatics: Glans penis into both ___ & ___ nodes

A

Deep Inguinal & External Iliac

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27
Q

Parasympathetic fibers come from what nerve roots via the Pelvic Splanchnic nerves?

A

S2-S4

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28
Q

Parasympathetic fibers from the Pelvic Splanchnic nerves go to?

A
  • Inferior Hypogastric Plexus
  • Deep Perineal pouch
  • Perineal Membrane
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29
Q

What do the parasympathetic fibers from S2-S4 via the Pelvic Splanchnic nerves stimulate?

A
  • Erection - vasodilation of Internal Pudenal A to corpora cavernosa & spongiosa
  • Bladder contraction
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30
Q

What nerves can a prostatectomy destroy, causing impotence?

A

Parasympathetic fibers (S2-S4) - Pelvic Splanchnic nerves & Hypogastric Plexus

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31
Q

Sympathetic fibers are carried by what nerves?

A
  • Sacral Splanchnic nerves
  • Superior Hypogastric Plexus
32
Q

Sympathetic fibers from the Sacral Splanchnic nerves & Superior Hypogastric plexus go to?

A

Hypogastric nerve to the Inferior Hypogastric Plexus

33
Q

Contraction of the Internal Urethral Sphincter in men and smooth muscle contractions of reproductive tracts are stimulated by what nerves?

A

Sympathetic fibers carried by Sacral Splanchnic nerves

34
Q

Somatic Afferent (sensation) from the penis is via the ___ and ___ nerves

A

Pudenal and Perineal nerves (S2-S4)

35
Q

What type of neuro fibers does the Prevertebral Plexus carry?

A
  • Sympathetic
  • Parasympathetic
  • Visceral Afferent
36
Q

What Dx should you be thinking of if a patient has painless hematuria?

A

Bladder Malignancy!

37
Q

What is the most common tumor of the urinary tract?

A

Bladder malignancy

38
Q

Bladder malignancy is most common in what decades of life?

A

sixth & seventh

39
Q

Where is bladder cancer most commonly located?

A

2/3 superficial

*1/3 are multifocal

40
Q

Bladder malignancy will invade the bladder wall then invade local structures such as?

A
  • prostate
  • rectum
  • uterus, ureters
  • lateral pelvic walls
41
Q

Bladder malignancy invades local structures via?

A

Internal iliac lymph drainage and nodes

42
Q

Posterior Urethral Valves: an obstruction can occur 2/2 to congenital membranes at the junction of the ____ and ____ urethras

A

posterior and penile

*Associated with VUR

43
Q

Pre-natal Hydronephrosis on fetal ultrasound is 2/2 to?

A

vesicoureteral reflux

44
Q

On ultrasound of a fetus what does a thickened bladder wall and bladder trabeculations indicate?

A

Pre-natal Hydronephrosis

45
Q

T/F: the Posterior Urethral Valves are true valves

A

False: not true valves but a fold of tissue - a membrane

46
Q

The majority of prostate cancers are in what zone?

A
  • Peripheral Zone (70%) - surrounds proximal urethra
  • Transitional Zone (20-30%) - posterior, surrounds distal urethra
  • Small amt in Central Zone - surrounds ejaculatory duct
47
Q

Prostate cancer is typically found in peripheral portions of the prostate and is ___

A

asymmetric

48
Q

The Anterior Fibromuscular Stroma (AFS) is ____

A

aglandular (without glands)

49
Q

The New Classification of prostate zones

A

On photo:

  • A = Seminal Vesicles
  • B = Peripheral Zone
  • C = Penile Urethra
50
Q

In BPH, central areas of the prostate enlarge involving the urethra. Hyperplasia of both ___ and ___ elements occurs.

A

stroma and glandular

(most of the growth is in the Transitional Zone)

51
Q

Carcinoma of the prostate arises from ___ tissue and is thus called an adenocarcinoma

A

glandular

52
Q

What classification system is used for adenocarcinoma of the prostate?

A

Gleason Classification

*Dr. Witwer said there won’t be any test questions on this but to just know that there is a loss of architecture, a lot of nuclei, and differing shapes in prostate malignancy

53
Q

Cancer of the prostate has a predilection to metastasize to?

A

Bone!!

54
Q

There is an increased incidence of ____ in undescended testes (cryptorchism)

A

malignancy!

55
Q

What is on your DDx for a painful testicle and/or scrotum?

A
  • Epididymitis
  • Orchitis
  • Epididymo-orchitis
  • Testicular Torsion
  • Vericocele
  • Hernia w/i scrotum

*Note: Use Duplex Doppler US to look for blood flow in the testicle and/or epididymus!

56
Q

What will you expect to see on Doppler US for epididymitis?

A
  • enlarged
  • heterogeneous
  • hypervascular
  • poss w/ reactive hydrocele
57
Q

A large epididymus and diffuse increased blood flow on Doppler US of the testicle indicates what Dx?

A

Epididymo-orchitis

58
Q

What is the bell clapper deformity?

A

Where the tunica vaginalis surrounds most of the testicle

59
Q

A large, avascular, hypoechoic testis on Doppler US is indicative of what Dx?

A

Testicular Torsion

60
Q

Increased blood flow to the epididymis and normal flow to the testis on Doppler US is indicative of what Dx?

A

Epididymitis

61
Q

Venous drainage of the testis is via the ____ ____ that runs within the Spermatic Cord

A

Pampiniform Plexus

62
Q

A varicosity of the Pampiniform Plexus is a ___

A

Varicocele

63
Q

Distended veins showing bidirectional flow in the veins of the testicle on Doppler US is indicative of what Dx?

A

Vericocele

64
Q

BPH most commonly arises in what zone?

A

Transitional Zone

65
Q

The Ischiocarvernous muscles (adjacent to the Ischiopubic rami) enclose the ___ ___

A

Corpora Cavernosum - which become the top portion of the penis

66
Q

The Bulbospongiosus muscle encloses the ___ ___

A

Corpus Spongiosum - which becomes the lower portion of the penis

67
Q

What structure of the penis encloses the urethra which comes from above?

A

Corpus spongiosum

68
Q

The prostate is a gland, glandular elements secrete substances that are conducive to the survivial of?

A

Sperm

69
Q

What do the Seminal vesicles produce?

A

Seminal fluid that helps the sperm survive

70
Q

The sperm come from the testicles, via the ___ ___ to the ejaculatory duct

A

Vas deferens

71
Q

When the sperm are in the ejaculatory duct what do they mix with?

A

Seminal fluid from the Seminal vesicles

72
Q

Ejaculation is mediated by what nervous system?

A

Sympathetic

73
Q

The arteries to the gonads, testicles, and ovaries are from the ___ ___ and the venous drainage is from the ___?

A
  • Abdominal Aorta
  • Inferior vena cava
  • This is because the ovaries and testicles embyrologically arise from just below the kidneys
74
Q

What portion of the prostate enlarges, involving th urethra with obstruction?

A
  • Periurethral portion
  • There is primarily enlargement of the stromal elements of the Transitional Zone of the Prostate
75
Q

Testicular malignancy is associate with what type of cells?

A

Germ cells (ie sperm progenitors)

RRPA Anatomy II (9 decks)

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