L10. Genitalia Flashcards
What are the 2 pouches of peritoneum in females and 1 in males and their importance
(This can be a surgical access point from the vagina for intrabdominal surgeries for supermodels)
M: Vesicorectal pouch
F: Vesicouterine pouch +
Pouch of Douglas (rectouterine)
This extends far inferiorly making it the most dependant part of the abdo cavity where fluids will gather and if there is an abscess, a fistula through to the vagina can happen.
What are the layers of the penis from outside to inside, including vessels within each layer?
- Skin
- Superficial (Dartos) fascia
- Areolar tissue : a)Superficial dorsal vein
- Deep (Buck’s) fascia:
a)2x dorsal nerves of the penis
b) 2x dorsal arteries
c) 1x deep dorsal vein of the penis which passes through anterior deficieny in the perineal membrane to the prostate/bladder - Infectious pathway)
5.Tunica Albuginea - Corpora Cavernosa-
a) 1 Deep artery each
Corpus spongiosus
a) urethra
What is the blood supply to the scrotum
Internal and External pudendal arteries
What is the pathway of sperm from seminiferous tubules to the outside- specifically vas deferens
- Seminiferous tubules to rete testis
- to Efferent ductules to Epididymis to
3.Vas deferens which travel in the spermatic cord through inguinal canal, entering the body cavity lateral to the inf epigastric artery,
a) crosses over the External iliac vessels and passes Medially towards the prostate
b) passes over the top of the bladder and ureter to join - Join duct from seminal vesicle at the back of bladder to form the ejaculatory duct
- Ejaculatory duct through the prostate to join
prostatic urethra - membranous then spongy urethra
What do the seminal vesicles do and where are they
They are above the prostate (behind the pubic symphysis. and just behind the bladder- between the bladder and rectum.
They secrete the liquid component of semen, fructose
What is the role of the prostate gland, the type of tissue it has and what is its blood supply - arterial and venous
Prostate secretes proteolytic enzymes an acid phosphatase for seminal fluid.
It also contains the prostatic urethra and the ejaculatory duct.
Prostatic tissue is alveoli lined with columnar glandular epithelium, embedded in a thick fibromuscular stroma.
Supplied by the Int iliac artery and drained by prostatic plexus which is joined by the deep dorsal vein of the penis to the internal iliac vein.
What are the prostatic ligaments and support
- Levator prostatatae from the levator ani muscle
- Puboprostatic ligament which anchors the prostate to the pubic bones anteriorly
What are the symptoms of enlargement of the prostate - due to benign prostatic hyperplasia or malignant.
Enlargement of the prostate primarily in transitional zone (benign) or in all zones.
- may push into the bladder creating a recess: incomplete urination or feeling of not being empty - can lead to urinary retention and infection
- may close off the urethra : slow stream of urine
- may go through the int sphincter: potential incontinence as int. sphincter can’t close properly - dribbling.
What is the lymphatic drainage of the male system vs female
Iliac nodes:
Vas deferens, bladder, prostate, erectile tissues
Body of uterus via the broad ligament, cervix, upper vagina
Para-aortic nodes at root of testicular/ovarian artery L2: Testes, ovaries, fundus, uterine tube
Deep inguinal and iliac nodes: Glans penis
Superficial inguinal: skin, Lower vagina, The round ligament of the uterus
What does anteversion and anteflexion mean and what are the alternatives
The angle that the uterus sits on top of the bladder can be described as anteflexion: facing forward Anteversion is the angle of the cervix. There are some women with midposed or retroverted uterus but this is only bad if its changing overtime.
What are the 3 components of the Broad ligament of the uterus and its purpose. What is the other ligament
Broad ligament is the peritoneum draping over the uterus and then folding back on itself. It transmits arteries , ANS nerves and lymphatics to uterine structures
- Mesosalphinx: around the uterine tubes
- Mesoovarium: around ovaries
- Mesometrium: around body of uterus
Other ligament is the Round ligament of the uterus passing out the inguinal canal to the labia majora.
it helps to pull the uterus forward into the anteverted position. (Also creates an alternate path for lymph)
What is the female and male version of water under the bridge
F: Ureter passes under the Uterine artery in the mesometrium
M: Vas def passes over the ureter
What is the function, arterial supply, venous drainage and nerve supply to the ovaries
Function: Ova and hormone production
Art: Ovarian artery at Para-aortic L2
Venous: Ovarian vein: IVC on right or Left renal vein on left.
Nerve: Ovarian plexus refers pain to the lower abdomen.
What is Bartholin’s cyst and what can it cause , original function of the Bartholins gland
Bartholins glands/Greater Vestibular gland in the superficial pouch (posterolateral from the vaginal opening) secrete mucous for lubrication.
If they become blocked they make Bartholins cyst which is inflammation which can lead to bacterial infection.
This can cause bartholins abscess.
What is Guevedoces (DHT syndrome)
Undervirilised male external genitalia for a genetically xy, due to lack of androgen DHT during development.
Puberty raised androgen sex hormones can show male genitalia but socially can choose to be female, female to be male or male.
