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Repro > Lecture 1 - Male Repro > Flashcards

Lecture 1 - Male Repro Flashcards

1
Q

Look at the male repro notes in the prework tab
2nd image and label:

A

1 = corpus cavernosum
2 = corpus spongiosum
3 = pubic symphysis
4 = bladder
5 = prostate
6 = rectum
7 = vas/ductus deferens
8 = deep inguinal ring

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2
Q

What is the cord structure that passes from the testis to the prostate?

A

Ductus deferens (vas deferens)

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3
Q

What tube connects the prostate to the ductus deferens to the testis?

A

Ejaculatory duct

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4
Q

Within the testes what is the site of spermatogenesis?

A

Seminiferous tubules

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5
Q

What do the seminiferous tubules join up to?

A

Epididymis

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6
Q

What is the name of the connective tissue that holds the seminiferous tubules in place?

A

Tunica albuginea

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7
Q

What is the name of the serosa that envelopes the testis?

A

Tunica vaginalis

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8
Q

What membrane is the serosa Tunica vaginalis derived from?

A

Peritoneum

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9
Q

What is Hydrocoele?

Is it painful or painless?

A

When there is excess fluid in the Tunica vaginalis (scrotal swelling)

Painless

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10
Q

Why do hydrocoeles in young boys get bigger when they cough?

Why doesn’t it change in men?

A

When you cough the abdominal muscles contract, this forces fluid from the abdomen through the patent processes vaginalis pushing more fluid into the Tunica vaginalis

In normal development, in adults the processus vaginalis closes so there isn’t an opening into the tunica vaginalis

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11
Q

How can a hydrocoele be diagnosed?

A

Use a flashlight to transilluminate it

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12
Q

Except for the stem cells producing sperm cells in the seminiferous tubules what are 2 other important cells?

A

Sertoli cells
Leydig cells

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13
Q

What is the function of Sertoli cells?

A

Support (essential for) spermatogenesis by removing excess cytoplasm from developing sperm

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14
Q

Where are leydig cells found and what is their function?

A

In spaces between seminiferous tubules

They help make testosterone

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15
Q

How are leydig cells adapted to help make testosterone?

A

Have lots of/prominent Smooth Endoplasmic Reticulum (SER)

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16
Q

Describe the arterial blood supply to the testicles:

A

The abdominal aorta branches to the testicular arteries
(Symmetrical)

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17
Q

Why is the venous supply to the testicles described as non symmetrical?

A

The left and right testicular veins drain into different blood vessels

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18
Q

Describe the venous drainage of the testicles:

A

The right testicular vein drains straight into the vena cava
Whereas the left testicular vein drains into the left renal vein first

Think it’s because the inferior vena cava is more on the right in terms of the aorta

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19
Q

How are the testicular veins structured?

A

They form into branches called the pampiniform plexus

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20
Q

What is varicocele?

What does it fell like on palpation?

A

When the pampiniform veins in the scrotum get enlarged usually due to valvular dysfunction

A bag of worms

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21
Q

Why is varicocele more common on the left than the right?

A

The left testicular vein drains into the left renal vein then vena cava whereas the right testicular vein drains straight into the vena cava

This means theres more chance for valvular dysfunction to happen on the left making the enlargement of the pampiniform veins more likely

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22
Q

What lymph nodes do the testes drain to and why?

A

Lumbar lymph nodes and para aortic nodes

The testes develop near the diaphragm

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23
Q

What lymph nodes does the skin of the scrotum drain to?

A

The superficial Inguinal lymph nodes

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24
Q

Why is a cancer that has metastasised from the testes not palpable at the superificala Inguinal lymph nodes?

A

It would go to the lumbar or para arotic lymph nodes

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25
Q

What is Bell-clapper deformity?

A

When the testes has completely become completely enveloped (instead of only being partially enveloped) in tunica vaginalis, this would allow the testes to twist in the tunica vaginalis

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26
Q

What is testicular torsion?

A

When the testes twists within the tunica vaginalis leading to the twisting of the spermatic cord

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27
Q

What happens to the blood supply during testicular torsion?

A

Spermatic cord is twisted
Venous drainage cut off (pampiniform plexus) causing pressure to build up
This cuts of the arterial blood supply
Leading to ischameic damage to the testes

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28
Q

How is testicular torsion treated?

A

Untwist testes
Put sutures in preventing testes twisting in tunica vaginalis

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29
Q

What separates the left and the right testes?

A

Septum of scrotum

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30
Q

How does the testes end up in place if they develop in the diaphragm?

A

They evaginate the abdominal wall muscles as they are pulled through the by the gubernaculum forming the spermatic fascia

31
Q

What is the gubernaculum?

A

Its a structure connecting lower pole of testes to bottom of scrotum guiding the testes down to the scrotum

32
Q

What strucutre follows attached to the testis as it descends to the scrotum?

A

Vas deferens (ductus deferens )
Testicular artery
Testicular vein

33
Q

What 3 layersss form the spermatic fascia?

A

The 3 abdominal wall muscles

34
Q

What is the rule of 3 for what makes up the spermatic cord?

A

Made of 3 fascial layers, 3 arteries and veins, 3 nerves and 3 other things

35
Q

What are 3 fascial layers of the spermatic cord?
From deepest to most superficial:

A

Internal spermatic fascia (derived from transversalis fascia)

Cremasteric fascia (derived from internal oblique)

External spermatic fascia (derived fro external oblique)

36
Q

What is internal spermatic fascia derived from?

A

Transversalis abdominis fascia

37
Q

What is cremasteric fascia derived from?

A

Internal oblique muscle of abdominal wall

38
Q

What is external spermatic fascia derived from?

A

External oblique (abdominal wall)

39
Q

What are the 3 arteries and veins making up the spermatic cord?

A

Testicular artery and veins (pampiniform plexus)

Vein and artery from the ductus deferens (vas)

Cremasteric vein and artery

40
Q

What is the function of the cremasteric muscle?

A

Contracts to rise testes up ((Thermoregulation)

Relaxes allowing testes to sink

41
Q

How are the testicular artery and vein arranged?

Why is this useful?

A

The pampiniform plexus surrounds the artery

The counter current system helps cool the arterial blood down

42
Q

What are the 3 nerves in the spermatic cord?

A

Autonomics (mainly sympathetics to vas deferens)
Genital branch of genitofemoral (motor to cremaster)
Ilioinguinal nerve (sensory)

43
Q

What is the role of parasympathetic and sympathetics in terms of erection and ejaculation?

Way to remember this

A

Parasympathetic = erection

Sympathetics = ejaculation

Point and Shoot
P for parasympathetic
S for sympathetic

44
Q

What is thee 3 other strucutres in the spermatic cord?

A

Ductus deferens
Lymphatics (drain to periaortic lymph nodes in abdomen)
Patent processes vaginalis (not normal in health adults usually destroyed in development

45
Q

What is the Cremasteric reflex?

What nerves are important to this?

A

When the superior medial thigh stroked the cremasteric muscle contracts causing the Ipsilateral teste to rise

Genitofemoral nerve and ilioinguinal nerve

Ilioinguinal nerve senses it, genitofemoral nerve sends motor impulses to cremasteric muscle

46
Q

Why is the cremasteric reflex useful to asses?

A

Can asses nerve function following a stroke or to see if affected by diabetic neuropathy

47
Q

Why is the term water under the bridge useful for locating the ureter in both men and women?

A

In men ureter (water) passes under ductus deferens

In women ureter (water) passes under uterine artery

48
Q

How is vasectomy performed?

A

Local anaesthetic
Ductus deference gets cut by making small ins ion in scrotal skin

49
Q

What actually is the function of the ductus deferens?

A

Transports sperm from the epididymis made int he testes to the ejaculatory duct which joins with the prostatic urethra

50
Q

What is the journey of sperm?

A

Sperm made in testis
Enters epididymis
Head of epididymis continuos with the ductus deferens which is in the spermatic cord
Sperm than passes up the spermatic cord through the deep Inguinal ring (through the 3 abdominal wall layers), to the ejaculatory duct which connects to the prostatic urethra, membranous urethra then spongy urethra

51
Q

What part of the prostate is normally affected by Benign Prostatic Hyperplasia (BPH)?

Why does BPH usullay lead to urinary retention?

A

Transitional zone

Urethra passes through prostate

52
Q

What area of prostate do prostate cancers usually occur?

A

Peripheral zone (more superficial part)

53
Q

Which gland contributes the most to the volume of the ejaculate?

A

Seminal vesicles

54
Q

What needs to be done to the penis to catheterise and why?

A

Pick up penis and pull

The urethra has 2 bends that need straightening

55
Q

What are the 2 main functions of the penis?

A

Expulsion of urine via urethra

Deposit sperm in female genital tract

56
Q

What does the transverse section of the penis look like?

Slide 18

A

ET

Corpus cavernosum = eyes
Urethra = mouth
Corpus spongiosum = around mouth

57
Q

Which muscle contributes the most to penis rigidity?

Why not the other one?

A

Corpus cavernosum

The corpus spongiosum surrounds urethra, would end up compressing it

58
Q

How does an erection occur?

A

Parasympathetic system vasodilates the penile arterioles and compresses the veins causing more blood to be going in than out

59
Q

Which system terminates an erection?

A

Sympathetic

60
Q

Which muscle attaches to the pubic symphysis?

A

Corpus cavernosum

61
Q

What is the tunica albuginea of the penis?

A

The dense connective white coloured tissues surrounding the erectile tissue

(COMPLETELY DIFFERENT TO THE TUNICA ALBUGINEA IN AROUND THE Seminferous tubules)

62
Q

What is a fractured penis?

A

When the tunica albuginea of the penis gets ruptured (needs immediate repair otherwise permanent deformity)

63
Q

What is the blood supply to the penis?

A

The internal iliac artery which then supplies the internal pudendal artery

64
Q

Why can diabetics have erectile dysfunction?

A

Diabetic neuropathy affecting internal pudenal artery

65
Q

Why is important to establish whether a trans man has a cervix or not?

A

If they do they need cervical screening

66
Q

What blood vessel does the ureter run over?

A

It descend into pelvis over the bifurcation of the common iliac artery into the internal and external iliac artery

67
Q

What is the rectovesical pouch?

A

The pouch between the rectum and bladder lined by the peritoneum

68
Q

What passes through the deep Inguinal ring?

A

Testicular artery and vein
Ductus deferens

69
Q

What are some causes of scrotal swelling?

A

Haematocoele
Varicocoele
Inguinal hernia
Hydrocoele
Epididymidis
Spermatocoele (cysts within epididymis

70
Q

Why does a lump in the testis of a 22 yr old need follow up?

A

Its cancer until proven otherwise
Do ultrasound then transiluminate

71
Q

How can you differentiate a hernia from a discrete testicular swelling?

A

Cough impulse (when cough hernia gets bigger since abdominal wall will contract since it forms the spermatic fascia)

Hernia is reducible

72
Q

Where does teh testicular artery come from?

A

Abdominal aorta, inferior to superior mesenteric artery but superior to inferior mesenteric artery

73
Q

What lymph nodes do the testicles drain to?

A

Para aortic nodes

Repro (19 decks)

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