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ANAT > Lecture 19-20 Male > Flashcards

Lecture 19-20 Male Flashcards

1
Q

External and internal genitalia both develop from common embryological primordium, true or false?

A

False

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2
Q

Where do the indifferent gonads develop?

A

Retroperitoneally high on the posterior body wall, medial the embryonic kidney or mesonephros

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3
Q

When do permanent kidneys or metanephros take over

A

At a concurrent time with the gradual degeneration of mesonephros

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4
Q

What are some of the mesonephros recycled as

A

Male internal genitalia

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5
Q

What do the female internal genitalia develop from?

A

A separate set of ducts, the paramesophrenic ducts

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6
Q

What influences the differentiation of the testes

A

The testis determining factor on the Y chromosome.

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7
Q

When does the gubernaculum start to form?

A

When the mesonephros degenerates

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8
Q

What is the gubernaculum

A

A strand of connective tissue on either side of the vertebral column

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9
Q

Where does the gubernaculum ultimately extend from

A

The inferior pole of the ovary or testis through the muscle of the abdominal wall and into the labioscrotal fold

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10
Q

What is the future inguinal canal

A

The transition of the gubernaculum through the abdominal wall

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11
Q

What enlarges as the mesonephros degenerates

A

Testis

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12
Q

What is the processus vaginalis

A

An outfolding of the peritoneum that forms anterior to each gubernaculum and grows into the scrotum with the testes

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13
Q

The processus vaginalis fully closes after the descent of the testes true or false

A

False, a small cavity is left in front of the testis but direct connection to the peritoneal cavity is lost

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14
Q

What does the inguinal canal contain

A

Connective tissue

Descended structures: ductus deferens, blood vessels, nerves and lymph vessels

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15
Q

What does the distal end of the gubernaculum remain as

A

A small structure anchoring the testis to the scrotum

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16
Q

What forms the deep and superficial inguinal ring

A

The opening in the transversalis fascia and the external oblique

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17
Q

What is another factor thought to be involved in the descend of the testis

A

Growth of the trunk

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18
Q

The female gubernaculum shortens during the descent of the ovaries true or false?

A

False, the male gubernaculum does descend during development

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19
Q

What ligaments does the gubernaculum become part of? (3)

A

Broad, ovarian and round

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20
Q

What is the path of the round ligament?

A

The uterotubular junction to the side wall of the pelvis and deep inguinal ring. Passes through the inguinal canal and superficial ring to end in mons or labium majora.

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21
Q

What is in the superficial fascia of the scrotum

A

Cutaneous dartos muscle

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22
Q

What is the role of the dartos muscle

A

Controlling the loss of heat by wrinkling the skin

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23
Q

What is the dense connective tissue covering the testes

A

Tunica albuginea

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24
Q

What is the posterior thickening of the tunica albuginea

A

Mediastinum testis

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25
Q

What does the mediastinum testis contain

A

Ducts connecting seminiferous tubules with the epididymus

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26
Q

The anterior, medial and lateral testis face what? What is this derived from?

A

Serous cavity

Processus vaginalis

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27
Q

What does the testis contain? What is it made of? (3)

A

Seminiferous tubules

Spermatogenic cells, Sertoli cells and Leydig cells

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28
Q

What do the different cells of the testis do?

A

Spermatogenic - sperm production
Sertoli - support, including binding testosterone
Leydig - testosterone production

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29
Q

What is the epididymus

A

A single tightly coiled tube on the superior and posterolateral sides of the testis

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30
Q

What is continuous with the epididymus

A

The ductus deferens

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31
Q

The entire epididymus is adhered to the testis, true or false?

A

False, only the head and tail is adhered.

The body is separated by the sinus

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32
Q

What are the functions of the epididymus (3)?

A

Absorbs testicular fluid, phagocytoses dead sperm and matures normal sperm

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33
Q

Where does the spermatic cord extend?

A

Deep inguinal ring to superior pole of testis

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34
Q

What does the spermatic cord contain?

A

Ductus deferens, arteries testis and ductus deferens, cremasteric artery, pampiniform plexus of veins, lymph vessels which drain the testes, nerves including sympathetic and parasympathetic fibres from inferior hypogastric plexus

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35
Q

What is the cremasteric artery a branch of? Anastomose with?

A

Inferior epigastric artery

Testicular artery

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36
Q

Lymph vessels of the spermatic cord drain the scrotum, true or false?

A

False

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37
Q

What do the pampiniform plexus form?

A

3-4 veins in the inguinal canal, then 2 veins after the deep inguinal ring

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38
Q

What is the spermatic cord covered by? What is its role

A

Cremasteric muscle. Elevates testis

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39
Q

What are the two supplies of blood to the testes?

A

Testicular artery

Cremasteric artery

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40
Q

What is the origin of the testicular artery

A

Aorta

41
Q

What does the testicular artery cross?

A

Psoas major with the ureters

42
Q

What do the testicular veins drain into?

A

Right into IVC, left into the renal vein

43
Q

Where does the ductus deferens travel?

A

From the tail of the epididymus, through the spermatic cord. At the deep inguinal ring it leaves the spermatic cord and passes medially over external iliac vessels onto lateral wall of pelvis. Crosses superior to ureter at base of bladder where it expands to form a dilation, the ampulla. Joined by duct of seminal vesicle to form ejaculatory duct.

44
Q

Where are the seminal vesicles

A

Paired structures between base of bladder and rectum

45
Q

What is medial to the seminal vesicles.

A

Ductus deferens

46
Q

What causes the seminal vesicles to secrete thick alkaline secretion?

A

Sympathetic stimulation of smooth muscle

47
Q

What is in the alkaline secretion from the seminal vesicles?

A

Fructose and coagulating agents

48
Q

How long are the ejaculatory ducts?

A

2cm

49
Q

How do the ejaculatory ducts run?

A

Anterior-inferiorly into prostate and join prostatic urethra at seminal colliculus.

50
Q

What does the penis consist of (3)?

A

Root, body and glans

51
Q

What do the dorsal corpora cavernosa form after the root of the penis?

A

Crura

52
Q

What are the crura covered inferiorly with?

A

Ischiocavernous muscle

53
Q

What do the ventral corpus spongiosum form distally and proximally?

A

Glans and bulb which is attached to the perineal membrae

54
Q

What wraps around the bulb?

A

Bulbospongiosis muscle and forms a sphincter

55
Q

What are the corpora cavernosae and corpus spongiosum covered with?

A

Dense layer of fibrous tissue - tunica albuginia

56
Q

What do the tunica albuginia consist of?

A

Corpora cavernosae - predominantly inextensible collagen + some elastin
Corpus spongiosum - predominantly extensible elastin + some collagen

57
Q

What does the erectile tissue consist of?

A

Vascular spaces lined with endothelium

58
Q

What are the vascular spaces surrounded by?

A

Bundles of smooth muscle plus many nerve endings and lymph vessels

59
Q

What bloodflow is predominantly central in the penis and which is predominantly peripheral (adjacent to the tunica albugineae)

A

Arterial

Venous

60
Q

What covers the penis

A

Prepuce - thin skin which forms a fold over glans in uncircumcised males

61
Q

What are the differences between the superficial fascia and deep fascia?

A

No fat

Closely adherent to corpora

62
Q

What does the suspensory ligament of penis span

A

Pubic symphysis to deep penile fascia of root and body

63
Q

How is the penis supplied?

A

Internal pudendal artery which supplies 2x deep dorsal arteries and sends separate branches to each corpora

64
Q

What is the internal pudendal artery a branch of?

A

Internal iliac artery

65
Q

What does the dorsal vein of the penis drain into?

A

Prostatic plexus and ultimately into the internal iliac vein

66
Q

What is the dual nerve supply of the penis?

A

Dorsal nerve and greater and lesser cavernous nerves

67
Q

What is the dorsal nerve of the penis?

A

A mixed nerve which is a terminal branch of the pudendal nerve. The pudendal nerve is derived from the sacral plexus

68
Q

What innervation does the dorsal nerve of penis confer?

A

Primarily somatosensory but also includes autonomic innervation, mostly sympathetic plus some parasympathetic fibres

69
Q

What do the sensory branches of the dorsal nerve of the penis innervate?

A

Skin of shaft and glans

Urethra

70
Q

What do the somatic branches of the dorsal nerve of the penis innervate? What do the muscles do upon somatic input

A

Bulbospongiosis, ischiocavernous muscles - the skeletal muscles contract during erection and ejaculation
Perineal muscles - perineal branch of the pudendal nerve causes perineal muscle contraction which assist erection

71
Q

What are the greater and lesser cavernous nerves derived from?

A

Prostatic plexus which in turn is the lowest part of the inferior hypogastric plexus

72
Q

What does damage to the prostatic plexus affect?

A

Erectile function

73
Q

What nerves do the plexus in the capsule of the prostate give rise to? What do they consist of?

A

Cavernous nerves

Mainly parasympathetic fibres + some sensory and sympathetic

74
Q

Where do the cavernous nerves run?

A

Through the urogenital diaphragm and supply arteries within the erectile tissue of the corpus cavernosum and corpus spongiosum

75
Q

What does the lesser cavernous nerve supply?

A

Corpus spongiosum and urethra

76
Q

What does the greater cavernous nerve supply?

A

Erectile tissue of corpus cavernosum. Some filaments also reach the corpus spongiosum

77
Q

Sympathetic innervation in male genital organs is:

A

Vasoconstrictor

78
Q

Parasympathetic innervation in male genital organs is:

A

Vasodilator

79
Q

What is the pudendal nerve derived from?

A

Ventral rami of the 2nd -4th spinal nerves (part of the sacral plexus

80
Q

Where does the pudendal nerve pass through?

A

The greater sciatic foramen between piriformis and coccygeus inferior to sciatic nerve
Joins pudendal artery to pass through the lesser sciatic forament between sacrotuberous ligament laterally and obturator internus medially
Enters the pudendal canal - an elongated slit within the obturator fascia

81
Q

What are branches of the pudendal nerve (3)?

A

Inferior rectal, perineal, dorsal nerve of the penis

82
Q

Where does the dorsal nerve of the penis travel

A

1) Passes along ischiopubic ramus
2) Pierces urogenital diaphragm at the level of the suspensory ligament lateral to the deep penile vein
3) Runs in an undulating course along the length of the dorsal shaft along with the dorsal artery and deep dorsal vein to the glans

83
Q

Where is the superior hypogastric plexus located?

A

Anterior to the bifucation of the aorta

84
Q

What is the superior hypogastric plexus

A

A continuation of the nerve plexuses in the upper abdomen

85
Q

What type of innervation does the superior hypogastric plexus contain?

A

Sympathetic, sensory and some parasympathetic from the pelvic splanchnics.

86
Q

What do the fibres from the sacral ventral rami also contribute to? (2)

A

Sciatic nerve and pudendal nerve

87
Q

How are the superior and inferior hypogastric plexuses connected?

A

Hypogastric nerve

88
Q

What fibres do the inferior hypogastric plexuses contain?

A

Sympathetic, parasympathetic and sensory fibres

89
Q

What do extensions of the inferior hypogastric plexus supply? (3)

A

Bladder, rectum, prostrate and penis

90
Q

What is the inferior hypogastric plexus medial to?

A

Internal iliac arteries

91
Q

Where is the prostatic plexus located?

A

In the capsule of the plexus

92
Q

What are the two branches of the prostatic plexus and what do they supply?

A

Superior cavernous nerves
Inferior cavernous nerves
Penis

93
Q

The erection is under parasympathetic control true or false?

A

True

94
Q

Ejaculations are under parasymapthetic control true or false?

A

False

95
Q

Detumescence is under sympathetic control true or false?

A

False

96
Q

How does an erection occur?

A

1) Blood flow into mostly central positioned arteries in the erectile tissues of corpora cavernosae and corpus spongiosum
2) Compression of the peripheral venous return vessels against the tunica albuginea
3) Compression is less in the corpus spongiosum which has an elastic tunica albuginea and the erectile tissue is less dilated so the urethra is not compressed

97
Q

Where does sympathetic stimulation in ejaculation cause contractions in? (6)

A

smooth muscle in the walls of epidigymus, vas deferens, prostate, bulbourethral glands and pelvic floor muscles
as well as closure of the neck of the bladder

98
Q

How does ejaculation occur?

A

Contraction causes expulsion of sperm stored in from epididymus and secretions form the accessory glands which collectively are semen. Sperm stored from the epididymus mixes with semen in the urethra but should not pass into the accessory glands or bladder

99
Q

How does detumescence occur?

A

Sympathetic sstimulation causes contraction of arterial muscle which decreases blood flow into the erectile tissue. The lowered pressure also reduces compression of veins facilitating veinous drainage.

ANAT (17 decks)

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