Lecture 21: Male and female genitalia

Question 1

Peritoneal Pouches, male vs female

Answer 1

Male (1)

• Vesicorectal puch

Female (2)

• Vesicouterine
• Rectouterine (pouch of douglas)

** peritoneum = continuous in pelvic cavity

Question 3

Perineal Muscles and attachment?

Answer 3

• Ischiocavernosus: attached along ishiopubic rami, aids erections (M) or tense vagina (F)
• Bulbospongiosus: attached post to perineal body

Question 4

Importance of pouches?

Answer 4

These are bad for fluid poolage. Mainly Pouch of Douglas.

Question 5

Erectile Tissue: Crus (M/F variation)

Answer 5

Crus of Clitoris (F): contributes to body of clitoris

Crus of Penis (M): Becomes corpus cavernosa of penis x2

Question 6

Erectile Tissue: Bulb (M/F variation)

Answer 6

Bulb of Vestibule (F): contributes to head of clitoris and surrounding vaginal orifice

Bulb of Penis (M): becomes corpus spongiosum and glans penis (1x contains urethra)

Question 7

All the vasculature of the penis comes from ________ and these are

Answer 7

All the vasculature of the penis comes from branches of the internal pudendal (a/v) and these are 2x dorsal arteries and 2x deep arteries and 1x deep dorsal vein in centre

Question 8

What is the scrotum, what does it contain?

Answer 8

An out-pouching of skin from the abdominal wall. Contains testes, epididymus and lower ends of spermatic cords (inner layers of scrotum same as spermatic cord).

Superficial fascia continuous with abdominal scarpa’s fascia but fat is replaced with smooth muscle “dartos fascia”

“dartos fascia”: continues posteriorly with deep fascia of perineum “colles fascia”

Question 10

Bulbospongiosus variation in M:F

Answer 10

Males: attached in midline aids erection + ejaculation

Females: split either side of vaginal orifice clitoral erection + feeling of orgasm

Question 11

How is the scrotum formed?

Answer 11

Formed when guburnaculum (mesenchymal cells) are condensed, goes thorugh inguinal canal, and is connected to testes. This drags testes through, which drags the peritoneum with it.

Now all sits in the scrotum with remenant of gubernaculum, and connection to peritoneum severes off ‘tunica vaginalis’

Question 12

Testes, function, structure and special temperature?

Answer 12

Creates sperm.

Tough fibrous capsule surrounds each testis. “tunica albuginea”

3 degrees cooler then abdomen -heat exchange between a/v in dartos and cremaster aid cooling

Each lobule has 1-3 seminiferous tubules → rete testis →((via efferent ductules))→ epididymus (sperm storage) → vas deferens

Question 13

Vas deferens

Answer 13

• Muscular tube that travels in spermatic cord, through inguinal canal
• Joins duct from seminal vesicle to form ejaculatory duct → into prostate to meet urethra

Question 14

Explain the Vas Deferens course to the prostate.

Answer 14

1. Enters the body cavity lateral to inf. epigastric artery
2. Crosses over external iliac vessels, passing medially towards prostate
3. Passes overtop of ureter to join seminal vesicles and form ED “water under the bridge”

Question 15

What are the seminal vesicles?

Answer 15

Horn structures either side posterior to bladder and sup. to prostate.

~5cm long but uncoil to 10-15cm.

Secrete liquid component of semen “fructose”.

Question 16

What is the prostate gland? What’s it’s supply?

Answer 16

Inferior to bladder, secretes proteolytic enzymes and acid phosphatase.

Contains Prostatic urethra and ejaculatory duct.

Supplied by: branches of the Internal Iliac artery (internal pudendal, middle rectal and inferior vesical arteries)

Veins: Deep dorsal of penis – plexus – internal iliac

Question 18

What is the lymphatics of the male gentilia overall, and what are the special exceptions to know about?

Answer 18

All eventually drain to iliac nodes.

• Testes: aortic nodes at root of testicular artery @L2
• Skin of penis and wall of scrotum: SF inguinal nodes
• Glans Penis: Deep inguinal and iliac nodes

Question 19

Label

Answer 19

Fornix: recess where vagina meets cervix

Question 20

Angles of the uterus

Answer 20

Anteversion and anteflexion flips the uterus forward so it rests on the bladder, for extra support.

(you can have retroflexed)

Question 21

Broad Ligament of the uterus

Answer 21

As the peritoneum sweeps over the uterus it forms the broad ligament that can be subdivided.

Mesosalpinx: over uterine tube

Mesovarium: over ovary

Mesometrium: over general structure

Meso = double fold

Question 23

Ligaments of the ovaries

Answer 23

Ligament of the Ovary: remenant of the gubernaculum

Suspensory Ligament of the ovary: ovary → body wall, where the suspensory vessels run through.

Question 25

External Female Gentialia

Answer 25

Vestibule: enclosed by labia minora, contains opening of urethra/vagina and vestibular glands

Clitoris: Contains erectile tissue (corresponds to male penis)

Question 26

Lymphatic drainange of uterus

Answer 26

Everything but ovary and uterine tubes drains to iliac nodes.

Ovary + uterine tubes: aortic nodes at root of ovarian artery

Question 28

Blood supply to scrotum is?

Answer 28

Internal and external Pudendal arteries

Question 29

Function of cremaster muscle?

Answer 29

Raises the testes/scrotum up for warmth + protection

Question 36

What is ‘Prostatic Enlargement’?

Answer 36

Affects all or part of the prostate, may be benign or malignant. (most men >+50yrs get.

Can press up into bladder → incontinence

Question 41

Ureter passes under the ______?

Answer 41

Ureter passes under the uterine artery.

“water under the bridge”

Question 43

Function, supply and innervation of the ovaries?

Answer 43

• Function:* ova + hormone prodution
• Arterial Supply:* Ovarian artery - (abd. aorta @L2)
• Venous drainage:* Ovarian vein (IVC on right, left renal vein on left)
• Nerve:* ovarian plexus

Question 46

Batholin’s cyst

Answer 46

Responsible for mucus secretion.

Posterior/lateral to vagina opening.

In SF pouch (not deep like in males)

Cyst ‘blockage’ → infection