Lecture 27 & 28: Reproductive System

Question 1

Difference between male and female reproductive systems

Answer 1

Relationship with urinary system: in males - both are physically and physiologically related due to urethra, in females - they are only anatomically related
Location: in males - most organs are outside of the pelvic cavity, in females - most organs are within the pelvic cavity
Relationship with peritoneal cavity: in males - abdominal pelvic cavity is closed, but in females - abdominal pelvic cavity is connected to external environment via uterine tube, uterine canal and vagina

Question 2

Male reproduction system

Answer 2

Includes testes, ducts (epididymis, ductus/vas deferens, ejaculatory duct), accessory sex glands (seminal vesicles, prostate, bulbourethral gland), penis, scrotum

Question 3

Testes

Answer 3

Formed within abdominal cavity near kidney during embryonic stage, and descend past inguinal canal into scrotum (outside the body cavity) to lower the temperature for spermogenesis
Spermatic cord forms by taking a layer of abdominal muscle
Has 2 borders (anterior/posterior), 2 surfaces (medial/lateral), 2 poles (superior/inferior); posterior end has hilum; superior pole has spermatic cord
Function: production of sperm and testosterone

Question 4

Internal structure of testes

Answer 4

Tunica albuginea: white connective tissue that surround the testes
Tunica albuginea sends septums into the testicles dividing it into lobules (250 per testicle) containing seminiferous tubules which create sperm

Question 5

Pathway of sperm

Answer 5

Once sperm are formed in testes, they go from seminiferous tubule to rete tetis to head of epididymis
Store up to 2 months in epididymis for maturation, then go to ductus deferens, and through spermatic cord with blood vessels (testicular artery), veins, nerves, and lymphatic structures

Question 6

Epididymis

Answer 6

6m muscular tube on posterior border of testes (which is only 2cm long)
Coils on itself
Sperm is delivered from testes to head of epididymis where it is stored for maturation, then goes to ductus deferens via tail of epididymis

Question 7

Ductus (vas) deferens

Answer 7

Long tube from tail of epididymis up inguinal canal into pelvis, across the ureter, to base of the bladder where it dilates (ampulla of vas deferens)
Then it narrows and joins seminal vesicle to form ejaculatory duct which pierces prostate on posterior side, and drains into prostatic part of urethra

Question 8

Seminal vesicle

Answer 8

Accessory gland
Secretes 60% of the fluid in semen
Longitudinal tube, accumulated behind bladder, coiled on itself
Between base of bladder and anterior wall of rectum
Forms ejaculatory duct with ductus deferens

Question 9

Prostate

Answer 9

Walnut shaped gland
Located between pubic symphysis and rectum (rectal ampulla)
Base associated with neck of bladder; apex sits on external urethra sphincter
Helps with production of semen
Can palpate prostate during rectal examination

Question 10

Bulbourethral gland

Answer 10

2 pea-shaped glands on deep perineal pouch of membranous urethra
Secretion delivered to spongy urethra in penis
Lubricates space within urethra and changes the pH of urethra to cleanse it from urine

Question 11

Penis

Answer 11

Consists of roof and shaft/body - both are erectile tissue
Within the root are 3 erectile tissues: crura (1 per side), bulb of penis (underneath external sphincter)
They are continuous in the body of the penis forming corpus cavernosum (continuation of crura; dorsal side) and corpus spongiosum (continuation of bulb; ventral side)
Bulb is covered by bulbospongiosus muscle
Crura is covered by ischiocavernosus muscle
Glans penis: expanded and most anterior part of corpus spongiosum, surrounded by prepuce (foreskin)
Tunica albuginea: layer of connective tissue that surrounds the body to keep everything in place
Spongy urethra passes through penis

Question 12

Female reproductive system

Answer 12

Includes pair of ovaries, pari of uterine tubes, uterus, vagina, external genital organs, mammary glands/breasts

Question 13

Ovary

Answer 13

2 small almond shaped organs on lateral wall of true pelvis
Has 2 borders (anterior/posterior), 2 surfaces (lateral/medial), 2 poles (superior/inferior); anterior border attaches to mesovarium and has hilum
Produces gametes (ovum), estrogen, progesterone
Surfaces are smooth before puberty, and rough after due to ovulation

Question 14

Ligaments of ovary

Answer 14

Ovarian ligament
Suspensory ligament
Mesovarium

Question 15

Ovarian ligament

Answer 15

Band of dense connective tissue

Attaches inferior pole of ovary to lateral border of uterus under uterine tube

Question 16

Suspensory ligament

Answer 16

Not a real ligament; elevation of peritoneum

Peritoneum passes over carrying ovarian vessels (artery, veins) to posterior abdominal wall

Question 17

Mesovarium

Answer 17

True ligament
Extension of peritoneum that attaches anterior border of ovary to broad ligament
Double layer that allows ovarian vessels to pass through to hilum on anterior border of ovary

Question 18

Uterine/fallopian tube

Answer 18

12cm muscular tube arising from close to ovary, over to the medial side to enter the uterus; 4 parts
Infundibulum: funnel shaped, faces ovaries, has finger like projections - fimbriae; ovarian fimbriae attaches to surface of ovary
Ampulla: widest part of tube (lateral 2/3); fertilization occurs here
Isthmus: narrowest part of tube (medial 1/3)
Intramural/uterine part: passes through wall of uterus

Question 19

Tubal pregnancy

Answer 19

When egg stays in fallopian tube instead of moving to the uterus

Question 20

Uterus

Answer 20

Upside down pear shaped organ in true pelvis between bladder and intestine
Fundus: upper round part; sits above entrance of uterine tube
Body: below fundas
Cervis: below body; contains cervical canal - connects to uterine cavity via internal os, and vaginal cavity via external os
Isthmus of uterus at level of internal os

Question 21

Surrounds of uterus

Answer 21

Anterior/inferior: bladder
Posterior/superior: sigmoid colon and ileum of small intestine
Surrounded by rectouterine pouch (pouch of Douglas) and uterovesical pouch

Question 22

Uterus angle

Answer 22

Angle of anteflexion: angle between axis of uterine and axis of cervix
Angle of anteversion: angle between axis of cervix and axis of vagina

Question 23

Supportive ligaments of uterus

Answer 23

To support the fetus
Broad ligament
Uterosacral ligament
Lateral cervical/transverse cervical/cardinal ligament
Round ligament of uterus
Pubocervical ligament
All ligaments except the broad ligament are true ligaments

Question 24

Broad ligament

Answer 24

2 layers of peritoneum (not a true ligament)
Extends from lateral border of uterus to lateral pelvic wall and pelvic floor
Includes mesometrium, mesovarium, mesosalpinx
Mesometrium: attaches to body of uterus
Mesovarium: double layer fold attaching to anterior border of ovary
Mesosalpinx: between uterine tube and ovary

Question 25

Uterosacral ligament

Answer 25

From inferior part of anterior sacrum and attaches to cervix of uterus and superior vagina

Question 26

Lateral cervical/transverse cervical/cardinal ligament

Answer 26

Attaches to cervix and lateral pelvic wall

Supporting ligament

Question 27

Round ligament of uterus

Answer 27

True ligament

Attaches to side of uterus under uterine tube, runs anteriorly through inguinal canal and attaches to labium majora

Question 28

Pubocervical ligament

Answer 28

From pubic symphysis to cervix on anterior side

Question 29

Vagina

Answer 29

Muscular tube connecting external environment to cervix
Lateral fornix: between cervix and vaginal wall
Posterior fornix: deepest fornix due to anteversion; reach the rectouterine pouch from here

Question 30

External genitalia in females

Answer 30

Vulva/pudendum
Mons pubis: round elevation in front of pubic symphysis
Labia majora: 2 folds of skin covered by hair
Labia minora: folds of skin not covered by hair
Clitoris: equivalent to penis; continuation of labia minora forms prepuce; in front of vestibule
Vestibule: space between R/L labia minora; contains urethral orifice, vaginal orifice, hymen (fold of skin at opening of vagina)
Greater vestibular glands: equivalent to bulbourethral glands

Question 31

Deep structures of external genitalia in females

Answer 31

Bulb of vestibule (2) equivalent to bulb of penis (1); vagina sits in between
Continues to make the clitoris
Crus of clitoris makes body of clitoris
Covered by bulbospongiosus and ischiocavernosus muscles

Question 32

Breast/mammary gland

Answer 32

Modified sweat gland
Conical shaped structure in pectoral region at ribs 2-6
Nipple: tip of breast
Areola: pigmented skin around nipple
Breast is within the superficial fascia; under superficial fascia is deep fascia which covers muscles

Question 33

Deep fascia of breast

Answer 33

Suspensory ligament: connective tissue that extends from skin to deep fascia covering pectoralis major muscle; supports weight
Pulling on suspensory ligament gives orange peel appearance
Divides glands into lobes which are drained by lactiferous ducts to lactiferous sinus, and milk accumulates in sinus to nipple

Question 34

Hormones of breast

Answer 34

Secretion of milk controlled by prolactin

Ejection of milk controlled by oxytocin

Question 35

Blood supply of reproductive system

Answer 35

Gonads (ovary/testes): testicular or ovarian artery
Remaining internal/external reproductive organs (uterus, vagina, prostate, penis): visceral branch of internal iliac artery

Question 36

Nerve supply of gonads

Answer 36

Sympathetic: lesser, least, lumbar splanchnic nerves via gonadal plexus
Parasympathetic: pelvic splanchnic nerves

Question 37

Nerve supply of remaining internal/external organs

Answer 37

Sympathetic: lesser, least, lumbar, sacral splanchnic nerves via inferior hypogastric plexus
Parasympathetic: pelvic splanchnic nerves

Question 38

Blood supply of breast

Answer 38

Internal thoracic artery
Anterior and posterior intercostal artery
Axillary artery

Question 39

Nerve supply of breast (skin and smooth muscle)

Answer 39

Intercostal nerves