Male and female external genitalia and pelvic organs

Question 1

What are the 4 borders of the inguinal canal?

Answer 1

Anterior border - external oblique aponeurosis, internal oblique aponeurosis laterally
Posterior border - transversalis fascia, medial fibres of the internal oblique and transversus abdominis
Roof - transversalis fascia, arching fibres of the internal oblique and transversus abdominus
Floor - inguinal ligament - lower border of the external oblique aponeurosis

Question 2

What is the conjoint tendon?

Answer 2

Medial fibres of the aponeuroses of the internal oblique and transversus abdominis together

Question 3

What are the contents of the inguinal canal in females?

Answer 3

Round ligament of the uterus
Ilioinguinal nerve
Genital branch of the genitofemoral nerve

Question 4

What are the contents of the inguinal canal in males?

Answer 4

All contained within the spermatic cord except the ilioinguinal nerve - runs in canal but outside spermatic cord

Question 5

How can the contents of the spermatic cord be remembered?

Answer 5

2 nerves
3 arteries
3 fascial layers
4 other structures

Question 6

What are the contents of the spermatic cord? (2, 3, 3, 4)

Answer 6

2 nerves - genital branch of the genitofemoral nerve, sympathetic nerve fibres

3 arteries - testicular arteries, cremasteric artery, artery to vas deferens

3 fascial layers - external spermatic fascia (external oblique aponeurosis); cremaster muscle and fascia (derived from internal oblique muscle); internal spermatic fascia (derived from transversalis fascia)

4 others - pampiniform venous plexus; lymphatics; vas deferens; processus vaginalis (derived from the peritoneum)

Question 7

what is the dartos?

Answer 7

A thin involuntary muscle beneath the skin of the scrotum

Question 8

What is each half of the scrotum separated by?
What does each half of the scrotum contain?

Answer 8

Separated by extended superficial fascia - forms a septum between the testes

Each half - testis, epididymis, distal part of spermatic cord

Question 9

What is the function of the testes?
What is their appearance?
What covers them?

Answer 9

Produce sperm and testosterone
Ovoid structures
Covered by same 3 fascia as the spermatic cord (external spermatic fascia, cremaster muscle and fascia, internal spermatic fascia) - and also partially a sac derived from the peritoneum called the tunica vaginalis

Question 10

What is the appearance of the epididymis?
What is its function?

Answer 10

Coiled tube, lying on posterior border of each testis. Expanded head superiorly, body and pointed tail lying at the lower pole of the testis

Stores spermatozoa that have been formed in the testis

Question 11

What are the testicular arteries a branch of?

Answer 11

Direct branches of the abdominal aorta

Question 12

What is the pathway of venous blood from the testis and epididymis?

Answer 12

Venous blood enters pampiniform venous plexus -> forms testicular vein ->
right tv - enters inferior vena cava
left tv - joins the left renal vein

Question 13

What is the function of the vas deferens?
What is the plural of the vas deferens?

Answer 13

function - carries sperm from the epididymis and travels with the testicular vessels in the spermatic cord

plural - vasa deferentia

Question 14

What is the pathway for sperm from formation?

Answer 14

Formed in the testis
Stored in the epididymis
Vas deferens carries sperm from the epididymis into the spermatic cord

Question 15

What 3 cylinders is the penis composed of?

Answer 15

3 cylinders of erectile tissue
2 corpora cavernosa dorsally
1 corpus spongiosum ventrally

Question 16

What are the 3 cylinders of the penis enclosed within?

Answer 16

Deep fascia of the penis (Buck’s fascia)
Then another layer as well but eh

Question 17

What is the glans an expansion of?
What is the name of the circular base of the glans?
What is the skin that extends from the shaft over the glans called?

Answer 17

• the corpus spongiosum
• the corona
• the foreskin (this is what is removed in circumcision)

Question 18

What do the corpus cavernosa contain?
What contains them?

Answer 18

Cavernous artery
Tunica albuginea

Question 19

What is the origination of the corpus cavernosa?
What are the cura?

Answer 19

Symmetrical - originate along the L/R ischial rami(BONE) to converge in the midline

Singular -crus- parts of the corpora cavernosa that are attached to the ischial rami

Question 20

What is the origin of the corpus spongiosum?
What does it contain?

Answer 20

Sits in the midline, has an expanded part proximally that is attached to the perineal membrane (the bulb of the penis)

Carries the penile urethra - opens via external urethral meatus

Question 21

What muscles cover the corpora cavernosa?
What muscles cover the corpus spongiosum/bulb?

Answer 21

Ischiocavernosus muscles
Bulbospongiosus muscle

Question 22

What is the function of the ischiocavernosus muscles?
What is the function of the bulbospongiosus muscles?

Answer 22

Force blood into the body of the penis from the cura
Forces blood into the glans penis, assists in maintaining erection (compresses veins that drain erectile tissues), contracts to rid urethra of remaining urine or semen

Question 23

What is the arterial supply to the penis?

Answer 23

Internal pudendal arteries - including deep artery of the penis and artery of the bulb of the penis
They branch from internal iliac

Question 24

What is the nerve supply to the penis?

Answer 24

S2-S4 - pudendal nerve - ischiocavernosus and bulbospongiosus muscles
Dorsal nerve of penis - general sensation and sympathetic innervation - it is a branch of the pudendal nerve
Peri-prostatic nerve plexus - parasympathetic fibres involved in erection

Question 25

What is the mechanism behind erection of the penis?

Answer 25

Arterial blood flow into corpora increases, arteries dilate
Corpora become engorged with blood
Corpus spongiosum engorges to a lesser extent - main role is to prevent compression of urethra to allow ejaculation

Question 26

Where is the navicular fossa?

Answer 26

in the glans of the penis

Question 27

What is the FULL path of the vas deferens?

Answer 27

Carries sperm from epididymis, through spermatic cord, through inguinal canal
From the deep inguinal ring, passes along the side wall of the pelvis, turns medially onto the back of the bladder
Here it has a dilated portion - the ampulla (medial to the seminal vesicle)
Terminates by joining duct of the seminal vesicle to form the ejaculatory duct

Question 28

What are the male pelvic organs?

Answer 28

Vasa deferentia, seminal vesicles, ejaculatory ducts, bulbo-urethral glands, prostate gland, bladder, rectum

Question 29

What is the appearance of the seminal vesicle?

Answer 29

Lobulated sac, ab 4cm long. Lie lateral to ampulla of vas deferens

Secrete a thick alkaline fluid that forms the bulk of seminal fluid(/semen)

Question 30

What is the appearance of the prostate gland?
What is its function?

Answer 30

A roughly spherical fibromuscular gland about the size of a walnut
Lies against the neck of the bladder, is pierced by the urethra and ejaculatory ducts

Secretions of the prostate gland are added to the seminal fluid during ejaculation

Question 31

What is hydrocoele?

Answer 31

Painless scrotal swelling
Accumulation of peritoneal fluid between the tunica vaginalis layers around the testis - when light is shone through it can be seen from the other side

Question 32

What is a varicocele?

Answer 32

Abnormal dilation of pampiniform venous plexus - causes a scrotal swelling
Described as feeling like a bag of worms
More common on the left side

Question 33

What is epididymo-orchitis?

Answer 33

Painful inflammation of the epididymis and testis - often caused by STI such as chlamydia or gonorrhoea, can be caused by urinary tract infection

Question 34

What is testicular torsion?

Answer 34

Caused by twisting of testis on the spermatic cord
Can lead to ischaemia of the testis - surgical emergency

Question 35

What is cryptorchidism?

Answer 35

Undescended testis
Infant born with one or both testes stuck along path of descent, not in the scrotum
Need below body temperature to function correctly, so often brought down surgically

Question 36

What is a vasectomy?

Answer 36

Means of male sterilisation
Scrotum is incised , vasa recta are are ligated, cauterised or clamped to prevent passage of sperm from testes

Question 37

What is erectile dysfunction?

Answer 37

Inability to achieve or maintain an erection - happens to most males at some point
A problem with… nerve pathways, reflexes, controlled blood flow to corpora, psychological arousal may lead to erectile dysfunction

Question 38

What is benign prostatic hyperplasia and prostatic malignancy?

Answer 38

Prostate gland completely encircles the urethra - benign enlargement of prostate is common with age and is called BPH
May lead to compression of urethra and inability to pass urine - called urinary retention
requires catheterisation
Prostate can be examined through a digital rectal exam

Question 39

What are the [9] named parts of the vulva?

Answer 39

Mons pubis
Labia majora
Labia minora
Clitoris
Vestibule
Vaginal opening
Hymen
Urinary meatus
Vestibular glands - greater and lesser

Question 40

Where is the mons pubis?
What is the mons pubis?

Answer 40

Part of the vulva
Mound of fatty tissue located in front of the pubic symphysis, causing and elevation of the hair bearing skin

Question 41

Where is the labia majora?
What is the labia majora?

Answer 41

Part of the vulva
Prominent hair-bearing folds of skin that meet at the mons pubis anteriorly

Question 42

Where is the labia minora?
What is the labia minora?

Answer 42

Part of the vulva
Smaller, hairless folds of skin located medial to the labia majora
Fuse together anteriorly to form the hood of the clitoris
Form the boundaries of the vestibule

Question 43

Where is the clitoris?
What is the clitoris?

Answer 43

In the vulva
Pea-sized, highly sensitive tissue comprised of the erectile corpora cavernosa and corpus spongiosum
Becomes engorged during sexual arousal

Question 44

Where is the vestibule?
What is the vestibule?

Answer 44

Part of the vulva, area between the labia minora
Contains the vaginal opening, urinary meatus and vestibular glands

Question 45

What is the vaginal opening also known as?
What structure is it a part of?

Answer 45

Vaginal introitus
In vestibule, in vulva

Question 46

Where is the hymen?
What is the hymen?

Answer 46

Part of vulva, in vagina

Thin membrane that partially covers the vaginal opening
Often ruptures first time of sexual intercourse
Can rupture spontaneously, during exercise, tampons or menstrual cups, or may just be absent

Question 47

Where is the urinary meatus?
What is the urinary meatus?

Answer 47

Posterior to clitoris, anterior to vaginal opening, part of the vestibule, in vulva

Opening of the urethra

Question 48

Where are the greater vestibular glands?
What are the vestibular glands?

Answer 48

Part of the vulva
Also Bartholin’s glands - just posterior to vaginal opening
Secrete a lubricant into vagina during sexual arousal

Question 49

Where are the lesser vestibular glands?
What are the lesser vestibular glands?

Answer 49

Part of the vulva
Also Skene’s glands, lie near the urethral opening
Function of fluid secreted is debated

Question 50

Where do the corpus cavernosa in the clitoris originate from?

Answer 50

Corpora cavernosa originate along L/R ischial rami as the ‘cura of the clitoris’ and converge in midline
The body of the clitoris is formed by the distal parts of the corpora cavernosa

Question 51

Where is the corpus spongiosum in females?

Answer 51

Lies in the midline on the perineal membrane - split into 2 parts that flank the vaginal opening
Named bulbs of the vestibule (bulb of the clitoris)
Anterior parts of the bulbs form the glans clitoris in the midline

Question 52

Where are the ischiocavernosus muscles in females?
Where is the bulbospongiosus muscle?

Answer 52

Cover the corpora cavernosa along ischial rami - forces blood into body of the clitoris

Cover the corpus spongiosum - forces blood into the glans clitoris, helps maintain clitoral erection and constricts around the vaginal orifice

Question 53

What is the blood supply to the clitoris?

Answer 53

Internal pudendal arteries (from internal iliac arteries)
Branch into deep arteries of the clitoris and arteries of the bulb of the vestibule

Question 54

What is the nerve supply of the clitoris?

Answer 54

Erectile tissues innervated by parasympathetic nerves

Ischiocavernosus and bulbospongiosus are innervated by the pudendal nerve (S2-S4)