Male Perineum

Question 1

State some differences between the male and female pelvis

Answer 1

Question 2

Answer 2

Question 3

• Vas deferens exits the scrotum in the spermatic cord and enters the …………. ……………
• It passes OVER and BEHIND the …………
• It then continues to become the………… … …………. …………… before entering the urethra through the prostate
• The ductus deferens, seminal vesicles & prostate empty into the prostatic urethra to form the semen

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Answer 3

• Vas deferens exits the scrotum in the spermatic cord and enters the inguinal canal
• It passes OVER and BEHIND the ureter
• It then continues to become the ampulla of ductus deferens before entering the urethra through the prostate
• The ductus deferens, seminal vesicles & prostate empty into the prostatic urethra to form the semen

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Question 4

Testis and associated structures

• Spermatozoa produced in the …………….. tubules
• They drain through the ……….. …………. and ………….. …………….. into the……………… where they are stored until ejaculation
• Epidydimis is composed of 3 parts: ………, ………. and …………
• The epididymis then continues to become the ………. …………. and leaves the scrotum

Answer 4

Testis and associated structures

• Spermatozoa produced in the seminiferous tubules
• They drain through the Rete testis and efferent ductules into the epididymis where they are stored until ejaculation
• Epidydimis is composed of 3 parts: head, body and tail.
• The epididymis then continues to become the Vas (ductus) deferens and leaves the scrotum

Question 5

LO3. Describe the vascular supply to the testes and explain its significance in relation to torsion and varicocele.

What is a varicocele and what causes it?

Describe the arterial supply to the testes?

Answer 5

Testicular artery –aka internal spermatic artery, branch of abdominal aorta, supplies testis
Deferential artery – supplies ductus deferens

Cremasteric artery – supplies Cremaster muscle and other coverings of the spermatic cord, branch of inferior epigastric artery

Question 6

What causes testicular tortion?

Answer 6

Question 7

What is a hydrocele?

Answer 7

Question 8

• Seminal vesicles are located laterally to the ……………. of DD.
• Excretory duct of each seminal vesicle + corresponding vas deferens = two …………… ducts.
• The ejaculatory ducts immediately pass through the substance of the…………… …………… before opening separately into the …………… …………….
• Bladder sits on the prostate – transfixed by the prostatic urethra
• Prostate gland surrounds the 1st part (Prostatic) of the urethra

Answer 8

• Seminal vesicles are located laterally to the ampullas of DD.
• Excretory duct of each seminal vesicle + corresponding vas deferens = two ejaculatory ducts.
• The ejaculatory ducts immediately pass through the substance of the prostate gland before opening separately into the prostatic urethra.
• Bladder sits on the prostate – transfixed by the prostatic urethra
• Prostate gland surrounds the 1st part (Prostatic) of the urethra

Question 9

Answer 9

Question 10

Answer 10

Question 11

Answer 11

Question 12

What is the Prostatic Urethra?

• Internal urethral sphincter – ………….. muscle, well organised in males, not females.
• Closed during ejaculation by……………. stimulus
• …………………….. relaxes the sphincter
• External urethral sphincter is a ……………… muscle

Answer 12

Prostatic Urethra

• Where the Urinary and Reproductive tracts meets
• Internal urethral sphincter – smooth muscle, well organised in males, not females.
• Closed during ejaculation by sympathetic stimulus
• Parasympathetic relaxes the sphincter
• External urethral sphincter is a skeletal muscle

Question 13

•LO1. Describe the anatomy of the urethra and its different parts in males in relation to continence and catheterisation

Answer 13

•Composed of 4 parts:

• Preprostatic part (1.5cm)
• Prostatic (2.5cm)
• Membranous (2cm)
• Spongy (15cm)
• External urethral orifice is the narrowest part
• Catheters can get caught in the navicular fossa (fossa terminalis).
• Urinary catheter must navigate a 90 deg bend as it passes from the perineum into the pelvis
• *Tip of the Urethral catheter can become lodged in the prostatic utricle

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Question 14

Answer 14

Question 15

Answer 15

Question 16

Lymphatic drainage from testis

• Lymphatic drainage of the testes follows the testicular arteries back to the ………….lymph nodes,
• Lymph from the scrotum drains to the …………. lymph nodes.

It is not very common for testicular cancer to metastasise, apart from to the ………….

Answer 16

Lymphatic drainage from testis

• Lymphatic drainage of the testes follows the testicular arteries back to the paraaortic lymph nodes,
• Lymph from the scrotum drains to the inguinal lymph nodes.

It is not very common for testicular cancer to metastasise, apart from to the lungs.

Question 17

Answer 17

Question 18

Describe the nerve supply to the penis and scrotum?

Answer 18

Question 19

LO9. Describe the innervation of and mechanisms involved in the erection of

cavernous tissue and in emission and ejaculation in the male.

Answer 19

Question 20

LO7. Describe the normal form of the prostate on rectal examination and how this changes in hypertrophy and malignancy

Answer 20

Question 21

LO10. Describe the venous drainage of the rectum and anal canal and explain the occurrence of piles

Answer 21