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Repro Ankis > Male Repro Tract > Flashcards

Male Repro Tract Flashcards

1
Q

Define the following terms:

a) spermatoceleb) Hydroceoelec) Haemotocoele

A

a) benign growth filled with clear liquid found at the head of the epididymis b) serous fluid in the tunica vaginalis c) Blood within the scrotal sac but outside the testis

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2
Q

What is an inguinal hernia?

A

Inguinal hernia: tissue (such as intestines) protrudes through a weak spot in the abdominal muscles, the resulting bulge can be very painful.

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3
Q

What are the three central contents of the spermatic cord?

A
  1. Pampiniform plexus; drains venous blood from testis to testicular vein, it wraps around the testicular artery and acts as a heat exchanger to cool the arterial blood before it reaches the testis
  2. Ductus deferens
  3. Lymphatics
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4
Q

What are the three arteries in the spermatic cord?

A
  1. Testicular artery: from AA, L2
  2. Ductus deferens artery
  3. Cremasteric artery; supplies cremasteric fascia and muscle
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5
Q

What are the three major nerves in the spermatic cord?

A
  1. Genital branch of the genitofemoral nerve/external spermatic nerve
  2. Autonomic nerves
  3. Ilioinguinal nerves
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6
Q

List the three fascias surrounding the spermatic cord in medial-lateral order, where do they each arise from?

A

Overall they are derived from the three layers of anterolateral abdominal wall muscles and collect around the testis as they push down

  1. Internal spermatic fascia; derived from the lining of transversus abdominis muscle
  2. Cremasteric fascia; derived from internal oblique muscle
  3. External spermatic fascia; derived from external oblique muscle
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7
Q

What does the Genitofemoral nerve innervate?

A

Gives off two divisions:

  1. Femoral: gives sensory innervation to the upper medial thigh
  2. Genital: supplies cremaster muscle around the testis
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8
Q

What is the cremasteric reflex?

A

When you stimulate the upper medial thigh the testis should rise!!!!!!!!!

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9
Q

Describe the anatomical course of the spermatic cord

A
  1. Formed in the opening of the inguinal canal
  2. Enters scrotum via superficial inguinal ring (terminal end of the inguinal canal)
  3. Ends at the posterior border of the testis; its contents disperse to supply the testis and the scrotum
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10
Q

What is a varicocele and why does it form?

A

A lump in the scrotum due to incompetent valves in the pampiniform plexus

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11
Q

What happens when there’s torsion?

A

The testicle rotates and twists the spermatic cord, reducing the bloodflow to the testis and causing sudden and severe pain/swelling

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12
Q

Which branch of the autonomic NS allows for peristalsis in the ductus deferens?

A

Sympathetic

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13
Q

Describe the pathway of the ductus deferens

A

From tail of epididymis to the ejaculatory duct, it is the ONLY structure that passes superiorly to the ureter (hence, water under the bridge)

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14
Q

Which structures form the ejaculatory duct?

A

Convergence of ductus deferens and the seminal vesicle duct

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15
Q

What is a vasectomy? Is it reversible?

A

When the ductus deferens is cut distal to the superficial inguinal ring, occasionally the cut ends can find each other and rejoin :’)

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16
Q

What are the two main components of the prostate?

A

1/3 Fibromuscular: contracts during ejaculation to squeeze out the fluid in the glandular tissue

2/3 Glandular: produces 20% of seminal fluid

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17
Q

Which vessels supply the prostate? (arterial and venous). Which lymph nodes drain it?

A

Supply: Internal iliac artery

Drain: venous blood goes into the prostatic venous plexus which communicates with the vertebral veins

Lymph drains into the internal iliac nodes

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18
Q

Name the three zones of the prostate, which are tumours usually found?

A

Central zone: surrounds the prostatic urethra

Peripheral zone: usually the zone with tumours

Transitional zone

19
Q

Where does prostate cancer commonly spread to and why?

A

Spreads to the vertebrae via the venous plexus as valveless veins form the plexus (so blood can flow freely in either direction)

20
Q

What do the seminal vesicles produce? Where do they arise from?

A

They produce alkaline fluid and develop as outgrowths of the ductus deferens

21
Q

Which vessels (arterial, venous) and which lymph nodes supply the seminal vesicles?

A

Blood supply: internal iliac artery

Vesical and prostatic venous plexus

Internal iliac, external iliac and sacral nodes

22
Q

What does the perineal membrane do?

A

Acts as an anchoring point for external genitalia

23
Q

Name four points on the journey of a male catheter where passage might be more difficult

A
  1. Navicular fossa; superior mucosal fold (right before external urethral orifice)
  2. The angle at the penile bulb and membranous urethra
  3. Prostate (crest/enlarged lobes)
  4. Sphincters (internal and external)
24
Q

Name four things you SHOULD feel in a DR examination and two things you MIGHT feel (that would still be physiological)

A

Should feel: walls of anal canal and inferior rectum, lymph nodes and prostate (posterior and median lobes)

Might feel inferior bladder and seminal vesicles

25
Q

Briefly describe the three vascular structures of the penis

A
  1. Corpus spongiosum; has urethra and expands distally to form ‘glans penis’
  2. 2X corpus cavernosum; erectile tissue filled with blood vessels
  3. Bulb of the penis; erectile tissue that roots the corpus spongiosum
26
Q

Which structures are contained within the superficial perineal pouch?

A

Penis, urethra, scrotal contents and superficial perineal muscles

27
Q

What could you do if you wanted to give your penis a greater flaccid length?

A

Cut the fundiform and suspensory ligaments of course!

28
Q

Where on its journey can the pudendal nerve be anesthetized?

A

When it passes close to the ischial spine (after exiting the greater sciatic foramen)

29
Q

Which arterial and venous vessels supply and drain the penis?

A

Arterial: 3 arteries all branching from the internal iliac: internal pudendal artery, deep and dorsal penile arteries, bulbourethral artery

Dorsal veins: drain into prostatic venous plexus -> vertebral plexus

  1. Superficial dorsal vein: skin and cutaneous tissue
  2. Deep dorsal vein: cavernous spaces
30
Q

Describe the vascular component of an erection *including any muscles involved!

A

In an erection, the coiled helicine arteries straighten to allow blood to fill the corpus cavernosum

  1. Erotic stimuli relaxes the smooth muscle surrounding the helicine arteries so the vessels can straighten
  2. The arterial-venous anastomoses closes to retain blood in the corpus cavernosum
  3. Ischiocavernosum and bulbospongiosum compress the venous plexus to retain blood in the penis
31
Q

Describe the nervous component of an erection, how do the nerves reach the penis?

A

Nerves lie on lateral pelvic wall and travel medially to form a plexus around the prostate

Parasympathetic S2-4: allows for an erection:

(Pelvic splanchnic nerves -> inferior hypogastric plexus -> prostatic plexus -> cavernous nerve)

32
Q

Where is the deep perineal pouch and which structures (in males and females) lies within it?

A

Between the pelvic floor and the perineal membrane; Voluntary muscles

Male: external urethral sphincter, bulbourethral glands
Female: multiple sphincters

33
Q

Name two things that can exacerbate the pain of having an infection or stones in the male bulbourethral gland

A

DR examination and defecation

34
Q

Where does the crura of the penis/clitoris attach to?

A

The pubic arch and the lateral parts of the perineal membrane

35
Q

Define priapism

A

Persistent painful non-stimulated erection that lasts more than 4 hours

36
Q

What is the major vascular difference between an erect and a flaccid penis?

A

In a flaccid penis the arterio-venous anastomoses allow blood to bypass the corpus cavernosum

37
Q

Describe the nervous component of ejaculation

A

Sympathetic brings about ejaculation: L1-2

  1. Closes the internal urethral sphincter
  2. Peristalsis of ductus deferens and seminal vesicles 3. Prostate smooth muscle contraction
38
Q

What innervates the somatic muscles of erection and ejaculation?

A

Branches of the pudendal nerve; S2-4

39
Q

What are major lymphatic nodes that drain the male repro tract?

A
  1. Superficial inguinal; scrotal, penile and perineal skin
  2. Deep inguinal; glans of penis, distal spongy urethra
  3. Para-aortic; testicles
  4. Internal iliac; corpus cavernosum, urethra (membranous and proximal spongy), most of the prostate, seminal vesicles and ducts
40
Q

Describe the structure of the pelvic floor

A

A bowl-shaped sheet of muscle that supports the pelvic viscera and assists with sphincters

41
Q

Describe the journey of sperm, from its creation to its release

A
  1. Following spermiogenesis, spermatozoa are released into the lumen of seminiferous tubules
  2. They travel through the rete testis, ductulli efferentes, epididymis and vas deferens
  3. They are released into the ejaculatory duct (along with secretions from the seminal vesicle and prostate), and into the prostatic urethra!
42
Q

Describe the two types of inguinal hernias, including

  • which is more common
  • how each forms
A
  1. Indirect: More common, the processus vaginalis is a weak area, if it fails to close some coils of the intestine can follow it down with the testis pushing through the deep inguinal ring and causing a lump.
  2. Direct: bulging of the peritoneal cavity, often caused by age-related stress and weakened muscles in the inguinal canal
43
Q

Which zone of the prostate tends to becomes bigger with age? What is this known as and what symptom can it cause?

A

Transitional zone, known as benign prostatic hyperplasia and can cause a degree of incontinence

44
Q

Which nerve innervates the deep perineal pouch?

A

Pudendal nerve

Repro Ankis (11 decks)

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