Male Reproduction

Question 1

The scrotum is a cutaneous fibromuscular sac, consisting of two layers, what are they?

Answer 1

1. heavily pigmented skin

2. dartos fascia

Question 2

What is the dartos fascia of the scrotum?

Answer 2

It is a fat free fascia layer including smooth muscle fibers responsible for the rugose (wrinkled) appearance of the scrotum.

Question 3

The scrotum is divided internally by this structure made of dartos fascia separating the scrotum into right and left compartments.

Answer 3

septum of the scrotum

Question 4

Externally the division of the scrotum into its two compartments is called the __________ __________, a continuous ridge marking the line of fusion of the embryonic labioscrotal swellings.

Answer 4

scrotal raphe

Question 5

The testis are the male gonads which produce two things:

Answer 5

1. Spermatozoa

2. Male hormones (primarily testosterone)

Question 6

How are the testes held in place within the scrotum?

Answer 6

It is suspended in the scrotum by spermatic cords, the left testis usually is suspended more inferiority than the right testes.

Question 7

This condition is the failure of the testes to descend. The failure to descend may be unilateral or bilateral.

Answer 7

cryptorchidism

Question 8

What is the occurrence of cryptorchidism in the population of full term infants? Of premature infants?

Answer 8

3% of full term infants; 30% of premature infants.

Question 9

The treatment of crytorchidism is important for what reasons?

Answer 9

1. To reduce the risk of testicular cancer

2. to increase chances of fertility

Question 10

What are the treatment options for crytorchidism?

Answer 10

1. Wait and see
2. Hormonal therapy by hCG and testosterone
3. Surgery by moving it down manually

Question 11

What structure covers the testes?

Answer 11

The tunica vaginalis

Question 12

The tunica vaginalis is derived from the parietal peritoneum is made of two layers. Name them.

Answer 12

1. Visceral Layer - adheres to the surface of the testes

2. parietal layer

Question 13

From what structure is the tunica vaginalis derived from?

Answer 13

It is derived from the parietal peritoneum membrane.

Question 14

This structure is a tough, fibrous outer surface, which thickens into a ridge on its internal, posterior aspect as the mediastinum of the testes. What is the structure?

Answer 14

Tunica albuginea

Question 15

This structure extends inward from the mediastinum to divide the testes into lobules.

Answer 15

Fibrous septa

Question 16

Describe the duct work in the testes.

Answer 16

Seminiferous tubules
straight tubules
rete testes
efferent ductules

Question 17

The site of spermatogenesis in the testes is in this structure…

Answer 17

Seminiferous tubules

Question 18

this structure is a network of canals in the mediastinum of the testes.

Answer 18

Rete testes

Question 19

This structure exits the testis on the posterior side of the epididymis.

Answer 19

efferent ductules

Question 20

The cavity of the tunica vaginalis is filled with…

Answer 20

serous fluid

Question 21

The blood supply of the testes arise from the abdominal arota inferior to the renal arteries and runs through the inguinal canal. What is this stucture?

Answer 21

Testicular arteries

Question 22

This network of 8-12 veins arising from the testis and epididymis converge superiorly to form the testicular veins. It is the site of counter current heat exchange.

Answer 22

pampiniform venous plexus

Question 23

Back flow of the blood in the testicular veins results in this condition.

Answer 23

varicocele

Question 24

99% of the instances of varicocele occur on the right or left testicular vein?

Answer 24

On the left testicular vein because the testicular vein hits the renal vein at a 90 deg angle.

Question 25

How is varivocele diagnosed?

Answer 25

Upon standing the scrotum takes on the appearance of a "bag of worms" which disappears when reclining,

Question 26

How is varicocele treated?

Answer 26

1. surgery - insicion is made in the scrotum and the veins are ligated 2. varicocele embolization - a catheter is fed through femoral vein and a coil is placed to block the flow of blood

Question 27

How is temperature regulated in the scrotum?

Answer 27

1. Countercurrent heat exchange | 2. muscles associated with the scrotum

Question 28

what muscles help with the regulation of heat in the scrotum?

Answer 28

1. The dartos muscle | 2. the cremaster muscle

Question 29

What is the function of the cremaster muscle?

Answer 29

The cremaster muscle is a continuous of the internal oblique muscle assiciated with the spermatic cord and causes the testes to be closer and farther from the abdominal region.

Question 30

This condition describes the twisting of the spermatic cord of the testes.

Answer 30

Torsion of the spermatic cord.

Question 31

How is torsion of the spermatic cord surgically corrected?

Answer 31

The testes (both of them) is surgically fixed to the scrotal septum.

Question 32

This condition described by excess fluid in the spermatic cord or tunica vaginalis. This may be due to a persistence processus vaginalis in vbabies or injury/inflammation of the epididymis in adults.

Answer 32

Hydrocele of spermatic cord and/or testes

Question 33

How is hydrocele of the spermatic cord and/or testes detected?

Answer 33

transillumination - a red glow indicates excess serous fluid. No red glow may indicate the presence of blood (this is worse).

Question 34

This condition is described as the collection of blood in the tunica vaginalis as a result of rupture of branches of the testicular artery from trauma.

Answer 34

hematocele of testes

Question 35

How do you differentiate hydrocele of the testes from hematocele of the testes in diagnosis?

Answer 35

blood in the hematocele will not transillulminate.

Question 36

Testicular cancer through account for a small percentage of cancer, they are most common among this demographic of men.

Answer 36

15-35 age group.

Question 37

early diagnosis of testicular cancer is done by these methods.

Answer 37

palpation and confirmation by utlrasound

Question 38

How is testicular cancer removed?

Answer 38

it is surgically removed via an inguinal approach to prevent the spread of cancer cells to the tissue of the scrotum which has a lymphatic drainage different from the testicles.

Question 39

Risk factors for testicular cancer include (4):

Answer 39

1. Abnormal testicle development 2. history of undescended testicle 3. klinefelter syndrome (XXY) 4. exposure to certain chemicals

Question 40

There are two main types of testicular cancer. Name them.

Answer 40

1. Seminoma | 2. Nonseminoma

Question 41

This type of testicular cancer is slow growing, usually found in men in their 30s and 40s, It usually does not spread and is very sensitive to radiation therapy.

Answer 41

seminoma testicular cancer

Question 42

this type of testicular cancer is more common and tends to grow more rapidly.

Answer 42

nonseminoma

Question 43

The kind of treatment used on testicular cancer is depended upon these factors.

Answer 43

1. Type of testicular tumor | 2. Stage of the tumor

Question 44

At this stage of testicular cancer, the cancer has not spread beyond the testicle.

Answer 44

Stage 1

Question 45

At this stage of testicular cancer, the cancer has spread to lymph nodes in the abdomen.

Answer 45

Stage 2

Question 46

At this stage of testicular cancer, the cancer has spread beyond the lymph nodes.

Answer 46

stage 3

Question 47

What are the treatment options for testicular cancer?

Answer 47

1. Orchiectomy - remove testes 2. radiation therapy - usually only seminomas 3. chemotherapy - for both seminomas and nonseminomas

Question 48

This highly coiled tube on the posterior side of the testes is the site of sperm maturation, motility, and storage until ejactulation. It is divided into 3 segments: head, body, and tail (cont. to vas deferens)

Answer 48

epididymis

Question 49

This structure is the continuation of the duct of the epididymis and is approx. 45cm long. It enters the pelvis through the inguinal canal.

Answer 49

ductus deferens

Question 50

the spermatic cord consists of these structures:

Answer 50

``` Ductus deferences testicular and ductus deferens arteries pampiniform plexus cremaster muscles lymphatic vessels nerves ```

Question 51

This procedure involves the cutting and ligation of the ductus deferens such that the ejaculated fluid from the seminal glands, prostate, and bulbourethral glands contain no sperm.

Answer 51

vasectomy

Question 52

This structure is an oblique passageway approx. 4 cm long that likes parallel and superior to the medial half of the inguinal ligament where the spermatic cord in males and the round ligmament of the uterus in females tun through.

Answer 52

inguinal canal.

Question 53

This structure is located superior to the middle in the inguinal ligament and lateral to the inferior epigastric artery.

Answer 53

Deep inguinal ring

Question 54

this structure occurs as a split in the diagonal, otherwise parallel fibers of the external oblique aponeurosis just superolateral to the pubic tubercle.

Answer 54

Superficial inguinal ring

Question 55

This type of inguinal hernias comprises 25-33% of all inguinal hernias and involves weakness of the anterior abdominal wall in the inguinal triangle where the parietal peritoneum and viscera pass through the inguinal canal.

Answer 55

Direct inguinal hernia

Question 56

This type of hernia comprises 66-75% of all inguinal hernias. The pariatal peritoneum and viscera traverses the inguinal canal within processus vaginalis and exits the superficial ring inside the spermatic cord, commonly passing into the scrotum/labium majus.

Answer 56

Indirect inguinal hernia

Question 57

How is a hernia exam performed?

Answer 57

Invagination of the skin of the upper scrotum to palpate superficial inguinal ring. If ring is dialated, it may admit finger without pain. A hernia is present if a sudden impulse is felt against the tip of the examining finger when the patient is asked to cough.

Question 58

There are three sets of accessory glands in the male reproductive parts. What are they?

Answer 58

Seminal vesicles prostate bulbourethral glands

Question 59

This accessory gland of male reproduction likes between the fundus of the bladder and the rectum and secretes a thick alkaline fluid with fructose and a coagulating agent that mised with the sperm as they pass into the ejaculatory ducts and urethra.

Answer 59

Seminal vesicles.

Question 60

This accessory gland of male reproduction is the largest and secretes a thin, milty fluid and provides ~20% of the volume of semen and is involved with activating sperm.

Answer 60

Prostate

Question 61

This condition is common after middle age affecting virtually every make who lives long enough and involves the enlargement of the prostate which can impede the urination.

Answer 61

benign hypertrophy of the prostate

Question 62

How is the impediment to urination treated in benign hypertrophy of the prostate?

Answer 62

Transurethreal resection of the prostate - where part of the prostate if removed by use of a instrument inserted into urethra.

Question 63

These accessory male reproductive glands produces a mucus-like secretion that cleans out the urethra before ejaculation.

Answer 63

bulbourethral glands.

Question 64

The penis consists of three structures, what are they?

Answer 64

Root, body, glans.

Question 65

The penis contains three cylindrical cavernous bodies of erectile tissue. What are they?

Answer 65

corpora cavernosa (2 bodies) and corpus spongiosum.

Question 66

This tissue of the penis is covered by tunica albuginea. The two halfs are fused with each other in the median place except where they separate for form the crura of the penis.

Answer 66

Corpora cavernosa

Question 67

This tissue of the penis surrounds the spongy urethra. It expands for form the glans of the penis.

Answer 67

corpus spongiosum

Question 68

The corpora cavernosa and corpus spongiosum are bound together by the deep fascia of the penis also known by this name...

Answer 68

Buck's fascia.

Question 69

The root of the penis is the part which attaches the penis to the rest of the body. What strutures make up the root?

Answer 69

Crura, bulb of the penis and the ischiocavernosus and bublospongiosus muscles

Question 70

This ligament of the penis passes inferiorly and splits to form a sling that that attached to the deep fascia of the penis at the junction of the root and body. Limits length.

Answer 70

Suspensory ligament of the penis

Question 71

This ligament of the penis splits to surround the penis and then unites and blends inferiorly with the dartos fascia forming the scrotal septum. limits girth.

Answer 71

fundiform ligament of the penis