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HD2 > Male Reproductive Anatomy > Flashcards

Male Reproductive Anatomy Flashcards

1
Q

What are the different layers from superficial to deep of testis? [6]

A

The layers that will be encountered are (in order):
1. Skin
2. Dartos fascia and muscle
3. External spermatic fascia
4. Cremasteric muscle and fascia
5. Internal spermatic fascia
6. Parietal layer of the tunica vaginalis

Some Damn Englishman Called It The Testes (Mnemonic to remember the layers)
Skin, Dartos fascia/muslce, External spermatic fascia, Cremasteric fascia/muscle, Internal spermatic fascia, Tunica vaginalis (parietal), Tunic albuginea (visceral)

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2
Q

Label A-E & Green Arrow [6]

A

A: Sigmoid colon
B: (Ampulla of) rectum
Green Arrow: (Ampulla of) vas deferens
C: External anal sphincter muscle
D: Internal anal sphincter muscle
E: Bulb of penis

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3
Q
A

A: Corpus spongiosum of penis
B: Spongy urethra
C: Corpus cavernosum
D: EAS
E: Prostate
F: IAS
G: Bladder

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4
Q

Label the highlighted numbers

A

25: Seminal vesicle
26: Ejaculatory duct
29: Epididymis
28: Vas deferens
14: Prostate
32: (Navicular fossa of urethra)
33:External urethral orifice
34: Testis

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5
Q

Label the highlighted numbers

A

25: Seminal vesicle
26: Ejaculatory duct
29: Epididymis
28: Vas deferens
14: Prostate
32: (Navicular fossa of urethra)
33:External urethral orifice
34: Testis

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6
Q

Label A-E

A

A: Ureter
B: seminal vesicle
C: rectum
D: prostate
E:bladder

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7
Q

Label A-G

A

A: Spermatic cord (cut)
B: Levator ani muscle
C: Bulb of penis
D: Corpus cavernosum of penis
E: Corpus spongiosum of penis
F: Epididymis
G: Testis

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8
Q

Label A-E

A

A: Testis
B: Epididymis
C: Left and right crus penis
D: bulb of penis
E: Bulbo-urethral or Cowper’s gland

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9
Q

Label A-E

A

A: Seminal vesicle
B vas deferens
C: Corpus cavernosum
D: Corpus spongiosum
EGlans penis:

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10
Q

Label A-F

A

A: ureter
B: vas deferens
C: seminal vesicle
D: Membranous urethra
E: Spongy urethra
F: Right and left corpus cavernosum of penis

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11
Q

Label A-E

A

A: Rectovesical pouch
B: Rectum
C: Deep inguinal ring
D: Inferior epigastric arteries
E: Femoral Nerve

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12
Q

Label A-E

A

A: Rectovesical pouch
B: Rectum
C: Deep inguinal ring
D: Inferior epigastric arteries
E: Femoral Nerve

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13
Q

Label A-G

A

A: Prostatic utricle (embryological remnant)
B: Ejac. ducts
C: Prostatic urethra
D: Membranous urethra
E: Spongy urethra
F: Sphincter urethrae muscle
G: Prostate

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14
Q

Label A-G

A

A: Deep dorsal vein of penis (unpaired)
B: Dorsal artery of penis (paired)
C: Tunica albuginea of corpora
cavernosa
D: Spongy (penile) urethra
E: Corpus spongiosum of penis
F: Deep artery of penis
G: Tunica albuginea of corpus
spongiosum

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15
Q

The two bony landmarks useful for identifying the inguinal ligament are the [] and [].

A

The two bony landmarks useful for identifying the inguinal ligament are the anterior superior iliac spine and pubic symphysis.

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16
Q

which structures pass through the male deep inguinal ring? [6]

A

spermatic cord: within this is the:
- testicular artery and vein
- cremaster artery and vein
- artery to vas ferens
- pampiniform plexus of testicular veins
- genitofemoral vein
- vas deferens

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17
Q

Which nerve supplies the cremaster muscle? [1]

A

genitofemoral

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18
Q

Which anatomical space does the spermatic cord travel through?

Urogenital hiatus

Femoral canal

Inguinal canal

Lesser sciatic foramen

A

Which anatomical space does the spermatic cord travel through?

Urogenital hiatus

Femoral canal

Inguinal canal

Lesser sciatic foramen

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19
Q
A

Seminal vesicle

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20
Q

Which vessel does the left testicular vein drain into?

Inferior vena cava

Common iliac vein

Left renal vein

External iliac vein

A

Which vessel does the left testicular vein drain into?

Inferior vena cava

Common iliac vein

Left renal vein

External iliac vein

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21
Q

What are the 3 borders of Hesselbachs triange? [3]

A

IPV
Lateral border of rectus abdominus
Inguinal ligament

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22
Q

The wall of the vas deferens consists largely of smooth muscle, arranged in three muscle layers:

What are they?

A

Inner Layer: Longitudinal smooth muscle

Intermediate Layer: Circular smooth muscle

Outer Layer: Longitudinal smooth muscle

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23
Q

Which artery supplies the testes? [1]
From which vessel does it branch? [1]

A

Testicular A from Abdominal aorta

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24
Q

Name the plexus of veins which the drains the testis.[1]

How is the plexus involved in regulatuing testicular temperature? [1]

A

Pampiniform plexus

Countercurrent mechansim: surrounds testis cools arterial blood before entering testis

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25
Q

Where does lymph from the testes drain? [1]

Where does lymph from the scrotum drain? [1]

A

Testes: para-aortic

Scrotum: Superficial inguinal

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26
Q

What are the two layers of muscle found in the scrotum? [2]

Which one is more superficial and which is deeper? [2]

A

Cermaster muscle: deeper

Dartos muscle: superficial

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27
Q

Which of dartos and cremaster muscle is smooth [1] and skeletal muscle [1]

A

Cremaster: skeletal muscle

Dartos: smooth muscle

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28
Q

Which nerves innervate the cremaster and dartos:

Anteriorly [2]
Posteriorly [1]

A

Anteriorly: Genitofemoral
Ilioinguinal

Posteriorly:
Pudendal

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29
Q

What is the homologue of the scrotum in women? [1]

A

Labia majoria

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30
Q

What is a varicocele? [1]

Which side are they more common on? [1] Why? [1]

A

pampiniform plexus become enlarged due to increaed venous pressure inside your scrotum

More common on left: the spermatic vein opens at a sharp angle into the left renal vein

31
Q

which nerve innervates the external urethral sphincter [1]

A

The pudendal nerve - gives voluntary control of

32
Q

Which of the following statements correctly describes the apex of the bladder?

Internal triangular area with smooth walls

Connected to umbilicus by the median umbilical ligament

Where the bladder is continuous with the urethra

Triangular in shape and directed posteriorly

A

Which of the following statements correctly describes the apex of the bladder?

Internal triangular area with smooth walls

Connected to umbilicus by the median umbilical ligament

Where the bladder is continuous with the urethra

Triangular in shape and directed posteriorly

33
Q

What effect does sympathetic innervation have on internal urethral sphincter? [1]

What effect does parasympathetic innervation have on internal urethral sphincter? [1]

A

Sympathetic action: mains contraction

Parasympathetic action: inhibits IAS - causing it relax and urine to pass

34
Q

What happens to detrusor muscle in order to compensate for increased workload of the bladder emptying? [1]

A

Hypertrophy

35
Q

The [] zone is the exclusive site of benign prostatic hyperplasia (BPH).

A

transition zone

36
Q

Prostate cancer arise from which zone?

A

Peripheral zone

37
Q

Which structure does the vas deferen join?

A

Seminal vesicle

38
Q

What are the contents of the anal triangle? [2]

A

Fatty tissue
Pudendal canal

39
Q

Name the structures within the pudendal canal [3]

Which muscle is the piudendal canal formed from the fascia of? [1]

A

(AKA alcocks canal)

internal pudendal artery, vein and nerv

sheath derived from the fascia of the obturator internus muscle

40
Q

Name the structures within the pudendal canal [3]

Which muscle is the piudendal canal formed from the fascia of? [1]

A

(AKA alcocks canal)

internal pudendal artery, vein and nerv

sheath derived from the fascia of the obturator internus muscle

41
Q

Label 1-5

A

1 Spermatic cord covered with
cremasteric fascia
2 Cremaster muscle
3 Position of epididymis
4 Internal spermatic fascia
5 Position of testis

42
Q

Which of the following is the dartos muscle? [1]

A

13 Skin and dartos muscle (reflected)

43
Q

Label A-D

A

A: Pampiniform venous plexus
(anterior veins)
B: Ductus deferens
C: Testicular artery
D: Artery of ductus deferens

44
Q

Which of the following is the gubernaculum testis?

A

22 Gubernaculum testis

45
Q

Label 1-8

A

1 Spermatic cord (cut surface)
2 Head of epididymis (cut surface)
3 Septa of testis
4 Mediastinum testis
5 Tunica albuginea
6 Superior pole of testis
7 Convoluted seminiferous tubules
8 Inferior pole of testis

46
Q
A

1 Ureter
2 Ductus deferens
3 Seminal vesicle
4 Ampulla of ductus deferens

5Prostate

47
Q

Label A-C [3]

A

A: Start of Vas deferens
B: Levator ani
C: Obturator internus muscle

48
Q

Varicocoele is classically most associated with cancer of which solid abdominal organ? [1]

Why? [1]

A

Acceptable responses: kidney, renal, renal cell carcinoma

close association of the testicular vein and renal vein.

49
Q

A young man attends A&E with rapid onset, terrible pain in his testicles. On examination, sensory stimulation of the anteromedial thigh has no effect on retraction of the testes. Which nerve is most likely involved?

A

Acceptable responses: genitofermoral nerve, genital, genital branch of genitofemoral nerve, genitofemoral, genital branch of genitofemoral, genital branch genitofemoral, genital branch genitofemoral nerve

50
Q

Indirect inguinal hernias arise from what? [1]

A

It is most common in infant males, due to a patent processus vaginalis.

51
Q

How can you distinguish a direct and indirect hernia clinically? [1]

A

A direct hernia can be distinguished from an indirect hernia clinically by reducing it then putting manual pressure over the deep inguinal ring and asking the patient to cough.

A direct hernia should reappear; an indirect hernia should no

52
Q

Detrusor muscle:

Sympathetic stimulation results in [],

Parasympathetic stimulation causes [], and [] of the bladder.

A

Sympathetic stimulation results in relaxation

parasympathetic stimulation causes contraction, and voiding of the bladder.

53
Q

Name the 4 regions of the male urethra

A

preprostatic urethra
prostatic urethra
membranous urethra
spongy urethra

54
Q

How does the internal urethral sphincter function with regards to ejaculation?

A

The internal sphincter has the additional function of contracting during ejaculation to prevent retrograde ejaculation into the bladder.

55
Q

prostate images x

A
56
Q

Which zone of prostate is most associated with cancer? [1]

A

Peripheral zone

57
Q

Which zone of prostate is most associated with BPE? [1]

A

Transitional

58
Q

A man is referred to neurosurgery urgently due to a concern about cauda equina syndrome. Which urinary symptom is typically associated with cauda equina syndrome acutelyy? [1]

A

Acceptable answers; urinary retention

Remember that the sympathetic outflow is thoracolumbar, whereas the parasympathetic outflow is craniosacral, so cauda equina syndrome will affect the parasympathetic nervous system but not the sympathetic

This means that the detrusor muscle will not be able to contract

59
Q

One of the best treatments for benign prostate enlargement is transurethral resection of the prostate (TURP). One complication of TURP is retrograde ejaculation. Presence of this complication is most likely to represent damage to which structure?

[1]

A

Acceptable responses: internal urethral sphincter, internal sphincter, IUS

60
Q

Where does the anal canal start? [1]
At the level of which muscle? [1]

A

Starts at anorectal junction

At level of puborectalis

61
Q

Role of Ischioanal fossa? [1]

A

primary function is to allow expansion and deformation of the anal canal to facilitate the passage of faeces.

62
Q

A 36-year-old, otherwise healthy man attends his GP with very small volume, bright red, painless rectal bleeding. He has been constipated for the last few weeks. What is the most likely cause for his symptoms?

Internal haemorrhoids
External haemorrhoids
Rectal varices

A

A 36-year-old, otherwise healthy man attends his GP with very small volume, bright red, painless rectal bleeding. He has been constipated for the last few weeks. What is the most likely cause for his symptoms?

Internal haemorrhoids
External haemorrhoids
Rectal varices

63
Q

The anal cushions contain which plexi? [2]

How do they relate to the pectinate line? [2]

A

internal haemorrhoidal plexus (just superior to the pectinate line)

external haemorrhoidal plexus (just inferior)

64
Q

A 66-year-old woman is diagnosed with anal cancer. The tumour is located above the pectinate line. What is the likely histology?

Adenocarcinoma
Squamous cell carcinoma

A

A 66-year-old woman is diagnosed with anal cancer. The tumour is located above the pectinate line. What is the likely histology?

Adenocarcinoma
Squamous cell carcinoma

65
Q

A 66-year-old woman is diagnosed with anal cancer. The tumour is located above the pectinate line.

This cancer is most likely to spread to which group of lymph nodes?

Superficial inguinal nodes
Internal iliac nodes
Para-aortic nodes

A

A 66-year-old woman is diagnosed with anal cancer. The tumour is located above the pectinate line.

This cancer is most likely to spread to which group of lymph nodes?

Superficial inguinal nodes
Internal iliac nodes
Para-aortic nodes

66
Q

A 66-year-old woman is diagnosed with anal cancer. The tumour is located above the pectinate line.

This cancer is most likely to metastasise to which of these organs first? [1]

A

Liver

The venous drainage of the superior anal canal is via the superior rectal vein, which drains into the inferior mesenteric vein, which drains into the hepatic portal vein.

67
Q

What may be an unwanted consequence of pudendal nerve block? [1]

A

Acceptable responses: Incontinence

68
Q

A woman in labour is due to undergo an episiotomy. Which of these is the most appropriate choice of anaesthetic for this procedure?

Spinal block
Caudal epidural
Pudendal nerve block
General anaesthetic

A

A woman in labour is due to undergo an episiotomy. Which of these is the most appropriate choice of anaesthetic for this procedure?

Spinal block
Caudal epidural
Pudendal nerve block
General anaesthetic

69
Q

Which structure is avoided in a mediolateral episiotomy? [1]

A

Acceptable responses: perineal body, external anal sphincter, anal sphincter complex

70
Q

The pudendal nerve has three main branches. What are they and what do they supply? [3]

A

Inferior rectal - supplies the external anal sphincter and inferior anal canal

Perineal - supplies the anterior perineum

Dorsal nerve of penis/clitoris - supplies the external genitalia

71
Q

A young man attends his GP because he has been experiencing erectile dysfunction. Fibres from which branch of the peripheral nervous system are responsible for genital erection? [1]

A

Acceptable responses: parasympathetic, parasympathetic nervous system

72
Q

Which is the main muscle involved in helping to maintain erection? [1]

EXAM Q

A

Acceptable responses: bulbosongiosus, bulbospongiosus

73
Q

Atherosclerosis of which artery is most likely to cause erectile dysfunction?

Superior gluteal artery
Inferior gluteal artery
Inferior rectal artery
Internal iliac artery
Perineal artery

A

Atherosclerosis of which artery is most likely to cause erectile dysfunction?

Superior gluteal artery
Inferior gluteal artery
Inferior rectal artery
Internal iliac artery
Perineal artery

The penile artery arises from the internal pudendal artery, which. arises from the internal iliac artery.

74
Q

Atherosclerosis of which artery is most likely to cause erectile dysfunction?

Superior gluteal artery
Inferior gluteal artery
Inferior rectal artery
Internal iliac artery
Perineal artery

A

Atherosclerosis of which artery is most likely to cause erectile dysfunction?

Superior gluteal artery
Inferior gluteal artery
Inferior rectal artery
Internal iliac artery
Perineal artery

The penile artery arises from the internal pudendal artery, which. arises from the internal iliac artery.

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