Male Reproductive Anatomy Flashcards
What are the different layers from superficial to deep of testis? [6]
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)
Label A-E & Green Arrow [6]
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
A: Corpus spongiosum of penis
B: Spongy urethra
C: Corpus cavernosum
D: EAS
E: Prostate
F: IAS
G: Bladder
Label the highlighted numbers
25: Seminal vesicle
26: Ejaculatory duct
29: Epididymis
28: Vas deferens
14: Prostate
32: (Navicular fossa of urethra)
33:External urethral orifice
34: Testis
Label the highlighted numbers
25: Seminal vesicle
26: Ejaculatory duct
29: Epididymis
28: Vas deferens
14: Prostate
32: (Navicular fossa of urethra)
33:External urethral orifice
34: Testis
Label A-E
A: Ureter
B: seminal vesicle
C: rectum
D: prostate
E:bladder
Label A-G
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
Label A-E
A: Testis
B: Epididymis
C: Left and right crus penis
D: bulb of penis
E: Bulbo-urethral or Cowper’s gland
Label A-E
A: Seminal vesicle
B vas deferens
C: Corpus cavernosum
D: Corpus spongiosum
EGlans penis:
Label A-F
A: ureter
B: vas deferens
C: seminal vesicle
D: Membranous urethra
E: Spongy urethra
F: Right and left corpus cavernosum of penis
Label A-E
A: Rectovesical pouch
B: Rectum
C: Deep inguinal ring
D: Inferior epigastric arteries
E: Femoral Nerve
Label A-E
A: Rectovesical pouch
B: Rectum
C: Deep inguinal ring
D: Inferior epigastric arteries
E: Femoral Nerve
Label A-G
A: Prostatic utricle (embryological remnant)
B: Ejac. ducts
C: Prostatic urethra
D: Membranous urethra
E: Spongy urethra
F: Sphincter urethrae muscle
G: Prostate
Label A-G
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
The two bony landmarks useful for identifying the inguinal ligament are the [] and [].
The two bony landmarks useful for identifying the inguinal ligament are the anterior superior iliac spine and pubic symphysis.
which structures pass through the male deep inguinal ring? [6]
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
Which nerve supplies the cremaster muscle? [1]
genitofemoral
Which anatomical space does the spermatic cord travel through?
Urogenital hiatus
Femoral canal
Inguinal canal
Lesser sciatic foramen
Which anatomical space does the spermatic cord travel through?
Urogenital hiatus
Femoral canal
Inguinal canal
Lesser sciatic foramen
Seminal vesicle
Which vessel does the left testicular vein drain into?
Inferior vena cava
Common iliac vein
Left renal vein
External iliac vein
Which vessel does the left testicular vein drain into?
Inferior vena cava
Common iliac vein
Left renal vein
External iliac vein
What are the 3 borders of Hesselbachs triange? [3]
IPV
Lateral border of rectus abdominus
Inguinal ligament
The wall of the vas deferens consists largely of smooth muscle, arranged in three muscle layers:
What are they?
Inner Layer: Longitudinal smooth muscle
Intermediate Layer: Circular smooth muscle
Outer Layer: Longitudinal smooth muscle
Which artery supplies the testes? [1]
From which vessel does it branch? [1]
Testicular A from Abdominal aorta
Name the plexus of veins which the drains the testis.[1]
How is the plexus involved in regulatuing testicular temperature? [1]
Pampiniform plexus
Countercurrent mechansim: surrounds testis cools arterial blood before entering testis
Where does lymph from the testes drain? [1]
Where does lymph from the scrotum drain? [1]
Testes: para-aortic
Scrotum: Superficial inguinal
What are the two layers of muscle found in the scrotum? [2]
Which one is more superficial and which is deeper? [2]
Cermaster muscle: deeper
Dartos muscle: superficial
Which of dartos and cremaster muscle is smooth [1] and skeletal muscle [1]
Cremaster: skeletal muscle
Dartos: smooth muscle
Which nerves innervate the cremaster and dartos:
Anteriorly [2]
Posteriorly [1]
Anteriorly: Genitofemoral
Ilioinguinal
Posteriorly:
Pudendal
What is the homologue of the scrotum in women? [1]
Labia majoria
What is a varicocele? [1]
Which side are they more common on? [1] Why? [1]
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
which nerve innervates the external urethral sphincter [1]
The pudendal nerve - gives voluntary control of
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
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
What effect does sympathetic innervation have on internal urethral sphincter? [1]
What effect does parasympathetic innervation have on internal urethral sphincter? [1]
Sympathetic action: mains contraction
Parasympathetic action: inhibits IAS - causing it relax and urine to pass
What happens to detrusor muscle in order to compensate for increased workload of the bladder emptying? [1]
Hypertrophy
The [] zone is the exclusive site of benign prostatic hyperplasia (BPH).
transition zone
Prostate cancer arise from which zone?
Peripheral zone
Which structure does the vas deferen join?
Seminal vesicle
What are the contents of the anal triangle? [2]
Fatty tissue
Pudendal canal
Name the structures within the pudendal canal [3]
Which muscle is the piudendal canal formed from the fascia of? [1]
(AKA alcocks canal)
internal pudendal artery, vein and nerv
sheath derived from the fascia of the obturator internus muscle
Name the structures within the pudendal canal [3]
Which muscle is the piudendal canal formed from the fascia of? [1]
(AKA alcocks canal)
internal pudendal artery, vein and nerv
sheath derived from the fascia of the obturator internus muscle
Label 1-5
1 Spermatic cord covered with
cremasteric fascia
2 Cremaster muscle
3 Position of epididymis
4 Internal spermatic fascia
5 Position of testis
Which of the following is the dartos muscle? [1]
13 Skin and dartos muscle (reflected)
Label A-D
A: Pampiniform venous plexus
(anterior veins)
B: Ductus deferens
C: Testicular artery
D: Artery of ductus deferens
Which of the following is the gubernaculum testis?
22 Gubernaculum testis
Label 1-8
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
1 Ureter
2 Ductus deferens
3 Seminal vesicle
4 Ampulla of ductus deferens
5Prostate
Label A-C [3]
A: Start of Vas deferens
B: Levator ani
C: Obturator internus muscle
Varicocoele is classically most associated with cancer of which solid abdominal organ? [1]
Why? [1]
Acceptable responses: kidney, renal, renal cell carcinoma
close association of the testicular vein and renal vein.
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?
Acceptable responses: genitofermoral nerve, genital, genital branch of genitofemoral nerve, genitofemoral, genital branch of genitofemoral, genital branch genitofemoral, genital branch genitofemoral nerve
Indirect inguinal hernias arise from what? [1]
It is most common in infant males, due to a patent processus vaginalis.
How can you distinguish a direct and indirect hernia clinically? [1]
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
Detrusor muscle:
Sympathetic stimulation results in [],
Parasympathetic stimulation causes [], and [] of the bladder.
Sympathetic stimulation results in relaxation
parasympathetic stimulation causes contraction, and voiding of the bladder.
Name the 4 regions of the male urethra
preprostatic urethra
prostatic urethra
membranous urethra
spongy urethra
How does the internal urethral sphincter function with regards to ejaculation?
The internal sphincter has the additional function of contracting during ejaculation to prevent retrograde ejaculation into the bladder.
prostate images x
Which zone of prostate is most associated with cancer? [1]
Peripheral zone
Which zone of prostate is most associated with BPE? [1]
Transitional
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]
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
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]
Acceptable responses: internal urethral sphincter, internal sphincter, IUS
Where does the anal canal start? [1]
At the level of which muscle? [1]
Starts at anorectal junction
At level of puborectalis
Role of Ischioanal fossa? [1]
primary function is to allow expansion and deformation of the anal canal to facilitate the passage of faeces.
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 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
The anal cushions contain which plexi? [2]
How do they relate to the pectinate line? [2]
internal haemorrhoidal plexus (just superior to the pectinate line)
external haemorrhoidal plexus (just inferior)
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 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 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 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 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]
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.
What may be an unwanted consequence of pudendal nerve block? [1]
Acceptable responses: Incontinence
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 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
Which structure is avoided in a mediolateral episiotomy? [1]
Acceptable responses: perineal body, external anal sphincter, anal sphincter complex
The pudendal nerve has three main branches. What are they and what do they supply? [3]
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
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]
Acceptable responses: parasympathetic, parasympathetic nervous system
Which is the main muscle involved in helping to maintain erection? [1]
EXAM Q
Acceptable responses: bulbosongiosus, bulbospongiosus
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
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.
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
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.
