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Reproduction and Child health > Male reproductive anatomy > Flashcards

Male reproductive anatomy Flashcards

1
Q

Embryologically, where are testes derived from? How do they travel to the scrotum? What do they pull with them?

A

Derived from intermediate mesoderm
Descend from high on the posterior abdo wall (L2) to the scrotum
Drag the neurovasculature supply and lymphatic vessels

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2
Q

What guides the testes down to the scrotum?

A

The gubernaculum and processus vaginalis help testes descend through the inguinal canal. (Same layers as ant abdo wall) - testes develop in retroperitoneal position

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3
Q

What is the primary function of the testes?

A

Site of spermatogenesis - seminiferous tubules

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4
Q

Where does lymph drain from the testes?

A

Para-aortic nodes (L2)

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5
Q

What is the processus vaginalis? What does the lower part form? What happens to the upper part?

A

Fold of parietal peritoneum, helps guide the testes down the inguinal canal
Lower part of processus vaginalis surrounds the testicle and becomes the tunica vaginalis
Upper part should seal off (obliterated)

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6
Q

What might a patent processus vaginalis result in? (open)

A

Potential weak spot - route taken by indirect hernias

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7
Q

What is the tunica albuginea and how does it relate to lobules and seminiferous tubules?

A

Tunica aluginea - tough fibrous coat (of testicle) that gives rise to septa and divides testes into lobules.
Lobules contain seminiferous tubules (site of spermatogenesis)

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8
Q

After sperm are produced in the seminiferous tubules, where do they go?

A

Move to the rete testes -> efferent ductules -> head of epididymis -> body/tail -> ductus deferens

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9
Q

What are the differences between spermatocele and hydrocele?

A

Spermatocele - swelling in epididymis (can feel boarders of testes)
Hydrocele - fluid surrounds whole testicle (can’t feel testicle)

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10
Q

What is the primary function of the scrotum?

A

Keep gonads 3-4 degrees COOLER than body temp

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11
Q

What are the spermatic cord layers derived from the ant abdo wall? starting from superficial

A

Ext oblique aponeurosis -> Ext spermatic fascia
Int oblique -> Cremasteric fascia (muscular)
Transversalis fascia -> Int spermatic fascia

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12
Q

What are the contents of the spermatic cord? (rule of 3) Name arteries, nerves and other structures)

A

Arteries:
1. TESTICULAR a. 2. Cremasteric a. 3. Ductus deferens a.
Nerves:
1. genitofemoral n. 2. Autonomic n. 3. ILIOINGUINAL n.
Other structures!:
1. Ductus deferens 2. Pampiniform plexus (veins) 3. Lymphatics

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13
Q

Where do the left and right testicular veins drain to? Where do the testicular arteries from?

A

Testicular arteries arise from the aorta

R. testicular vein drains to IVC and L. testicular vein drains to left renal veins

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14
Q

What are varicoceles?

A

Abnormal dilations of the pampiniform plexus
‘BAG OF WORMS’
More common the left

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15
Q

What happens in a vasectomy? and what must be watch out for?

A

Male sterilization
Ductus deferens is cut and ligated just distal to superficial inguinal ring
Must watch out for ilioinguinal nerve (innervation to ext genitalia and pubic area)

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16
Q

What is testicular torsion and why might testicular pain be a SURGICAL EMERGENCY?

A

Twisting of the testis upon the spermatic cord - compromise blood supply.
ALL testicular pain is TORSION unless proven otherwise

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17
Q

Is the smooth muscle of ductus deferens capable of peristaltic action?

A

Yes - with sympathetic innervation

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18
Q

Embryolgically, what is the ductus deferens derived from?

A

Embryonic mesonephric duct

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19
Q

Describe the seminal vesicles. Do they store sperm? What is their main function?

A

Paired accessory sex glands (5cm long) located posterolateral to bladder.
DO NOT store sperm
Produce alkaline fluid - contributes to ejaculate
Combine with ductus deferens to form ejaculatory ducts - open into prostatic urethra
Related posteriorly to the rectovesical pouch

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20
Q

What percentage of seminal fluid (ejaculate) does the prostate contribute to?

A

20%

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21
Q

How can you palpate the prostate gland?

A

DRE - posterior aspect is easily palpable

22
Q

Where does the prostatic venous plexus drain to?

A

Internal iliac veins and/or vertebral plexus

23
Q

What lobes/zones do benign prostatic enlargement and prostate cancer often occur?

A

BPH - Median lobe/transitional zone

Prostate cancer - peripheral zone

24
Q

Why might prostate cancer present with back pain?

A

Metastatic deposits in the vertebrae via the venous plexus

25
Q

What are the male parts of the urethra (starting from deep)?

A 
Preprostatic
prostatic
membranous
spongy
navicular fossa
26
Q

What are the three places of resistance during a male catheterisation?

A

1) Navicular fossa
2) Fixed angle - urethra bends in the root of the penis after passing through the perineal membrane
3) Prostate/internal/external urethral sphincters

27
Q

What tissue forms the glans at the end of the penis?

A

Corpus spongiosum - expands (contains urethra)

28
Q

Where are the bulboureathral/Cowper’s glands located?What can happen if they become infected?

A

In DPP
Can become infected/develop stones
Cause perineal pain and pain on defecation / DRE

29
Q

What can happen as a result of blunt force trauma to the penile bulb (base of penis)?

A

Rupture the urethra resulting in extravasion of urine (or blood) into the SPP

30
Q

The anatomical position of the penis is in …

A

erection

31
Q

What is the innervation of the bulbospongiosus and ischiocavernosus muscle?

A

Pudendal nerve S2-4

32
Q

What are the ligaments which support the base of the body of the penis?

A

Fundiform ligament

Suspensory ligament

33
Q

What is the foreskin anchored to the glans by?

A

Frenulum

34
Q

Why do open vascular channels allow blood to enter and engorge mainly the corpora cavernosa and not the spongiosum?

A

Because spongiosum contains the urethra and can collapse and stop ejaculation

35
Q

What can cause the fracture of a penis?

A

Traumatic rupture of corpus cavernosum

36
Q

What is the difference between phimosis and paraphimosis?

A

Phimosis - foreskin cannot be retracted over the glans (stuck around the glans)
Paraphimosis - foreskin in stick in retracted position behind the glans

37
Q

What is priapism and how would you treat it?

A

Persistent (painful) non-stimualted erection that lasts >4 hours and unrelieved by ejaculation
Treat by draining blood from lateral side of penis with injection. Avoid the dorsal side as it has major neurovasculature

38
Q

What is the primary function of the ischioanal fossae?

A

Fat filled wedges help to support the pelvic floor

Fat allows for rectal distension and defecation

39
Q

What is fournier gangrene?

A

Necrotizing fasciitis of the perineal region

40
Q

What does the scarpa’s fascia become when it covers the penis/scrotum and SPP?

A

Dartos fascia

Colle’s fascia

41
Q

Where does scarpa’s fascia bind to below the inguinal ligament?

A

Binds to the fascia lata of thigh just below the inguinal ligament

42
Q

What canal lies in lateral ischioanal fossae within fascia over the obturator internus?

A

Pudendal (Alcock’s) canal - main neurovascular supply to the penis and clitoris

43
Q

What are the three terminal branches of the pudendal nerve?

A
  1. Inferior rectal
  2. Perineal
  3. Dorsal nerve of the penis
44
Q

Where do the parasymp and symp fibres unite on the lateral pelvic wall? Where do they come from?

A

Inferior hypogastric plexus
Parasymp - come from pelvic splanchnic nerves
Symp - hypogastric nerves and sacral splanchnic nerves

45
Q

Where do the nerves go from the inferior hypogastric plexus?

A

Travel medially to form plexi associated with pelvic organs (e.g. rectum and prostate)

46
Q

What might happen if you damage cavernous nerves during a prostate removal?

A

Cavernous nerves extend from prostatic plexus and move into penis - bring about erection. If the autonomic nerves are damaged during surgery, may result in impotence

47
Q

Where do the following structures drain to?

Testicles, glans of penis, distal urethra, scrotum, penile and perineal skin?

A

Testicles - para-aortic nodes
glans of penis, distal urethra - deep inguinal
Scrotum, penile and perineal skin - superficial inguinal
Everything else - internal iliac nodes

48
Q

What is the innervation for erection, emission and ejaculation? (hint: point shoot and score)

A

Parasymp, Symp and Somatic

49
Q

What does erection involve?

A

Straightening of the coiled helicine arteries which allows blood to fill the corpus cavernosum by relaxing of smooth muscle in helicine arteries.
Bulbospongiosus and ischiocavernosus muscles compress venous plexus (retain blood in penis)

50
Q

What happens during emission?

A

Symp innervation (L1/2) brings about secretion from glands, peristalsis of ductus deferens and close of internal urethral sphincter -> seminal fluid and sperm move to bulb of penis

51
Q

What happens during ejaculation?

A

Rhythmic contractions of somatically innervated bulbospongiosus - squeezes penile bulb and urethra
Also helps urethral emptying in male following urination

Reproduction and Child health (21 decks)

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