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MD3002 Anatomy > Male reproductive organs > Flashcards

Male reproductive organs Flashcards

1
Q

Where do the primordial germ cells come from?

A

The wall of the yolk sac (ectodermal)

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2
Q

What structure attaches to the inferior part of the testes and pulls it inferiorly?

A

Gubernaculum

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3
Q

What can lead to an indirect inguinal hernia or a hydrocele?

A

If the proximal part of the tunic vaginalis stays open

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4
Q

Why does the scrotom allow for in the testes?

A

Keeps temperature lower than body core which makes it ideal for spermatogenesis

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5
Q

Describe the skin of the testes?

A
  • Rugose
  • Has no fat
  • Contains the dartos muscle
    Smooth muscle
    Supplied by sympathetic fibres in the genital branches of the genitofemoral nerves
  • Has midline raphe and divided by septum
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6
Q

What are the layers of the scrotum from superficial to deep?

A
  • Skin
  • Subcutaneous tissue (supf fascia): dartos muscle and fascia
  • External spermatic fascia: from fasacia of external oblique muscle
  • Cremasteric muscle and fascia: fibres and fascia of internal oblique muscl
  • Internal spermatic fascia: from transversalis fascia
  • Tunica vaginalis (visceral and parietal layers): from peritoneum
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7
Q

How can the scrotum be divided neurologically?

A
  • Anterior 1/3

- Posterior 2/3

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8
Q

What is the blood supply to the scrotum?

A
  • Anteriorly: external pudensal branches of the femoral artery
  • Posteriorly: Branches of the internal pudendal branch of the internal iliac
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9
Q

What is the venous drainage to the scrotum?

A

Mirrors arterial supply

  • Anteriorly: External pudendal veins to the great (long) saphenous vein
  • Posteriorly: Internal pudendal veins to the internal iliac vein
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10
Q

What is the nerve supply to the scrotum?

A
  • Anterior 1/3: L1 with ilioinguinal and genitofemoral nerves
  • Posterior 2/3: S2-3 via scrotal branches of the perineal branches of the pudendal nerve
  • This is significant if operating under regional anaesthesia
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11
Q

What is the lymphatic drainage of the scrotum?

A

Superficial inguinal nodes

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12
Q

What is hydrocele?

A

Fluid accumulation within parietal and visceral layers of tunica vaginalis

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13
Q

What are the testes suspended by?

A

Spermatic chord (tethered by gubernaculum)

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14
Q

What do the Leydig cells secrete?

A

Testosterone

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15
Q

What do the Sertoli cells secrete?

A

Inhibin

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16
Q

What are the coats/tunics which line the testis?

A
  • Tunica vaginalis
  • Tunica albuginea
  • Tunica vasculosa with branches of testicular vessels
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17
Q

Describe the tunica vaginalis?

A
  • Visceral and parietal layers
  • A potential space for movement of testis
  • Hydrocele
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18
Q

Describe the tunica albuginea

A
  • Tough and fibrous
  • Maintains internal pressure to help sperm transport
  • Forms mediastinum and septae, turns into lobes
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19
Q

Where does spermatogenesis take place in the testes and where does the sperm travel?

A

Seminiferous tubules (sperm then passes to the rete testis in the mediastinum and then via the efferent ductules to the epididymis)

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20
Q

What is the blood supply to the testis?

A
  • Testicular artery from aorta at L2 (plus anastomosis with cremasteric artery and artery to ductus deferens)
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21
Q

What is the venous drainage of the testis?

A

TEsticular vein starting as a pampiniform venous plexus (converge as left testicular vein draining into left renal vein and right testicular vein draining into the IVF)

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22
Q

WHat is the lymph drainage of the testis?

A

Para-aortic (lumbar) nodes

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23
Q

What is the nerve supply to the testis?

A

Sympathetic lesser splanchnic nerve, T10-11, with referred pain being peri-umbilical

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24
Q

What is cryptochidism?

A

Undescended testes

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25
Q

When is cryptorchidism usually treated?

A

6 months old

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26
Q

How is cryptorchidism treated medically?

A
  • Human chorionic gonadotropin (hCG)
  • Gonadotropin-releasing hormone
  • If these do not work surgery (orchiopexy)
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27
Q

Can cryptorchidism recurr?

A

Re-ascent can occur in up to 25%

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28
Q

What are the risks of cryptorchidism?

A

Testicular cancer and infertility

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29
Q

WHat is rectractile testis?

A
  • Descended testis which moves back and forth between scrotum and groin
  • Cremaster muscle overactive
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30
Q

Are recractile testis a concern?

A

For most boys, the problem goes away sometime before or during puberty

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31
Q

How long is the epididymis?

A

Approx 6m long (highly coiles tube)

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32
Q

What does the epididymis contain?

A

Head, body and tail

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33
Q

What does the epididymis continue as?

A

Ductus deferens

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34
Q

What does the epididymis do?

A
  • Contractions of the smooth muscle on the wall of the epididymis expel mature spermatozoa into the ductus deferens
  • Maturation and acquisition of motility of the spermatozoa
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35
Q

Describe the ductus/vas deferens

A

Thick-walled, cord-like tube around 45cm long

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36
Q

Describe the course of the ductus/vas deferens?

A
  • Lies posterior to the testis and medial to the epididymis
  • Leaves the scrotum and passes through the abdominal wall within the spermatic cord and the inguinal canal
  • Emerges into the abdomen lateral to the inferior epigastric artey and lies on the lateral wall of the pelvis
  • Lies medial to the pelvic vessels before passing antero-medially to the ureter (anterior to the rectum)
  • Joins with duct of the seminal gland to form the ejaculatory duct
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37
Q

What are the 3 arteries in the spermatic cord?

A
  • Testicular artery and pampiniform venous plexus
  • Artery to ductus deferens
  • Cremasteric artery and vein
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38
Q

What are the 3 tubes in the spermatic cord?

A
  • Ductus deferens
  • Lymphatic vessels from testes
  • Vestige (obliterated tube) of processus vaginalis
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39
Q

What are the 2 nerves of the spermatic cord?

A
  • Genital branch of genitofemoral (L1/2)

- Sympathetics (efferents and afferents to testes)

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40
Q

What artery does the artery of ductus deferens arise from?

A

Inferior vesical artery

41
Q

What artery does the cremasteric artery arise from?

A
  • Inferior epigastric
42
Q

What is the cremasteric reflex (L1)?

A

Ipsilateral testiculat retraction on stroking superior medial thigh

43
Q

What do varcose pampiniform veins feel like?

A

Bag of worms

44
Q

Which side is more likely to have a varcose pampiniform venous plexus?

A

Left due to almost right angle at which the left testicular vein drains into the left renal vein

45
Q

What are the symptoms of varcose pampiniform veins?

A
  • Dull, aching or throbbing pain in testicle, may lead to infertility
46
Q

What is a vasectomy?

A

Bilateral bisection of ductus deferens

47
Q

Where is the majority of sperm produced?

A

Seminal glands (vesicles)

48
Q

Where do the smeinal glands sit?

A

Just above prostate gland between the bladder and rectum

49
Q

What do the seminal glands produce?

A

Secrete seminal fluid to nourish sperm

50
Q

What do the seminal glands produce?

A

Alkaline fluid which contains fructose and choline (forensic), nourishes sperm

51
Q

What 2 ducts unite to form the ejaculatory duct?

A

Dilated ampullary end of the ductus deferens unites with the duct from the seminal gland to form the ejaculatory duct that passes through the prostate gland to enter the urethra

52
Q

Where does the prostate lie?

A
  • Inferior to the neck of the bladder
  • Posterior to the pubic symphysis
  • Anterior to the rectum
  • Superior to the urogenital diaphragm
  • Prostatic urethra descends through anterior prostated
53
Q

What is the prostate?

A

A fibromuscular glandular organ that surrounds the urethra

54
Q

What does the prostate secrete?

A
  • Prostaglandins
  • Acid phosphatase
  • Proteolytic enzymes
  • Prostate-specific antigen (PSA) into bloodstream
55
Q

Where do the prostatic ducts open?

A

20 - 30 of them open chiefly into the prostatic sinuses that lie on either side of the seminal colliculus (verumonatanum) on the posterior wall of the prostatic urethra

56
Q

Where does the prostatic utricle open?

A
  • The centre of the seminal colliculus

- On each side of the prostatic utricle is the opening of the ejaculatory ducts

57
Q

What are the 5 lobes of the prostate?

A

No histological boundaries

  • Median (middle) lobe: between urethra and ejaculatory ducts (BPH)
  • Posterior lobe: behind urethra, inferior to ejaculatory ducts
  • Anterior lobe: anterior to urethra (has no glandular tissue)
  • Left and right lobes: on both sides of the urethra
58
Q

What are the MacNeal’s zones of the prostate?

A
  • Transitional zone, around urethra, anterior to ejaculatory ducts
  • Central zone, posterior to transitional zone, contains ejaculatory ducts
  • Peripheral zone, around transitional and central zone
  • Anterior zone
59
Q

What prostate zone does a benign prostatic hypertrophy usually develop from?

A

Transitional zone

60
Q

What prostatic zone is where cancers usually develop?

A

Peripheral zone

61
Q

What are the 3 diseases of the prostate?

A
  • Inflammation
  • Benign prostatic hypertrophy
  • Cancer
62
Q

What can bulbo-urethral glands also be known as?

A

Cowper’s glands

63
Q

Where are the bulbo-urethral glands found?

A
  • Deep perineal pouch, postero-lateral to the membranous urethra
  • Surrounded by transervse fibres of external urethral sphincter muscle
64
Q

What do the bulbo-urethral glands secrete and where?

A
  • Drains into spongy urethra

- Secretes mucus before ejaculation and neutralize the pH of the urethra and lubricates urethra

65
Q

What fascia surrounds the penis?

A

Superficial (dartos) fascia (indistinct merging of Camper’s and Scarpa’s) surrounds whole penis

66
Q

What is phimosis?

A

Prepuce that is too tight to retract

67
Q

What forms smegma?

A

Secretions of sebaceous glands in the foreskin

68
Q

What is the foreskin?

A

Fold of skin continuous with the glans and therefore also with the mucous membrane of the urethra

69
Q

What is the tip of the penis called?

A

The glans

70
Q

What does the body of the penis contain?

A

Spongy urethra and 3 long cylindrical bodies

71
Q

Describe the corpora cavernosa (cavernous bodies)

A
  • Divided by a septum that is complete proximally, but pectiniform distally
  • Each surrounded by thick tunica albuginea
  • Filled with blood during erection
72
Q

Describe the corpus spongiosum (spongy body)

A
  • Transmits the urethra

- Forms the glans as a cap over the cavernous bodies

73
Q

What are the cavernous and spongy bodies surrounded by?

A

Deep (Buck’s) fascia

74
Q

What are the cavernous and spongy bodies surrounded by?

A

Deep (Buck’s) fascia

75
Q

What muscle surrounds the roots of the penis?

A

Ischiocavernosus muscle (attaches to ischium)

76
Q

What muscle surrounds the bulb of the penis?

A

Bulbospongiosus

77
Q

What are the functions of the bulbospongiosus?

A
  • Compresses the urethra during ejaculation

- Compresses the urethra to expel urine

78
Q

What muscles support the penis and contribute towards an erection?

A
  • Bulbospongiosus

- Ischiocavernosus

79
Q

What are the supportive ligaments of the penis?

A
  • Fundiform ligament

- Suspensory ligament

80
Q

What are the 4 parts of the urethra?

A
  • Preprostatic
  • Prostatic
  • Membranous
  • Spongy
81
Q

What does the preprostatic urethra prevent?

A

Retrograde ejaculation

82
Q

Where is the preprostatic urethra found?

A

In bladder neck

83
Q

Where do the ejaculatory ducts open?

A

In the prostatic urethra

84
Q

Where is the membranous urethra found?

A

In deep perineal pouch

85
Q

What is the membranous urethra surrounded by?

A

External urethral sphincter (voluntary)

86
Q

What are the 2 parts of the spongy urethra?

A
  • Bulbar urethra (in bulb of penis)

- Penile urethra (spongy body)

87
Q

Describe the structure of the membranous part of the urethra and the external urethral sphincter

A
  • Second narrowest part
  • Within the striated external urethral sphincter (slow twitch) and pubourethral or puboprostatic part of levator ani (mixed and fast twitch) to resist surges of raised intr-abdominal pressure
  • The external urethral sphincter is actually shaped like an inverted pear with its base on the perineal membrane and its apex pushing up into the prostatic urethr
88
Q

Are pubourethral and puboprostatic fibres voluntarycor involuntary?

A

Voluntary (part of levator rami)

89
Q

What part of the urethra is the longest?

A

Spongy

90
Q

What are the glands that enter the spongy urethra?

A
  • Bulbourethral gland

- Plus many scattered glands epecially in navicular fossa (lacuna magna)

91
Q

What is the navicular fossa?

A

Expansion of the urethra in the glans of the penis

92
Q

What are the 2 curvatures in the spongy urethra?

A

Dissapear during erection
- Infrapubic curvature: Between membranous and bulbar urethra
- Prepubic curvature: In the spongy urethra
Must be straightened when passing catheter

93
Q

What artery are the prostate gland and male urethra supplied by?

A

Inferior vesicular artery

94
Q

What is the venous drainage of the prostate gland and male urethra?

A

Prostatic venous plexus

  • Drains into internal iliac vein
  • Has connections with vertebral veins as well (prostatic cancer)
95
Q

What is the lymphatic drainage of the prostate?

A
  • Internal iliac lymph nodes

- Prostate may drain to presacral nodes too

96
Q

What is the somatic motor for control of the external urethral sphincter supplied by?

A

Pudendal nerve (S2-4) and its perineal branches

97
Q

What is the autonomic nerve supply to the male reproductive system?

A
  • Parasympathetics: from S2-4 -> pelvic splanchnic nerves -> pelvic plexus
  • Sympathetics from L1-2 -> superior hypogastric plexus -> pelvic plexus
98
Q

What is the visceral afferent nerve supply?

A

Via sacral parasympathetics (S2-4)

99
Q

What is the somatic afferent nerve supply?

A

Pudendal nerve (S2-4) and its perineal branches

MD3002 Anatomy (14 decks)

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