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Anatomy (TOPNOTCH SUPPLEMENT) > Male Reproductive System > Flashcards

Male Reproductive System Flashcards

0
Q

Surrounded by a thick connective tissue layer (tunica albuginea)

Further surrounded incompletely by a peritoneal sac (tunica vaginalis)

Contents:

  • seminiferous tubules
  • straight tubules
  • Rete testes
  • efferent ductules

Blood supply: abdominal aorta via testicular artery

  • rich collateral blood supply provided by:
    1. Internal iliac artery via artery of the ductus deferens
    2. Inferior epigastric artery via cremasteric artery
    3. Femoral artery via external pudendal artery

Venous drainage:

  • Pampiniform plexus unite to form testicular veins
  • R testicular vein –> IVC
  • L testicular vein –> L renal vein (L-sided testicular varicocele may indicate occlusion of L testicular vein or L renal vein by a malignant renal tumor

Lymph drainage:

  • testes: deep lumbar nodes near the renal hilus (spread of testicular CA)
  • scrotum: superficial inguinal nodes
A

Testes

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1
Q

Testes descend along the normal pathway but do not reach the scrotum

If bilateral –> associated with sterility

⬆️ incidence of cancer & torsion

A

Cryptorchidism

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2
Q

Testes descends along an abnormal pathway

A

Ectopic tests

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3
Q

Small patency of processus vaginalis remain –> peritoneal fluid flows into tunica vaginalis surrounding the testes

A

Hydrocele

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4
Q

Abnormal dilatation of Pampiniform plexus & testicular vein (bag of worms)

More common on the left side (90%) - caused by compression of left testicular vein by sigmoid colon

Associated with infertility

A

Varicocele

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5
Q

Rotation of testes around the spermatic cord, usually toward the penis (eg. medially)

⬆️ in bell clapper deformity (testes is horizontal & tunica vaginalis is attached high on spermatic cord)

An emergency because it can cause ischemic necrosis within 6 hours

A

Torsion

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6
Q

MC form of testicular CA in men older than 60 year old

Occurs when malignant lymphoma metastasizes to the testes

A

Testicular lymphoma

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7
Q

MC form of testicular CA in infants & boys up to 3-year old

⬆️ a-fetal protein levels

A

Yolk sac tumor

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8
Q

MC type of germ cell neoplasm in 20-40% year old

Painless testicular mass, usually on the right side or diffuse nodularity

⬆️ b-hCG

A

Seminoma

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9
Q

Germ cell neoplasm

Early histology: resemble a blastocyst with 3 primary germ layers “male pregnancy”

Well differentiated cells from each primary germ layers (endoderm, mesoderm & ectodermh

A

Testicular teratoCA

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10
Q

Highly coiled duct, consists of head, body & tail

Sperm maturation & storage occur in the head & body

Tail is continuous with the vas deferens

A

Epididymis

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11
Q

Begins at the inferior pole of the testes –> enter spermatic cord –> inguinal canal –> deep inguinal ring

Joined by seminal vesicle to form the ejaculatory duct opens into the prostatic urethra

A

Ductus deferens (vas deferens)

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12
Q

Vasectomy cuts through the ff???

A

Skin –> COLLE’S fascia & dartos muscle –> external spermatic fascia –> cremasteric fascia & muscle –> internal spermatic fascia –> extraperitoneal fat

Tunica vaginalis is not cut

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13
Q

Contents of the spermatic cord

A

Ductus deferens

Artery of ductus deferens

Testicular artery

Cremasteric artery

Pampiniform venous plexus

Sympathetic & parasympathetic nerves

Genitofemoral nerve

Lymphatics

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14
Q

Function: produces seminal fluid, which fructose & choline

In forensic med: detection of choline crystals is the preferred method of determining the presence of sperm

A

Seminal vesicle

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15
Q

Location: between base of urinary bladder & urogenital diaphragm

  • anterior surface: related to retropubic space
  • posterior surface: related to the seminal vesicles & rectum

Collection of tubulo-alveolar glands

A

Prostate gland

16
Q

5 lobes of prostate gland

A

R & L lateral

R & L posterior

Middle

17
Q

3 zones of prostate gland

A

Peripheral (site of most cancers)

Central

Transitional (periurethral) -BPH

18
Q

The lumen of the glands normally contain deposits

A

Corpora amylacea

19
Q

Contains citric acid, phosphatase, prostaglandins, fibrinogen, & prostate-specific antigen (PSA)

Serine protease that liquefies semen after ejaculation

Serum acid phosphatase & PSA - diagnostic tools to detect prostatic CA

A

Prostatic fluid

20
Q

Arterial supply prostate gland

A

INTERNAL ILIAC ARTERY via inferior vesical artery

21
Q

Venous drainage of prostate gland

2 pathways

A

Prostatic venous plexus –> internal iliac veins –> IVC

Route of prostatic CA metastasis to the heart & lungs

Prostatic venous plexus –> vertebral venous plexus –> cranial dural sinuses

Route of prostatic CA metastatic to vertebral column & brain

22
Q

Hypertrophy of transitional (periurethral) zone

MC location: lateral & middle lobes

Compresses prostatic urethra –> obstructs urine flow

May be caused by ⬆️ sensitivity of prostate to dihydrotestosterone (DTH)

Not premalignant

SSX: urinary frequency, nocturia, sense of incomplete emptying of the bladder

Tx: surgery, 5a-reductase inhibitor (finasteride) to block the conversion of testosterone & DHT; or a-adrenergic antagonists (e.g. Terazosin, Prazosin) to inhibit prostate gland secretion

A

Benign prostatic hypertrophy (BPH)

23
Q

MC location: peripheral zone, which usually involves the posterior lobes

Dx: Serum PSA

Bone metastasis is common

Tx: surgery, radiation, Leuprolide (GnRH agonist that inhibits FSH & LH release, cyproterone or flutamide (androgen receptor antagonists)

A

Prostatic carcinoma

24
Q

External genitalia

A

Scrotum

Penis

25
Q

3 columns of erectile tissue

A

1 corpus Spongiosum

2 corpora cavernosa

26
Q

Supported by suspensory ligament

Innervations: dorsal nerve of the penis

A

Penis

27
Q

Blood supply of penis

A

INTERNAL PUDENDAL ARTERY via deep artery of the penis & dorsal artery of the penis

28
Q

Venous drainage of the penis

A

DEEP DORSAL VEIN OF THE PENIS –> prostatic venous plexus –> internal iliac vein –> IVC

SUPERFICIAL DORSAL VEIN OF THE PENIS –> external pudendal vein –> great saphenous vein –> femoral vein –> external iliac vein –> IVC

29
Q

Begins as bulb of the penis & ends as glans penis, ventrally located, transmits the urethra

A

Corpus Spongiosum

30
Q

Begin as the cruris of the penis & end proximal to the glans, dorsally situated

A

Corpora cavernosa

31
Q

Urethral folds do not fuse completely –> external urethral orifice opens onto the ventral surface

Associated with chordee (penis that curves ventrally)

A

Hypospadias

32
Q

External urethral orifice opens onto the dorsal surface

Associate with bladder extrophy

A

Epispadias

33
Q

Adult female

A

Gonads: ovary, follicles, Rete ovarii

Paramesonephric ducts: uterine tubes, uterus, cervix, upper part of vagina

Mesonephric ducts: duct of Gartner

Phallus: clitoris

Urogenital folds: labia minora

Labioscrotal swellings: labia majora

34
Q

Adult male

A

Gonads: testes, seminiferous tubules, Rete testes

Paramesonephric ducts: appendix of testes

Mesonephric ducts: epididymis, ductus deferens, seminal vesicle, ejaculatory duct

Phallus: glands & body of penis

Urogenital folds: ventral aspect of penis

Labioscrotal swellings: scrotum

Anatomy (TOPNOTCH SUPPLEMENT) (71 decks)

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