MALE REPRODUCTIVE SYSTEM II

Question 1

1. Which structures make up the internal Male genitalia?

Answer 1

• Vas Deferens
• Prostate
• Urethra
• Female equivalents:
• Oviducts (Fallopian Tubes)
• Skene’s Glands (sexual secretions)
• Urethra

Question 2

2. The prostate gland develops rapidly at puberty. What is its shape?

Answer 2

• inverted cone
• its apex is found at the pelvic Diaphragm

Question 3

3. What are the 4 zones of the Prostate?

Answer 3

1. Peripheral Zone
   (70% Glandular tissue)
2. Central Zone
   (20% Glandular tissue)
3. Transition Zone
   (75% Glandular tissue)
4. Anterior Fibromuscular Stroma

Question 4

4. Which zone of the Prostate Gland can be felt during a rectal exam?

Answer 4

• the Peripheral Zone

Question 5

5. Which zone of the Prostate Gland is most likely to develop tumours and carcinomas?

Answer 5

• the Peripheral Zone

Question 6

6. Which zone of the Prostate Gland is most likely to develop Benign Prostatic Hyperplasia?

Answer 6

• the Transitional Zone

Question 7

7. What is benign Prostatic Hyperplasia?

Answer 7

• the prostate gland enlarges and
  hardens with age
• this is not cancerous
• the enlarged prostate gland presses
  on the Urethra
• individual has to urinate more
  frequently
• they cannot delay urination
• they have trouble starting a urine
  stream
• weak urine flow
• dribbling at the end of urination

NB:
- 50% of men have symptoms by 50
- 70% of men have symptoms by 70

Question 8

8. What structure passes through the Prostate?

Answer 8

• the prostatic Urethra
• carries urine and semen out of the body

Question 9

9. Which structures pierce the posterior part of the Prostate Gland?

Answer 9

• the Seminal Vesicles and the Ductus
  Deferens
• they form the ejaculatory ducts that
  pierce the posterior
  surface (just below the bladder)
• they drain into the Prostatic Urethra

Question 10

10. Which substance is elevated during prostate cancer?

Answer 10

• Prostate Specific Antigen levels in
  the blood
• this is a protease that liquifies
  semen
• allowing the release of spermatozoa
• healthy males have low
  concentrations of this antigen

Question 12

11. How do we clinically prove Prostate enlargment?

Answer 12

1. Digital Rectal Exam
2. Urine test
3. Blood test

Question 13

12. What is the blood supply to the Prostate Gland?

Answer 13

• Inferior Vesical Artery (main supply)
• Middle Rectal Artery
• Internal Pudendal Artery

Question 14

13. What surrounds the Prostate Gland?

Answer 14

• thin, strong capsule
• condensation of fascia (false
  capsule) at the periphery
• the prostatic venous plexus lies
  between these two capsules

Question 15

14. What does the Prostatic Venous Plexus drain into?

Answer 15

• drains into the Internal Iliac Veins
• connects to the Vertebral Venous
  plexus
• bone metastasis can be caused by
  prostate cancer (along this route)

Question 16

15. What is the Lymphatic drainage of the Prostate Gland?

Answer 16

1. Lymph drainage from the Posterior
   Lobe
   - External Iliac Nodes
   (lateral pathway)
   - Internal Iliac Nodes
   (laterodorsal pathway)
   - Sacral Nodes (dorsal pathway)
   - Promontorial Common Iliac Nodes
   (dorsal pathway)
2. Lymph drainage from the Anterior
   Lobe
   - External Iliac Nodes
   - Inferior Gluteal Nodes
   (part of Internal Iliac)

Question 17

16. What is the shape of the Seminal Vessicles?

Answer 17

• they are pear shaped (piriform)
• consist of a sac-like tube that folds
  in on itself

Question 18

17. What is the function of the Seminal Vesicles?

Answer 18

• produce Seminal fluid
• a major component of Semen (60%)
• contains elements to nourish the
  sperm
  (fructose and prostaglandins)
• helps to transport sperm during
  ejaculation

Question 19

18. What are the bulbourethral (Cowper’s) glands?

Answer 19

• small, paired glands near the base
  of the penis
• a short duct from each gland enters
  at the proximal end of the penile
  (spongy) urethra at the bulb of the
  penis
• secrete alkaline mucus in response
  to sexual stimulation
• neutralises acidity of Vagina
• cleanses the urethra of urine before
  ejaculation

Question 20

19. What is the female equivalent to Bulbourethral glands?

Answer 20

• Bartholin’s (greater vestibular)
  glands
• found on either side of the Vaginal
  Introitus
• produce a mucus secretion that
  lubricates the vaginal canal and the
  vulva

Question 21

20. What are the 4 sections of the Urethra?

Answer 21

1. Pre-Prostatic (0.5-1.5 cm)
2. Prostatic (3 cm)
   - widest and most dilatable part
   - passes through the apex of the
   Prostate
3. Membranous (1-2 cm)
   - enclosed by external urethra
   sphincter (helps to hold urine in)
   - shortest and least dilatable part of
   urethra
4. Spongy Urethra (15cm)
   - the longest part
   - the External Meatus is the narrowest part

Question 22

21. What is the Urethral Crest (Vermunotanum)?

Answer 22

• the narrow, longitudional ridge on
  the posterior wall of the Prostatic
  urethra
• formed by an elevation of the
  mucous membrane

Question 23

22. What is the Prostatic Sinus?

Answer 23

• the groove on either side of the
  Urethral Crest
• 20-30 ducts of the Prostate Gland
  open into these sinuses

Question 24

23. What is the Seminal Colliculus?

Answer 24

• rounded eminence (risen tissue) at
  the middle of the prostatic urethra
• prevents the oozing of semen from
  the Seminal Ducts
• it has an upper depression
  (Prostatic Utricle opening)
• it has two lower depressions
  (ejaculatory duct openings)

Question 25

24. What is the Prostatic Utricle?

Answer 25

- a sinus (sac with slit like opening) lined with epithelium - opens between two ejaculatory ducts - it is a remnant of the Mullerian Duct

Question 26

25. Which part of the Urethra is most likely to be injured during Catheterisation?

Answer 26

- short part of the intermediate urethra - it is not protected - the urethral wall is thin and vulnerable to punctures

Question 27

26. What does a ruptured Urethra lead to?

Answer 27

- extravasation of urine - leakage of urine and blood into the tissue around it (deep perineal pouch) - the fluid can pass through the urogenital hiatus and leak around the Prostate and Bladder - caused by pelvic girdle fractures - the attachments of the Perineal Fascia determine the flow of the extravasated urine - the urine cannot pass far into the thighs - due to the Superficial Perineal fascia blending with the Fascia Lata

Question 28

27. What sex does the external genitalia begin as during development?

Answer 28

- External genitalia begins as female in both males and females

Question 29

28. What tissue do the gonads arise from (during development)?

Answer 29

- Mesoderm

Question 30

29. What does the male reproductive tract develop from?

Answer 30

- Mesonephric Duct

Question 31

30. What does the female reproductive tract develop from?

Answer 31

- Paramesonephric Duct

Question 32

31. What are remnants of the Mesonephric duct in adults?

Answer 32

- Appendix Testis - Appendix Epididymis

Question 33

32. What predisposes an individual to inguinal hernias and hydroceles?

Answer 33

- a Processus Vaginalis that has not closed - the Processus Vaginalis - an embryonic outpouching of the peritoneum - it precedes the testis in their descent down within the gubernaculum (then closes)