Repro 1 - Anatomy & Embryology Flashcards
Which autonomic innervation does male sexual response?
1) Erection: Parasympathetic (pelvic nerve), Nitric oxide-> cGmp-> vasodilation->proerectile./ Norepinephrine -> Calcium->Antierectile.
2) Emission: Sympathetic ( Hypogastric nerve).
3) Ejaculation: Visceral and somatic nerves (pudendal nerve).
How does Sidenafil work?
Decrease cGMP levels with PDE-5 inhibitors .
What is the ligament that connect the cervix to the side wall of pelvis?
Cardinal Ligament, there is also uterine vessels, ureter at risk of injury during ligation of uterine vessels in hysterectomy.
What is the ligament that is ligated during hysterectomies?
Broad Ligament connects uterus, Fallopian tubes, and ovaries to pelvic side wall.
What structures contain the suspensory ligament of the ovary?
Ovarian vessels, there also connect ovaries to lateral pelvic wall, ligate vessels during oophorectomy to avoid bleeding.
Which structures are connected by ovarian ligament?
Connect medial pole of ovary to lateral uterus, it is derivative of gobernaculum.
What kind of epithelium is the vagina?
Stratified squamous nonkeratinized.
Which of these tissue have Simple columnar epithelium ciliated?
A)Fallopian tube
B)Endocervix
Fallopian tube is ciliated, however Endocervix also have simple columnar epithelium but without cilia.
Tissue simple cuboidal epithelium belong to?
Ovary, outer surface.
Which are the branches from the pudendal nerve?
1) Inferior rectal nerve - anus
2) Dorsal nerve of the penis (or clitoris)
3) Perineal nerves - posterior scrotal or posterior labial nerves
What is the anatomical landmark to pudendal nerve block in surgery ?
Ischial spine, also it is just behind sacrospinous ligament.
What pathway does follow the sperm during ejaculation?
- Seminiferous tubules
- Epididymis
- Vas deferens
- Urethra
- Penis. Mnemonic: SEVEN UP
Why the varicocele is more common on the left ?
Because the left spermatic vein enters the left renal vein at a 90 grades angle, flow is less laminar on the left than on right, left venous pressure > right venous pressure.
Female patient with ovary CA, what nodes you should palpate in this particular patient?
Para-aortic lymph nodes, looking for metastasis, also in Testes CA.
Which structures are involved with the Superficial inguinal node?
Distal vagina, Vulva and Scrotum.
Which drain the proximal vagina and uterus in the Lymphatic system?
Obturator, external iliac and Hypogastric nodes, the node are not palpable.
What is the hernia that cross through internal inguinal ring lateral to inferior epigastric artery?
Inguinal Indirect Hernia, much more common in males, the infants undergo a failure of processus vaginalis to close ( can form hydrocele).
What anatomical structure is crossed by Direct Inguinal Hernia?
Hesselbach triangle conformed by inferior epigastric vessels, lateral border of rectus abdominis and inguinal ligament.
Which hernia is most common in female?
Femoral Hernia, protrudes below inguinal ligament through femoral canal below and lateral to pubic tubercle.
What is the function of the Mesonephric (wolffian) duct?
Develops into male internal structures: (except prostate)
- Seminal vesicle
- Epididymis
- Ejaculatory duct
- Ductus deferens. In females, remnant is Gartner duct.
Paramesonephric duct (Müllerian) develops in…
Fallopian tubes, uterus, upper portion of vagina.
*lower portion of the vagina is from urogenital sinus.
What is the Bicornuate uterus?
It is an incomplete fusion of Müllerian ducts, there are high risk of complicated pregnancy.
What is the function of SRY gene?
This gene produces Testis-determining factor that helps testes development.
What hormone is secreted by Sertoli cells?
Sertoli cells secrete Müllerian Inhibitory factor (MIF) that suppresses development of paramesonephric ducts.
What is the function of the testosterone ?
Mesonephric ducts become internal male genitalia
What enzyme convert testosterone to Dyhidrotestosterone (DTH)?
5- a reductase, and DHT is important to convert urogenital sinus and genital tubercle become external male genital structures.
Which characters develop the patient with deficient in 5-a reductase, but MIF present?
- Genetically male child.
- Internal male structures.
- Ambiguous external genitalia.
Genetic male, Male external genitalia but, Male and female internal genitalia, which combination of Factors the patient present?
Deficient in MIF, but 5-a reductase present.
Where is the abnormal opening of penile urethra in Hypospadia?
The abnormal opening of penile urethra on ventral surface of penis due to failure of urethral folds to fuse, also Hypospadia is more common than Epispadia.
Which congenital penile abnormalities are associated with Inguinal hernia and Cryptorchidism?
Hypospadias.
Which of the congenital penile abnormalities is associated with extrophy of the bladder?
Epispadias.
*exstrophy of the bladder is a congenital gap in the bladder wall and the abdominal wall in front of it.
what structures does form the gobernaculum and processus vaginalis in males ?
Males: gobernaculum (anchor testes) and processus vaginalis(Tunica vaginalis).
Females: gobernaculum ( ovarian ligament and round ligament of the uterus)
What cell type lines the uterus?
Columnar epithelium.
What ligament of the female pelvis connects the cervix to the pelvic side wall?
Cardinal ligament
What ligament connects the ovaries to the lateral pelvic wall?
Suspensory ligament of the ovaries.
What ligament connects the uterus, Fallopian tubes and ovaries to the pelvic side wall?
Broad ligament
What ligament contains the uterine vessels?
Cardinal ligament
To where does the testicular cancer first metastasize?
Para-aortic l.n.
What is the male homologue to each of the following female structures? Vestibular bulbs, labia minora, Bartholin glands, urethral and paraurethral glands (of skene).
Vestibular bulbs (corpus spongiosum), labia minora (ventral shaft of the penis), Bartholin glands( bulbourethral glands),urethral and paraurethral glands (prostate).
What gene product come from the SRY gene that underlies male genital development?
Testis determining factor
What structure anchors the testes to the scrotum?
Gubernaculum
