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Sem 4 > Repro 4: Male Reproductive System > Flashcards

Repro 4: Male Reproductive System Flashcards

1
Q

What is the tough fibrous outer surface that encloses the testis?

A

Tunica albuginea

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2
Q

What layer covers the testis after the tunica albuginea?

A

Tunica vaginalis

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3
Q

Embryologically, what attaches the testis to the posterior abdominal wall?

A

Gubernaculum

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4
Q

What is oligozoospermia?

A

A clinical condition where there is an abnormally low spermatozoa count in the semen

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5
Q

What is the blood supply to the testes?

A

Testicular arteries, which arise directly off the AA, inferior to the renal arteries

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6
Q

What is the venous drainage of the testes?

A

Testicular veins which arise from the pampiniform venous plexus

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7
Q

Where do the testicular veins drain into?

A

R testicular vein -> IVC

L testicular vein -> L renal vein

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8
Q

When sperm leaves the testis, what structures does it pass through?

A

From the testes via the rete testis (interconnected passageways) and enters the ductuli efferentes (series of coiled ductules), these join to form the epididymis which then continues with the vas deferens

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9
Q

What is the function of the epididymis?

A

For sperm transport, maturation and transport

Sperm pass through the epididymis and mature and become motile, then are stored in the tail segment until ejactulation

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10
Q

What is the contents of the spermatic cord?

A 
Vas deferens
Pampiniform venous plexus
Cremasteric artery
Artery to vas
Testicular artery
Lymphatics
Processus vaginalis
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11
Q

Other than venous drainage, what other function does the pampiniform venous plexus have?

A

Wraps around the testicular artery for thermoregulation, as blood in the veins is at a lower temperature than in arteries so it keeps the gonad cool to enable spermatogenesis

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12
Q

What are the fascial coverings of the spermatic cord and what is their derivatives?

A

Internal spermatic fascia (from transversalis fascia)
Cremasteric muscle and fascia (from transversalis abdominis and internal oblique)
External spermatic fascia (from aponeurosis of external oblique)

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13
Q

What is the epithelium of the spermatic cord?

A

Pseudostratified to columnar, with stereocilia

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14
Q

What are the seminal vesicles?

A

Two small glands posterior to the prostate gland
Glands consist of a tube that join the ampulla of the vas deferens called the ejaculatory duct
Secretions account for 70-80% of ejaculate

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15
Q

What is often raised in the blood with prostatic disorders?

A

PSA (prostate specific antigen)

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16
Q

Enlargement of which lobe of the prostate causes urethral obstruction?

A 
Central zone (similar to middle lobe)
Undergoes BPH with age
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17
Q

Which part of the prostate is prone to malignancy?

A

Outer zones

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18
Q

How is the prostate examined?

A

Digital rectal examination

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19
Q

What is the course of the vas deferens?

A

Transverses the inguinal canal
Anterior to pelvic bone
Tracks around the bladder retroperitoneally
Joins with seminal vesicles (at dilated ampulla) to form the ejaculatory duct

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20
Q

What is a hydrocoele?

A

Accumulation of serous fluid in the tunica vaginalis

Most commonly to failure of processus vaginalis to close

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21
Q

What is a haematocoele?

A

Collection of blood in the tunica vaginalis?

22
Q

How can a hydrocoele and haematocoele be differentiated in clinical practice?

A

Hydrocoele will transluminate but a haematocoele will not transluminate

23
Q

What is a variococoele?

A

Dilation of pampiniform venous plexus, forming varicosities
Feels “like a bag of snakes”
Enlargement disappears when lay down, as gravity allows veins to empty

24
Q

Which side is a variococoele more common on, and why?

A

More common on the left side due to the angle of entry of the L testicular vein into the L renal vein

25
Q

What is a spermatocoele?

A

Collection of fluid in the epididymis

Aka epididymal cyst

26
Q

What is testicular torsion?

A

Twisting of the spermatic cord

Obstructs venous drainage, causing oedema, haemorrhage and arterial obstruction
Can cause testicular necrosis

27
Q

What is the lymph drainage of the testis?

A

Drain to paraaortic nodes

As they develop in posterior abdominal wall

28
Q

What is the lymph drainage of the scrotum?

A

Drain to superficial inguinal nodes

29
Q

Where do prostate malignancies often metastise to?

A

Vertebrae and brain

30
Q

The penis is formed by which three cylindrical bodies of erectile tissue?

A

Pair of corpus cavernosa which each lie dorsally

Single corpus spongiosum ventrally

31
Q

What is the blood supply to the penis?

A

Cavernous arteries and branches of the internal pudendal arteries

32
Q

What are the perineal muscles in the penis?

A
  • bulbospongiosus (compresses bulb of penis to expel last drops of urine/semen, helps maintain erection)
  • ischiocavernosus (compresses veins to force blood into distal corpus cavernosa to help maintain erection)
33
Q

What are the 4 parts of the urethra?

A

Pre-prostatic
Prostatic
Membranous
Spongy

34
Q

Which part of the uretha is least distensible and why?

A

The membranous segment

As it passes through thick perineal pouch (and so is also most likely part to be damaged in urethral catheterisation)

35
Q

What is the pelvis made up of?

A

2 inominate bones (hip bones) + sacrum + coccyx

36
Q

What is the lines terminalis?

A

Line around the pelvis made up of the pubic crest, pectineal line, and arcuate line

37
Q

What is the great and lesser pelvis?

A

Greater (false) pelvis is the superior portion, which provides support for lower abdominal viscera and has no obstetric relevance

The lesser (true pelvis) is the inferior portion which forms the bony canal where pelvic viscera lie. It has major obstetric relevance

38
Q

What is the pelvic inlet and pelvic brim?

A

The pelvic inlet is the junction between the greater and lesser pelvis
The pelvic brim is bony edges of the pelvic inlet

39
Q

What are the borders of the pelvic inlet?

A

Anterior: pubic symphysis
Posterior: sacral promontory
Lateral: arcuate line on inner surface of ileum and pectineal line on superior ramus

40
Q

What is the borders of the pelvic outlet?

A

Anterior: pubic arch
Posterior: tip of coccyx
Lateral: ischial tubersosities

41
Q

How is a woman’s pelvic adapted for childbirth compared to a mans pelvis?

A
  • most women have a gynecoid pelvis, compared to a male android pelvis
  • have wider and broader structure
  • are lighter in weight
  • oval shaped pelvic inlet (compared to android heart shaped pelvic inlet)
  • less prominent ischial spines allow a greater bispinous diameter
  • a greater angled sub pubic arch more than 80-90 degrees, compared to 50-60 degrees in an android pelvis
  • shorter, more curved sacrum with less pronounced sacral promontory

-also sacrospinous and sacrotuberous ligaments can stretch under influence of progesterone in pregnancy to increase size of pelvic outlet further

42
Q

What is the obstetric conjugate?

A

The distance from the sacral promontory to the midpoint of the public symphysis (the midpoint is the thickest part of the bone, however this can’t be palpated due to the bladder so we use the diagonal conjugate)

43
Q

What is the diagonal conjugate?

A

Measured from the sacral promontory to the inferior border of the pubic symphysis (which we can measure manually via the vagina)

Will be slightly larger than the obstetric conjugate bit is still a good estimation

44
Q

What is the sacrospinous ligament?

A

From the lateral sacrum and coccyx round to the ischial spines, it divides the sciatic foramen into the greater and lesser formamen

45
Q

What is the sacrotuberous ligament?

A

From the posterior ileum, lateral sacrum and coccyx to the ischial tubersosities
Transforms the sciatic notch into the sciatic foramen

46
Q

What is the function of the blood testis barrier?

A

To protect the gametes by preventing access from the immune system

47
Q

The vas deferens have how many layers of smooth muscle?

A

3, longitudinal, circular and longitudinal

The smooth muscle contracts in ejaculation to propel gametes from the epididymis to the ejaculatory duct

48
Q

Which parts of the prostate are most prone to BPH and prostatic carcinoma?

A

BPH most likely in transitional zone

Carcinoma most likely in peripheral zone (so must be very large to compress the urethra and show urinary symptoms)

49
Q

The transitional zone of the prostate surrounds what?

A

Urethra

50
Q

Where do the gonads develop in an embryo?

A

Within the mesonephric ridge, and then descend through the abdomen

Sem 4 (25 decks)

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