Reproductive Organs Flashcards
What is the inguinal canal?
Oblique passage which allows structures to pass from abdominal wall to external genitalia
Where is the inguinal canal located (in relation to the pelvis)?
Above the inguinal ligament, along its medial half
What is the deep inguinal ring?
Aperture in the transversalis fascia
What is the superficial inguinal ring?
Aperture in the external oblique aponeurosis
What does the inguinal canal transmit in males?
Spermatic cord
What does the inguinal canal transmit in females?
Round ligament
What are factors that normally prevent herniation of abdominal contents through the inguinal canal? (2)
- Deep and superficial inguinal rings are in different positions
- Lower fibres of transverse abdominis and internal oblique arch over canal, closing it during abdominal contraction
What does the inguinal canal transmit in both sexes?
Ilioinguinal nerve
What are the 3 layers of tissue the spermatic cord acquires as it travels through the inguinal canal?
- Internal spermatic fascia
- Cremeasteric fascia
- Superficial spermatic fascia
Where is the internal spermatic fascia derived from?
Transverse abdominis muscle
Where is the cremasteric fascia derived from?
Internal oblique muscle
Where is the superficial spermatic fascia derived from?
Aponeurosis from external oblique
Describe the path of the spermatic cord and where it acquires its extra layers
Deep inguinal ring - internal spermatic fascia
Cremasteric fascia
Superficial inguinal ring - superficial spermatic fascia
What are the 3 arteries in the spermatic cord?
- Artery of the vas
- Cremaster artery
- Testicular artery
What are the 3 veins in the spermatic cord?
- Vein of the vas
- Cremasteric vein
- Testicular vein
What are the 3 nerves in the spermatic cord?
- Ilioinguinal nerve
- Genitofemoral nerve
- Sympathetic nerve (vas & testicular pain)
What does the ilioinguinal nerve do?
Skin sensation to anterior 1/3 of external genitalia
What does the genitofemoral nerve innervate?
Cremaster muscle
What 3 structures are in the spermatic cord?
- Vas deferens
- Tunica vaginalis
- Lymphatics
What is the tuica vaginalis?
Sac of peritoneum covering the testes
What is the processus vaginalis?
Tube-like connection from tunica vaginalis up to peritoneum
What is the convoluted tube lying on the posterior border of the testis?
Epididymis - sperm passes along it to the vas deferens
What is the thick white coat that covers the testis, found under the tunica vaginalis?
Tunica albuginea
What forms the testicular vein?
Pampiniform plexus of veins
What important role do veins play in the testes?
Temperature control to optimise sperm production
How does scrotal skin appear? (3)
Thin, wrinkled and more darkly pigmented
What divides the scrotum into right and left halves?
Incomplete midline septum
The fascia under the scrotal skin contain fibres of what involuntary muscle?
Dartos fascia
What is Buck’s fascia?
Deep fascia that forms a thick layer over the corpus cavernosum and a thinner layer over the corpus spongiosum
What are the 3 cylinders of erectile tissue?
2 cylinder of corpus cavernosum
1 cylinder of corpus spongiosum
Function of the corpus cavernuosum?
Fills with blood, allowing penis to become HARD
Function of the corpus spongiosum? (2)
Transmits the URETHRA
Enables penis to become ERECT
What is the glans penis?
The distal end of the penis, covered by foreskin.
What is the common outlet for urine and semen?
Distal part of the urethra
What is the navicular fossa?
Enlargement of the urethra in the glans penis to let urine flow in a smooth stream
In what direction does external oblique muscle travel?
Downwards and inwards
What direction does internal oblique muscle travel?
Upwards and inwards
At ASIS - horizontally
Below ASIS - downwards and inwards
How is the superficial inguinal ring formed?
Triangular deficit formed by some ex. oblique fibres running under the spermatic cord and some ex. oblique fibres running over the spermatic cord
What is a direct hernia?
Passes directly through transversalis fascia and the internal oblique layer and through the superficial inguinal ring
What is an indirect hernia?
Passes through the deep inguinal ring, through the inguinal canal, and out the superficial inguinal ring
How can you distinguish between a direct and indirect hernia using other structures?
If LATERAL to inferior epigastric A –> indirect hernia
MEDIAL to inferior epigastric A –> direct hernia
What are the boundaries of the urogenital triangle?
Laterally - inferior pubic rami
Inferiorly - line joining ischial tuberosities
Describe the structures of the pelvis (5)
Pubic symphysis Pubic tubercles Superior pubic rami Inferior pubic rami Ischium
What is the perineal membrane?
Membrane (in urogenital triangle) to which the external genitalia are attached
What is the region between the perineal membrane and the pelvic diaphragm/ floor?
Deep perineal pouch
What is labia majora and what type of skin covers it?
Areas outside the introitus
Lined by: normal skin hair-bearing and sweat glands
What is labia minora and what type of skin covers it?
Skin lining the vaginal opening
Lined by: non-hair-bearing skin w sweat glands
What is the clitoris formed from?
Two erectile structures: corpora cavernosa
What forms the hood of the clitoris?
Labia minora
What spinal nerve supplies the dermatome of the distal part of the anal canal?
S5
What passes through the greater sciatic foramen?
Pudendal nerve and vessels
Sciatic nerve
Describe the left renal vein
L gonadal and L adrenal veins join it as it enters the IVC
Describe the right renal vein
Drains into the IVC
L gonadal and L adrenal veins drain into IVC too
What is the anatomical outermost layer of the kidney?
Capsule
What is the outermost functional layer of the kidney?
Renal cortex
What does the ureter run under? (3)
Uterine artery
Gonadal arteries
Vas deferens
What are the layers surrounding the kidneys?
Capsule
Perinephric fat
Perinephric fascia
How can medullary pyramids be identified?
Appear finely striped - due to blood vessels, CD and LoH
What muscles surround the region of the kidney?
Quadratus lumborum
Psoas
Iliacus
What nerve pierces through and runs down the anterior surface of psoas?
Genitofemoral (L1-2)
What nerve emerges from the medial border of psoas?
Obturator (L2, 3, 4)
What nerve sits between the psoas and iliacus?
Femoral nerve (L2, 3, 4)
What do the iliohypogastric and ilioinguinal nerves (L1) supply?
Areas of the pubis
What nerve arises from the lateral border of the psoas?
Lateral cutaneous nerve of the thigh (L1-2)
At what vertebral level does the aorta bifurcate?
L4 (umbilicus)
Where are the 3 narrowings where a kidney stone can get stuck?
Ureteropelvic junction (R pelvis--> ureter) Crossing over the iliac vessels Ureterovesical junction (ureter enters bladder)
How can you differentiate between femoral and inguinal hernias?
Above pubic tubercle –> inguinal hernia
Below pubic tubercle –> femoral hernia
What is the blood supply of the bladder? (3)
Internal iliac A
Vesicle A (sup + inf)
Internal iliac V
What stops urine from passing back up the ureter when bladder pressure increases?
Ureter enters bladder at an oblique angle
Increased pressure presses against ureter in the bladder, closing it
Why do veins in the thoracic cavity not have valves?
Negative pressure in chest from inspiration propels blood up veins ( during expiration gravity pulls them back down)
What does the loss of brain control in micturition do?
SC controls full normal emptying of bladder –> patient suddenly urinates
What effect does loss of sensation have on micturition? (3)
Brain and SC cannot tell if bladder is full
Patient constantly dribbles urine
High pressure in bladder and kidney –>kidney damage
What effect does loss of spinal cord motor have on micturition? (2)
Patient knows bladder is full but cannot empty it
High pressure in bladder, renal failure
How can you differentiate a female pelvis from a male pelvis? (3)
Female pelvis:
- wide pubic arch + pelvic outlet
- round/ oval pelvic inlet
- ischial spines and tuberosities are more everted
How can you differentiate a male pelvis from a female pelvis? (4)
Male pelvis:
- narrow pubic arch + pelvic outlet
- heart-shaped/ smaller pelvic inlet
- ischial spines are closer together
- ischial tuberosities are longer
What structures border the bladder? (4)
Sup: sigmoid colon, SI, uterus
Ant: pubic symphysis
Lat: levator ani
Post: rectum, seminal vessels, vagina, cervix
What is the smooth region of the bladder where the ureters enter?
Trigone
What are the sphincters of the male and female urethra?
Males: internal US (above prostate), external US (urogential diaphragm, below prostate)
Females: external urethra (urogenital diaphragm)
What are the four ligaments of the uterus?
Broad ligament
Round ligament of uterus
Round ligament of ovary
Suspensory ligament of ovary
What arteries anastamose and supply the uterus?
Uterine artery
Ovarian artery
Diseases of the ovarian fossa will affect what nevre?
Obturator nevre (pain in medial compartment of thigh)
What is the pouch of Douglas?
Peritoneal covering over posterior surface of uterus and the rectum
Usually filled with small bowel or sigmoid colon
What is the vesicouterine pouch?
Space between uterus and bladder
