S1 L2 Male Reproduction system Flashcards
- *Overview of the male reproductive system**
- Label picture
- Route of sperm
- Function of the penis
Label picture:
pic
Route sperm:
Made in the seminferious tubules of the testes ->
Matures and stored in Epididymis ->
Moves along ductus deferens ———–****———–>
Moves through penis in urethra
****secretions from seminal vesciles, prostate gland, Cowper’s gland
- *Function of the penis:**
- Expulsion of urine via urethra
- Deposition of sperm in female genital tract
- *Microstructure of the testes**
- Label
- Tunica vaginalis: Derived from? Example of a pathology that can occur with this?
Tunica vaginalis:
Derived from the peritoneum of the abdomen - so in a peritoneal sac
Tunica vaginalis can fill with fluid
- *Clinical correlates: Hydrocoele**
- What is this
- What does it look like?
- Test for it?
Hydrocoele: Swelling of the scrotum that occurs when fluid collects in the tunica vaginalis
Test:
Hydrocoele illuminates when light shined on the scrotum
- *Sertoli and Leydig cells**
- What are the roles of these cells? — characteristic about the Leydig cell
Sertoli cells:
These cells are part of the seminferous tubules and help in the production of sperm
Leydig cells:
These cells are found adjacent to the seminferious tubules in the testicles produce testosterone
Lots of SER - important for lipid metabolism
- *Testicular blood supply and lymphatic**
- Artery
- Veins
- Lymph from teste
- Lymph from scrotum
Artery:
Abdominal aorta -> testicular artery
Veins:
Left:
Pampiniform plexus ->
Left testicular vein ->
Left renal vein ->
IVC
Right:
Pampiniform plexus ->
Right testicular vein ->
IVC
Left teste sits lower than right teste
Lymph:
To the lumbar and para-aortic nodes, along the lumber-vertebrae NOT inguinal lymph nodes
Scotum drains into inguinal lymph node
Clinical correlates: Testicular torsion
What happens with this?
Problem?
Why does it occur?
What happens with this?
Spermatic cord twists
Problem?
Occludes vein -> causing swelling -> increases pressure, then blocks the arteries, leads to ischaemia
Why does it occur?
Tunica vaginalis in most men is partially envaginated. But, if testes is fully envaginated into tunica vaginalis, the testes can twist.
Clinical correlates: Can testicles swap sides?
No! Due to the testicular septum
- *How do the testes descend?**
- details about the fascia
- Names of the key pieces of anatomy and there roles
- Abdominal wall muscles (3)
- Gubernaculum: Fibrous band - role to guide the testes down from the abdomen to the scrotum
Like “putting a finger into clingfilm”
- *Spermatic cord**
- How to remember this
- List all contents
- Role of these
- *3 fascial layers:**
- External spermatic fascia
- Cremasteric fascia
- Internal spermatic fascia
- *3 arteries/veins:**
- Testicular artery
- Testicular vein -> forms pampiniform plexus lower down
- Cremasteric vessels
- *3 nerves:**
- Nerve to vas (this is the nerves to ductus deferens, sympathetic nerve)
- Nerve to cremaster (comes off the genito-femoral nerve, feeds the cremaster muscle)
- Genital branch of the Ilioinguinal nerve (supplies the skin of the groin)
- *3 others:**
- Ductus deferens (also called: vas deferens)
- Lymphatics
- Processes vaginalis (string of peritoneum) —– THIS IS PATHOLOGICAL
Role of the cremaster muscle
- *Is erection or ejaculation sympathetic or parasympathetic?**
- how to remember this?
Role of the cremaster muscle:
Transistent retraction of the testes out of the scrotum, caused by contraction of the cremaster muscle — this occurs to regulate temperature and protect from external trauma
Is erection or ejaculation sympathetic or parasympathetic?
- How to remember this?
– Ejaculation is a sympathetic nerve (nerve to the vas)
– Erection of the penis is regulated by parasympathetic nerve
Remember as:
Point and Shoot (Point for erection is parasympathetic, shoot for ejaculation is sympathetic)
- *How to remember the anatomy of the ureter and ductus deferens?
(male) **
What happens in a vasectomy?
Water (ureter) under the bridge (ductus deferens)
i.e. the ureter goes under the ductus deferens
What happens in a vasectomy?
Cut the ductus deferens - stops sperm entering the ejaculate material
The prostate and ejaculatory ducts
- Label the diagram of the prostate (including the zones)
- % of sperm coming from which places?
Clinical correlates:
- Benign Prostatic hyperplasia
Commonly which zone? What symptoms?
- Prostate cancer
Commonly which zone? What symptoms?
- **Benign Prostatic hyperplasia** Transistional zone (central portion), causes urinary symptoms
- Prostate cancer
Peripheral zone, ‘further away’ from ureter, often doesn’t lead to urinary symptoms
Male urethra and catherisation
- Describe this
- What to be aware of?
Two bends to put the catheter through
To get past the bends:
Bend 1: Lift the penis
Bend 2: Apply more pressure
- *Structure of the penis (and the regions of the urethra)**
- Label the diagrams
- Role of the two ‘main major’ muscles
Role of these two muscles:
- Corpus cavernosum: Erectile tissue (this is what causes an erection)
- Corpus spongioform: Contains blood vessels that fuse with blood to help make an eraction and keep the urethra open during the erection
in the alien face looking pic:
- Corpus cavernosa is the 2 bigger circles
- Corpus spongioform is the smaller circle around the urethra
What happens in an erection and termination of an erection
- Talk about contriction and contraction
- Types of nerves
- Vasodilatation in penile arterioles, and compression of veins results in erection.
- Vasodilatation is initiated by parasympathetic stimulation
- Erection is terminated by vasoconstriction (sympathetic)
- Ejaculation is a complex process primarily orchestrated by the sympathetic system
Tunica albuginea of the penis
- What is this?
Collagen fibres in the tunica albuginea are arranged at right angles to each other (one circumferential, one parallel to the penile long axis)
Fibrous envelop that extends the legnth of the corpora cavernosa and corpora spongioform
in pic - the blue line
Clinical correlates:
Penile fracture
- What is this
Rupture of the tunica albuginea
Blood supply to the penis
Internal iliac artery ->
Internal pudenal artery ->
Splits into 3: Dorsal arteries of the penis / Deep arteries of the penis / Bulbourethral arteries of the penis
Fill in the gaps:
- The penis is anchored to the _____
- The penis is homologous to the _____
- For a trans man (F -> M), what is important to remember (_____ sreening)
- Where is the skin taken from when building a penis?
bone (pubic symphysis)
clitoris (in a female)
cervical screening (may still have a cervix, if it hasn’t been removed)
Skin taken from: radial forearm or anteriolateral thigh
Fill in the table
Fill in the table
- *Clinical correlates: Varicocele**
- What is this?
- What does palpation of it feel like?
- Vein affected
- Why is it more common on the left?
What is this:
Varicocele is enlargement of the scrotum. Similar to varicose veins you see in the leg. Can lead to low sperm production and infertilty.
Vein affected:
Left testicular vein
Palpation:
Bag of worms
Why more common on the left:
Left - there are more veins = more valves = more likely to get a backflow and incompetent veins = therefore, commoner on the left
MORE LIKELY TO BE A PATHOLOGY ON THE LEFT
