S1) The Man Flashcards
Label the following structures in the male reproductive system:
What are Sertoli cells?
Sertoli cells are the somatic cells of the testis that are essential for testis formation and spermatogenesis
Where are Sertoli cells found?
Found in the seminiferous tubule
What are Leydig cells and what do they do?
- Leydig cells are interstitial cells of Leydig, are found adjacent to the seminiferous tubules in the testicle.
- Produce testosterone in the presence of LH
In three steps, explain what happens during testicular torsion
⇒ The spermatic cord twist upon itself
⇒ This occludes the blood supply (testicular artery)
⇒ Pressure builds up and necrosis of testis results
Can testicles swap sides?
No, as a scrotal septum separates the two testicles
Describe the process in which the testes push through the abdominal wall
- The testes evaginate the abdominal wall as they are pulled through by the gubernaculum
- This forms the spermatic fascia (made of layers of abdominal muscle)
What are the three fascial layers in the spermatic cord?
- Internal fascia
- Cremasteric fascia
- External fascia
Identify the three arteries supplying the spermatic cord
- Testicular artery
- Artery to vas
- Cremasteric artery
Identify the three veins draining the spermatic cord
- Testicular vein
- Vein to vas
- Cremasteric vein
Identify the three nerves innervating the spermatic cord
- Ilioinguinal nerve
- Nerve to cremaster (genital branch of genitofemoral nerve)
- Sympathetic
What happens during a vasectomy?
- Vas deferens are sectioned
- Sealed/tied to prevent sperm from entering into the urethra
- Prevents fertilisation
What are the consequences to the sperm count after a vasectomy?
Sperm count reduces
What are the consequences to the composition of the ejaculate after a vasectomy?
- No visible difference
- Semen is made in accesory glands and sperm only composes 2-5%
Which nerve is responsible for the cremasteric reflex?
Muscular reflex of genitofemoral nerve in males
What does the prostate do?
- Maintains urinary continence (surrounds urethra)
- Creates an alkali secretion
- Propels seminal fluid into urethra during ejaculation
Which zones in the prostate does cancer and BPH affect?
- Benign prostatic hyperplasia affects transitional zone
- Prostate cancers tend to be in peripheral zone
What are the functions of the penis?
- Expulsion of urine via urethra
- Deposition of sperm in female genital tract
Describe the processes that guide erection
- Vasodilatation in penile arterioles, and compression of veins results in erection (parasympathetic)
- Erection is terminated by vasoconstriction (sympathetic)
Which nervous system orchestrates ejaculation?
Ejaculation is a complex process primarily orchestrated by the sympathetic system
Which artery is the main blood supply to the penis?
Pudendal artery
On the following figure of the testis, identify:
- Pampiniform plexus of veins
- Testicular artery
- Vas deferens
- Epididymis
- Seminiferous tubules
Where is the origin of the testicular arteries?
Branch of abdominal aorta, inferior to renal arteries
Describe the venous drainage of the right and left testis
- Right testis: inferior vena cava
- Left testis: renal vein
Discriminate between the lymphatic drainage of the scrotum and that of the testis
- Scrotum – drains into inguinal lymph nodes
- Testes – drains into para-aortic lymph nodes
What is the cremasteric reflex?
- The cremasteric reflex can be stimulated by stroking the superior and medial part of the thigh
- Produces immediate contraction of the cremaster muscle, elevating the testis to the side that has been stimulated
From which layers of the anterior abdominal wall are the fascial coverings of the spermatic cord derived?
- External oblique muscle
- Internal oblique muscle
- Transversus abdominis muscle
On the diagram below, label:
- The vas deferens
- The spermatic cord
- External spermatic fascia
- Cremaster muscle
- Cremasteric fascia
- Internal spermatic fascia
- Tunica vaginalis
What are the contents of the spermatic cord?
- Nerve to cremaster (genital branch of genitofemoral nerve)
- Artery & vein to vas deferens
- Pampiniform plexus of testicular veins
- Sympathetic nerve
- Cremasteric artery and vein
- Ilioinguinal (on the outside, in superficial to external spermatic fascia)
- Tunica vaginalis
- Testicular artery & vein
- Lymph vessels
- Vas deferens
Mnemonic: Not All People Steal Cookies In The Teacher’s Lovely Van
Which structures of the male reproductive system have smooth muscle that contract in peristaltic waves during emission?
- Seminal vesicles
- Prostate
- Vas deferens
Identify the three accessory glands of the male reproductive system
- Seminal vesicles
- Bulbourethral gland
- Prostate gland
Describe the contents of the seminal vesicle secretions as well as its overall contribution to the seminal fluid
- Secretions contain alkali, fructose, prostaglandins and clotting factors
- Compose 70% of total semen volume
Describe the contents of the bulbourethral gland secretions and its overall function
- Produces an alkali-rich mucous fluid
- Neutralises residual acidity in male urethra
Describe the contents of prostate gland secretions and its contribution to the overall volume of seminal fluid
- Secretions contain proteolytic enzymes
- Contributes to 25% of seminal fluid
What is the usual size of the prostate?
- Walnut
- 2-4 cm
Which part of the prostate gland is felt on rectal examination?
Peripheral zone
Enlargement of which part of the prostate causes urethral obstruction?
Transitional zone
Describe the venous drainage of the prostate gland
- Blood drains via prostatic venous plexus which drains into the internal iliac veins
- This connects posteriorly to the vertebral venous plexus
Which part of the urethra is least distensible?
Membranous urethra
Name the erectile tissue in the penis
- Corpora cavernosa
- Corpus spongiosum
Identify possible causes of scrotal swelling
- Orchitis
- Infections
- Hernia
- Hydrocoele
Generally, how can one discriminate between a hernia and a testicular swelling?
Hernias change with position
What is a hydrocoele?
Hydrocoele is a collection of serous fluid in the tunica vaginalis
What is a haematocoele?
Haematocoele is a collection of blood in the tunica vaginalis
How can one distinguish between a haematocoele and a hydrocoele?
- Transillumination (light is applied to testicular swelling)
- Due to dense nature of blood, light is unable to pass through
What is a varicocoele?
Varicocoele is the gross dilation of veins draining the testes
Why is the left testicle commonly affected in varicocoele?
- Left testicular vein drains into the left renal vein at a 90o angle
- Renal vein is smaller than IVC and there is no valve, building up pressure
What does a varicocoele look and feel like upon palpation?
A bag of worms
