S1) The Man Flashcards

1
Q

Label the following structures in the male reproductive system:

A
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2
Q

What are Sertoli cells?

A

Sertoli cells are the somatic cells of the testis that are essential for testis formation and spermatogenesis

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3
Q

Where are Sertoli cells found?

A

Found in the seminiferous tubule

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4
Q

What are Leydig cells and what do they do?

A
  • Leydig cells are interstitial cells of Leydig, are found adjacent to the seminiferous tubules in the testicle.
  • Produce testosterone in the presence of LH
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5
Q

In three steps, explain what happens during testicular torsion

A

⇒ The spermatic cord twist upon itself

⇒ This occludes the blood supply (testicular artery)

⇒ Pressure builds up and necrosis of testis results

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6
Q

Can testicles swap sides?

A

No, as a scrotal septum separates the two testicles

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7
Q

Describe the process in which the testes push through the abdominal wall

A
  • 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)
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8
Q

What are the three fascial layers in the spermatic cord?

A
  • Internal fascia
  • Cremasteric fascia
  • External fascia
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9
Q

Identify the three arteries supplying the spermatic cord

A
  • Testicular artery
  • Artery to vas
  • Cremasteric artery
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10
Q

Identify the three veins draining the spermatic cord

A
  • Testicular vein
  • Vein to vas
  • Cremasteric vein
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11
Q

Identify the three nerves innervating the spermatic cord

A
  • Ilioinguinal nerve
  • Nerve to cremaster (genital branch of genitofemoral nerve)
  • Sympathetic
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12
Q

What happens during a vasectomy?

A
  • Vas deferens are sectioned
  • Sealed/tied to prevent sperm from entering into the urethra
  • Prevents fertilisation
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13
Q

What are the consequences to the sperm count after a vasectomy?

A

Sperm count reduces

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14
Q

What are the consequences to the composition of the ejaculate after a vasectomy?

A
  • No visible difference
  • Semen is made in accesory glands and sperm only composes 2-5%
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15
Q

Which nerve is responsible for the cremasteric reflex?

A

Muscular reflex of genitofemoral nerve in males

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16
Q

What does the prostate do?

A
  • Maintains urinary continence (surrounds urethra)
  • Creates an alkali secretion
  • Propels seminal fluid into urethra during ejaculation
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17
Q

Which zones in the prostate does cancer and BPH affect?

A

- Benign prostatic hyperplasia affects transitional zone

  • Prostate cancers tend to be in peripheral zone
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18
Q

What are the functions of the penis?

A
  • Expulsion of urine via urethra
  • Deposition of sperm in female genital tract
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19
Q

Describe the processes that guide erection

A
  • Vasodilatation in penile arterioles, and compression of veins results in erection (parasympathetic)
  • Erection is terminated by vasoconstriction (sympathetic)
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20
Q

Which nervous system orchestrates ejaculation?

A

Ejaculation is a complex process primarily orchestrated by the sympathetic system

21
Q

Which artery is the main blood supply to the penis?

A

Pudendal artery

22
Q

On the following figure of the testis, identify:

  • Pampiniform plexus of veins
  • Testicular artery
  • Vas deferens
  • Epididymis
  • Seminiferous tubules
A
23
Q

Where is the origin of the testicular arteries?

A

Branch of abdominal aorta, inferior to renal arteries

24
Q

Describe the venous drainage of the right and left testis

A
  • Right testis: inferior vena cava
  • Left testis: renal vein
25
Q

Discriminate between the lymphatic drainage of the scrotum and that of the testis

A
  • Scrotum – drains into inguinal lymph nodes
  • Testes – drains into para-aortic lymph nodes
26
Q

What is the cremasteric reflex?

A
  • 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
27
Q

From which layers of the anterior abdominal wall are the fascial coverings of the spermatic cord derived?

A
  • External oblique muscle
  • Internal oblique muscle
  • Transversus abdominis muscle
28
Q

On the diagram below, label:

  • The vas deferens
  • The spermatic cord
  • External spermatic fascia
  • Cremaster muscle
  • Cremasteric fascia
  • Internal spermatic fascia
  • Tunica vaginalis
A
29
Q

What are the contents of the spermatic cord?

A
  • 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

30
Q

Which structures of the male reproductive system have smooth muscle that contract in peristaltic waves during emission?

A
  • Seminal vesicles
  • Prostate
  • Vas deferens
31
Q

Identify the three accessory glands of the male reproductive system

A
  • Seminal vesicles
  • Bulbourethral gland
  • Prostate gland
32
Q

Describe the contents of the seminal vesicle secretions as well as its overall contribution to the seminal fluid

A
  • Secretions contain alkali, fructose, prostaglandins and clotting factors
  • Compose 70% of total semen volume
33
Q

Describe the contents of the bulbourethral gland secretions and its overall function

A
  • Produces an alkali-rich mucous fluid
  • Neutralises residual acidity in male urethra
34
Q

Describe the contents of prostate gland secretions and its contribution to the overall volume of seminal fluid

A
  • Secretions contain proteolytic enzymes
  • Contributes to 25% of seminal fluid
35
Q

What is the usual size of the prostate?

A
  • Walnut
  • 2-4 cm
36
Q

Which part of the prostate gland is felt on rectal examination?

A

Peripheral zone

37
Q

Enlargement of which part of the prostate causes urethral obstruction?

A

Transitional zone

38
Q

Describe the venous drainage of the prostate gland

A
  • Blood drains via prostatic venous plexus which drains into the internal iliac veins
  • This connects posteriorly to the vertebral venous plexus
39
Q

Which part of the urethra is least distensible?

A

Membranous urethra

40
Q

Name the erectile tissue in the penis

A
  • Corpora cavernosa
  • Corpus spongiosum
41
Q

Identify possible causes of scrotal swelling

A
  • Orchitis
  • Infections
  • Hernia
  • Hydrocoele
42
Q

Generally, how can one discriminate between a hernia and a testicular swelling?

A

Hernias change with position

43
Q

What is a hydrocoele?

A

Hydrocoele is a collection of serous fluid in the tunica vaginalis

44
Q

What is a haematocoele?

A

Haematocoele is a collection of blood in the tunica vaginalis

45
Q

How can one distinguish between a haematocoele and a hydrocoele?

A
  • Transillumination (light is applied to testicular swelling)
  • Due to dense nature of blood, light is unable to pass through
46
Q

What is a varicocoele?

A

Varicocoele is the gross dilation of veins draining the testes

47
Q

Why is the left testicle commonly affected in varicocoele?

A
  • 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
48
Q

What does a varicocoele look and feel like upon palpation?

A

A bag of worms