Session 1- Male

Question 1

State layers of the testes

Answer 1

Some daft englishman called it the testes
Skin Dartos External spermatic fascia Cremasteric fascia and muscle Internal spermatic fascia Tunica vaginalis Tunica Albuginea

Question 2

What is the dartos?

Answer 2

Muscle that wrinkles scrotum

Question 3

Nerve supply to dartos

Answer 3

Genitofemoral nerve, L1/2

Question 4

What is the cremaster

Answer 4

Muscle that elevates testes

Question 5

What is the cremasteric reflex

Answer 5

Elevates testes in response to medial thigh stroke (afferent ilioinguinal or genitofemoral, efferent genital branch of genitofemoral)

Question 6

What structure drains the testes?

Answer 6

Paminiform plexus drains into testicular vein

Question 7

What is the spermatic cord

Answer 7

Structure travelling from deep inguinal ring - superficial inguinal ring - testes

Question 8

Contents of spermatic cord

Answer 8

Vas deferens,
3 fascial layers- external spermatic fascia, cremasteric fascia, internal spermatic fasica
3 veins- testicular vein, vein to vas, cremasteric
3 arteries- testicular artery, artery to vas, cremasteric
3 nerves- ilioinguinal, genitofemoral, sympathetics (ejaculation by vas)

Question 9

What’s a bell clapper deformity?

Answer 9

Testes on its side so tunica vaginalis is wider than the longer, prone to torsion

Question 10

What happens first in torsion?

Answer 10

Vein obstructed first, then pressure builds, then obstructs artery

Question 11

What are the three layers of the testes fascia made from?

Answer 11

External abdo oblique - external spermatic fascia
Internal abdo oblique - cremasteric fascia and muscle
Transversus abdominis - internal spermatic fascia

Question 12

What is the descent of the testes guided by

Answer 12

The gubernaculum

Question 13

Is the venous drainage of each testes different?

Answer 13

Yes- R drains into IVC, L drains into L renal vein

Question 14

What % of ejaculate is sperm

Answer 14

5

Question 15

What %s make up ejaculate

Answer 15

5% sperm, 10% bulbourethral, 30% prostate, 60% seminal glands

Question 16

Function of sertoli and leydig cells

Answer 16

Sertoli are nurse cells for baby sperm, leydig make testosterone

Question 17

What happens if excess fluid in tunica vaginalis

Answer 17

Hydrocoele

Question 18

What is the rete testis

Answer 18

Sperm travel through after seminferous tubules to get into epididymis

Question 19

Structurally, how is an erection formed

Answer 19

Collagen arranged at R angle in both longitudinal and circumferential to give cyclindrical erection

Question 20

What artery is in the middle of the corpus cavernosum

Answer 20

Cavernous artery

Question 21

If the penis looks like bug eyes, which bit is the eyes and which is the mouth (and where is urethra)

Answer 21

Corpus cavernosum is the eyes, corpus spongiosum is the mouth, urethra is in the mouth

Question 22

Describe what happens to the vas deferens during emission

Answer 22

Has SM peristaltic waves, supplied by autonomic nerves (inferior hypogastric plexus)

Question 23

3 zones of the prostate

Answer 23

Peripheral, central, transitional

Question 24

Name the artery, vein, and nerve in the layer outside the corpus cavernosum

Answer 24

Dorsal artery, deep dorsal vein, dorsal nerve

Question 25

Describe location of the three zones of the prostate

Answer 25

Peripheral is inferior and posterior Central is directly inferior to bladder Transitional is between peripheral and central

Question 26

Which prostate zone can you feel on DRE

Answer 26

Peripheral

Question 27

Which prostate zone will be enlarged in prostate cancer

Answer 27

Peripheral

Question 28

Which prostate zone will be enlarged in BPH

Answer 28

Transitional

Question 29

Describe lymphatic drainage of the testes and scrotum

Answer 29

Testes drain to para-aortic because that's where they came from (risk of cervical spread) Scrotum drains to inguinal

Question 30

Where is the prostate in relation to the internal and external urethral sphincters

Answer 30

Below IUS, above EUS

Question 31

Name the three parts of the male urethra

Answer 31

Prostatic urethra, membranous urethra (in bulbourethral area), penile (spongy) urethra

Question 32

Which part of the M urethra is the narrowest and least distensible?

Answer 32

Membranous urethra

Question 33

What are the 3 erectile tissues of the root of the penis?

Answer 33

Right crura, Left crura, bulb

Question 34

What do the R & L crura and the bulb become in the body of the penis

Answer 34

Crura become corpus cavernosum, bulb becomes corpus spongiosum

Question 35

Why is it called the spongiosum

Answer 35

Only partly fills with blood so as not to occlude the urethra

Question 36

What are the muscles in the root of the penis

Answer 36

Bulbospongiosus x2 - empties spongy urethra of contents and maintains erection Ischiocavernosus x2 - forces blood from crura into cavernosa for erection

Question 37

What forms the glans penis?

Answer 37

Corpus spongiosum

Question 38

Describe the blood supply to the penis

Answer 38

Internal iliac - internal pudendal - dorsal & cavernous arteries

Question 39

Fractured penis?

Answer 39

Ruptured tunica albuginea- won't get straight erection if scar forms

Question 40

Describe the route of sperm

Answer 40

Seminal vesicle, epididymis, Up through vas deferens, joins with seminal vesicle to form ejaculatory duct, into prostatic urethra

Question 41

Scrotal swelling differentials

Answer 41

Torsion, cancer, hydrocoele, epididymitis, inguinal hernia, varicoele, epididymal cysts, spermatocoele

Question 42

What is varicoele

Answer 42

Distention of pampiniform plexus, seen on surface as tortuous mass

Question 43

Why is varicoele normally on the left

Answer 43

because left testes drains into L renal vein not IVC, and enters at a right angle rather than obliquely

Question 44

What is the most common age for hydrocoele and why

Answer 44

1-2yo because path of descent is still patent and fluid fills the tunica vaginalis

Question 45

How to tell difference between epididymal cysts and spermatocoele

Answer 45

Well they're both in the epididymis but the spermatocoele one won't transilluminate because its filled with sperm