Session 5 - Male pelvis and perineum Flashcards
In the male and female pelvis:
what are the differences in the pelvic inlet?
female = oval/round male = narrow/heart-shaped
In the male and female pelvis:
what are the differences in the sub pubic angle?
female = round >80 degrees male = narrow 50-60 degrees
In the male and female pelvis:
what are the differences in the ischial spines?
project medially in males and not in females
In the male and female pelvis:
what are the differences in the greater/false pelvis?
in females it is shallow and in males it is deep
In the male and female pelvis:
what are the differences in the lesser/true pelvis?
females = wide, shallow and cylindrical males = narrow, deep and tapering
What is the X:Y ratio in the male and female pelvis?
X = distance between the pubic symphysis and the anterior margin of the acetabulum Y = the diameter of the acetabulum
females - 1 or >1
males - less than 1
What is the caecum?
a short, pouch-like region of the large intestine between the ascending colon and vermiform appendix (connected to the junction of the small and large intestines)
What are the seminal vesicles?
a pair of simple tubular glands posteroinferior to the urinary bladder of some male mammals. They secrete fluid that partly composes the semen.
Which or the 2 bends of the male urethra can be straightened before passing a catheter?
the second one - the one that is close to the glanjsof the penis
the one closer to the bulb of the penis cannot be straightened
Give an overview of the course of the ductus deferens
passes from the testes —–> inguinal canal —–> over and behind the urethra —–> through the prostate
Where do the seminiferous vesicles open into?
into the ducts deferens between the ampulla and the ejaculatory duct
Where are the bulbourethral glands?
(posterior and lateral to the membranous portion of the urethra at the base of the penis)
between the two layers of the fascia of the urogenital diaphragm, in the deep perineal pouch.
What are the two layers of the fascia of the urogenital diaphragm?
superior and inferior fascia surround the internal sphincter (splinter urethrae)
What is the purpose of the internal urethral sphincter?
prevents semen passing up from the prostate to the bladder during ejaculation
(NOT to stop urine passing through)
Give the names of the opening that can be found at the prostatic urethra, where the urinary and reproductive tracts meet
Which opening can cause complications during catheterisation?
- openings of the prostate gland
- openings of the ejaculatory ducts (seminal gland secretions and sperm)
- prostatic utricle (a cul-de-sac) - the tip of the catheter can become lodged here
What is the perineum?
the diamond shape area between the pubic symphysis, ischial tuberosities and coccyx
divided into anterior (urogenital) and posterior (anal) triangles
(LA: the diamond shaped areas between the thighs when the person sides on the back with thighs flexed and abducted)
Describe the anterior triangle of the perineum
‘the urogenital triangle’
divided into superficial and deep paths/pouches by the perineal membrane
Describe the posterior triangle of the perineum
‘the anal triangle’
there is ischio-anal fossae - fat filled spaces operating the anal canal and elevator and from the pelvic wall
Where is the deep perineal space?
above the PM and below the fascia of the pelvic membrane
Where is the superficial perineal space?
below the PM and perineal fascia
What are the deep and superficial perineal spaces?
potential spaces that only become real when fluid leaks into them
What are the contents of the superficial perineal pouch in males?
contains the erectile tissues that form the penis and clitoris, and three muscles – the ischiocavernosus, bulbospongiosus and superficial transverse perineal muscles
What are the erectile tissues of the superficial perineal pouch on males?
- corpus spongiosum - median erectile tissue mass - bulb of the penis
- corpora caveronosae - lateral erectile tissue - attached to the ischiopubic rami (paired muscles)
(3 erectile tissue masses altogether)
they meet and form the shaft and head of the penis (or clitoris in females)
How do the erectile tissue of the superficial perineal pouch differ in females?
the corpus spongiosum divides around the vestibule to form vestibular bulbs
the corpus spongiosum and corpora caveronosae meet and form the clitoris (not the penis)
What are the contents of the deep perineal pouch in males?
(contains part of the urethra) external urethral sphincter, the bulbourethral glands and the deep transverse perineal muscles
What is the spermatic cord?
a collection of vessels, nerves and ducts that run to and from the testes
the cord-like structure in males formed by the vas deferens and surrounding tissue that runs from the deep inguinal ring down to each testicle
Where is the spermatic cord formed and where does it go to?
formed at the opening of the inguinal canal (the deep inguinal ring)
The cord passes through the inguinal canal, entering the scrotum via the superficial inguinal ring. It continues into the scrotum, ending at the posterior border of the testes.
What are the 2 fascial layers surrounding the spermatic cord?
External spermatic fascia
Cremaster muscle and fascia
Internal spermatic fascia
Where is the testes are the spermatozoa stored until ejaculation?
the body of the epididymis
Describe the structure of the penis
- corpus spongiosum contains the urethra
- corpus cavernosum (paired) - this stop just before the glans
- the glans is part of the spongiosum
What are the artery branches supplying the cavernous spaces (that are usually coiled)?
helicine arteries
Summarise the nerves of the pelvis and perineum
pelvic sympathetic: T10-L2 via hypogastric plexus
pelvis parasympathetic: S2-S4
perineum - pudendal nerve S2-S4
