Session 6 - Male Anatomy and the Pelvic Floor TBC

Question 1

What are the contents of the scrotum?

Answer 1

Testis
Epididymis
Spermatic cord (first part)

Question 2

Describe the structure of the testis:

Answer 2

Surrounded by the tunica vaginalis (but not enclosed by it)
Enclosed by tunica albuginea a thick fibrous capsule
Fibrae septae (invaginations of tunica albuginea) organise the testis into lobules.

Question 3

Describe the blood supply and drainage to the testes:

Answer 3

Testicular arteries direct from the abdominal aorta
Drainage is via the left and right testicular veins. The right direct into the IVC the left into the left renal vein then the IVC.

Question 4

What is the lymphatic drainage of the testes?

Answer 4

Para-aortic nodes

Question 5

After spermatocytes leave the seminiferous tubules where do they go?

Answer 5

Rete Testis
Ductus efferentes
Epididymis - Head, Body and Tail

Question 6

What is a hydrocoele?

Answer 6

When there is serous fluid in the tunica vaginalis. Causes swelling of the scrotum. As the tunica vaginalis is peritoneal in origin it can produce serous fluid resulting in a lump. Can also get hydrocoele of the cord.

Question 7

What is a haematocoele?

Answer 7

Blood within the tunica vaginalis causing a lump or swelling in the scrotum.

Question 8

What is a varicocoele?

Answer 8

Varicosities of the pampiniform plexus.

Question 9

What is a spermatocoele?

Answer 9

Epididymal cyst - collection of fluid within the epididymis

Question 10

How could you tell the difference between a fluid filled or blood filled cyst?

Answer 10

Use transillumination

Question 11

What is testicular torsion?

Answer 11

Twisting of the spermatic cord which can lead to blockage of blood supply to the testes and risks necrosis. Very painful.

Question 12

What is the contents of the inguinal canal?

Answer 12

3,3,3
Testicular artery 
Cremasteric artery 
Artery to vas 
3 
Gential branch of genital-femoral nerve 
Parasympathetic 
Sympathetics
3 
Vas deferens
Lymphatics 
Pampiniform plexus

Question 13

What is the function of the pampiniform plexus?

Answer 13

It acs as a heat exchange system to ensure that blood supplied to the testis via the testicular artery is at a slightly lower temperature than body temperature.

Question 14

What are the coverings of the testis and spermatic cord?

Answer 14

Deep to superficial
Tunica albuiginea (testis only)
Tunica vaginalis (surrounding testis) 
Internal spermatic fascia 
Cremasteric muscle and fascia 
External spermatic fascia 
Dartos fascia and muscle 
Skin

Question 15

What is the cremasteric reflex?

Answer 15

Reflex elicited by stroking the superior, medial part of the thigh which causes contraction of the cremaster muscle causing the testicle to lift.
Sensory component - femoral branch of genitofemoral
Motor component - genital branch of genitofemoral

Question 16

What is the nervous supply to the scrotum?

Answer 16

Lumbar plexus - anterior surface

Sacral plexus - Posterior and inferior surfaces

Question 17

What is the lymphatic drainage of the scrotum

Answer 17

Superficial inguinal nodes

Question 18

Describe the course of the vas deferens:

Answer 18

Ascends in the spermatic cord and travel through the inguinal canal. It then tracks along the pelvic side wall returning back on itself to pass between the bladder and urethra. It then forms a dilated ampulla which open with the seminal vesicles into the ejaculatory duct.

Question 19

Where are the seminal vesicles found and how much of the ejaculate do they form?

Answer 19

Lie between the bladder and the rectum. They account for 70-80% of the ejaculate. Duct of VD and SV form ejaculatory duct.

Question 20

Describe the anatomical relationships the prostate has with other parts of the body:

Answer 20

Base - neck of the bladder
Apex - Urethral sphincter and deep perineal muscles
Muscular anterior surface - urethral sphincter
Posterior - ampulla of rectum
Infero-lateral - levator ani

Question 21

What zones does BPH usually effect?

Answer 21

Middle lobule - this means the prostate is smooth.

Question 22

Via what routes could a malignancy of the prostate metastasise?

Answer 22

Lymphatic route - to internal iliac and sacral nodes

Venous routes - Internal vertebral plexus to vertebrae and brain.

Question 23

Describe the internal structure of the penis:

Answer 23

Pair of corpora cavernosa dorsally.

A single corpus spongiosum ventrally - contains the urethra.

Question 24

Describe the blood supply to the penis:

Answer 24

Branches of the internal pudendal arteries - anterior division of the internal lilac artery.

Question 25

Where would you find the bulbospongiosus muscle and what is its function?

Answer 25

Arises from the fibrous central tendon of the perineum and wraps around the root of the penis.
Function is to help expel the last drops of urine and to help maintain erection.

Question 26

Where would you find the ischiocavernous muscle and what is its function?

Answer 26

Arises from the ischial tuberosity and inserts into a fascia on the crus penis.
Its function is to compress veins helping to maintain an erection.

Question 27

What are the parts of the male urethra?

Answer 27

Pre-prostatic
Prostatic
Membranous
Spongy

Question 28

What is the pelvic floor?

Answer 28

Muscular and fibrous tissue diaphragm (mainly made of the levator ani muscle) that fills the lower part of the pelvic canal closing off the abdominal cavity.
It supports the pelvic organs and is pierced by the urethra vagina and rectum.