Session 6 - Male Anatomy and the Pelvic Floor TBC Flashcards
What are the contents of the scrotum?
Testis
Epididymis
Spermatic cord (first part)
Describe the structure of the testis:
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.
Describe the blood supply and drainage to the testes:
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.
What is the lymphatic drainage of the testes?
Para-aortic nodes
After spermatocytes leave the seminiferous tubules where do they go?
Rete Testis
Ductus efferentes
Epididymis - Head, Body and Tail
What is a hydrocoele?
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.
What is a haematocoele?
Blood within the tunica vaginalis causing a lump or swelling in the scrotum.
What is a varicocoele?
Varicosities of the pampiniform plexus.
What is a spermatocoele?
Epididymal cyst - collection of fluid within the epididymis
How could you tell the difference between a fluid filled or blood filled cyst?
Use transillumination
What is testicular torsion?
Twisting of the spermatic cord which can lead to blockage of blood supply to the testes and risks necrosis. Very painful.
What is the contents of the inguinal canal?
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
What is the function of the pampiniform plexus?
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.
What are the coverings of the testis and spermatic cord?
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
What is the cremasteric reflex?
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
What is the nervous supply to the scrotum?
Lumbar plexus - anterior surface
Sacral plexus - Posterior and inferior surfaces
What is the lymphatic drainage of the scrotum
Superficial inguinal nodes
Describe the course of the vas deferens:
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.
Where are the seminal vesicles found and how much of the ejaculate do they form?
Lie between the bladder and the rectum. They account for 70-80% of the ejaculate. Duct of VD and SV form ejaculatory duct.
Describe the anatomical relationships the prostate has with other parts of the body:
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
What zones does BPH usually effect?
Middle lobule - this means the prostate is smooth.
Via what routes could a malignancy of the prostate metastasise?
Lymphatic route - to internal iliac and sacral nodes
Venous routes - Internal vertebral plexus to vertebrae and brain.
Describe the internal structure of the penis:
Pair of corpora cavernosa dorsally.
A single corpus spongiosum ventrally - contains the urethra.
Describe the blood supply to the penis:
Branches of the internal pudendal arteries - anterior division of the internal lilac artery.
