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ESA 4 - Repro > Session 6 - Male Repro System > Flashcards

Session 6 - Male Repro System Flashcards

1
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8
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9
Q

Where is the body of the penis suspended from?

A

pubic symphysis

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10
Q

What is the glans made from?

A

corpus spongiosum

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11
Q

Through which erectile tissue does the male urethra run?

A

corpus spongiosum

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12
Q

What are the 4 muscles located in the root of the penis? What is their action?

A
  • Bulbospongiosus x2 – Found in the bulb. Contacts to empty spongy urethra of any residual semen or urine. Anterior fibres aid in maintaining erection by increasing pressure in the bulb of the penis.
  • Ischiocavernosus x2 – Surrounds left and right crura. Contracts to force blood from cavernous spaces in the crura into the corpus cavernosa, helping to maintain an erection.
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13
Q

What are the 2 fascial coverings of the penis under the skin?

A
  • Each mass of erectile tissue has 2 fascial coverings
  • Superficial layer is the deep fascia of the penis, a continuation of deep perineal fascia.
  • Under deep fascia is tunica albuginea
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14
Q

What is the suspensory ligament a condensation of? What does it connect?

A

condensation of deep fascia. Connects erectile bodies to pubic symphysis

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15
Q

What is the fundiform ligament a condensation of?

A

Condensation of abdominal subcutaneous tissue

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16
Q

How is the foreskin connected to the glans? What is the potential space between the glans and the foreskin (prepuce) called?

A

By the frenulum

Preputial Sac

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17
Q

What does the internal pudendal artery arise from?

A

internal iliac

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18
Q

Describe the venous drainage of the penis

A

Venous blood drained via deep dorsal vein of penis (empties into prostatic venous plexus) and superficial dorsal veins (drains skin and cutaneous tissue)

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19
Q

What is the innervation of the penis? Which spinal nerve roots? What nerve supplies sensory, sympathetic and PS innervation?

A
  • Supplied by S2-S4
  • Sensory and sympathetic innervation supplied by pudendal nerve
  • PS innervation is from prostatic nerve plexus.
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20
Q

Is erection governed by sympathetic or PS? What about ejaculation?

A

Point and Shoot – PS is erection, Sympathetic is ejaculation

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21
Q

What is hypospadias? What are the different types of Hypospadias?

A

A congenital condition in which patients are born with the opening to their urethra on the ventral aspect of the penis

Subcoronal, midshaft, penoscrotal

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22
Q

What is phimosis? What are the symptoms and why?

A

Prepuce fits tightly over glans and cannot be retracted. Causes irritation when smegma accumulates in preputial sac.

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23
Q

What is paraphimosis? What is the result?

A

Rectraction of prepuce constricts neck of glans, interfering with venous and lymphatic drainage. Can cause glans to enlarge to extent that prepuce cannot be drawn over it.

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24
Q

What is peyronie’s disease? What are the symptoms?

A
  • Abnormal curvature of shaft of penis caused by build up of scar tissue
  • Pain on erection
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25
Q

What is the common cause behind ED?

A

Vascular aetiology, e.g. hypertension

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26
Q

What is priapism? What can happen?

A
  • Erection for more than 4 hours
  • Caused by blood being trapped in erectile bodies
  • Can lead to scarring and ED.
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27
Q

What is the innervation of the testes?

A

Testicular plexus

28
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What is the arterial supply to the testes and epididymis?

A

Testicular arteries, arising from Abd Aorta

29
Q

What is the venous drainage of the testicles? How do the right and left testes differ? How does the venous drainage cool the blood?

A
  • Venous drainage via testicular veins. Formed from pampiniform plexus in scrotum.
  • Left testicular vein drains into left renal vein
  • Right testicular vein drains directly into IVC
  • Pampiniform plexus surrounds testicular arteries and cools the blood down by 2-8 deg C.
30
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What lymphatic nodes drain the testes? Where are they located?

A

lumbar and preaortic nodes located at L1

31
Q

What is hydrocoele?

A

Serous fluid within tunica vaginalis.

32
Q

What is haematocoele? How can you distinguish from hydrocoele?

A

collection of blood in tunica vaginalis. Distinguishable from hydrocele by transillumintion, light cannot pass through dense blood.

33
Q

What is varicocoele? Why is the left more commonly affected?

A

dilation of veins. Left testicle more commonly affected due to drainage into smaller left renal vein at a perpendicular angle.

34
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What is the function of the dartos muscle?

A

Acts to regulate temperature of scrotum by wrinkling the skin – decreases SA and reduces heat loss

35
Q

What arteries feed the scrotum?

A

anterior and posterior scrotal arteries arising from external and internal pudendal arteries respectively

36
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What is the venous drainage of the scrotum?

A

Scrotal veins, drains into external pudendal veins

37
Q

What is the cutaneous innervation of the antero lateral scrotum?

A

geintal branch of genitofermoal nerve

38
Q

What is innervation for anterior and posterior scrotum?

A

Anterior and posterior scrotal nerves

39
Q

What is the innervation of the inferior scrotum

A

Perineal branches of posterior femoral cutaneous nerve

40
Q

What drains the lymphatics of the scrotum?

A

Superficial inguinal nodes

41
Q

Where is the spermatic cord formed?

A

Deep inguinal ring

42
Q

Through which canal does the spermatic cord enter?

A

inguinal canal

43
Q

What are the 3 fascial layers of the spermatic cord and where are they each derived from?

A
  • External spermatic fascia – derived from aponeurosis of external oblique
  • Cremaster muscle and fascia – internal oblique and its fascial oblique
  • Internal spermatic fascia – transversalis fascia
  • 3 fascial layers also covered by layer of superficial fascia which lies underneath scrotal skin
44
Q

What is the cremasteric reflex? How is it stimulated and which nerves are involved?

A
  • Stimulated by stroking superior and medial thigh
  • Produces contraction of cremaster muscle, elevating testis on ipsilateral side.

Spinal reflex consists of 2 parts:

  • Sensory limb – genitofemoral nerve
  • Motor limb – genital branch of genitofemoral nerve
45
Q

Name the contents of the spermatic cord. there are 9 things!!!

A

Spermatic cord contents “3 arteries, 3 nerves, 3 other things”:
3 arteries: testicular, ductus deferens, cremasteric.
3 nerves: genital branch of the genitofemoral, cremasteric, autonomics.
3 other things: ductus deferens, pampiniform plexus, lymphatics.

46
Q

What is the function of the vas deferens? What are its 3 layers?

A
  • Takes sperm from epididymis to the ejaculatory duct.
  • Wall contains a smooth muscle coat which consists of 3 layers – inner layer of longitudinal muscle, intermediate layer of circular muscle, outer layer of longitudinal muscle.
47
Q

What is testicular torsion? How is it diagnosed?

A
  • Spermatic cord twists upon itself leading to occlusion of testicular artery and necrosis of testes
  • Diagnosis confirmed via ultrasound
48
Q

What is the secretion of the prostate gland and what does it do?

A
  • Secretes proteolytic enzymes into semen which act to break down clotting factors in the ejaculate.
  • Allows semen to remain in a fluid state
49
Q

What is the arterial and venous supply of the prostate?

A

Arterial – Prostatic arteries derived from internal iliac
Venous – Prostatic venous plexus, drains into internal iliac veins

50
Q

What is the sympathetic, PS, and sensory innevation of the prostate?

A

Sympathetic, PS, and sensory form inferior hypogastric plexus.

51
Q

How does benign prostatic hyperplasia present? Which area of the prostate enlarges?

A
  • Compresses on both bladder and urethra
  • Presents with urinary frequency, urgency and difficulty initiating micturition
  • Enlargement in the transitional zone of prostate
52
Q

How does prostatic carcinoma preesent? Which area of the prostate enlarges?

A
  • Compresses on both bladder and urethra
  • Presents with urinary frequency, urgency and difficulty initiating micturition
  • Malignant cells commonly originate from peripheral zones, therefore symptoms present late in the disease.
53
Q

What does the bulbourethral glands contribute to semen?

A
  • Produce mucus secretion which serves as lubrication during sexual arousal.
  • Secretions are alkaline and help to neutralise acidity of vagina.
54
Q

Where is the bulbourethral gland found? What is its epithelium?

A
  • Bulbourethral glands found enclosed within fibres of the external urethral sphincter.
  • Lined by columnar epithelium
55
Q

What is the vasculature of the bulbourethral gland?

A

Derived from arteries to the bulb of the penis

56
Q

What is the innervation of the bulbourethral gland?

A

Prostatic plexus

57
Q

What is the lymphatic drainage of the bulbourethral gland?

A

Internal and external iliac lymph nodes

58
Q

What do the seminal vesicles contribute to semen?

A

Produces 70% of volume of semen:

  • Alkaline fluid
  • Fructose – provides energy source for spermatozoa
  • Prostaglandins – Suppress the female immune response to foreign semen
  • Clotting factors – designed to keep semen in the female reproductive tract post ejaculation
59
Q

What is the internal lining of the seminal vesicles?

A

pseudostratified columnar

60
Q

What structures are derived from mesonephric ducts embryologically?

A

SEED

Seminal glands, Ejaculatory ducts, Epididymis, Ductus deferens are all derived from mesonephric ducts.

61
Q

What is the lymphatic drainage of the seminal vesicles?

A

external and internal iliac lymph nodes

62
Q

What is a seminal gland abscess? how is it detected?

A
  • Abscess formation in seminal glands allows pus to enter peritoneal cavity in event of rupture.
  • Detected by DRE
63
Q

How can seminal vesicles be used to diagnose STIs?

A
  • Seminal glands can be massaged via DRE to release their secretions
  • These can be collected and used for microscopy of STIs, e.g. gonorrhoea.
64
Q

State the course of the vas deferens

A
  1. tail of epididymis
  2. inguinal canal
  3. side wall of pelvis
  4. joints ducts from seminal vesicle to form ejaculatory ducts
65
Q

Which presents first: benign or cancer prostate? Why?

A

benign

Because the hypertrophy in benign occurs in the transitional zones of the prostate which is more medial

66
Q

Why is a right sided varicocoele more worrying than a left sided one?

A

Right is more indicative of problems such as raised IVC pressure due to an obstruction

Right test vein attaches straight to IVC

Left sided is also more likely due to a lack of valves in the left test vein

67
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A

ESA 4 - Repro (15 decks)

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