SUGER Flashcards
Describe the erectile tissues in the penis root.
Left and right crura are lateral, bulb is at the midline.
Describe the ischernocavius & bulbospongiosus muscle of the penis root.
Ischernocavius: surrounds the crura & maintains erections.
Bulbospongiosus: surrounds the bulb, empties the urethra & maintains erections.
Describe the erectile tissues of the penis body.
The corpora cavernosa are derived from crura & are separated by the septum. The corpus spongiosum is derived from the bulb & the urethra runs through it.
Describe the glans penis.
A conical expansion of the corpus spongiosum. It has the external urethral orifice.
Describe the external, deep and innermost penis fascia.
External: Fascia of Colles, derived from the fascia of Scarpa from the abdominal wall.
Deep: Buck’s fascia, derived from the deep perineous fascia.
Innermost: tunica albuginea, forms the septum and a capsule round each erectile tissue.
Describe the suspensory & fundiform ligaments of the penis.
Suspensory connects the erectile bodies to the pubis symphysis. Fundiform surrounds the penis & attaches it to the pubis symphysis.
Describe the prepuce, frenulum & preputial sac of the penis.
The prepuce (foreskin) covers the glans. The frenulum attaches the prepuce to the glans. The potential space between these is the preputial sac.
Name the 3 arteries that supply the penis and where they branch from.
Dorsal and deep penis arteries, bulbourethral artery. They all come from the internal pudendal artery, from the internal iliac artery.
Describe the deep & superficial dorsal veins of the penis.
Deep- drains cavernous spaces into the prostatic venous plexus.
Superficial- drain skin & subcutaneous tissue.
How is the penis innervated?
S2-S4 & spinal ganglia.
Describe the 5 boundaries of the perineum.
Anterior: pubic symphysis Posterior: tip of coccyx Lateral: medial thigh Roof: pelvic floor Base: skin & fascia
Describe the boundaries of the anal triangle and urogenital triangle of the perineum.
Anal: Posterior half below ischial tuberosities. Bound by coccyx & sacrotuberous ligaments.
Urogenital: anterior half above ischial tuberosities. Bound by pubic symphysis & ischiopubic rami.
Name the contents of the anal triangle of the perineum.
Anal aperture, external anal sphincter, ischioanal fossae & pudendal nerve.
Describe the contents and path of the neurovascular supply to the perineum.
Contents: pudendal nerve (S2-S4), internal pudendal artery & vein.
Path: ischial tuberosities -> ischioanal fossae -> branches to supply urogenital & anal triangles
Describe the perineal body.
Irregular & fibromuscular, at the junction between triangles. Lies just deep to skin & has skeletal & smooth muscle, and collagenous & elastic fibres.
Name the structures attached to the perineal body.
Levator ani (pelvic floor); bulbospongiosus muscle; superficial & deep transverse perineal muscles; external anal & urethral sphincters.
Name the layers of the urogenital triangle, from deep to superficial.
Deep perineal pouch; perineal membrane; superficial perineal pouch; perineal fascia; skin.
Describe the deep perineal pouch of the urogenital triangle.
A potential space containing the urethra & external urethral sphincter. In females it contains the vagina. In males it contains the bulbourethral glands & deep transverse perineal muscles.
Describe the superficial perineal pouch of the urogenital triangle.
A potential space containing the erectile tissues of the penis/clitoris, Bartholin’s glands, ischiocavernosus, bulbospongiosus & superficial transverse perineal muscles.
Describe the layers of the perineal fascia in the urogenital triangle.
Deep layer: covers superficial muscles & penis/clitoris.
Superficial (deep): Colles fascia, continues from Scarpas fascia.
Superficial (superficial): continues from Campers fascia.
Describe 4 functions of the skin.
barrier against environment
vitamin D synthesis
body temperature regulation
sensory function
Describe the 4 cell types in the epidermis.
mature keratinocytes
melanocytes
Langerhans cells (antigen presenters)
Merkel cells (sensory mechanoreceptors)
Describe the 3 deep layers of the epidermis.
Stratum basale: mitosis of keratinocytes
Stratum spinosum: desmosomes (tight intercellular junctions) join keratinocytes
Stratum granulosum: lipids & other waterproof molecules
Describe the 2 superficial layers of the epidermis.
Stratum lucidum: cells lose nuclei & produce keratin.
Stratum corneum: cells lose all organelles & produce keratin.
Describe the 2 layers of the dermis and how it is connected to the epidermis.
superficial papillary layer
deep reticular layer (thicker & more durable as thicker collagen bundles)
connected by dermo-epidermal junctions
Describe the hypodermis.
Subcutaneous tissue, a major body store of adipose tissue.
Describe the 5 structures found in the dermis.
fibroblasts (make collagen & elastin)
mast cells (histamine granulated immune cells)
blood vessels
cutaneous sensory nerves
skin appendages from epidermis (nails, hair follicles, glands)
Describe the 2 types of sweat glands.
Eccrine: odourless, produce NaCl and water for thermoregulation
Apocrine: large glands in axillary & genital areas. Secretions broken down by cutaneous microbes causing odour.
What 2 structures make up a pilosebaceous unit?
Hair follicle & sebaceous gland.
How long does it take for a keratinocyte to travel through the epidermis and what is this called?
30-40 days, cornification.
How would menopause be diagnosed?
12 months of amenorrhoea (no menstruation)
FSH at 40microlitres/litre or above
Describe the relationship between menopause and heart disease.
Oestrogen decreases LDL and increases HDL cholesterol. So after menopause, female rates of heart disease increase to match those of males.
Describe the relationship between menopause and bone density.
Oestrogen reduces the number of osteoclasts. So after menopause, more bone is reabsorbed causing lower bone density and wrist/hip fractures.
Describe the hot flushes that take place in menopause.
Overheating and redness spreading from face to chest. Peripheral vasodilation and an overall increase in body temp may be caused by LH changes.
Describe the relationship between menopause, incontinence and UTIs.
Bladder and urethra are same tissue as vagina so atrophy in menopause.
Describe the vaginal changes during menopause.
Vaginal atrophy leads to dry, thin vaginal walls. This causes dyspareunia (pain during penetration).
Describe the 2 types of vaginal bleeding during menopause.
1- menstruation from ovulatory cycles
2- oestrogen breakthrough bleeding from anovulatory cycles can be fortnightly and is caused by high oestrogen and low progesterone.
Both cease as oestrogen lowers.
At what age would menopause be described as early?
40-45
Describe the 5 steps of hormonal changes in menopause
less follicles
less binding sites for FSH & LH & ovary is less sensitive to them
less oestrogen so more anovulatory cycles
lack of oestrogen causes FSH & LH to rise
less follicles = less inhibin = more FSH
Which hormones are the gonadotropins?
FSH & LH
