SUGER

Question 1

Describe the erectile tissues in the penis root.

Answer 1

Left and right crura are lateral, bulb is at the midline.

Question 2

Describe the ischernocavius & bulbospongiosus muscle of the penis root.

Answer 2

Ischernocavius: surrounds the crura & maintains erections.
Bulbospongiosus: surrounds the bulb, empties the urethra & maintains erections.

Question 3

Describe the erectile tissues of the penis body.

Answer 3

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.

Question 4

Describe the glans penis.

Answer 4

A conical expansion of the corpus spongiosum. It has the external urethral orifice.

Question 5

Describe the external, deep and innermost penis fascia.

Answer 5

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.

Question 6

Describe the suspensory & fundiform ligaments of the penis.

Answer 6

Suspensory connects the erectile bodies to the pubis symphysis. Fundiform surrounds the penis & attaches it to the pubis symphysis.

Question 7

Describe the prepuce, frenulum & preputial sac of the penis.

Answer 7

The prepuce (foreskin) covers the glans. The frenulum attaches the prepuce to the glans. The potential space between these is the preputial sac.

Question 8

Name the 3 arteries that supply the penis and where they branch from.

Answer 8

Dorsal and deep penis arteries, bulbourethral artery. They all come from the internal pudendal artery, from the internal iliac artery.

Question 9

Describe the deep & superficial dorsal veins of the penis.

Answer 9

Deep- drains cavernous spaces into the prostatic venous plexus.
Superficial- drain skin & subcutaneous tissue.

Question 10

How is the penis innervated?

Answer 10

S2-S4 & spinal ganglia.

Question 11

Describe the 5 boundaries of the perineum.

Answer 11

Anterior: pubic symphysis
Posterior: tip of coccyx
Lateral: medial thigh
Roof: pelvic floor
Base: skin & fascia

Question 12

Describe the boundaries of the anal triangle and urogenital triangle of the perineum.

Answer 12

Anal: Posterior half below ischial tuberosities. Bound by coccyx & sacrotuberous ligaments.
Urogenital: anterior half above ischial tuberosities. Bound by pubic symphysis & ischiopubic rami.

Question 13

Name the contents of the anal triangle of the perineum.

Answer 13

Anal aperture, external anal sphincter, ischioanal fossae & pudendal nerve.

Question 14

Describe the contents and path of the neurovascular supply to the perineum.

Answer 14

Contents: pudendal nerve (S2-S4), internal pudendal artery & vein.
Path: ischial tuberosities -> ischioanal fossae -> branches to supply urogenital & anal triangles

Question 15

Describe the perineal body.

Answer 15

Irregular & fibromuscular, at the junction between triangles. Lies just deep to skin & has skeletal & smooth muscle, and collagenous & elastic fibres.

Question 16

Name the structures attached to the perineal body.

Answer 16

Levator ani (pelvic floor); bulbospongiosus muscle; superficial & deep transverse perineal muscles; external anal & urethral sphincters.

Question 17

Name the layers of the urogenital triangle, from deep to superficial.

Answer 17

Deep perineal pouch; perineal membrane; superficial perineal pouch; perineal fascia; skin.

Question 18

Describe the deep perineal pouch of the urogenital triangle.

Answer 18

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.

Question 19

Describe the superficial perineal pouch of the urogenital triangle.

Answer 19

A potential space containing the erectile tissues of the penis/clitoris, Bartholin’s glands, ischiocavernosus, bulbospongiosus & superficial transverse perineal muscles.

Question 20

Describe the layers of the perineal fascia in the urogenital triangle.

Answer 20

Deep layer: covers superficial muscles & penis/clitoris.
Superficial (deep): Colles fascia, continues from Scarpas fascia.
Superficial (superficial): continues from Campers fascia.

Question 21

Describe 4 functions of the skin.

Answer 21

barrier against environment
vitamin D synthesis
body temperature regulation
sensory function

Question 22

Describe the 4 cell types in the epidermis.

Answer 22

mature keratinocytes
melanocytes
Langerhans cells (antigen presenters)
Merkel cells (sensory mechanoreceptors)

Question 23

Describe the 3 deep layers of the epidermis.

Answer 23

Stratum basale: mitosis of keratinocytes
Stratum spinosum: desmosomes (tight intercellular junctions) join keratinocytes
Stratum granulosum: lipids & other waterproof molecules

Question 24

Describe the 2 superficial layers of the epidermis.

Answer 24

Stratum lucidum: cells lose nuclei & produce keratin.

Stratum corneum: cells lose all organelles & produce keratin.

Question 25

Describe the 2 layers of the dermis and how it is connected to the epidermis.

Answer 25

superficial papillary layer deep reticular layer (thicker & more durable as thicker collagen bundles) connected by dermo-epidermal junctions

Question 26

Describe the hypodermis.

Answer 26

Subcutaneous tissue, a major body store of adipose tissue.

Question 27

Describe the 5 structures found in the dermis.

Answer 27

fibroblasts (make collagen & elastin) mast cells (histamine granulated immune cells) blood vessels cutaneous sensory nerves skin appendages from epidermis (nails, hair follicles, glands)

Question 28

Describe the 2 types of sweat glands.

Answer 28

Eccrine: odourless, produce NaCl and water for thermoregulation Apocrine: large glands in axillary & genital areas. Secretions broken down by cutaneous microbes causing odour.

Question 29

What 2 structures make up a pilosebaceous unit?

Answer 29

Hair follicle & sebaceous gland.

Question 30

How long does it take for a keratinocyte to travel through the epidermis and what is this called?

Answer 30

30-40 days, cornification.

Question 31

How would menopause be diagnosed?

Answer 31

12 months of amenorrhoea (no menstruation) | FSH at 40microlitres/litre or above

Question 32

Describe the relationship between menopause and heart disease.

Answer 32

Oestrogen decreases LDL and increases HDL cholesterol. So after menopause, female rates of heart disease increase to match those of males.

Question 33

Describe the relationship between menopause and bone density.

Answer 33

Oestrogen reduces the number of osteoclasts. So after menopause, more bone is reabsorbed causing lower bone density and wrist/hip fractures.

Question 34

Describe the hot flushes that take place in menopause.

Answer 34

Overheating and redness spreading from face to chest. Peripheral vasodilation and an overall increase in body temp may be caused by LH changes.

Question 35

Describe the relationship between menopause, incontinence and UTIs.

Answer 35

Bladder and urethra are same tissue as vagina so atrophy in menopause.

Question 36

Describe the vaginal changes during menopause.

Answer 36

Vaginal atrophy leads to dry, thin vaginal walls. This causes dyspareunia (pain during penetration).

Question 37

Describe the 2 types of vaginal bleeding during menopause.

Answer 37

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.

Question 38

At what age would menopause be described as early?

Answer 38

40-45

Question 39

Describe the 5 steps of hormonal changes in menopause

Answer 39

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

Question 40

Which hormones are the gonadotropins?

Answer 40

FSH & LH