The pelvis Flashcards
What are the 3 parts of the penis?
Root
Body
Glans
Where is the root of the penis located?
the superficial perineal piuch of the pelvic floor
What makes up the root of the penis?
three erectile tissues
- crura x2 (left and right)
- bulb of the penis (transversed by the urethra)
Two muscles
- Ischiocavernosus x2
- Bulbospongiosus
What is the body of penis suspended from?
The pubic symphysis
what makes up the body of the penis?
Three cylinders of erectile tissue
- 2x Corpora Cavernosa
- Corpus spongiosum
what shape is the glands of the penis?
Conical in shape
what is the glands of the penis formed from?
distal expansion of the corpus spongiosum
Where do the left and right Cura attach?
To the ipsilateral Ischial ramus, tehy are covered by the ischiocavernosal muscels.
Where does the Urethra lie in the penis?
Runs through the Corpus spongiosum, on the ventral aspect of teh penis
what is the most superficial fascia covering the penis?
The external fascia of Colles, which is a continunity of the fascia of Scarpa (which covers the abdo wall)
What is the deeper layer of fascia covering the penis?
Deep fascia of the penis, buck’s fascia.
continuation of deep perineal fascia, holds all the 3 erectile muscels together.
what is the tunica albuginea?
strong fascia taht forms individual capsules around each body and is fused in the midline. - forms the incompleate septum between the two corpora.
what ligament connects the erectile bodies of the penis to the pubic symphysis?
Suspensory ligament
and the fundiform ligament
What is the arterial suply of the penis?
Dorsal artery of the penis
deep arteries of the penis
bulbourethral artery
all branches of the internal pudendal artery (branch of internal illiac artery)
what are the four segments of the male urethra?
pre-prostatic, prostatic, membranous and spongy.
The smallest diameter is the membranous
how much urine can be held in the bladder in a healthy invidiual?
400 - 600ml
What is the name of the folded internal lining of the bladder?
Rugae
What are the external features of the bladder?
Apex - superiorly, pointing towards the pubic symphysis (connected to the umbilicus by the median umbilica ligament)
Body
Fundus
Neck - continous with the urethra
what is the Trigone ?
triangular area, smooth walls, marked at the top by the R and L urethers and teh urethra at the bottom.
what is the embryological origin of the trigone.
intergration of two mesonephric ducts
what is the type epithelium of the bladder?
Transitional epithelium
what type of muscle is found within the bladder wall?
specalised smooth muscle
detrusor muscle
what is the function of the internal urethral sphincter in men?
consists of smooth fibers, under autonomic control, prevents seminal reguratation during ejeculation
What type of muscel is the external urethral sphincter?
skeletal muscle
what vessel provides arterial suply to the bladder?
superior vesical branch of the internal illiac artery
what is the venous drainage of the bladder?
vesical venous plexus - drains to the interal iliac veins
Lymphatic drainage of the bladder
supero-lateral aspect of the bladder - external iliac nodes
neck and fundus - internal iliac, sacral and iliac nodes.
what are they sympathetic, parasympathetic and somatic inovations of the bladder?
sympathetic - Hypogastirc nerves T12 - L2 = causes relaxation of detrusor muscels, allowing bladder to fill
Parasympathetic - pelvic nerves s2 - s4 , contaction of detrusor muscles
Somatic - pudendal nerve S2 - 4, control of external urethral sphincer
What is the role of the prostate?
sectreation of proteolytic enzymes into the serum, breaks down cloting factors so seamen stays liquid.
leave via the prostatic duct into the prostatic portion of the urethra
what are the anatomical lobes of the prostate?
Inferior posterior
Inferolateral
Superomedial
Anteromedial
what are the histological divisions of the prostate?
central zone
- around ejaculatory ducts
- 25% of volume
transitional zone
- centrally
- surrounds urethre
10% volume
- typicaly undergo hyperplasia
peripheral zone
- 65%
- permit urine reflux, inflamation, carcinoma
fibromuscular stroma
- no glands present
what part of the prostate is felt in DRE?
Peripheral Zone - which is most likely to develop carcinoma
blood suply to the prostate?
Prostatic arteries, come fromm the internal iliac arteries.
Drainage from the prostatic venous plexus, drain into the interal iliac veins
How does prostate cancer spread to the vertebral bodies to form skeletal mets?
spreads via the Batson venous plexus to the vertebral bodies
Describe the lymphatic drainage of the Penis?
Penile skin - superficial inguinal lymph nodees
Glans - deep inguinal lymph nodes
Erectile tissue - Internal iliac lymph nodes
generaly the Inguinal lymph nodes drain external genitalia in men
what to the sacral spinal nerves s2, s3, s4 form?
the Pudendal nerve
what nerve maintains voluntary uriany continence?
Pudendal nerve - S2, s3,s4
where are spermatozoa produced?
seminiferous tubles
what is the journey of sperm through the testis?
spermatozoa are produced in the seminiferous tubes
travel through the tubules collecting in rete testes
travel through afferent tubules to the epididymis
what is the peritoneal sac of the testis?
tunica vaginalis
what is the fibrous capsule that encloses the testes
Tunica albuginea
what are the parts of the epididymis
Head - proximal, formed by the efferent tubules of the testes
body - heavily coiled
tail - distal, marks the origin of the vas deferens.
what is the innovation of the testes
testicular plexus - derived from the renal and aortic plexus
what is the arterial supply of the testes?
testicular artery
cremasteric artery (from the inferior epigastric artery)
artery of vas deferens (branch of the inferior vesical artery)
what is the venous drainage of the testes?
pampiniform plexus
network of veins that wrap around the main testicular vein
lymphatic drainage of the scrotum?
superficial inguinal nodes
what testes is most commonly affected by a varicocele ?
Left
as it is longer and drains into the L renal vein at a perpendicular angle
Embryologically what does the scrotum derive from?
paired genital swellings
where is the dartos muscle located ?
sheet of smooth muscle
immediately under the skin of teh scrotum
what is the function of the dartos muscle
helps to regulate the temperate of the scrotum, by wrinkling of the skin.
what is the arterial supply to the scrotum
anterior scrotal artery = branch of the external pudendal artery
posterior scrotal artery = branch of the internal pudendal artery
what artery do the internal pudendal arteries branch off ?
the internal Illiac
nerve supply of the anterior aspect of the scrotum.
genital branch of the genitofemoral nerve
ilioinguinal nerve
nerve supply to the posterior aspect of the scrotum
perineal branches of the pudendal nerve
posterior femoral cutaneous nerve
at what level is the transtubercular plane
L5 vertebra
lymph drainage from above the pectinate line ?
internal iliac nodes
lymph drainage from below the pectinate line?
inguinal lymph nodes
what is the widest part of the urethra?
prostatic part
what is the venous drainage of bladder ?
vesicoprostatic plexus
