Trans - Male and Female Internal Genitalia Flashcards
T/F: Some parts of the male internal genitalia are intraperitoneal, some are retroperitoneal
F. All are retroperitoneal
Components of the male internal genitalia
Glands – prostate, seminal vesicle, Cowper’s gland
Ducts – ductus deferens, ejaculatory ducts, urethra
Shape of the prostate
Tetrahedral, walnut-shaped
The prostate is traversed by:
Prostatic urethra, 2 ejaculatory ducts
Parts of the urethra
Prostatic
Membranous
Spongy
Prostatic ducts open into what structure
Prostatic sinuses
T/F: Prostatic fluid is only secreted prior to ejaculation
F. Continuous secretion, with a ~2000 fold increase during ejaculation
T/F: The prostate has a true fibrous capsule
F
What region of the prostate is most predisposed to cancer? Why?
Posterior region, because of its glandular nature
Cholinergic innervations of the prostate
Nervi erigentes
Function of sphincter vesicae
Prevent retrograde ejaculation
Benign prostatic hypertrophy is usually related to what lobes?
Anterior and middle
Prostatic carcinoma is usually related to what lobes?
Posterior
Seminal vesicle secretes fluid containing ________ and _________
Fructose for sperm nutrition
Fibrinogen as a coagulating agent
The ampulla of the ductus deferens is located (medially/laterally)________ to the seminal vesicle
Medially
Seminal vesicle: arterial supply
Inferior vesical artery
Middle rectal artery
Seminal vesicle: venous drainage
Inferior vesical vein
Middle rectal vein
Cowper’s glands are also known as
Bulbourethral glands
Characteristics of the first part of the ejaculate
Prostatic and sperm-rich
Characteristics of the second part of the ejaculate
Seminal and sperm-poor
PSA test screens for:
Prostate cancer
Normal values when analyzing semen
60 million
60% normal shape
60% normal forward motility
4 digital rectal exam positions
- Ambulatory – standing with knees bent
- Knee-chest position
- Modified lithotomy – patient on back, knees flexed
- For bedridden patients – left latera/Sims position
Benign prostatic hypertrophy usually involves what lobe
Anterior
Urinary PCA 3 is a genetic marker test for early detection of __________
Prostatic cancer
T/F: Ovarian follicles are seen in gross anatomy dissections
F, they are only seen histologically
Ligament that attaches the anterior border of the ovary to the broad ligament of the uterus
Mesovarium
Ligament that suspends tubal pole of ovary to external iliac vessels
Infundibulopelvic ligament
Ligament that attaches uterine pole of ovary to lateral margin of uterus
Ovarian ligament
Epithelium of Fallopian tubes
Ciliated columnar
Site of fertilization
Ampulla of uterine tubes
Where fimbrae are located
Infundibulum
Ectopic pregnancy: definition
Pregnancy outside the uterus
T/F: The normal uterine position is retroverted
F. The normal uterine position is anteverted
Parts of the cervix
- Supravaginal – above the vagina
2. Portio vaginalis – within the vagina
Layers of the uterus
- Endometrium – shed off during menstruation
- Myometrium – muscular layer
- Serosa – peritoneal coat
Uterine abnormalities
- Bicornuate – 2 uteri
- Septate – no complete separation of 2 uteri, with septum
- Unicornuate – only one Mullerian duct matures
Components of broad ligament of uterus
- Mesosalpinx - attached to fallopian tubes
- Mesovarium – attached to ovaries
- Mesometrium – attached to uterus
Female: mesovarium :: Male: _________
Mesorchium
Condensations of connective tissue around blood vessels at the base of the broad ligaments
Cardinals
Transverse cardinal that helps prevent uterine prolapse
Mackenrodt’s Ligament
Homologous structures
Female: round ligament :: Male: __________
Ductus deferens
Ligaments that attach posterior uterine wall to sacrum
Uterosacrals
Separates vaginal orifice from anal opening
Perineal body
Contributes to closure of the vagina
Sphincter vaginae
Epithelium of ectocervix
stratified squamous
Epithelium of endocervix
columnar
Main artery of internal genitalia
Internal iliac artery
Gonadal arteries arise from the ________
Aorta
Superior rectal artery arises from the ____________
Inferior mesenteric artery
Most variable branch of the internal iliac artery
Obturator artery
Parietal branches of the anterior division of internal iliac artery
- Obturator artery
- Inferior gluteal artery
- Internal pudendal artery
Visceral branches of the anterior division of the internal iliac artery
- Obliterated umbilical artery
- Inferior vesical artery
- Middle rectal artery
- Uterine/vaginal artery
Parietal branches of the posterior division of the internal iliac artery
- Iliolumbar artery
- Lateral sacral artery
- Superior gluteal artery
Venous plexuses of the internal genitalia drain into the _________
Internal iliac vein
Venous plexuses of the internal genitalia
- Vesical
- Prostatic or Uterine/Vaginal
- Rectal
Somatic innervation of the internal genitalia
- Sacral plexus – L4-L5, S1-S3, partly S4
2. Coccygeal plexus – S4, S5, coccygeal nerves
Sympathetic innervation of internal genitalia
- Sacral sympathetic trunk
- Hypogastric nerves
3, Pudendal nerve - Nerve to levator ani
Parasympathetic innervation of internal genitalia
Pelvic splanchnic nerves – nervi erigentes
Parasympathetic innervation of internal genitalia controls ________
Relaxation of arteries to penis/clitoris, causing erection
Surfaces of the prostate
- Superior - blends with bladder
- Inferolateral - lies on levator ani
- Inferoposterior - lies on rectum
- Apex - where urethra emerges
Lobes of the prostate
- Anterior
- Median/Middle
- Posterior
- Right and Left Lateral
Significance of prostatic lobes
Used as landmarks in endoscopy and digital rectal examinations
Lobe mainly composed of fibromuscular tissue
Anterior lobe
Also called isthmus of the prostate
Anterior lobe
Lobe between urethra and prostatic duct
Median/Middle lobe
Lobe closest to the finger during digital rectal exam
Posterior lobe
Lobe of the prostate inferior to the bladder neck
Right lateral lobe
Left lateral lobe
Zones of the prostate
- anterior
- transitional
- central
- peripheral
Basis of prostatic zones
Histological landmarks
Significance of prostatic zones
Useful in pathology
The urethra is in which zone of the prostate
Transitional
The anterior lobe/transitional zone comprise what percent of prostatic gland volume?
5%
The median lobe/central zone comprise what percent of prostatic gland volume?
25%
The posterior lobe/peripheral zone comprise what percent of prostatic gland volume?
70%
The posterior prostatic lobe surrounds what part of the urethra?
Distal
The middle prostatic lobe surrounds what structure?
Ejaculatory ducts
The anterior prostatic lobe surrounds which part of the urethra?
Proximal
Seminal vesicle hyperplasia often causes ________
Compression of urethra and distension of bladder
Tortuous, branching diverticula from the ampullated ends of the ductus deferens
Seminal vesicles
Prostate size is dependent upon ________
Hormones
Prostate: arterial supply
Prostatic arteries from inferior vesical arteries
Prostate: venous drainage
Prostatic plexus draining into internal iliac veins
Prostate: lymphatic drainage
Major - internal iliac lymph nodes
Minor - sacral lymph nodes
pH of semen
7.5 (slightly alkaline to counteract vaginal acidity)
Percent contribution into semen of the ff:
a. Prostate
b. Seminal vesicle
c. Epididymis
d. Sperm cells
a. 15-30%
b. 50-80%
c. ~10%
d. 1-2%
Gives semen its odor
spermine
Functions in semen liquefaction
Plasminogen activator, seminin
Inflammation of the prostate
Prostatitis
PCA3 score: importance
to determine possible risks from prostatic cancer
PCA3 score: computation
PCA3 / PSAmRNA
PSA = prostate specific antigen PCA = number of overexpressed genes
higher PCA3 score means:
more predisposition for hyperplasia or cancer
female adnexa is composed of
ovaries and fallopian tubes
why is the ovary not covered by peritoneum?
to allow follicles to rupture and ova to be released into the peritoneal cavity
Highly vascularized area in ovary
medulla
Vestigial tubular structures in mesosalpinx that are the remnants of the mesonephric tubules
Epoophoron and paraophoron
circular gutter around cervix forms:
vaginal fornices
Components of prostatic fluid
- Zinc
- Citrate
- Spermine
- Cholesterol, Lipids
- Plasminogen activator
- Seminin
- Acid phosphatase
- PSA (seminin, seminal protease, 9. chymotrypsin-like protease)
- Electrolytes
- Glucose