Unit 7 - Male Genitalia / Female Genitalia

Question 1

Label the coronal section of the penis.

Answer 1

Question 2

Where do the nerves and arteries supply the penis arise from?

Answer 2

> Dorsal arteries branch from internal pudendal artery which is a branch of internal iliac artery.

> Dorsal nerves arise from pudendal nerve

Question 3

Label the male pelvis.

Answer 3

Question 4

Describe the pathway of sperm starting from its production in the seminiferous tubules ending with its passage through the spongy urethra.

Answer 4

0- Bulbourethral gland secretes alkaline solution
1- Testis (seminiferous tubules)
2- Rete testis
3- Head > Tail of epididymis
4- Vas deferens > through inguinal canal
5- Ampulla of vas deferens
6- Seminal vesicle
7- Ejaculating duct
8- Urethra (all 4 parts)
9- External urethral opening

Question 5

1- What is the purpose of the inguinal canal in males?

2- Give a reason why it is important to understand the structure of the inguinal canal?

Answer 5

1- Functions as a passageway for structures between the intra- and extra-abdominal structures. > Transmits the spermatic cord(nerves, arteries,veins lymphatics) and gonadal vessels

2- Potential weakness in the abdominal wall, and thus a common site of herniation….
Testicular torsion > spermatic chord twists upon itself leading to strangulation of testicular artery = necrosis of testis

Question 6

Below is an image of the prostate showing its key zones.
Which zones are commonly associated with the following pathologies?
1- Benign prostatic hyperplasia
2- Prostatic carcinoma

Answer 6

1- Benign prostatic hyperplasia > Transitional zone
» Increase in size of prostate without presence of malignancy

2- Prostatic carcinoma > Peripheral zone

Question 7

Where does Vas deferens start and end? Describe its entire course.

Answer 7

1- Tail of epididymis
2- Inside spermatic chord
3- Cross inguinal canal
4- Emerges from spermatic chord at deep inguinal ring
5- Crosses external iliac vessels
6- Cross the ureter
7- Along bladder
8- Joins the duct of the seminal vesicle to form the Ejaculatory duct

Question 8

What is found within the spermatic chord?

Answer 8

• Testicular artery
• Vas deferens
• Testicle
• Pampiniform plexus
• Nerves
• Lymph nodes

Question 9

Name the 3 glands within the male genital system and state their function.

Answer 9

1- Bulbourethral: Lubricate/ neutralise urine before ejaculation

2- Seminal gland: Produce fluids that will turn into semen

3- Prostate gland: Produce hormones, produce seminal fluid, which is a component of semen and helps regulate urine flow

Question 10

1- Describe which order you would encounter the parts of male urethra when inserting a catheter.
Within which structures is each part found?

2- Which urethral sphincter is voluntary/involuntary? State the function for the involuntary sphincter that ONLY males have.

Answer 10

Question 1-
1- Spongy > Cavernous spongiosum
2- Membranous > External urethral sphincter
3- Prostate > Prostate
4- Pre-prostate > Internal urethral sphincter

Question 2-
- External = Voluntary
- Internal = Involuntary
> Prevents retrograde ejaculation (semen going up the bladder)

Question 11

Insertion of a urinary catheter in male urethra…
* Which of these parts might offer resistance?

Answer 11

The membranous urethra is a short and narrow segment, passing through the urogenital diaphragm. Resistance may be encountered in this area

Question 12

What is the duct that is formed with the joining of the seminal vesicle and the ductus deferens

Answer 12

• Ejaculatory duct

*You have a right and left ejaculatory duct as you have 2 testes , 2 ductus deferens , 2 seminal vesicles and 2 ejaculatory ducts which then come together to form one prostatic urethra.

Question 13

Describe the effect of sympathetic and parasympathetic innervation to male genital organs.

Answer 13

• PARASYMPATHETIC: POINT (erect)
  > Pelvic splanchnic nerve
  > S2-S4
• SYMPATHETIC: SHOOT (ejaculate)
  >Lumbar splanchnic nerve
  > L1 and L2

Question 14

Describe the somatic innervation to male genitalia?

Answer 14

• SOMATIC: Sensation
  > Pudendal nerve
  > S2-4

Question 15

From where does the blood supply arise to the following structures:

a) Testis
b) Scrotum
c) Penis

Answer 15

a) Testis : Paired testicular arteries from abdominal aorta

b) Scrotum: Anterior and posterior scrotal arteries from external and internal pudendal artery

c) Penis: Dorsal arteries and deep artery and bulbourethral artery from internal pudendal artery from internal iliac artery

Question 16

Describe the difference between the abdomen, pelvis and perineum.

Answer 16

The abdomen is the area between the thorax and the pelvis, which contains the digestive organs > Bordered superiorly by the diaphragm and inferiorly by the pelvic bones.

The pelvis is the bony structure located between the abdomen and the legs, which provides support for the pelvic organs and the lower extremities. It is made up of the ilium, ischium, and pubis bones, which fuse together during development. Contains internal genitalia

The perineum is the area between the anus and the external genitalia in both males and females. It contains various muscles, nerves, and blood vessels that are involved in bowel and bladder control, sexual function, and childbirth.

Question 17

Answer the following on abdomen, pelvis and perineum:
- Is peritoneum present in each region?
- What separates each of the 3 regions?

Answer 17

• Peritoneum lines the abdominal cavity and covers the organs within it
• The pelvic cavity is lined by the pelvic peritoneum, which is a continuation of the abdominal peritoneum.
• The perineum, on the other hand, is lined by the pelvic fascia and the urogenital diaphragm, which are connective tissues that support and separate the pelvic organs from the external genitalia and the anus.

Question 18

Define the following parts of the penis.
- Bulb
- Crura
- Body
- Glands

Answer 18

• Bulb: Base of penis
• Crura: Root of corpus cavernosa attach to ishiopubic rami as 2 separate structures
• Body: Part between roots and glands
• Glands: Tip of penis

Question 19

What is the function of the following muscles in erection and ejaculation in both females and males?
- Bulbospongiosus
- Ischiocavernosus

What is their innervation?

Answer 19

• Innervated by the pudendal nerve
• Located in perineum

1- Ischiocavernosus
> Maintains the rigidity of the penis/clitoris during erection, and for helping to expel semen or vaginal secretions during ejaculation or orgasm.

2- Bulbospongiosus
> MALES:
- Expel semen during ejaculation via contracting rhythmically
- Compress the urethra aid in the expulsion of urine
> FEMALES
- Contracts rhythmically, which can enhance sexual pleasure and help to maintain clitoral erection.
- Compress the vaginal opening during orgasm, which can increase sexual satisfaction and aid in achieving orgasm.

Question 20

1- Where do testicular arteries arise? Why is their location so dissimilar from the blood supply to the rest of pelvis and perineum?

2- Do the left and right testicular veins follow the same drainage pattern?

Answer 20

1- Abdominal aorta
> Testis produced in lumbar region and during foetal development move down via Gubernaculum

2- NO
- Right = IVC
- Left = Left renal vein

Question 21

Why is the lymphatics of testis different to scrotum? What is the clinical significance of this?

Answer 21

Testis = Para aortic lymph nodes
Scrotum = Superficial inguinal
> Testis originate from lumbar/abdominal region > Tescticular cancer can spread to abdomen!

Question 22

1- What is the opening/ exit from the inguinal canal?

2- What passes through inguinal canal in females and males?

3- What forms the floor of inguinal canal?

4- What common pathology affects the canal?

Answer 22

1- (Image)

2-
Males : Spermatic chord
Females : Round ligament of uterus
Vessels and nerves

3- Inguinal ligament

4- Inguinal hernias

Question 23

Where would you locate the bladder?

Answer 23

• The most anterior organ
• On top of pubic symphysis

Question 24

What is the similarity between spermatic chord in males and suspensory ligament in females?

Answer 24

The female suspensory ligament is a band of fibrous tissue that attaches the ovary to the lateral pelvic wall. It contains the ovarian artery, ovarian vein, and ovarian nerve. The suspensory ligament helps to support and stabilize the ovary within the pelvic cavity.

The male spermatic cord is a bundle of structures that extends from the testes to the inguinal canal, and includes the vas deferens, testicular artery, pampiniform plexus of veins, lymphatic vessels, and nerves. The spermatic cord helps to suspend and position the testes within the scrotum.

Question 25

Label the coronal section of the female genital system.

Answer 25

Question 26

Label the saggittal section of the female pelvis.

Answer 26

Question 27

Identify the structures found in the female perineum.

Answer 27

Question 28

Name the 1 urethral sphincter females have.
Under what innervation is it?

Answer 28

• External urethral sphincter
• Voluntary > Pudendal nerve S2-4

Question 29

What relationship do the superficial and deep perineal pouches have to the perineal membrane?
What does each pouch contain?

Answer 29

• Deep = Superior to perineal membrane
  > Contains: urethra, external urethral sphincter, and the vagina in the female. In males, it also contains the bulbourethral glands and the deep transverse perineal muscles.
• Superior= Inferior to perineal membrane
  > Contains the erectile tissues that form the penis and clitoris, and three muscles – the ischiocavernosus, bulbospongiosus and superficial transverse perineal muscles. The greater vestibular glands

Question 30

What are the boundaries of urogenital and anal triangles?

Answer 30

Question 31

What is the typical position of the uterus?

Answer 31

Antiflexed: Tilts forwards at cervix and points towards abdomen
Antiverted: Uterus at right angle of longitudinal vagina

Question 32

What are the two spaces found in the female pelvis that are formed by reflections of peritoneum?

Answer 32

1) Rectouterine > Between rectum and uterus

2) Vesicouterine > Between bladder and uterus

Question 33

In females, What two structures are remnants of foetal gubernaculum?

Answer 33

1- Ovarian ligament
2- Round ligament of uterus
> Support ovaries and uterus

Question 34

Pelvic floor muscles help with continence, Label the pelvic floor muscles.
What is the pelvic floor innervation?
What does the pelvic floor do?

Answer 34

*Tendinous arch of lelevator ani allows muscles to originate from it.

• Pudendal nerve S2-4

> Separates pelvic cavity above to perineum below.

Question 35

What passes through the pelvic floor?

Answer 35

1- Urethra
2- Vagina
3- Anus
4- Blood vessels
5- Nerves e.g. pudenda;

Question 36

What is the blood supply to:
a) Uterus
b) Ovaries
c) Vagina

Which arteries anastomose what is the clinical significance?

Answer 36

Uterine + Vaginal
> Still have blood supply if 1 artery gets blocked

Question 37

What nerve is associated with the ovary?
Where might this nerve refer ovarian pain to?

Answer 37

• Ovarian nerve > branch of abdominal aortic plexus
• Referes pain to abdomen

Question 38

What is the clinical significance of posterior vaginal fornix?

Answer 38

• Allows doctors to assess size + position of uterus and ovaries
• Cervical samples
• Diagnostic tests

Question 39

What is the true and false pelvis?

Answer 39

• Iliopectenial lines

Question 40

What are the differences between male and female pelvis?

Answer 40

Question 41

What is the pelvic inlet? What forms it?
How does it change during pregnancy?

Answer 41

-Pelvic bones widen during pregnancy
> Pubic symphysis can temporarily separate

Question 42

Label the ligaments that hold the uterus in place.
What is their function?

Answer 42

1- Broad Ligament: Double-layered sheet of peritoneum that extends from the sides of the uterus to the walls of pelvic floor. The broad ligament supports the uterus and other pelvic organs, such as the ovaries and fallopian tubes, and also contains blood vessels, nerves, and lymphatic vessels.

2- Round ligament: Extend from the sides of the uterus, through the inguinal canal, and into the labia majora. They help to maintain the position of the uterus and also play a role in sexual function

3- Uterosacral ligament: Anchor the cervix to the sacrum and help to maintain the position of the uterus.

4- Cardinal ligament: Contain important blood vessels and nerves that supply the uterus and other pelvic organs

Question 43

Label the 3 parts of the broad ligament.

Answer 43

1- Mesosalpinx: This is the part of the broad ligament that surrounds the fallopian tubes.

2- Mesovarium: This is the part of the broad ligament that attaches to the ovary. Contains blood vessels, lymphatic vessels, and nerves that supply the ovary.

3- Mesometrium: This is the largest and most inferior part of the broad ligament that supports the uterus. It extends from the lateral walls of the pelvis to the uterus and contains blood vessels, lymphatic vessels, and nerves that supply the uterus

Question 44

Label the vulva components and their functions.
What is its somatic nerve supply?

Answer 44

• Pudendal nerve

Question 45

What is mons pubis?

Answer 45

• Fleshy area of tissue located above the pubic bone in the female genital area. It is covered with pubic hair after puberty and serves as a cushion for the pubic bone during sexual activity.