Urogenital system

Question 1

Give an overview of the anatomy of the male urogenital system.

Answer 1

EXTERNAL GENITALIA:
1. Penis
   - contains urethra
      i. prostatic part
      ii. membraneous part
      iii. spongy part
      - transport urine and sperm (ejaculation)
   - two swelling bodies
      i. corpus cavernosa (erection)
      ii. corpus spongiosum (glans penis)
2. Scrotum
   - layered
      i. skin
      ii. tunica daros
      iii. external spermatic fascia
      iv. cremaster muscle
      v. internal spermatic fascia
    (al these layers are around the spermatic cord and the testicles)
      vi. tunica vaginalis
      vii. tunica albuginea
    (only around the testicles)

INTERNAL GENITALIA:
3. Spermatic cord
   - contain tubes
      i. ductus deferens (transport of sperm)
      ii. blood vessels
      iii. nerves
4. Testicles
   - situated under the epididymes
   - production of sperm (spermatogenesis)
   - contained in tunica albuginea
5. Epididymes
   - contain efferent ductules
   - divided in
      i. caput
      ii. corpus
    (tightly coiled)
      iii. cauda (store sperm)
   - form ductus deferens
6. Glands
   i. Seminal vesicles
      - 70% semen
      - fructose
      - prostaglandine
   ii. prostate
      - 30% semen
      - buffer (neutralise acidity of vagina)
   ii. cowper's glands
      - alkaline fluid (lubrification)

Question 2

Give an overview of the anatomy of the female urogenital system.

Answer 2

EXTERNAL GENITALIA
1. Vagina
   - vaginal vestibule
2. Labia
   i. majora
      - broader skin fold
   ii. minora
      - folds of skin + mucous membrane
      - join to form clitoral hood
3. Clitoris
   - swelling body
4. Pubic mound
   - fatty tissue on pubic bone
5. Glands
   i. Bartolin gland
      - lubrification
   ii. Skene gland
      - lubrification
INTERNAL GENITALIA
6. Uterus
   - hollow organ with tubes at both ends
   - specific position
      i. anteversion
      ii. anteflexion
   - suspended by ligaments and connective tissue
      i. round
      ii. broad
      iii. cardinal
      iv. uterosacral 
7. Ovaries
   - storage of egg cells
   - connected to uterus via fallopian tubes
   - ligaments:
      i. suspensory
      ii. ovarian
      iii. mesovary 
8. Fallopian tubes
   - divided in:
      i. fimbriae
      ii. infundibulum
      iii. ampulla (conception)
      iv. istmus
9. Vagina
   - cevix

Question 3

How does the urogenital system develop?

Answer 3

At conception sex determination by the male chromosome occur.
At week 4/6 the genitalia ridge develop, caused by the migration of primordial germ cells from the yolk sac. The genitalia ridge is the structure responsible for the formation of the genital tubercle, urethral fold and genital swelling.
At week 7 the indifferentiated gonads develop into sex-specific structures, depending on the hormones.
At week 10 the penis/scrotum and the vagina will form.

Question 4

What are peritoneal spaces? What can they cause?

Answer 4

Peritoneal spaces are spaces between two organs in which fluid can collect and cause pathogens development.
In female they are called:
- excavation vesico-uterina
- excavation recto-uterina
In male it is called:
- excavation rectovesicalis

Question 5

Give an overview of the vascularisation, Lymphoid structure and innervation of the reproductive system.

Answer 5

VASCULARISATION

• in testes/ovaries: testicular/ovarian artery and vein are present, which derive from the aorta and vena cava
• in uterus: only arteries are present:
  
  • internal iliac artery
  • uterine and vaginal artery

LYMPHOID STRUCTURE

• para-aortal
• iliacal
• inguinal

INNERVATION

• somatic:
  
  • pudendal nerve (afferent and efferent)
• autonomous:
  
  • lumbosacral (afferent and efferent)

Question 6

Give an overview of the inguinal canal.

Answer 6

The inguinal canal connect the skin and the abdominal cavity. It is found in both females, which connect the labia majora and the abdomen, and in males, which connects the scrotum and the abdomen, and contains the spermatic cord.

Development:

• at week 8 the testis and epididymis are developed, and the gubernaculum is attached caudally
• the scrotum expand from the abdomen, during the process called labioscrotal swelling
• the testis moves, through processus vaginalis, bringing with them all the layers of the abdomen
• the processus vaginalis disappear, leaving only the distal part (tunica vaginalis

Structure:

• lateral wall = external oblique
• medial wall = transverse fascia
• inferior wall = inguinal ligament
• superior wall = internal oblique abdominal muscle + transverse abdominis muscle

Content: 
- nerves:
   *ilioinguinal nerve
(males)
- spermatic cord
(females)
- round ligament of uterus

Question 7

What is the inguinal hernia?

Answer 7

The inguinal hernia is a protrusion of abdominal content through weak spot in abdomen wall:

• lateral/indirect: through deep inguinal ring
• medial/direct: through transverse fascia

Symptoms:

• bump
• painful when strangulation occur

Diagnosis:

• physical exam
• ultrasound/MRI

Treatment:

• without strangulation:
  
  • no treatment
• with strangulation:
  
  • emergency

Question 8

How are mammae structured?

Answer 8

The thoracic wall is formed by various strata:

1. skin + hair follicles
2. connective + fatty tissue
3. glandular tissue = mamma/breasts
4. muscle

The mamma can be found in both males and females and it is structures as:
- lobi glandula mammaria
- ducti lactiferi
- nipple+areola
- ligaments of cooper
The mamma present the internal thoracic artery as vascularisation, and the lateral, medial and under pectoris minor as lymphoid structure