Urology and Andrology Lecture (Dr. Olinger) Flashcards
Urinary Bladder Description
- Hollow pouch with strong muscular distensible walls, temporary reservoir for Urine, connects to the Ureters (2) and Urethra
Urinary Bladder Components
- TRIGONE (formed by the two Ureteric Orifices and Internal Urethral Orifice)
a) . URETERIC ORIFICES (openings for the Ureters into the Urinary Bladder)
b) . INTERNAL URETHRAL ORIFICE (Opening for the Urethra in the Neck of the Urinary Bladder)
c) . INTERURETERIC FOLD (superior limit of the Trigone, joins the two Ureteric openings)
d) . UVUVLA OF THE URINARY BLADDER (swelling in the posterior wall of Urinary Bladder at the Internal Urethral Orifice)
2. APEX (anterior)
3. BODY (between Apex and Fundus)
4. FUNDUS (posterior, part furthest away from the Internal Urethral Orifice)
- NECK (tapers off into Urethra)
a). Involuntary Internal Sphincter (in the walls of the Neck of the
Urinary Bladder) - DETRUSOR M. (primary component of the wall of the Urinary Bladder)
- VESICLE FASCIA (loose connective tissue surrounding the Detrusor M.)
MALE URETHRA
- Conveyance of Urine from Urinary Bladder to the External Urethral Orifice at the Glans Penis
A). PREPROSTATIC URETHRA (in the Neck of the Urinary Bladder)
B). PROSTATIC URETHRA (in the Prostate Gland, communicates with Prostatic Utricle and Ejaculatory Duct)
1). URETHRAL CREST (median ridge that swells in the center of
the Prostate Gland as the Seminal Colliculus, and is surrounded on either side by the Prostatic Sinus)
2). PROSTATIC SINUS (space on either side of the Urethral
Crest and Seminal Colliculus, excepts secretions from the Prostatic Ductules)
a. OPENINGS OF THE PROSTATIC DUCTULES (drainage point for Prostatic Fluid, into the Prostatic Sinus)
3). SEMINAL COLLICULUS (rounded mound on the Urethral Crest, possesses three slit-like openings)
a. PROSTATIC UTRICLE (small blind ended pouch in
the Seminal Colliculus, embryological remnant of the Uterovaginal Canal)
b. OPENINGS for the EJACULATORY DUCTS
C) MEMBRANOUS URETHRA (short, through External Urethral
Sphincter)
D) SPONGY URETHRA (inside the Corpus Spongiosum)
1) . INTRABULBAR FOSSA (internal expansion of the Spongy Urethra in the Bulb of the Penis, receives secretions from the Bulbourethral Glands)
a. OPENINGS for the DUCTS of the Bulbourethral Glands
2) . NAVICULAR FOSSA (internal expansion of the Spongy Urethra in the Glans Penis)
3. URETHRAL GLANDS (mucus secreting glands that empty directly into the Spongy Urethra)
FEMALE URETHRA
- Conveyance of Urine from the Urinary Bladder to the External Urethral Orifice in the Vestibule of the Vagina
A). PARAURETHRAL GLANDS (homologous to the Prostate Gland, secretions are conveyed via a common duct to an area near the External Urethral Orifice)
B). URETHRAL GLANDS (mucus secreting glands that empty directly into the Urethra)
External Penis and Scrotum
A). PENILE RAPHE (midline Skin fold between Glans Penis and
Scrotum)
B). SCROTAL RAPHE (midline Skin fold between Penile Raphe and Perineal Raphe)
C). PERINEAL RAPHE (midline Skin fold between Scrotal Raphe and Anus)
SPERMATIC CORD
- Suspends the Testis in the Scrotum and contains the Ductus Deferens, Testicular A., Artery of the Ductus Deferens, Cremasteric A., Pampiniform Plexus (of veins), Sympathetic Nerve Fibers and Genital branch of Genitofemoral N.
A). DUCTUS DEFERENS
- Muscular tube, conveys sperm, continuation of the Duct of the Epididymis, begins at the Tail of the Epididymis, travels through the Inguinal Canal as part of the Spermatic Cord, enters the Pelvis, swells to the Ampulla of the Ductus Deferens, and joins with the Ducts of the Seminal Vesicles, posterior to the Urinary bladder to form the Ejaculatory Ducts
1. AMPULLA of the DUCTUS DEFERENS (part of the Duct closest to the Ejaculatory Ducts)
B). TESTICULAR A. (from the Aorta, supplies the Testis and Epididymis)
C). PAMPINIFORM PLEXUS (of veins) (drains into Testicular V.)
D). AUTONOMIC SENSORY Ns. (Sympathetic and Parasympathetic nerve fibers on the Ductus Deferens and arteries)
E). GENITAL BRANCH of the GENITOFEMORAL N. (innervating the Cremaster M.)
F). LYMPHATICS (drain into the Lumbar Lymph Nodes)
G). ARTERY of the DUCTUS DEFERENS (comes from the Inferior Vesicle A., supplies the Ductus Deferens)
H). CREMASTERIC A. (comes from the Inferior Epigastric A., supplies
the Cremaster M.)
I). ILIOINGUINAL N. (produces Anterior Scrotal N.)
Layers of the Scrotum
A). SKIN (Rugose, pigmented)
B). DARTOS FASCIA (derived from Membranous Superficial Fascia,
associated with a layer of smooth muscle that inserts onto the Skin, giving the Scrotum a wrinkled appearance)
C). DARTOS M. (smooth muscle fibers associated with Dartos Fascia, inserting onto the Skin)
Layers of the Spermatic Cord (Superficial to Deep)
A). EXTERNAL SPERMATIC FASCIA (derived from External Oblique M. Aponeurosis)
B). CREMASTERIC FASCIA (derived from the Internal Oblique M. aponeurosis)
1. CREMASTER M. (thin slips of muscle on the Cremasteric Fascia, derived from the Internal Oblique M., reflexively draws the Testis superiorly to produce an optimal temperature for Spermatogenesis, innervated by the Genital Branch of the Genitofemoral N.)
C). INTERNAL SPERMATIC FASCIA (derived from the Transversalis Fascia)
Layers of the Testis
A). TUNICA VAGINALIS (double layered, closed peritoneal sac
covering the Testis and Epididymis)
1. PARIETAL TUNIC AVAGINALIS (adherent to Internal Spermatic Fascia, derived from Parietal Peritoneum)
- VISCERAL TUNICA VAGINALIS (adherent to Tunica Albuginea, derived from Visceral Peritoneum)
a. SINUS of the EPIDIDYMIS (small recessed slit in the Visceral Tunica Vaginalis between the Epididymis and T estis)
B). TUNICA ALBUGINEA (tough, fibrous coat adherent to Testis)
TESTIS
- Ovoid organ suspended from Spermatic Cord in the Scrotum, produces Spermatozoa
A). SEMINIFEROUS TUBULES (site of Spermatozoa formation)
B). STRAIGHT TUBULE (transfer Spermatozoa to Rete Testis)
C). RETE TESTIS (sinusoidal spaces where Spermatozoa enter the Efferent Ductules of the Epididymis)
D). SEPTUM (separate between lobular formations of Seminiferous and Straight Tubules)
Epididymis
- Tightly packed convoluted Duct of the Epididymis, rests
on the posterior Testis, tapers off to a single deferent duct, the Ductus Deferens, stores Spermatozoa
A). HEAD (most superior and largest region, formed by tightly coiled ends of several Efferent Ductules)
1. LOBULES (compartmentalization of the coiled ends of several Efferent Ductules)
B). BODY (longest portion, between Head and Tail, convoluted Duct of the Epididymis)
C). TAIL (tapering region between Body and Ductus Deferens)
D). EFFERENT DUCTULES (transfer Spermatozoa from Rete Testis to Head and Body of Epididymis)
Penis
A). DEEP FASCIA OF THE PENIS (surround the erectile tissue and deep Vasculature, made of Deep Perineal Fascia)
B). REGIONAL ORGANIZATION (Root, Body and Glans Penis)
1. ROOT OF THE PENIS (attached, includes the Bulb and Crura
of the Penis, Bulbospongiosus M. and Ischiocavernosus M.)
- BODY OF THE PENIS(free, includes connective tissue,
paired corpora Cavernosa, Corpus Spongiosum and Spongy Urethra) - GlLANS PENIS (distal conical expansion, continuous with Corpus Spongiosum proximally)
C). ERECTILE TISSUE ORGANIZATION
1. VENTRAL CYLINDER of PENILE ERECTILE TISSUE (central,
unpaired, from proximal to distal: Bulb of the Penis, Corpus Spongiosum and Glans Penis)
a). BULB of PENIS (erectile tissue at the Root of the Penis, continuous with the Corpus Spongiosum)
b). CORPUS SPONGIOSUM (ventrally positioned erectile tissue, transmits the Spongy Urethra) i. Spongy Urethra (see above)
c) . GLANS PENIS (the distal conical expansion of the Corpus Spongiosum)
i. CORONA OF THE GLANS (margin of the Glans Penis which projects proximally over the Corpus Cavernosa)
ii. NECK OF THE GLANS (separation of the Body and Glans Penis)
- DORSAL CYLINDERS OF THE PENILE ERECTILE TISSUE (paired, from proximal to distal: Crura of the Penis, CorporaCavernosa)
a) . CRURA OF PENIS (erectile tissue associated proximally with the corresponding Inferior Pubic Ramus, continuous with the two Corpus Cavernosa)
i. RIGHT CRUS of the Penis
ii. LEFT CRUS of the Penis
b). CORPUS CAVERNOSUM (paired erectile tissue, houses the paired Deep A. of the Penis)
D). EXTERNAL URETHRA ORIFICE (exit point of the Urethra at the tip of the Glans Penis)
E). PREPUCE (Skin and Fascia of the Penis that covers the Glans
Penis to a variable extent)
1. FRENULUM (ventrally located median fold)
Clinical Note: Deferentectomy or Vasectomy
- Deferentectomy, or Vasectomy is the LIGATION and/or excision of the Ductus Deferens through an incision made in the SUPERIOR SCROTUM, thereby rendering the resultant ejaculant devoid of Spermatozoa.
Prostate Gland
- Unpaired, largest accessory gland of the male reproduction system, produces Prostatic Fluid which makes up 20% of Seminal Fluid, described as having an ANTERIOR lobe, POSTERIOR lobe, TWO LATERAL lobes and a MIDDLE lobe
A). PROSTATIC DUCTS (convey Prostatic Fluid from the parenchyma of the Gland to the Prostatic Sinus)
Clinical Note: Enlargement of the Prostate Gland
- Enlargement of the Prostate Gland: Occurs with INCREASING AGE and can IMPINGE on the PROSTATIC URETHRA, IMPEDING URINATION.
- Enlargement of the Prostate Gland and Prostatic Cancer can both be determined by DIGITAL RECTAL EXAMINATION.
