Week 2 (day 5) - Anatomy Dissection workshop - male and female reproductive system

Question 1

Define what is meant by the perineum.

Answer 1

This is the shallow compartment that lies between the levator ani superiorly and the perineal skin inferiorly

Question 2

Which structures pass through the levator ani in the male? Give the function of the levator ani muscle.

Answer 2

The rectum and urethra The muscle functions to assist in faecal and urinary continence and also offers pelvic floor support

Question 3

What muscle has the final voluntary control of faecal continence?

Answer 3

This would be the external anal sphincter

Question 4

What are the nerve roots of the pudendal nerve? What type of nerve fibres does the pudendal nerve contain?

Answer 4

Pudendal nerve roots - S2,3,4 Type of fibres - * somatic motor - to levator ani and muscles of the perineum * somatic sensory from the perineum * and sympathetic fibres - sympathetic nerve fibres in all spinal nerve rami

Question 5

What is located within the red box?

Answer 5

This is the ischioanal fossa

Question 6

Why might a perianal abscess spread readily through the ischioanal fossa?

Answer 6

This is because the ischioanal fossa is mainly fat and loose connective tissue There is not a good blood supply and few immune cells so a minimal barrier to infection is presented

Question 7

What is the nerve supply to the perineal muscles? What muscles are located in the superficial perineal pouch?

Answer 7

The nerve supply is the pudendal nerve The ischiocaernosus, bulbospongiousus and the superficial transverse perineal muscles are located here

Question 8

What do the perineal muscles? In particular what does the bulbospongiosus and the ischiocavernsosus cover in males?

Answer 8

Perineal msucles cover the erectile tissue in males and females Males Bulbospongiosus muscle covers bulb of penis - the corpus spongiosum Ischiocavernosus muscles coverse crura of penis - the corpus cavernosum

Question 9

What is the function of the perineal muscles in males and females?

Answer 9

Males Perineal muscles assist with erection and assist with the the final part of micturition Females These muscles are usually underdeveloped but assist in pelvic floor support

Question 10

Where does fertilisation normally occur? Can you think of a clinical procedure, in the female pelvis, during which the ureter may be damaged? Where does the lymph from the ovaries drain to?

Answer 10

Fertilisation normally occurs in the ampulla of the uterine tube Pelvic procedure in female where ureter may be damaged - hysterectomy Lymph from ovaries drains into the lumbar lymph nodes

Question 11

Why may the ureter become injured during a hysterectomy?

Answer 11

In a hysterectomy the uterine artery needs ligated to prevent haemorrhage As the ureter passes inferior (and posterior) to the uterine artery it is at risk of damage here This is a posterior view of the uterus

Question 12

Describe the route taken by gametes (sperm and ovum) from production through to fertilisation.

Answer 12

Seminiferous tubules - rete testis - epididymis - ductus (vas) deferens in spermatic cord - seminal vesicle - ejaculatory duct - prostate gland then urethra - membranous urethra - spongy urethra - external urethral meatus (for fertilisation – vagina, cervix and uterine tube) Ovary - into peritoneal cavity - fimbrae sweep into infundibulum of uterine tube - to ampulla for fertilisation

Question 13

When a female patient is in anatomical position, excess (abnormal) fluid within the peritoneal cavity will collect in which pouch? How might this fluid be drained?

Answer 13

This is the rectouterine puch (pouch of douglas) Fluid in the peritoneal cavity in a female can be drained by passsing a needle through the posterior fornix of the vagina

Question 14

Can you name the structure formed by a double layer of peritoneum, extending between the uterus and the lateral pelvic walls and floor?

Answer 14

This is the broad ligament

Question 15

What is the name given to the condition when the uterus descends into the vagina? How might it be caused?

Answer 15

This is a uterine prolapse Could be caused by weakened pelvic floor or increased intra-abdominal pressure

Question 16

What is the difference between a cystocele and a rectocele?

Answer 16

Cystocele - this is when the bladder herniates into the vaginal wall

Rectocele - this is when the rectum herniates into the vaginal wall

Causes for both include childbirth

Question 17

What is the function of the external urethral sphincter? Where is it found?

Answer 17

It is involved in the final control of urination Found in the urogenital triangle

Question 18

List the components of fluid secreted by the seminal vesicles. (which sugar and which vitamin if cant remember anything else)

Answer 18

proteins, enzymes, fructose, mucus, vitamin C, flavins, phosphorylcholine and prostaglandin

Question 19

What are the functions of the fluid/mucus secreted by the bulbourethral (Cowper’s) glands?

Answer 19

Secretes mucous to lubricate urethra and neutralises acid in the urethra

Question 20

What structures are located in the spermatic cord?

Answer 20

The testicular artery Testicular veins (pampiniform plexus of veins) Testicular nerve s - the genital branch of the genitofemoral nerve supplying the cremaster muslce, the sympathetics going to the testicls Lymphatics

Question 21

The cremasteric reflex is a superficial reflex observed in human males. This reflex is elicited by lightly stroking or poking the superior and medial (inner) part of the thigh. The normal response is an immediate contraction of the cremaster muscle that pulls up the testis ipsilaterally (on the same side of the body). Why may this reflex be lost in testicular torison? (helps tell difference between testicular torison and torsion of appendix of testis)

Answer 21

The reflex will be lost in testicular torsion as there is torsion of the spermatic cord and therefore the nerve supplying the cremaster muslce - the genital branch of the genitofemoral nerve cant innervate the muslce The cremaster muscle function is to raise and lower the testis

Question 22

What are the nerve roots of the genitofemoral nerve? What muscle does the genitofemoral nerve pierce?

Answer 22

Nerve roots are L1 and L2 Genitofoemral nerve pieces the psoas major muscle

Question 23

It begins at the of the epididymis, ascends through the scrotum to the testis and medial to the epididymis, travels through the abdominal wall as part of the , crosses over the external iliac vessels to enter the travels along the lateral wall of the pelvis and ends by joining the duct of the to form the .

Answer 23

It begins at the tail of the epididymis, ascends through the scrotum posteriorly to the testis and medial to the epididymis, travels through the abdominal wall as part of the spermatic cord , crosses over the external iliac vessels to enter the pelvis , travels, along the lateral wall of the pelvis and ends by joining the duct of the seminal gland (vesicle) to form the ejaculatory duct .