SUGER Flashcards

1
Q

Describe the erectile tissues in the penis root.

A

Left and right crura are lateral, bulb is at the midline.

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2
Q

Describe the ischernocavius & bulbospongiosus muscle of the penis root.

A

Ischernocavius: surrounds the crura & maintains erections.
Bulbospongiosus: surrounds the bulb, empties the urethra & maintains erections.

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3
Q

Describe the erectile tissues of the penis body.

A

The corpora cavernosa are derived from crura & are separated by the septum. The corpus spongiosum is derived from the bulb & the urethra runs through it.

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4
Q

Describe the glans penis.

A

A conical expansion of the corpus spongiosum. It has the external urethral orifice.

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5
Q

Describe the external, deep and innermost penis fascia.

A

External: Fascia of Colles, derived from the fascia of Scarpa from the abdominal wall.
Deep: Buck’s fascia, derived from the deep perineous fascia.
Innermost: tunica albuginea, forms the septum and a capsule round each erectile tissue.

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6
Q

Describe the suspensory & fundiform ligaments of the penis.

A

Suspensory connects the erectile bodies to the pubis symphysis. Fundiform surrounds the penis & attaches it to the pubis symphysis.

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7
Q

Describe the prepuce, frenulum & preputial sac of the penis.

A

The prepuce (foreskin) covers the glans. The frenulum attaches the prepuce to the glans. The potential space between these is the preputial sac.

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8
Q

Name the 3 arteries that supply the penis and where they branch from.

A

Dorsal and deep penis arteries, bulbourethral artery. They all come from the internal pudendal artery, from the internal iliac artery.

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9
Q

Describe the deep & superficial dorsal veins of the penis.

A

Deep- drains cavernous spaces into the prostatic venous plexus.
Superficial- drain skin & subcutaneous tissue.

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10
Q

How is the penis innervated?

A

S2-S4 & spinal ganglia.

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11
Q

Describe the 5 boundaries of the perineum.

A
Anterior: pubic symphysis
Posterior: tip of coccyx
Lateral: medial thigh
Roof: pelvic floor
Base: skin & fascia
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12
Q

Describe the boundaries of the anal triangle and urogenital triangle of the perineum.

A

Anal: Posterior half below ischial tuberosities. Bound by coccyx & sacrotuberous ligaments.
Urogenital: anterior half above ischial tuberosities. Bound by pubic symphysis & ischiopubic rami.

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13
Q

Name the contents of the anal triangle of the perineum.

A

Anal aperture, external anal sphincter, ischioanal fossae & pudendal nerve.

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14
Q

Describe the contents and path of the neurovascular supply to the perineum.

A

Contents: pudendal nerve (S2-S4), internal pudendal artery & vein.
Path: ischial tuberosities -> ischioanal fossae -> branches to supply urogenital & anal triangles

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15
Q

Describe the perineal body.

A

Irregular & fibromuscular, at the junction between triangles. Lies just deep to skin & has skeletal & smooth muscle, and collagenous & elastic fibres.

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16
Q

Name the structures attached to the perineal body.

A

Levator ani (pelvic floor); bulbospongiosus muscle; superficial & deep transverse perineal muscles; external anal & urethral sphincters.

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17
Q

Name the layers of the urogenital triangle, from deep to superficial.

A

Deep perineal pouch; perineal membrane; superficial perineal pouch; perineal fascia; skin.

18
Q

Describe the deep perineal pouch of the urogenital triangle.

A

A potential space containing the urethra & external urethral sphincter. In females it contains the vagina. In males it contains the bulbourethral glands & deep transverse perineal muscles.

19
Q

Describe the superficial perineal pouch of the urogenital triangle.

A

A potential space containing the erectile tissues of the penis/clitoris, Bartholin’s glands, ischiocavernosus, bulbospongiosus & superficial transverse perineal muscles.

20
Q

Describe the layers of the perineal fascia in the urogenital triangle.

A

Deep layer: covers superficial muscles & penis/clitoris.
Superficial (deep): Colles fascia, continues from Scarpas fascia.
Superficial (superficial): continues from Campers fascia.

21
Q

Describe 4 functions of the skin.

A

barrier against environment
vitamin D synthesis
body temperature regulation
sensory function

22
Q

Describe the 4 cell types in the epidermis.

A

mature keratinocytes
melanocytes
Langerhans cells (antigen presenters)
Merkel cells (sensory mechanoreceptors)

23
Q

Describe the 3 deep layers of the epidermis.

A

Stratum basale: mitosis of keratinocytes
Stratum spinosum: desmosomes (tight intercellular junctions) join keratinocytes
Stratum granulosum: lipids & other waterproof molecules

24
Q

Describe the 2 superficial layers of the epidermis.

A

Stratum lucidum: cells lose nuclei & produce keratin.

Stratum corneum: cells lose all organelles & produce keratin.

25
Q

Describe the 2 layers of the dermis and how it is connected to the epidermis.

A

superficial papillary layer
deep reticular layer (thicker & more durable as thicker collagen bundles)
connected by dermo-epidermal junctions

26
Q

Describe the hypodermis.

A

Subcutaneous tissue, a major body store of adipose tissue.

27
Q

Describe the 5 structures found in the dermis.

A

fibroblasts (make collagen & elastin)
mast cells (histamine granulated immune cells)
blood vessels
cutaneous sensory nerves
skin appendages from epidermis (nails, hair follicles, glands)

28
Q

Describe the 2 types of sweat glands.

A

Eccrine: odourless, produce NaCl and water for thermoregulation
Apocrine: large glands in axillary & genital areas. Secretions broken down by cutaneous microbes causing odour.

29
Q

What 2 structures make up a pilosebaceous unit?

A

Hair follicle & sebaceous gland.

30
Q

How long does it take for a keratinocyte to travel through the epidermis and what is this called?

A

30-40 days, cornification.

31
Q

How would menopause be diagnosed?

A

12 months of amenorrhoea (no menstruation)

FSH at 40microlitres/litre or above

32
Q

Describe the relationship between menopause and heart disease.

A

Oestrogen decreases LDL and increases HDL cholesterol. So after menopause, female rates of heart disease increase to match those of males.

33
Q

Describe the relationship between menopause and bone density.

A

Oestrogen reduces the number of osteoclasts. So after menopause, more bone is reabsorbed causing lower bone density and wrist/hip fractures.

34
Q

Describe the hot flushes that take place in menopause.

A

Overheating and redness spreading from face to chest. Peripheral vasodilation and an overall increase in body temp may be caused by LH changes.

35
Q

Describe the relationship between menopause, incontinence and UTIs.

A

Bladder and urethra are same tissue as vagina so atrophy in menopause.

36
Q

Describe the vaginal changes during menopause.

A

Vaginal atrophy leads to dry, thin vaginal walls. This causes dyspareunia (pain during penetration).

37
Q

Describe the 2 types of vaginal bleeding during menopause.

A

1- menstruation from ovulatory cycles
2- oestrogen breakthrough bleeding from anovulatory cycles can be fortnightly and is caused by high oestrogen and low progesterone.
Both cease as oestrogen lowers.

38
Q

At what age would menopause be described as early?

A

40-45

39
Q

Describe the 5 steps of hormonal changes in menopause

A

less follicles
less binding sites for FSH & LH & ovary is less sensitive to them
less oestrogen so more anovulatory cycles
lack of oestrogen causes FSH & LH to rise
less follicles = less inhibin = more FSH

40
Q

Which hormones are the gonadotropins?

A

FSH & LH