4) Anatomy of the Male Reproductive System

Question 1

What is the scrotum?

Answer 1

Cutaneous fibro-muscular sac for the testes and associated structures

Question 2

Where is the scrotum located?

Answer 2

Posteroinferior to the penis

Inferior to the pubic symphysis

Question 3

What does the mid-line scrotal raphe indicate?

Answer 3

The bilateral embryonic formation of the scrotum

Question 4

What are the testes?

Answer 4

Male gonads
Paired, ovoid reproductive glands
Produce spermatozoa & male hormones

Question 5

The tunica albuginea of the testes has a thick ridge posteriorly, what is this called & what is its function?

Answer 5

Mediastinum of the testis

Allows fibrous septums to extend inwards between lobules of seminiferous tubules

Question 6

How do the testes arise?

Answer 6

Mesonephric ridge, upper lumbar regions, lower pole of kidneys
Tethered to labioscrotal folds (genital swellings, future scrotum) by the gubernaculum

Question 7

Describe the descent of the testes

Answer 7

Move caudally
Musculo-fascial layer evaginates into scrotum as it develops + peritoneal membrane = Processus vaginalis
Testes cross the inguinal canal
Exit the anterolateral abdominal wall

Question 8

What does the spermatic cord in males contain?

Answer 8

Fascial layers
Processus vaginalis
Vas deferens
Lymphatics
Testicular vessels & nerves

Question 9

Where does the spermatic cord run?

Answer 9

Deep inguinal ring
Lateral to inferior epigastric vessels
Within the inguinal canal
Through superficial inguinal ring to posterior border of testis

Question 10

What is the scrotal ligament a vestigial remnant of?

Answer 10

The gubernaculum

Question 11

What is the arterial supply to the testes?

Answer 11

Abdominal aorta > Testicular arteries

Question 12

Describe the course of the testicular arteries

Answer 12

Testicular a. arise from the abdominal aorta just inferior to the Renal a.
Pass retroperitoneally, cross over ureters & inferior part of external iliac arteries to reach deep inguinal rings
Pass through inguinal canal, superficial inguinal ring
Enter spermatic cords

Question 13

What is the venous drainage of the testes?

Answer 13

Asymmetrical
Testes > Pampiniform Venous Plexus > Right testicular vein > IVC
Testes > Pampiniform Venous Plexus > Left testicular vein > Left Renal vein

Question 14

The testicular vein wraps around the testicular artery. What is the significance of this?

Answer 14

Blood from abdominal aorta is cooled as it passes through the testicular artery

Question 15

What are the 3 parts of the epididymis and what is its function?

Answer 15

Head (caput)
Body (corpus)
Tail (caudal)

Sperm transport, maturation (become motile) & storage

Question 16

What is the innervation to the testes & scrotum?

Answer 16

Lumbar plexus - anterior surface

Sacral plexus - posterior & inferior surfaces

Question 17

Why is the lymphatic drainage of the testes & scrotum different?

Answer 17

Linked to the different locations in which they developed

Question 18

What is the lymphatic drainage of the testes & scrotum?

Answer 18

Testes - Drain to paraaortic nodes

Scrotum - Drain to superficial inguinal nodes

Question 19

What is the function of the vas deferens?

Answer 19

Straight muscular tube within spermatic cord
Transports sperms rapidly to prostatic urethra
(autonomic innervation to smooth muscle permits rapid contractions)

Question 20

During ejaculation which ducts dilate to facilitate sperm & semen secretions to the prostatic urethra?

Answer 20

Ejaculatory duct

Seminal vesicle

Question 21

Describe the course of the ductus deferens

Answer 21

Ascends in spermatic cord
Transverses inguinal canal
Tracks around pelvic side wall
Passes between bladder & ureter
Forms a dilated ampulla & opening into ejaculatory duct

Question 22

What neurovasculature is contained within the spermatic cord?

Answer 22

Testicular artery, cremasteric artery, artery to vas
Pampiniform plexus
Genital branch of Genitofemoral nerve

Question 23

What are the 3 covering of the spermatic cord and where do they come from?

Answer 23

Anterolateral abdominal wall:

• External spermatic fascia (aponeurosis of external oblique)
• Cremasteric muscle & fascia (internal oblique & transversalis)
• Internal spermatic fascia (transversalis fascia)

Question 24

Where do the seminal vesicles lie?

Answer 24

Posterior to the prostate

Between bladder & rectum

Question 25

Describe the seminal vesicles

Answer 25

Small glands | Gland body - single highly convoluted tube, joins ampulla of ductus deferens to form ejaculatory duct

Question 26

What is the function of the seminal vesicles?

Answer 26

Produce coagulated secretions | comprise 70-80% of volume of ejaculate

Question 27

What are the borders of the prostate gland?

Answer 27

Base - Neck of bladder Apex - Urethral sphincter & deep perineal muscles Anterior surface - muscular urethral sphincter Posteriorly - Ampulla of rectum Inferio-lateral - Levator Ani

Question 28

What important structure does the prostate gland surround?

Answer 28

Prostatic urethra

Question 29

What secretions does the prostate gland produce?

Answer 29

Secretions contain: Prostaglandins, proteolytic enzymes & citric acid Form ~30% of volume of ejaculate

Question 30

What is the location & function of the bulbourethral glands?

Answer 30

Located within urogenital diaphragm Contain tubular & alveolar-type glands Produce clear water secretion prior to ejaculation that may lubricate the urethra

Question 31

Describe the structure of the penis

Answer 31

Root, body & glans Internal structure: Pair of corpora cavernosa dorsally Single corpus spongiosum ventrally

Question 32

What is the arterial supply to the penis?

Answer 32

Abdominal aorta > Common Iliac > Internal iliac > Anterior division of Internal Iliac > Internal Pudendal artery

Question 33

What venous drainage supplies the penis?

Answer 33

Venous plexus of the Penis > Deep dorsal vein of the penis > Prostatic venous Plexus > Internal Iliac vein > Inferior Vena Cava

Question 34

What are the 2 superficial muscles of the perineum?

Answer 34

Bulbospongiosus | Ischiocavernosus

Question 35

What is the function of the bulbospongiosus?

Answer 35

Helps to expel last drops of urine & maintain erections

Question 36

What is the function of the ischiocavernosus?

Answer 36

Compresses veins, helps maintain erections

Question 37

The male urethra is divided into how many parts? | What are their names?

Answer 37

``` 4 Pre-prostatic Prostatic Membranous Spony (penile) ```

Question 38

Which is the least distensible part of the male urethra?

Answer 38

Membranous part Passes through perineum & pelvic floor Has greastest risk of trauma due to catheterisation

Question 39

What is a hydrocoele?

Answer 39

Serous fluid in tunica vaginalis of scrotum

Question 40

What is a haematocoele?

Answer 40

Blood in the tunica vaginalis of the scrotum

Question 41

What is a varicocoele?

Answer 41

Varicosities of the pampiniform plexus in the scrotum

Question 42

What is a spermatocoele?

Answer 42

Retention cyst within the epididymis | a.k.a. epididymal cyst

Question 43

What is epididymitis?

Answer 43

Inflammation of the epididymal cyst

Question 44

What is an indirect inguinal hernia?

Answer 44

Hernia indirectly into inguinal area, via inguinal canal, through deep inguinal ring Lateral to inferior epigastric vessels Reopening of processus vaginalis gives potential continuity between peritoneal cavity & tunica vaginalis

Question 45

What is a direct inguinal hernia?

Answer 45

Hernia directly into inguinal area | Medial to inferior epigastric vessels

Question 46

What is testicular torsion?

Answer 46

Twisting of the spermatic cord Risk of necrosis of testis Usually occurs above upper pole of testis

Question 47

Why does cancer of the prostate often present later than benign prostatic hyperplasia (BPH)?

Answer 47

No urinary symptoms Cancer cells more peripheral Only occlude urethra at later stage

Question 48

Which location does benign prostatic hyperplasia usually occur?

Answer 48

Central zone of prostate

Question 49

What are the symptoms of benign prostatic hyperplasia?

Answer 49

Dysuria Nocturia Urgency

Question 50

Where do prostatic malignancies usually occur?

Answer 50

Peripheral zone of prostate

Question 51

Where do prostatic malignancies commonly metastasise?

Answer 51

Via lymphatics Internal iliac & sacral nodes & Venous drainage Internal venous plexus to vertebrae & brain

Question 52

Which antigen is elevated in prostatic disorders?

Answer 52

Blood levels of Prostatic-Specific Antigen | produced by abnormal prostatic epithelial cells

Question 53

How can the prostate be examined?

Answer 53

Digital rectal examination (DRE) | Exploits anatomical relationship of prostate to rectum