Male Reproductive System 1 Flashcards

1
Q

What are the main features of the scrotum?

A
  • rugose skin
  • contains dartos muscle (smooth)
  • has midline raphe and divided by septum
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2
Q

What nerves supply the dartos muscle?

A

sympathetic fibres in genital branches of genitofemoral nerves

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3
Q

Describe how the anterolateral abdominal wall contributes to the scrotum in development

A
  • during development testes migrate from posterior abdo wall through anterior wall into scrotum
  • takes the layers of the abdominal walls, ductus deferens, testicular vessels and loop of parietal peritoneum known as processus vaginalis with it
  • becomes tunica vaginalis after birth and lies as a closed potential space
  • forms layers of scrotum
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4
Q

What is the clinical significance of the proximal part of the tunica vaginalis staying patent?

A
  • indirect inguinal hernia

- hydrocele (fluid accumualtion)

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5
Q

What are the layers of the scrotum from superficial to deep?

A
  • skin
  • subcutaneous tissue (dartos muscle and fascia)
  • external spermatic fascia
  • cremasteric muscle and fascia (from internal oblique)
  • internal spermatic fascia (from transversalis)
  • tunica vaginalis (visceral and parietal layers from peritoneum)
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6
Q

What is the blood supply/drainage of the scrotum?

A

Arteries:

  • anterior (1/3): external pudendal branches of femoral artery
  • posterior (2/3): braches of internal pudendal branch of internal iliac artery

Veins:

  • anterior (1/3): external pudendal veins to great saphenous vein
  • posterior (2/3): internal pudendal vein to internal iliac vein
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7
Q

What is the nerve supply and lymphatic draingage of the scrotum?

A

Nerves:

  • anterior (1/3): L1 with ilioinguinal and genitofemoral nerves
  • posterior (2/3): S2-3 by scrotal branches of the perineal branches of pudendal nerve

Lymphatics:
- superficial inguinal nodes

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8
Q

Where would you aspirate for hydrocele?

A
  • between the layers of tunica vaginalis

- aspirated by anterior or lateral approach to avoid posterior epididymis

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9
Q

What are the important features of the testes?

A
  • in scrotum
  • suspended by the spermatic cord
  • tethered by gubernaculum
  • left testes is lower than the right
  • produces sperm and secretes testosterone (Leydig) and inhibin (Sertoli)
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10
Q

Describe the tunica albuginea

A
  • it is a tough, fibrous collagenous layer around the testes
  • maintains internal pressure
  • sends in septae to create seminiferous lobules where the seminiferous tubules are
    (location of spermatogenesis)
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11
Q

What is the function of the epididymis?

A
  • maturation and acquisition of motility of spermatozoa
  • during ejaculation, contractions of smooth muscle on the wall of epididymis expel the mature spermatozoa into the ductus deferens
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12
Q

What are the different parts of the epididymis?

A
  • head
  • body (descending)
  • tail
  • vas deferens (curves back on itself and ascends up)
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13
Q

What is the blood supply/drainage of the testes?

A

Arteries:

  • testicular artery from aorta at L2
  • anastomosis with cremasteric artery and artery to ductus deferens

Veins:
- testicular vein

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14
Q

What is the lymphatic drainage and nerve supply of the testes?

A

Lymphatics:
- lymph to para-aortic (lumbar) nodes

Nerve Supply:
- sympathetic lesser splanchnic nerve T10-11
(referred pain is periumbilical)

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15
Q

Describe the position of the vas deferens

A
  • lies posterior to testis and medial to epididymis
  • leaves scrotum and passes through abdominal wall within spermatic cord in the inguinal canal
  • emerges into abdomen lateral to inferior epigastric artery and lies on lateral wall of pelvis
  • passes anteromedially to ureter
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16
Q

What is found in the spermatic cord?

A

Blood Vessels:

  • testicular vessels (artery (from aorta L2) and pampiniform venous plexus)
  • artery of ductus deferens (from superior vesical artery)
  • cremasteric artery and vein (from inferior epigastric artery)

Tubule Structures:

  • ductus deferens (carrying sperm from epididymis to ejaculatory duct)
  • lymphatic vessels (from testes to para-aortic nodes)
  • vestige (of processus vaginalis)

Neural Structures:

  • genital branch of genitofemoral nerve (cremaster muscle)
  • sympathetic afferents and efferents (from lesser splanchnic nerve T10-11)
17
Q

Describe the cremasteric reflex?

A
  • tests L1

- ipsilateral testicular retraction when stroking superior medial thigh

18
Q

Describe varicocele

A
  • dilated and tortuous pampiniform plexus in scrotum
  • almost always left sided
  • dull aching, throbbing pain
  • can cause infertility
19
Q

Describe the locations and functions of the ejaculatory duct and seminal vesicle

A

Ejaculatory duct:

  • from union of vas deferens and duct of seminal vesicle
  • releases contents into prostatic urethra

Seminal vesicle:

  • left and right seminal glands lie above prostate glands between bladder and rectum
  • secrete seminal fluid to nourish sperm
20
Q

Describe the location of the prostate

A
  • inferior to neck of bladder
  • posterior to pubic symphysis
  • anterior to rectum
  • superior to urogenital diaphragm
21
Q

What is the function of the prostate?

A
  • secretes at time of ejaculation:
  • prostaglandins
  • acid phosphatase
  • proteolytic enzymes
  • protease-specific antigen
22
Q

Where do the prostatic and ejaculatory ducts open?

A
  • prostatic ducts open into the prostatic sinuses that lie on either side of the seminal colliculus on posterior wall of prostatic urethra
  • prostatic utricle opens onto centre of seminal colliculus
  • on each side of prostatic utricle is opening for ejaculatory ducts
23
Q

What are the lobes of the prostate and what areas are susceptible to tumours?

A
  • 5 lobes
  • median lobe: between urethra and ejaculatory ducts (benign prostatic hypertrophy)
  • posterior lobe: behind urethra, inferior to ejaculatory ducts
  • anterior lobe: anterior to urethra, no glandular tissue
  • left and right: on either side of urethra
24
Q

What are the MacNeal’s Zones and what areas are susceptible to tumours?

A
  • transitional zone: around urethra and anterior to ejaculatory ducts (benign prostatic hypertrophy)
  • central zone: posterior to transitional, contains ejaculatory ducts
  • peripheral zone: around transitional and central (carcinomas)
  • anterior zone
25
Q

What is the arterial supply and venous drainage of the prostate?

A
  • inferior vesical artery

- prostatic venous plexus (drains to internal iliac vein and has connections with vertebral vein)