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MRCS A > ANATOMY - MALE REPRODUCTIVE SYSTEM > Flashcards

ANATOMY - MALE REPRODUCTIVE SYSTEM Flashcards

1
Q

What are the 3 parts of the penis?

A

Root, body, glans

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2
Q

What is the most proximal section of the penis?

A

Root

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3
Q

What structure is the root of the penis within?

A

Superficial pouch of pelvic floor

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4
Q

What 5 muscles and tissues does the root of the penis comprise of?

A

2 x crura + 1 x bulb = erectile tissues
ischiocaverosus + bulbospongiosus = mm

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5
Q

What is the ‘free’ part of the penis called

A

Body of penis

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6
Q

What bone is the body of the penis suspended from?

A

Pubic symphysis

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7
Q

What is the most distal section of the penis?

A

Glans

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8
Q

Shape of glans penis

A

Conical

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9
Q

What tissue is the glans penis the distal expansion of?

A

Corpus spongiosum

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10
Q

What tissue does the crus in the penis become?

A

Corpus cavernosum

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11
Q

What tissue does the bulb in the penis become?

A

Corpus spongiosum

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12
Q

What structure travels through the bulb of the penis?

A

Urethra

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13
Q

What are the 4 muscles of the penis?

A

2 x bulbospongiosum
2 x ischiocavenrosus

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14
Q

What part of the penis is the bulbospongiosum associated with

A

Bulb

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15
Q

Role of bulbospongiosum muscle (2)

A

Contracts to empty urethra
Increases pressure within bulb to maintain erection

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16
Q

What structure do the ischiocavernosus muscles surround?

A

Crura

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17
Q

Role of ischiocavernosus muscle

A

Forces blood from crura to corpus cavernosa
(to maintain erection)

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18
Q

Name of 3 fascia of penis

A

External Colles fascia
Deep Bucks fascia
Tunica Albuginea

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19
Q

What is the Colles fascia of the penis an extension of?

A

Scarpas fasica abdomen

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20
Q

Which fascia of the penis holds the erectile tissues together?

A

Bucks fascia

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21
Q

What structure does the tunica albunigea encapsulated?

A

Caverosum

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22
Q

What does the suspensory ligament of the penis connect?

A

Erectile bodies to pubic symphysis

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23
Q

Fundiform ligament penis structure

A

From the linea alba - forms a sling around the penis and connects to the pubic symphysis

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24
Q

arterial supply penis (3)

A

Dorsal aa penis
Deep aa penis
Bulboarethral aa

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25
Q

What are the penile arteries branches of?

A

Internal pudendal aa

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26
Q

What is the internal pudendal aa a branch of?

A

Internal iliac aa

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27
Q

Venous supply penis - cavernous bodies

A

Deep dorsal veins

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28
Q

Where do the deep dorsal veins of the penis drain into?

A

Prostatic venous plexus

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29
Q

Venous supply penis - skin/cutaneous tissue

A

Superficial dorsal veins

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30
Q

Innervation of the penis - nerve roots

A

S2-4

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31
Q

Sympathetic innervation of the penis

A

Dorsal nn of the penis (branch pudendal nn)

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32
Q

MALE Parasympathetic innervation of the penis

A

Periprostatic nn plexus

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33
Q

Role of testes (2)

A

Sperm production
Hormone synthesis

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34
Q

Role of epididymis

A

Storage sperm

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35
Q

Which testicle lies lower?

A

Left

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36
Q

What cells line the semineferous tubules?

A

Sertoli cells

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37
Q

Role Sertoli cells

A

Spermatozoa maturation

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38
Q

Role of interstitial tissue testes

A

Support semineferous tubules + produce testosterone

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39
Q

Route of spermatozoa from semineferous tubules to epididymis

A

semineferous tuubules –> rete testes –> efferent tubules –> epididymis

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40
Q

What covers the testes?

A

Tunica vaginalis

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41
Q

What fibrous structure protect the testicular parenchyma?

A

Tunica albuginea

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42
Q

3 parts of the epididymis

A

Head
Body
Tail

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43
Q

Nerve innervation testes

A

Testicular plexus (from renal/aortic plexi)

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44
Q

3 arterial supplies to testes

A

Testicular aa
Cremasteric aa
Aa to vas deferens

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45
Q

Origin testicular aa

A

Abdominal aorta

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46
Q

Origin cremasteric aa

A

Inferior epigastric aa

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47
Q

Origin aa to vas deferens

A

Inf vesical aa

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48
Q

VV drainage testes

A

Testicular vv from pampiniform pelxus

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49
Q

VV drainage testes

A

Testicular vv from pampiniform plexus

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50
Q

Drainage left testicular vv vs right testicular vv

A

Left –> L renal vv –> IVC
Right –> IVC

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51
Q

Lymphatic drainage testes

A

Lumbar + para-aortic nodes

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52
Q

Lymphatic drainage scrotum

A

Superficial inguinal nodes

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53
Q

Embryological origin scrotum

A

genital swellings

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54
Q

Which muscle in the scrotum causes it to wrinkle?

A

Dartos muscle

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55
Q

Why is it important for the dartos muscle to wrinkle the scrotum?

A

Decreases surface area –> reduces heat loss

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56
Q

arterial supply to scrotum

A

Anterior and posterior scrotal aa

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57
Q

Origin anterior scrotal atery

A

External pudenal artery

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58
Q

Origin posterior scrotal artery

A

Internal pudendal artery

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59
Q

Nerve supply anterolateral scrotum

A

Anterior scrotal nerve

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60
Q

what is the anterior scrotal nerve a branch of?

A

ilioinguinal

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61
Q

Nerve supply posterior scrotum

A

Posterior scrotal nerve

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62
Q

what is the posterior scrotal nerve a branch of?

A

Perineal branch of pudendal nerve

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63
Q

Lymphatic drainage scrotum

A

Superficial inguinal nodes

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64
Q

3 fascial coverings spermatic cord

A

External spermatic fascia
Cremasteric fascia
Internal spermatic fascia

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65
Q

What is the external spermatic fascia derived from?

A

deep subcutaneous fascia

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66
Q

What is the cremasteric fascia dervied from?

A

Internal oblique mm

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67
Q

What is the internal spermatic fascia derived from?

A

transverse fascalis fascia

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68
Q

afferent/sensory limb cremasteric reflex

A

Ilioinguinal nn

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69
Q

efferent/motor limb cremasteric reflex

A

genital branch GF nn

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70
Q

Contents spermatic cord (9)

A

3 aa - testicular, cremasteric, aa to vas deferens
pampiniform plexus
2 nn
genital branch GF
Autonomic

3 other
vas deferens
processus vaginalis
lymph vessels

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71
Q

journey of spermatozoa to the prostatic urethra

A

testes –>semineferous tubules –> rete testes –> efferent tubules –>epididymis –> vas deferens –> ampulla –> ejaculatory duct –> prostatic urethra

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72
Q

How many muscle layers in vas deferens

A

3

73
Q

What are the 3 layers of muscle in the vas deferens

A

inner - longitudinal SM
intermediate - circular SM
outer - longitudinal SM

74
Q

what is the inner muscle layer of the vas deferens lined with? (and their role)

A

microvilli
help sperm advance

75
Q

Course of vas deferens

A

continuous w/ epididymis
through inguinal canal as part of cord
moved down lateral pelvic wall close to ischial spine
turns medially between bladder + ureter –> posterior surface bladder
Ampulla + duct from semial vesicle –> ejaculatory duct

76
Q

Role of prostate gland

A

Secretes proteolytic enzymes into semen which break down clotting factors when ejaculating

77
Q

What is superior and inferior to the prostate gland?

A

Superior = external urethral sphincter
Inferior = bladder neck

78
Q

What is inferolateral to the prostate gland

A

Levator ani muscles

79
Q

What proportion of the prostate gland is gladular tissue?

A

⅔

80
Q

What proportion of the prostate gland is fibromuscular

A

1/3

81
Q

What are the 3 main zones of the prostate gland

A

Central zone
Transition zone
Peripheral zone

82
Q

how do central zone prostatic ducts differ from peripheral zone prostatic ducts?

A

Central are oblique - less reflux
Peripheral are vertical - more reflux

83
Q

What zone of the prostate do you feel on DRE

A

peripheral zone

84
Q

Which zone of the prostate surrounds the urethra?

A

transitional

85
Q

Which zone of the prostate typically undergoes BPH?

A

transitional

86
Q

Which zone of the prostate is most at risk of malignant change?

A

peripheral

87
Q

What is the 4th ‘zone’ of the prostae gland

A

Fibromuscular stroma

88
Q

What does the fibromuscular stroma of the prostate gland merge with?

A

Urogenital diaphragm

89
Q

arterial supply prostate

A

prostatic artery

90
Q

what is the prostatic artery a branch of?

A

Internal iliac

91
Q

venous supply prostate

A

prostatic venous plexus

92
Q

prostatic venous plexus drains into…

A

internal iliac vv

93
Q

nerve supply prostate

A

inferior hypogastric plexus

94
Q

Shape of bulbourethral glands

A

pea shaped

95
Q

where do the bulbourethral glands open into

A

spongy urethra

96
Q

Embryological origin bulbourethral glands

A

urogenital sinus

97
Q

function bulbourethral glands

A

produce mucus secretions containing glycoproteins aka pre cum
LUBRICATION + CLEAR OUT URETHRA + NEUTRALISE

98
Q

arterial supply bulbourethral glands

A

artery to bulb of penis

99
Q

nerve supply bulbourethral glands

A

hypogastric nn
pelvic nn (from pudendal nn)

100
Q

lymphatic drainage bulbourethral glands

A

internal/external iliac nodes

101
Q

shape seminal vesicles

A

5cm long, tubular

102
Q

function seminal vesicles

A

produce many of constituents semen

103
Q

where are the seminal vesicles

A

between bladder fundus and rectum

104
Q

what 2 structures separate the seminal vesicles from the rectum?

A

retrovesicle pouch
periprostatic fascia

105
Q

what is the mucosa of the seminal vesicles lined with?

A

pseudostratified columnar epithelium

106
Q

effect of testosterone on epithelium of seminal vesicles

A

makes taller

107
Q

which structures are derived embryologically from the mesonephric ducts (SEED)

A

S - Seminal glands
E - ejacualtory ducts
E - epididymis
D- ductos vas deferens

108
Q

What % of semen volume is from the seminal vesicles

A

70%

109
Q

constituents seminal fluid from vesicles (4)

A

alkaline fluid to neutralise
fructose for sperm energy
prostaglandins to suppress female immune response to sperm
clotting factors

110
Q

internal iliac artery branches (8)

A

obturator artery
superior vesical
inferior vesical
middle rectal
internal pudendal
lateral sacral
superior gluteal
inferior gluteal

111
Q

Draw internal iliac artery branches

A

DO IT!!!

112
Q

Which arteries supply the seminal vesicles? (2)

A

Inferior vesical aa
Middle rectal aa
FROM INTERNAL ILIAC AA

113
Q

Innervation seminal vesicles + how to remember

A

point and shoot
parasymp - erection (point)
symp - ejaculation - (shoot)

114
Q

LN drainage seminal vesicles

A

external and internal iliac LN

115
Q

urethra - lining

A

stratified columnar epithelium

116
Q

length male urethra

A

15-20cm

117
Q

What are the 3 parts of the male urethra

A

prostatic urethra
membranous urethra
penile/bulbous urethra

118
Q

Which part of the male urethra is the widest?

A

prostatic

119
Q

which part of the male urethra is the narrowest

A

membranous

120
Q

which ducts does the prostatic urethra receive? (2)

A

ejaculatory ducts
prostatic ducts

121
Q

aa supply prostatic urethra

A

inferior vesical aa

122
Q

LN drainage prostatic urethra

A

obturator + internal iliac LN

123
Q

what structure surrounds membranous urethra

A

external urethral sphincter

124
Q

aa supply membranous urethra

A

bulbourethral aa

125
Q

LN drainage membranous urethra

A

obturator + internal iliac LN

126
Q

which ducts are received in the bulbous urethra

A

bulbourethral glands

127
Q

what happens to the bulbar urethra in the glans and what does it become

A

dilates –> navicular fossa

128
Q

aa supply bulbar urethra

A

internal pudendal aa

129
Q

LN drainage bulbar urethra

A

superficial + deep inguinal LN

130
Q

nn supply urethra male

A

prostatic plexus

131
Q

length of female urethra

A

4cm

132
Q

route female urethra

A

neck of bladder –> through perineal membrane –> vesibule –> urethral orifice

133
Q

What 2 mucous glands sit either side of the urethral orifice in females + what are the homogenous with in men

A

Skene’s glands
homogenous with prostate

134
Q

aa/vv supply female urethra (3)

A

internal pudendal aa/vv
vaginal aa /vv
inferior vesical branch of vaginal aa/vv

135
Q

nn supply female urethra (3)

A

vesical plexus
pudendal nn
pelvic splanchnic (visceral afferents)

136
Q

proximal female urethra LN drainage

A

internal iliac

137
Q

distal female urethra LN drainage

A

superficial inguinal LN

138
Q

Role of bladder (2)

A

Temporary storage of urine
Assists in expulsion of urine

139
Q

typical maximum volume of bladder in a healthy adult

A

400-600mls

140
Q

Name of superior aspect of bladder

A

apex

141
Q

what connects the apex of the bladder to the umbilicus? what is the significance?

A

Median umbilical ligament
remnant of urachus

142
Q

shape of fundus of bladder and position

A

posterior
triangular shaped

143
Q

which part of the bladder is continous with the urethra?

A

neck

144
Q

trigone wall vs rest of bladder wall + why?

A

smooth walled
as developed from mesonephric ducts

145
Q

muscle of the bladder

A

destrusor muscle

146
Q

How does the detrusor muscle of the bladder maintain structural integrity when stretched?

A

its fibres are orientated in multiple directions

147
Q

what happens to the fibres of the detrusor muscle in outflow obstruction?

A

become hypertrophic

148
Q

what are the 2 sphincters in the urethra?

A

internal urethral sphincter
external urethral sphincter

149
Q

difference in males vs females internal urethral sphincter

A

males - circular smooth fibres - under autonomic control - prevent regurg
females - no muscle present

150
Q

internal vs external urethral sphincter - which is under voluntary control

A

external urethral sphincter

151
Q

aa supply bladder MALES

A

superior vesical aa
inferior vesical aa
(obturator + inf gluteal also supplement)

152
Q

aa supply bladder FEMALES

A

superior vesical aa
vaginal aa
(obturator + inf gluteal also supplement)

153
Q

vv drainage bladder

A

vesical venous plexus

154
Q

where does the vesical venous plexus drain into?

A

internal iliac veins

155
Q

lymphatic drainage superolateral bladder

A

external iliac LN

156
Q

lymphatic drainage neck + fundus bladder (3)

A

internal iliac
sacral
common iliac LN

157
Q

sympathetic nn for bladder + nn root

A

hypogastric nn T12-L2 - relaxes mm –> retention

158
Q

parasympathetic nn bladder + nn root

A

pelvic nn S2-4

159
Q

somatic nn bladder + nn root

A

pudendal nn S2-3
inn ext sphincter (voluntary control)

160
Q

How does bladder communicate with brain

A

sensory - afferent nn in bladder wall
signal need to urinate when bladder is full

161
Q

what is the bladder stretch reflex

A

primitive spinal reflex
micturition = response to stretch of bladder wall

162
Q

when do you lose bladder stretch reflex?

A

toilet training

163
Q

reflex arc of bladder stretch reflex

A

bladder fills –> stretch –> sensory nn transmit to SC –> parasymp nn (pelvic) –> contraction detrusor mm

164
Q

reflex bladder - SC transection level

A

Above T12

165
Q

Sx reflex bladder

A

bladder not aware of filling
constantly relaxed
spinal reflex present - empties as it fills

166
Q

flaccid bladder - SC transection level

A

Below T12

167
Q

Sx flaccid bladder

A

detrusor mm paralysed
no spinal reflex
bladder becomes abnormally distended –> overflow incontinence

168
Q

length of ureters

A

25cm

169
Q

embryological origin ureters

A

uteric bud from mesonephric duct

170
Q

course of ureters in abdomen

A

renal pelvis @ uteropelvic junction –> along ant psoas major –> cross bifurcation of common iliac aa at sacroiliac joint

171
Q

ureters in abdomen - peritoneal or retroperitoneal?

A

retroperitoneal

172
Q

course of ureters in pelvis

A

down lateral pelvic wall –> turn anteromedially at ischial spine –> pierce bladder obliquely

173
Q

aa supply - ureters in abdomen (3)

A

renal aa
testicular/ovarian aa
uteral branch of abdomen aorta

174
Q

aa supply - ureters in pelvis (2)

A

superior + inferior vesical aa

175
Q

aa to watch out for in terms of relation to ureters (3)

A

ovarian aa
uterine aa (water under the bridge) - vas deferens in males
superior vesical aa

176
Q

nn supply ureters (3)

A

renal plexus
testicular/ovarian plexus
hypogastric plexus

177
Q

which dermatome does referred pain from the ureters present at?

A

T11/12

178
Q

Another name for Pelvic Splanchnic Nerves?

A

nervi erigentes

179
Q

neumonic to remember layers of the scrotum

A

Some Damn Examiner Called It The Testes
Skin
Dartos mm
External Spermatic Fascia
Cremasteric fascia
Internal Spermatic Fascia
Tunica
Testes

MRCS A (36 decks)

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