Anatomy Practical 2 Flashcards
(42 cards)
1
Q
Where do the testes originally develop?
A
- high on posterior abdominal wall
- descend before birth through inguinal canal into anterior abdominal wall into scrotum
- carry vessels, ducts (vas deferens), nerves, lymphatics with them
2
Q
Where is the lymph drainage of the testes?
A
Para-aortic lymph nodes in abdomen
3
Q
What does the spermatic cord connect?
A
- pouch in scrotum and abdominal wall
4
Q
What is the tunica vaginalis?
A
Covers sides and anterior aspects of testis
- closed sac of peritoneum
- normally connection closes after testicular descent = fibrous remnant
5
Q
What is the tunica albuginea?
A
- interstitial tissue surrounding testis
6
Q
What produces the spermatozoa?
A
Seminiferous tubules of testes
- project to rete testis
7
Q
Features of epididymis
A
- single long coiled duct
- along side of testes
- efferent ductules/head
- true epididymis/body and tail
- spermatozoa acquire ability to move/stored here until ejaculation
- end continuous with vas deferens
8
Q
Features of ductus deferens
A
- long muscular duct
- transports spermatozoa from tail of epididymis to ejaculatory duct
- ascends as part of spermatic cord
- through inguinal canal
- behind bladder to prostate
9
Q
Features of inguinal canal
A
- area of junction between anterior abdominal wall and thigh
- weakened from development and diverticulum changes
10
Q
How does the processus vaginalis form?
A
- from initial high testis position in posterior abdominal wall passes through: - transversalis fascia - musculature of internal oblique - aponeurosis of external oblique (each gives covering layer)
11
Q
Why is a testes covering from the transversus abdominal muscle not acquired?
A
- outpouching passes under arching fibres of the muscle
12
Q
What is the gubernaculum?
A
Extends from inferior border of developing gonads to labioscrotal swellings
- allows descent of testes into scrotum
13
Q
What happens if the processus vaginalis does not obliterate?
A
- indicates end of development and happens when testes fully descended
- if not: potential weakness exists and inguinal hernia may develop
14
Q
What are the structures in the spermatic cord?
A
- ductus deferens
- artery to ductus deferens
- testicular artery
- pampiniform plexus of veins
- cremasteric artery and vein
- genital branch of genitofemoral nerve to cremaster muscle
- sympathetic and visceral afferent nerve fibres
- lymphatics
- remnants of processes vaginalis
15
Q
What is the inguinal canal?
A
- slit like passage above and parallel to inguinal ligament
- begins at DIR ends at SIR
- occupied by spermatic cord and ilio-inguinal nerve from lumbar plexus
16
Q
What fascia enclose the spermatic cord content below the SIR?
A
- internal spermatic fascia (deepest layer arising from transversalis fascia, margins attached to DIR)
- cremasteric fascia with cremaster muscle (from internal oblique)
- external spermatic fascia (most superficial layer covering spermatic cord, arising from aponeurosis of external oblique, attached to SIR margins)
17
Q
What is the significance of Hasselbach’s triangle with hernias?
A
- defines direct inguinal hernias
18
Q
What is vasectomy?
A
- method of sterilising males
- part of ductus deferens is ligated/excised through incision in superior scrotum
- ejaculatory fluid from seminal glands, prostate and bulbourethral glands contains no sperm
19
Q
What is the detrusor muscle?
A
- muscle of bladder wall
- becomes sphincter at bladder neck
- IUS
- contracts during ejaculation to prevent retrograde of ejaculation into bladder
20
Q
What are the seminal vesicles?
A
- 2 elongated structures
- between bladder and rectum
- superiorly oblique to prostate
- secrete thick alkaline fluid (fructose - sperm energy and coagulation agent - mix sperms)
21
Q
What is the arterial supply of the seminal vesicles?
A
- inferior vesicle and middle rectal arteries
22
Q
What are the anatomical relations of the prostate?
A
- base: neck of bladder
- apex: fascia on superior surface of urethral sphincter and deep perineal muscles
- muscular anterior surface: retropubic space and pubic symphysis
- posterior: ampulla of rectum
- inferolateral: levator ani
23
Q
What are the features of the prostate?
A
walnut sized gland
- glandular part 2/3
- fibromuscular part
- dense fibrous capsule = plexuses of prostatic nerves and veins
24
Q
What passes into the prostate?
A
- ejaculatory ducts
- anteroinferiorly
- into prostatic urethra: through 2 slit openings either side of prostatic utricle
25
What are the 4 parts of the urethra?
- pre-prostatic (IUS surrounds it) (through bladder neck)
- prostatic (ejaculatory ducts, prostatic utricle and sinuses open into) (descends through anterior prostate)
- membranous/intermediate (through deep perineal pouch) (EUS fibres surround and bulbourethral glands)
- spongy (through corpus spongiosum) (longest, mobile, bulbourethral glands open into proximal part)
26
What are the differences in symptoms of BPH and prostate cancer?
- same
| - prostate cancer: bone pain and haematuria, hypercalcaemia (spreads)
27
What is the treatment of prostate cancer?
- active surveillance (if low risk, monitor tumour for growth signs, monitor symptoms, serial PSA, physical exam, repeat biopsies, to avoid overtreatment as serious permanent side effects of treatment sometimes when tumour may not actually cause any problems)
- radial prostatectomy
- prostate brachytherapy
- external beam radiation therapy
- high intensity focused ultrasound
- chemotherapy
- oral therapeutic drugs
- cryosurgery
- hormonal therapy
28
What are the external genitalia attached to?
- roots anchored to bony margin of anterior half of pelvic outlet and thick fibrous perineal membrane
- consist of erectile (vascular) tissue and associated skeletal muscles
29
What is the innervation of the penis and perineurium?
- 2 hypogastric nerves formed from SHP separation at L5
- at pelvic level plexus contains symp, PS and visceral afferent fibres
- innervate pelvic viscera and erectile tissues of perineum
30
How is the IHP formed?
- by pelvic splanchnic nerves
- PS leave anterior rami of sacral spinal nerves from S2-S4
- innervate erectile tissue (vasodilatory, bladder constriction, erectile stimulation)
31
How do sympathetic fibres enter the plexus?
- from upper sacral parts of sympathetic trunk (T10-L2)
- contract SM in IUS and IAS
- cause SM contraction associated with reproductive tract
- move semen and secretion from epididymis and glands into urethra during ejaculation
32
What is the mucous membrane of the upper half of the anal canal derived from?
- hindgut
- upper 2/3
- columnar epithelium
- IMA and vein
- superior rectal artery lymph drainage
33
What is the mucous membrane of the lower anal canal derived from?
- strat. squamous epithelium
- no anal columns
- inferior rectal branch of pudendal nerve
- inferior rectal artery
- lymph to superficial inguinal nodes
34
What does the pectinate line represent?
- dentate line
| - hindgut-proctodeum junction
35
Which anal sphincter does the puborectalis blend with?
- external sphincter
36
What is the anorectal ring?
- internal sphincter and puborectalis muscles and external sphincter
- felt on exam
37
What are prolapsed haemorrhoids?
- lump around anus need to pushed back or return to anal canal following bowel movement
- some unable = painful
- generally haemorrhoids not painful
38
How are haemorrhoids treated?
- increase fibre and fluids in diet
- avoid straining/spending long on toilet
- avoids constipation and reduces anal canal pressure
- rubber band ligation
- hemorrhoidectomy
39
What is perianal haematoma?
- small painful lump at edge of anus ruptured blood vessel after passing stool, resolves itself
40
What is a peri-anal abscess?
- associated with fever, unwell, glands surrounding anal canal blocked and infected with bacteria
41
What is a fistula-in-ano?
Connection between inside of anal canal and skin around it
| - result of previous abscess
42
What is an anal fissure?
- small tear in skin lining anus
| - resolve without surgery
