...genital sytem

Question 1

Differentiate btw male genetalia.

Answer 1

internal genetalia:

• testes + epidydimis
• ductus deferens + funiculus spermaticus
• accessory sex glands: prostate + gl. vesiculosa + gl. bulbourethralis (COWPER)

​_{testes + epidydimus belong to int. genetalia bc they originate from abd. cavity, descended w/ peritoneal covering (cavitas serosa scroti) into scrotum}

​external genetalia:

• penis
• urethra
• scrotum

Question 2

Briefly explain the function of the male genetalia.

Answer 2

1. testes produce spermatozoa (∽ 74d)
2. transported to epididymis → maturation (∽ 8-17d)
3. pass through ductus deferens to urethra, sperms mixed with secretions of accessory sex glands
4. leave body cavity through urethra

Question 3

Describe the macroscopic structure of the testes.

Answer 3

• sup./inf. pole
• epididymis
  
  • 3 parts: caput, corpus, cauda
  • fixed to sup. pole by lig. epididymis sup./inf.
  • ​becomes ductus deferens at inf. pole
• covered by capsule = tunica albuginea

Question 4

Briefly describe the microscopic structure of the testes.

What is their function?

Answer 4

seperated by septula testis into lobuli testes
→ contain seminiferous tubules

⇒ spermatozoa are produced in wall of seminiferous tubules

• in interstitium btw seminiferous tubules: LEYDIG cells → produce testosterone

Question 5

Which remnants of embryological structures can be found in mature testes?

Answer 5

appendix testis:

• 3-4 mm wide at sup. pole
• remnant of MÜLLERIAN duct

​appendix epididymis:

• at sup. pole of head of epidiymis
• remnant of WOLFFIAN duct

Question 6

Which vessels supply/drain the testes?

Innervation?

Answer 6

supply:

• a. testicularis (from aorta pars abdominalis)
  _{orginate from lumbar region, follow during descencus}

​drainage:

• plexus pampiniformis → unite in canalis inguinalis
  → v. testicularis dextra → v. cava inf.
  → v. testicularis sin. → v. renalis sin.

innervation:

• symph: plexus testicularis (rr. from plexus intermesentericus/renalis)

Question 7

What is a varicocele and what might be the cause?

Answer 7

e. g. kidney tumors can grow into v. renalis → cause constriction of left v. testicularis →
* *dilation of plexus pampiniforis/vv. testicularis** → changes in blood circulation → reduced spermatic production

Question 8

List the coats of the testes/scrotum from the innermost to the outermost layer.

Answer 8

1. tunica vaginalis = mesorchium
   
   • ​​epiorchium
   • periorchium
2. fascia spermatica int.
3. m. cremaster
4. fascia spermatica ext.
5. scrotum - tunica DARTOS
6. scrotum - skin

Question 9

1 - 5

Which structures are formed by #2

No #4.

Another name for #3 and #5.

Answer 9

1) testes + epididymis
2) peritoneum → proc. vaginalis + deep ing. ring
3) epiorchium (visceral layer of tunica vaginalis)
5) periorchium (parietal layer of tunica vaginalis)

Question 10

6 - 10

Answer 10

6) fascia transversalis abdominis
7) m. transv. abd.
8) m. obliq. int.
9) m. obliq. ext.
10) m. cremaster (prod. by #7 + #8)

Question 11

11 - 16

Answer 11

11) fascia spermatica ext.
12) scrotum
13) tunica DARTOS
14) skin
15) cavitas serosa scroti
16) fascia spermatica int.

Question 12

What is the function of tunica dartos?

Answer 12

movement of scrotal skin → temperature regulation (optimally 2 °C below body temperature)

Question 13

Which structure can be found on the dorsal aspect in the middle of the scrotum?

Answer 13

raphe scroti = continuation of raphe perinei

Question 14

What might be the reason for an innate inguinal hernia?

Answer 14

no obliteration of proc. vaginalis peritonei that forms tunica vaginalis testis

Question 15

What is a hydrocele testis?

Answer 15

accumulation of fluid in cavitas serosa scroti → balloon-like enlargement

Question 16

What can cause a testicular torsion and what are possible consequences?

Answer 16

thin mesorchium → testicular torsion → strangulation of blood vessels → irreversible damage to testes

Question 17

What causes the cremaster reflex?

Answer 17

petting of inner surface of thigh → r. femoralis of n. genitofemoralis + cutaneous rr. of n. obturatorius → reflectory contraction of m. cremaster

Question 18

What is cryptorchidism?

Answer 18

non-descent of testis into scrotum → stay in abd. cavity → high body temperature → damage to parenchyme of testes → no spermatic production

Question 19

Which vessels supply/drain the scrotum?

Innervation?

Answer 19

supply:

• coats of testes: a. cremasterica (a. epigastrica inf.)
• scrotum: a. pudenda int.

​drainage:

• v. pudenda ext. → v. saphena magna
• v. pudenda int. → v. iliaca int.

innervation:

• rr. scrotales of n. ilioinguinalis/n. pudendus

Question 20

Which structures are connected by vas deferens?

How long is it, how thick?

Relate the structure of its wall to its function.

Answer 20

connects epididymis + urethra

• 35 - 40cm long
• 3mm thick

thick muscular layer → emission of sperms

Question 21

What are the parts of vas deferens?

Answer 21

1. pars epididymica ductus deferentis in inner aspect of epididymis
2. pars funiculi spermatici in spermatic cord
3. pars inguinalis in canalis inguinalis
4. pars pelvica in lesser pelvis

then:

• ampulla ductus deferentis before entering prostate
• ductus ejaculatorius in prostate
• opens into colliculus seminalis of urethra

Question 22

Which vessels supply/drain vas deferens?

Innervation?

Answer 22

supply:

• a. ductus deferentis (from a. umbilicalis)

drainage:

• plexus pampiniformis (cf. scrotal supply/innervation)
• ​*innervation:
• symph: plexus hypogastricus inf.

Question 23

What are the layers of funiculus spermaticus?

Answer 23

from innermost to outermost

1. fascia spermatica int
2. m. cremaster
3. fascia spermatica ext.

Question 24

What are the contents of funiculus spermaticus?

Answer 24

• vas deferens
  
  • a. ductus deferentis
  • plexus pampiniformis
• 2 aa. testiculares
• r. genitalis of n. genitofemoralis
• parasymph. fibers of plexus testicularis
• lymph vessels

_{<strong>​</strong><em>cf. histology flashcards</em>}

Question 25

Which structures accompany funiculus spermaticus?

Answer 25

* **n. ilioinguinalis** * **a. cremasterica**

Question 26

What are the 3 accessory sex glands in males? What is their common function?

Answer 26

* paired **gl. vesiculosa** * paired **gl. bulbourethralis (COWPER)** * **prostate** **​**⇒ produce chief constituent of ejaculate

Question 27

Where is gl. vesiculosa (= seminal vesical) located? How big is it? How much of the ejaculate is produced by it?

Answer 27

**behind bladder, lateral to ampulla ductus deferentis** * 5cm long * 1cm wide * 1cm thick ⇒ produce 50-80% of ejaculate

Question 28

How is gl. vesiculosa examined?

Answer 28

palpable via rectum

Question 29

Which vessels supply/drain gl. vesiculosa?

Answer 29

_supply:_ * **a. vesicalis inf.** * **a. rectalis med.** * **a. ductus deferentis** **​**_drainage:_ * **plexus venosus vesicalis/prostaticus** ​_innervation:_ * **plexus hypogastricus inf.** **__​_**<sub>only difference btw supply/drainage innervation of gl. vesiculosa/prostate:
- gl. vesiculosa: a. ductus deferentis (since more cran.)
- prostate: a. pudenda int. (since more caud.)</sub>

Question 30

What are the boundaries of the prostate? How big is it, weight? How much of the ejaculate is produced by it?

Answer 30

⇒ produces 15 - 30% of the ejaculate containing e.g. acid phosphatase * 3cm long, 4cm wide, 2cm thick * 20g _boundaries:_ * *ant:* **lig. puboprostaticum** to pubic bone * *post:* **fascia rectoprostatica (DENONVILLIER)** to rectum * *cran:* **base** attaches to bladder * *caud:* **apex** is sitting on pelvic diaphragm

Question 31

Divide the prostate into zones.

Answer 31

* **periurethral zone** around urethra * **anteromedial zone** anterior part of prostate (no glands) * **central zone** encloses ductus ejaculatorii * **peripheral zone** main mass laterally * **transitional zone** btw central/peripheral zone

Question 32

Why are the prostatic zones clinically relevant?

Answer 32

* **benign prostate hyperplasia** develops mainly in central/transitional zone (occurs in 50% of all men over 50) * **prostate carcinomas** develop mainly in peripheral zone ⇒ impairs micturition due to occlusion of urethra

Question 33

Which vessels supply/drain the prostate? Innervation?

Answer 33

_supply:_ * **a. rectalis med.** * **a. vesicalis inf.** * **a. pudenda int.** ​_drainage:_ * **plexus vensosus vesicalis/prostaticus** **​**_innervation:_ * **plexus hypogastricus inf.** _​_<sub>only difference btw supply/drainage innervation of gl. vesiculosa/prostate:
- gl. vesiculosa: a. ductus deferentis (since more cran.)
- prostate: a. pudenda int. (since more caud.)</sub>

Question 34

Where are gll. bulbourethrales located? Another name?

Answer 34

**COWPER glands** on urogenital diaphragm ⇒ lubricate pars spongiosa of urethra

Question 35

Which 2 structures attach the penis to the body?

Answer 35

* **lig. fundiforme penis** hooks around penis * **lig. suspensorium penis** attaches at dorsum ⇒ both attach it to abd. wall / symphysis pubica _{MNEMONIC: fundiforme = forms a fundus, "holds" penis}

Question 36

Where are the 3 constrictions of the penis?

Answer 36

* **ostium urethrea int.** * **pars membranacea** * **ostium urethrae ext.**

Question 37

Which gll. can be found in urethra pars spongiosa? What is their function?

Answer 37

gll. urethrales (**LITTRE**) ⇒ produce a colloid secretion containing glycosaminoglycans **protecting the epithelium** against urine

Question 38

Which structures form ductus ejaculatorius?

Answer 38

**ductus deferens** (from epididymis) + **ductus excretorius** (from gl. vesiculosa)

Question 39

#1 - 5

Answer 39

1) urethra pars intramuralis 2) urethra pars prostatica 3) urethra pars membranacea 4) urethra pars spongiosa 5) ostium ureteris

Question 40

#6 - 10 Another name for #10.

Answer 40

6) trigonum vesicae 7) colliculus seminalis 8) prostate 9) ductuli prostatici 10) gll. bulbourethrales (**COWPER**)

Question 41

#11 - 15

Answer 41

11) crura of penis 12) ductus gll. bulbourothrales 13) corpus cavernosum 14) glans penis 15) preputium

Question 42

#16 - 20

Answer 42

16) fossa navicularis 17) ostium urethrae ext. 18) corpus bulbospongiosum 19) corona glandis 20) crista urethralis

Question 43

#21 - 23 Another name for #23.

Answer 43

21) openings of ductuli ejacultorii 22) ostium urethrae int. 23) openings of gll. urethrales (**LITTRE**)

Question 44

How do you call the condition when the preputium cannot be fully retracted?

Answer 44

**phimosis**

Question 45

Which vessels supply/drain the penis and the accompanied part of the urethra? Innervation?

Answer 45

_supply:_ * **a. dorsalis penis** → skin, preputium, glans * **a. profunda penis** → aa. helicinae → corpora cavernosa * **a. bulbi penis** (from. a. prof. penis) → aa. urethrales → urethra, corpus spongiosum _drainage:_ * **v. dorsalis profunda** → plexus venosus vesicalis/prostaticus * **2 v. dorsalis superficialis** → v. pudenda ext. → v. saphena magna * **v. bulbi penis** → v. dorsalis prof. _innervation:_ * *sens:* **n. dorsalis penis** (from n. pudendus) * **plexus hypogastricus inf.**

Question 46

#1 - 5

Answer 46

1) corpus cavernosum 2) corpus spongiosum 3) urethra 4) septum penis 5) tunica albuginea

Question 47

#6 - 10 Another name for #6.

Answer 47

6) fascia penis (**BUCK**) 7) subcutis 8) cutis 9) a. prof. penis 10) v. dorsalis prof. penis

Question 48

#11 - 13

Answer 48

11) v. dorsalis sup. penis 12) a. dorsalis penis 13) a. bulbi penis

Question 49

Explain the function of Viagra®.

Answer 49

Viagra® = **inhibitor of phosphodiesterase** → slower decomposition of cGMP

Question 50

Explain the process of erection.

Answer 50

1. **stimulation** of erection center in S3 2. **parasymp. innervation** releases acteylcholine 3. endothelial cells of a. helicinae/corpora cavernosa **release** **NO** → diffuses into smooth m. 4. activates guanylate cyclase → **production of cGMP** 5. relaxation of smooth m. of corpora cavernosa → **vasodilation** of aa. helicinae in corpora cavernosa 6. filled corpora cause **compression of v. dorsalis prof. penis** against tunica albuginea → no venous drainage 7. **erection** due to increasing pressure in corpora cavernosa (∽ 10x → 1,200 mmHg)

Question 51

What is priapism? What might be a cause?

Answer 51

condition where penis **doesn't return to its flaccid state** e.g some types of leucemia can cause problems in the blood circulation of the penis

Question 52

Which nn. cause the emission of semen from vas deferens into the urethra?

Answer 52

**symph. ejaculation center** in **L2/3**

Question 53

What is responsible for ejaculation?

Answer 53

rhythmic contraction of **m. bulbospongiosus** _{1) parasymp. erection centers in S3→ erection
2) symp. emission centers in L2/3 → emission
3) n. pudendus → ejaculation}

Question 54

Differentiate btw 2 types of potency.

Answer 54

**potentia coeundi** = being able to have sex **potentia generundi** = being able to reproduce ⇒ if both: fertile

Question 55

Which structures belong to the external female genetalia? Another name? What is their common function?

Answer 55

_also: **vulva**_ * **mons pubis** * **labia majora pudendi** * **labia minora pudendi** * **clitoris** * **vestibulum vaginae** * **gll. vestibulares majores/minores** ⇒ protection, sexual arousal, lubrication

Question 56

Which structures belong to the internal female genetalia? What is their function?

Answer 56

* **vagina** * **uterus** * **ovaries** * **tubae uterinae** ​⇒ reproduction, birth

Question 57

Which structures are referred to as adnexa?

Answer 57

**tubae uterinae** + **ovaries**

Question 58

Explain the structure of the clitoris.

Answer 58

_similar to penis_ * 2 **corpora cavernosa** covered by fascia clitoridis + **m. ischiocavernosus** * **​**form crura + corpus + glans clitoridis * seperated by a septum * attached to symphysis pubica by **lig. suspensorium clitoridis**

Question 59

What do labia majora/minora consist of? What are they continuous with?

Answer 59

_labia majora pudendi:_ * **adipose tissue + venous plexuses** * contain **ligg. teretes uteri** *(cf. female perineum)* * continuous w/ commissurae labiorum *​*_labia minora pudendi:_ * **conn. tissue + sebaceous glands** * continuous w/ frenulum clitoridis → preputium clitoridis, frenulum labiorum

Question 60

#1 - 5

Answer 60

1) mons pubis 2) labium majus pudendi 3) labium minus pudendi 4) commissura labiorum ant. 5) commissura labiorum post.

Question 61

#6 - 10

Answer 61

6) frenulum labiorum pudendi 7) carunculae hymenales 8) rugae vaginales 9) crista urethralis vaginae 10) ostium urethrae ext.

Question 62

#11 - 14 Another name for #14.

Answer 62

11) frenulum clitoridis 12) glans clitoridis 13) preputium clitoridis 14) projection of gl. vestibularis maj. (**BARTHOLIN**)

Question 63

Which structures open into vestibulum vaginae?

Answer 63

**urethra** + **vagina** + **BARTHOLIN gll.**

Question 64

How do you call the opening to the vagina?

Answer 64

ostium/**introitus vaginae**

Question 65

Which vessels supply/drain the vulva? Innervation?

Answer 65

_supply:_ * **a. pudenda int.** * rr. labiales post. → labia minora * a. bulbi vestibuli → bulbus vestibuli * a. profunda clitoridis → crus clitoridis * a. dorsalis clitoridis → glans clitoridis * rr. labiales ant. → labia majora _drainage:_ * **v. pudenda int.** * **​**corpus/glans → v. dorsalis prof. clitoridis → plexus venosus vesicalis * **v. pudenda ext.** * **​​​**v. dorsalis sup. clitoridis * vv. labiales ant. _​innervation:_ * *sens:* nn. labiales ant from **n. ilioinguinalis**, nn. labiales post./n. dorsalis clit. from **n. pudendus** * **plexus hypogastricus inf.**

Question 66

How do you call the part of the vagina surrounding the entrance to the uterus? Why is it clinically relevant?

Answer 66

**fornix vaginae** * pars ant. * pars. post. * pars lat. ⇒ excavatio rectuoterina (**DOUGLAS pouch**) is palpable via pars post. of fornix

Question 67

Which vessels supply/drain the vagina? Innervation?

Answer 67

_supply:_ * **a. vaginalis** (from a. iliaca int.) * rr. vaginales (from **a. uterina**) * **a. vesicalis inf.** * **a. rectalis med.** _​drainage:_ * **plexus venosus vagina** → v. iliaca int. _innervation:_ * *sens:* **n. pudendus** * **plexus uterovaginalis**

Question 68

Explain the peritoneal relation of the different parts of the uterus, tuba uterina, and ovary.

Answer 68

corpus = **intraperitoneal** cervix = **subperitoneal** tuba uterina **= intraperitoneal** ovary = **intraperitoneal**

Question 69

Differentiate btw peri-, para-, meso-, myo- and endometrium.

Answer 69

* **mesometrium** = part of lig. latum that attaches at margo uteri * **parametrium** = fibrous structure connecting cervix to bladder, sacrum, wall of pelvis, inguinal canal * **perimetrium** = peritoneum covering rest of uterus * **mesometrium** = muscular layer of uterus * **endometrium** = mucous membrane of uterus

Question 70

#1 - 5 Another name for #2. What is the difference btw #4 and #5 besides their location?

Answer 70

1) excavatio vesicouterina 2) excavatio rectouterina (**DOUGLAS pouch**) 3) corpus uteri 4) cervix uteri - portio supravaginalis → attached to parametrium = **paracervix** 5) cervix uteri - portio vaginalis

Question 71

#6 - 10 #6 is pointing at the innermost layer of the uterus. Another name for #10.

Answer 71

6) endometrium 7) myometrium 8) perimetrium 9) fornix post. vaginae 10) ostium anatomicum uteri int. (= **internal os**)

Question 72

#11 - 15 Another name for #11, 13, 15.

Answer 72

11) ostium uteri (= **external os**) 12) cavitas uteri 13) spatium retropubicum (**RETZIUS**) 14) isthmus uteri 15) facies intestinalis/post.

Question 73

#16 - β Another name for #16. ⍺ and β are pointing at the angles.

Answer 73

16) facies vesicalis/ant. ⍺) angle of anteflexio β) angle of anteversio

Question 74

#1 - 5 #3 - 5 are pointing at the purple structures.

Answer 74

1) lig. ovarii proprium 2) lig. teres uteri 3) mesometrium 4) mesovarium 5) mesosalpinx

Question 75

#6 - 10

Answer 75

6) lig. latum 7) lig. suspensorium ovarii 8) lig. cardinale 9) cervix portio supravaginalis 10) cervix portio vaginalis

Question 76

#11 - 15 Another name for #11.

Answer 76

11) pars uterina tubae (= intramural part) 12) isthumus tubae uterinae 13) ampulla tubae uterinae 14) infundibulum tubae uterinae 15) fimbriae

Question 77

#16 - 20

Answer 77

16) ureter 17) a./v. iliaca int. 18) a./v. uterina 19) r. vaginalis a. ut. 20) r. helicanus a. ut.

Question 78

#21 - 24

Answer 78

21) r. tubarius a. ut. 22) r. ovarius a. ut. 23) a./v. ovarica 24) plexus ovaricus

Question 79

Describe the course of lig. teres uteri.

Answer 79

tubal angle → **canalis inguinalis** → labium majus

Question 80

Which structure(s) mainly support(s) the uterus?

Answer 80

**pelvic diaphragm**, not ligg.

Question 81

Which vessels supply/drain the uterus? Innervation?

Answer 81

_supply:_ * rr. helicini of **a. uterina** _drainage:_ * **vv. uterinae** → plexus venosus uterinus → vv. iliacae int. _innervation:_ * **plexus uterovaginalis** (from plexus hypogastricus inf.) (= **FRANKENHÄUSER's ganglion)**

Question 82

What can happen in case of a tubal pregnancy? What is a common cause?

Answer 82

**inflammational stenosis in tuba** → embryo remains in tuba → grows → **rupture + critical bleedings**

Question 83

Where else does the tuba open into?

Answer 83

peritoneal cavity via **ostium abdominale**

Question 84

Which vessels supply/drain the tuba uterina? Innervation?

Answer 84

_supply:_ * **a. ovarica** * r. tubarius (from **a. uterina**) _drainage:_ * **plexus venosus uterinus** → v. iliaca int. _innervation:_ * **plexus ovaricus** * **plexus hypogastricus**

Question 85

How are the superior/inferior pole, and ant. and post. border of the ovary called? Does anything attach?

Answer 85

* superior pole = **extremitas tubaria,** lig. suspsensorium ovarii attached * inferior pole = **extremitas uterina**, lig. ovarii proprium attached * ant. border = **margo liber** * post. border = **margo mesovaricus,** mesovarium attached

Question 86

Which vessels/nerves lie adjacent to the ovary? Why are they clinically relevant?

Answer 86

* **ureter** dorsally * **a. umbilicalis** caudally * **a./n. obturatorius** caudally ⇒ inflammation of ovary can **radiate pain** up to the inner surface of the thigh

Question 87

Which vessels supply/drain the ovary? Innervation?

Answer 87

_supply:_ * **a. ovarica** (via lig. suspensorium ovarii) * r. ovaricus of **a. uterina** _drainage:_ * **vv. ovaricae** * → left into v. renalis * → right into v. cava inf. _​innervation:_ * _​_**plexus ovaricus**

Question 88

Explain the 4 phases of sexual reaction.

Answer 88

1. **phase of sexual arousal:** * stimulation of clitoris * **​​**gl. vestibulares lubricate introitus vag. * corpora cav. + glans swell due to **vasocongestio**n (filling w/ venous blood) + **increase of muscle tone** 2. **plateau phase:** * widening of sup. portion of vagina * orgasmic platform (due to vasocongestion) in inf. portion of vagina 3. **orgasmic phase:** * **​​​​**contraction of orgasmic platform, uterus + pelvic diaphragm 4. **phase of dissolution:** * **​​**organs return to initial state