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REPRO > Lecture 1: The male reproductive system > Flashcards

Lecture 1: The male reproductive system Flashcards

1
Q

How do you examine the prostate gland?

A

Rectal examination

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2
Q

What envelopes the prostatic urethra?

A

Prostate gland. As the prostate in men enlarges as they get older, it puts pressure on the urethra causing symptoms e.g. getting up in night to wee

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3
Q

What structures does the urethra pass through?

A
  • prostate gland
  • pelvic floor
  • erectile tissue of penis
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4
Q

Where does spermatogenesis occur?

A

Epithelial lining of the seminiferous tubule

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5
Q

Where do the seminiferous tubules drain into?

A

Rete testis (hilum), then the efferent tubules and then the head of the epididymus (here fluid is absorbed and sperm are concentrated)

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6
Q

What does the epididymus go on to form?

A

Ductus (vas) deferens

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7
Q

What is the arrangement of the seminiferous tubules?

A

Compartments separated by connective tissue (connective tissue septae).
The entirety of the seminiferous tubule is surrounded by tunica albuginea (white coat)

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8
Q

What is the testes surrounded by?

A

Serous membrane: tunica vaginalis (as the testes descend they pull with them some peritoneum)
-has a visceral layer and parietal layer

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9
Q

What is a hydrocoele?

A

When the tunica vaginalis is filled with fluid

-transilluminate

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10
Q

What cells form the seminiferous tubule?

A

Sertoli cells- these support the developing sperm and remove excess cytoplasm from the sperm to make it streamline

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11
Q

Where do the sperm come from?

A

Germinal epithelium where stem cells are found to make sperm

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12
Q

Where are leydig cells found and what are their function?

A

Tissue between the seminiferous tubule

  • synthesise hormones e.g. testosterone- derived from cholesterol and therefore these cells have large volumes of SER
  • large nuclei
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13
Q

What is the blood supply to the testes?

A

As the testes decended their neurovascular supply stretched

  • right/left tesicular artery (from abdominal aorta), inferior to superior mesenteric artery and superior to inferior mesenteric artery
  • right/left testicular vein (right joins the IVC, left joins the left renal vein)
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14
Q

Which testes sits lower than the other?

A

Left sits lower than the right

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15
Q

What happens to the left testicular vein?

A

It twists around the left testicular artery and forms the pampiniform plexus. This allows heat exchange to make the hot arterial blood cooler, as the optimum temp for spermatogenesis is 35 degrees: counter-current exchange system

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16
Q

What is the lymphatic drainage of the testes?

A

Drain lymph to the para-aortic lymph nodes

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17
Q

What is the lymphatic drainage of the scrotal skin?

A

Drain lymph into the superficial inguinal lymph nodes

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18
Q

Can testes get twisted?

A

Yes-surgical emergency
Torsion
-veins get occluded
-this causes increased capillary pressure, which compresses the arteries
-cut off blood supply to testes and it can die/necrose

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19
Q

How can you become infertile due to testicular torsion?

A

Testes have ‘immune priviledge’- isn’t detected by the immune system
But if one testes is necrosed, the immune system will now be able to see the other teste and attack the remaining one= infertility

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20
Q

What anatomy predisposes people to testicular torsion?

A

Bell-clapper deformity (failure of normal posterior anchoring leaves testes free to swing/rotate in tunica vaginalis)

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21
Q

Can testes swap sides?

A

No, there is a scrotal septum

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22
Q

Where does the testes have to travel from?

A

Inside the abdomen to the scrotum, but the testes don’t penetrate the abdominal wall, it evaginates it. This forms the wall of the spermatic cord (spermatic fascia)

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23
Q

What connects the bottom of the scrotum and inferior part of the testes?

A

Gubernaculum-guides testes down

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24
Q

What is the spermatic cord?

A

Everything enclosed within the spermatic fascia formed by the abdominal wall

25
Q

What is within the spermatic cord?

A

3 FASCIAL LAYERS-derive from the 3 layers of abdominal wall
-external spermatic fascia (from external oblique)
-cremasteric fascia (from internal oblique)
-internal spermatic fascia ( from transversalis fascia)
3 ARTERIES
-testicular artery
-cremasteric artery
-artery to vas deferens
3 VEINS
-testicular vein (forms paminiform plexus round the artery)
-cremaster vein
-vein to vas deferens
3 NERVES
-genital branch of the gentiofemoral nerve (lumbar plexus to cremaster muscle)
-vas deferens receives a rich sympathetic innervation
-ilioinguinal nerve (sits outside the cord)
VAS DEFERENS
LYMPHATICS: carry lymph from testes to para-aortic lymph nodes
MAY SEE OBLITERATED PROCESSUS VAGINALIS

26
Q

What is the difference between the fascial layers in the spermatic cord?

A

External and internal spermatic fascia are fibrous, whereas the cremasteric fascia contains muscle fibres: making the cremaster muscle

27
Q

What is the function of the cremaster muscle?

A

Regulate the height at which the testes sit in the scrotum

28
Q

What is the connection between the abdomen and scrotum which disappears as you grow?

A

In baby there is a peritoneal connection between the abdomen and the scrotum: processus vaginalis.
This is obliterated when you grow

29
Q

What are the important pelvic relations of the vas deferens?

A
  • ureter passes underneath the vas (ureter:water under the bridge: vas): males
  • ureter passes underneath the uterine artery: females
30
Q

What is a vasectomy?

A

Surgical procedure for male sterilisation

31
Q

What structures join with the vas deferens to form the ejacultory duct?

A

Seminal vesicles. The 2 ejaculatory ducts pass through the prostate gland to enter the urethra.

32
Q

What three tubes pass through the prostate gland?

A
  • 2 ejaculatory ducts near the back

- urethra in the centre

33
Q

Why is the prostate a bad design?

A

Because the prostatic urethra is in the centre of the prostate, and the prostate can enlarge causing compression of the urethra. The urethra is enclosed by the transitional zone

34
Q

What zone of the prostate enlarges in benign prostatic hyperplasia?

A

Transitional zone

35
Q

What zone of the prostate do cancers tend to be found?

A

Superficial/peripheral areas of the gland, so doesn’t always affect urinary flow

36
Q

How much does the testes contribute to the volume of the ejaculate?

A

10%

37
Q

Where does the majority of the ejaculatory volume come from?

A 
Seminal vesicle (65%)
Prostate (25%)
38
Q

Why is male catherterisation hard?

A

There are bends in the urethra so we have to try and straighten the bends out: straighten penis for first bend, then pull down for the bend below the pelvic floor

39
Q

What are the functions of the penis?

A
  • expulsion of urine via urethra
  • deposition of sperm into the female genital tract
  • removal of competitors sperm (shape of penis makes it like a plunger)
  • attraction of mates
40
Q

What is the structure of the penis?

A

3 major blocks of erectile tissue
Face of ET
-corpus cavernosum (eyes)
-urethra within corpus spongiosum (mouth)

41
Q

How do you get an erection?

A

Vasodilatation in erectile tissue: caused by parasympathetic stimulation
To terminate erection, you get vasoconstriction caused by sympathetic stimulation

42
Q

Is the penis attached to bone?

A

Yes, suspensory ligaments hold the penis to the pubic symphysis. These can be cut so the penis in flaccid state lies lower and appears bigger. However it doesn’t change length of penis in erect position as the corpus cavernosum is attached to bone.

43
Q

What is the penis homologous to in females?

A

Clitoris

44
Q

What is the white membrane surrounding the erectile tissue in the penis?

A

Tunica albuginea

  • provides shape of penis in erection
  • has collagen fibres running in transverse and longitudinal planes to provide support
45
Q

What is the blood supply of the penis?

A

Internal iliac artery > internal pudendal artery > arteries to penis

46
Q

What is a fractured penis?

A

Rupture of tunica albuginea, blood from corpus cavernosum will leak out and you get a huge haematoma

47
Q

What drains the scrotum (veins/lymph)?

A
  • scrotal veins

- superficial inguinal nodes

48
Q

What drains the prostate gland (veins/lymph)?

A
  • prostatic venous plexus > internal iliac vein

- internal iliac/sacral nodes

49
Q

What is the lymphatic drainage of vas deferens and seminal vesicles?

A

Internal and external iliac nodes

50
Q

How is the epididymus divided and where does final sperm maturation occur?

A

Head, body, tail

-sperm maturation occurs in the head

51
Q

Which nodes will a testicular tumour metastasise to first?

A

Para-aortic nodes

52
Q

Function of seminal vesicles?

A
  • secrete fructose, alkaline fluid, coagulating factor
  • nutrition for sperm, neutralise acidic vagina, coagulate semen after ejaculation
  • 65% of ejaculatory fluid
53
Q

Function of bulbulourethral glands?

A

Mucus like secretion which reduces friction and neutralises acid of urine in urethra prior to ejaculation
-minimal % of ejaculatory fluid

54
Q

What is the crura of the penis?

A

Proximal projections of the corpus cavernosum

55
Q

What is the bulb of the penis?

A

Proximal expansion of the corpus spongiosum

56
Q

What is a varicocoele?

A

If venous drainage of the testes is blocked/obstructed, the veins can enlarge forming a varicocoele

57
Q

What is the optimum temperature for spermatogenesis?

A

Outside the body at 35 degrees

58
Q

What joins the ejaculatory duct at the prostate?

A

Vas deferens

59
Q

What is the inguinal canal?

A

As testes decend they took layers of abdominal wall forming the inguinal canal which extends inferiorly and medially passing structures from abdomen to external genetalia
(common point of hernias)

REPRO (18 decks)

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