The ductus (vas) deferens emerges from the deep inguinal ring and passes posteriorly along the lateral pelvic wall behind what?
the bladder
The dilated terminal end of the ductus deferens is what?
the ampulla
The duct of the seminal vesicle joins the ductus deferens to form what?
the ejaculatory duct
Are the seminal vesicles located laterally or medially to the ampulla?
laterally
What does the seminal vesicle add to the semen? Why?
fructose and alkaline fluid - to maintain mobility of the sperm
fructose for ATP production and alkaline fluid to neutralize acid in female reproductive tract
The ejaculatory ducts descend obliquely thorugh what to enter the urethra?
the prostate gland
Describe the prostate gland. WHat does it sit on?
It’s a fibromuscular glandular organ that lies inferior to the neck of the bladder resting on the UG diaphragm
What does the prostate do?
it secretes prostatic fluid, a milky alkaline fluid that neutralizes the acidity of the vaginal tract and liquefies the semen via the enzyme PSA, increasing the lifespan of sperm and improving changes for pregnancy
Describe how prostate cancer can metastasize?
metastasis can occur via connections to the valveless vertebral venous plexus or to the internal iliac veins - most common to bone, lungs and liver
Contraction of what under sympathetic conrtol prevents urination during ejaculation?
internal urethral sphincter (within the prostate)
What are the 4 zone classifications of the prostate?
central
transitional
peripheral
anterior fibromuscular
What cells are involved in BPH?
stromal and epithelial tissues of the periurethral and transitional zones
Can BPH be palated from the rectum?
no
How does BPH present?
difficult but frequent urination, nocturia, decreased/intermittent force of stram or ssensation of incomplete bladder emptying
The peipheral zone is mostly glandular tissue which is why it has the highest incidence of what?
prostatic carcinoma
Can prostatic carcinoma be palpated by digital rectal exam?
yes
What are the three parts of the male urethra?
prostatic - in prostate
membranous - in UG diaphragm
penile (spongy) - within the penis
What are the divisions of the uterus?
fundus
body
cervix
What are the two openings of the cervical canal?
internal ox
external ox
What are the layers of the uterine wall?
endometrium inside
myometrium is the thick smooth muscle
perimetrium is periteonum and connective tissue
What are the two potential normal positions of the uterus?
anteversion - when the axis of the cervix forms a 90 degree angle with the axis of the vagina
anteflexion - uterus is bent forward on itself at the level of the internal oss to form a 170 degree angle
What position is the uterus in when the bladder is full?
retroverted - inclined posteriorly
The body of the uterus is enclosed between layers of what?
broad ligament
The close relationship between what two structures is very improtant during hysterectomy?
ureter to the uterine artery
the utereter crosses under the uterine artery near the cervix so can be easily injured during hysterectomy
What part of the broad ligament surrounds the fallopian tubes?
mesosalpinx
The fallopian tubes connect the uterine cavity to what?
the periteonal cavity
What is the name for the lateral extremity of the fallopian tube with fimbriae over the ovary?
infundibulum
a
What is widest and longest part of the fallopian tube?
ampulla
What’s the narrowst part of the fallopian tube?
isthmus
What part of the fallopian tube pierces the uterine wall?
hte intramural portion
Where in the fallopian tube does fertilization usually occur?
ampulla
What part of the broad ligament attaches the ovary?
the mesovarium
What is the depression on the lateral pelvic wall in which the ovaries lie?
the ovarian fossa
What structure transmits vessels and lymphatics to the ovary from the abdomen?
the suspensory ligament of the ovary
What is the round ligament of the ovary a remnant of? what does it do?
upper part of the gubernaculum
attaches the ovary to the uterus
What covers the ovary? Why is this special?
it’s not covered by peritoneum like the rest - it’s covered by germinal epithelium which is continuous with the mesothelium of the mesovarium.
Where is the ovum actually expelled?
into the peritoneal cavity
THe vaginal lumen surrounding the cervix is divided into what four regions?
the fornices: anterior, posterior, right lateral and left lateral
At hat angle is the vagina usually oriented?
40-60 degrees from the horizontal
What is culdocentesis?
when a long thin needle is inserted through the posterior fornix of the vagina into the rectouterine pouch to determine the presence of fluid
The vessels of the pelvis are mostly branches of what artery?
the internal iliac artery
THe anterior division of the internal iliac artery gives off what branches?
umbilical artery obturator artery uterine artery vaginal or inferior vesical artery middle rectal internal pudendal inferior gluteal
What does the umbilical artery become?
th medial umbilical ligament
What ar ethe three branches of the posterior division of the internal iliac artery?
superior gluteal
lateral sacral
iliolumbar
What line indicates the embryonic division between the part of the gut derived from hindgut and that derived from proctodeum?
pectinate line
What are the shallow depression in the endothelium where anal glands open?
crypts
What are the folks of endothelium overlying superior rectal veins?
anal columns
What is the site where the rectum turns back to become the anal canal, consisting of fiber sof the puborectalis, itnernal and external anal sphicnters?
anoretal ring
What are the folds of muscular layer sand mucosa that are not true valves but do slow the movement of feces through the rectum?
transverse rectal folds
What innervates the internal anal sphincter?
autonomic fibers
What innervates the external anal sphincter?
rectal branches of the pudendal nerve