Peritoneal Pouches, male vs female
- Vesicorectal puch
- Rectouterine (pouch of douglas)
** peritoneum = continuous in pelvic cavity
Importance of pouches?
These are bad for fluid poolage. Mainly Pouch of Douglas.
Perineal Muscles and attachment?
Ischiocavernosus: attached along ishiopubic rami, aids erections (M) or tense vagina (F)
Bulbospongiosus: attached post to perineal body
Bulbospongiosus variation in M:F
Males: attached in midline aids erection + ejaculation
Females: split either side of vaginal orifice clitoral erection + feeling of orgasm
Erectile Tissue: Crus (M/F variation)
Crus of Clitoris (F): contributes to body of clitoris
Crus of Penis (M): Becomes corpus cavernosa of penis x2
Erectile Tissue: Bulb (M/F variation)
Bulb of Vestibule (F): contributes to head of clitoris and surrounding vaginal orifice
Bulb of Penis (M): becomes corpus spongiosum and glans penis (1x contains urethra)
All the vasculature of the penis comes from ________ and these are
All the vasculature of the penis comes from branches of the internal pudendal (a/v) and these are 2x dorsal arteries and 2x deep arteries and 1x deep dorsal vein in centre
What is the scrotum, what does it contain?
An out-pouching of skin from the abdominal wall. Contains testes, epididymus and lower ends of spermatic cords (inner layers of scrotum same as spermatic cord).
Superficial fascia continuous with abdominal scarpa's fascia but fat is replaced with smooth muscle "dartos fascia"
"dartos fascia": continues posteriorly with deep fascia of perineum "colles fascia"
Blood supply to scrotum is?
Internal and external Pudendal arteries
Function of cremaster muscle?
Raises the testes/scrotum up for warmth + protection
How is the scrotum formed?
Formed when guburnaculum (mesenchymal cells) are condensed, goes thorugh inguinal canal, and is connected to testes. This drags testes through, which drags the peritoneum with it.
Now all sits in the scrotum with remenant of gubernaculum, and connection to peritoneum severes off 'tunica vaginalis'
Testes, function, structure and special temperature?
Tough fibrous capsule surrounds each testis. "tunica albuginea"
3 degrees cooler then abdomen -heat exchange between a/v in dartos and cremaster aid cooling
Each lobule has 1-3 seminiferous tubules → rete testis →((via efferent ductules))→ epididymus (sperm storage) → vas deferens
- Muscular tube that travels in spermatic cord, through inguinal canal
- Joins duct from seminal vesicle to form ejaculatory duct → into prostate to meet urethra
Explain the Vas Deferens course to the prostate.
- Enters the body cavity lateral to inf. epigastric artery
- Crosses over external iliac vessels, passing medially towards prostate
- Passes overtop of ureter to join seminal vesicles and form ED "water under the bridge"
What are the seminal vesicles?
Horn structures either side posterior to bladder and sup. to prostate.
~5cm long but uncoil to 10-15cm.
Secrete liquid component of semen "fructose".
What is the prostate gland? What's it's supply?
Inferior to bladder, secretes proteolytic enzymes and acid phosphatase.
Contains Prostatic urethra and ejaculatory duct.
Supplied by: branches of the Internal Iliac artery (internal pudendal, middle rectal and inferior vesical arteries)
Veins: Deep dorsal of penis -- plexus -- internal iliac
What is 'Prostatic Enlargement'?
Affects all or part of the prostate, may be benign or malignant. (most men >+50yrs get.
Can press up into bladder → incontinence
What is the lymphatics of the male gentilia overall, and what are the special exceptions to know about?
All eventually drain to iliac nodes.
- Testes: aortic nodes at root of testicular artery @L2
- Skin of penis and wall of scrotum: SF inguinal nodes
- Glans Penis: Deep inguinal and iliac nodes
Fornix: recess where vagina meets cervix
Angles of the uterus
Anteversion and anteflexion flips the uterus forward so it rests on the bladder, for extra support.
(you can have retroflexed)
Broad Ligament of the uterus
As the peritoneum sweeps over the uterus it forms the broad ligament that can be subdivided.
Mesosalpinx: over uterine tube
Mesovarium: over ovary
Mesometrium: over general structure
Meso = double fold
Ureter passes under the ______?
Ureter passes under the uterine artery.
"water under the bridge"
Ligaments of the ovaries
Ligament of the Ovary: remenant of the gubernaculum
Suspensory Ligament of the ovary: ovary → body wall, where the suspensory vessels run through.
Function, supply and innervation of the ovaries?
Function: ova + hormone prodution
Arterial Supply: Ovarian artery - (abd. aorta @L2)
Venous drainage: Ovarian vein (IVC on right, left renal vein on left)
Nerve: ovarian plexus
External Female Gentialia
Vestibule: enclosed by labia minora, contains opening of urethra/vagina and vestibular glands
Clitoris: Contains erectile tissue (corresponds to male penis)
Lymphatic drainange of uterus
Everything but ovary and uterine tubes drains to iliac nodes.
Ovary + uterine tubes: aortic nodes at root of ovarian artery
Responsible for mucus secretion.
Posterior/lateral to vagina opening.
In SF pouch (not deep like in males)
Cyst 'blockage' → infection