Male Internal Genetalia

Question 1

Describe the prostate’s location with relation to ther viscera.

The seminal vesicle?

Answer 1

• Prostate
  
  • inferior to bladder
  • sitting on the pelvic floor
• Seminal vesicle
  
  • between bladder and rectum

Question 2

Identify the peritoneal coverings within the pelvis

Answer 2

• Visceral peritoneum
  
  • superior surface of bladder
  • base of bladder
  • anterior surface of rectum

Question 3

Identify the fascia indicated in blue, yellow, pink, green, & red

What is the purpose of this fascia?

The blacked out words are not important

Answer 3

• Blue: transversalis fascia (membranous)
  
  • external to peritoneum
• Yellow: Parietal pelvic fascia (membranous)
  
  • continuation of transversalis fascia
• Pink: Visceral pelvic fascia (membranous)
  
  • reflection of parietal pelvic fascia
• Green: endopelvic fat/fascia
  
  • fatty, loose areolar tissue
• Red: extraperitoneal fat/fascia
  
  • continuous with endopelvic fat/fascia

Reinforce position of the organs relative to the pelvis itself & pelvic floor – also thickenings called ligaments or septa provide support

Question 4

Identify the features indicated in the provided image

Answer 4

Question 5

Why is it important that the ureters pierce the bladder at an oblique angle?

Answer 5

as the bladder fills, it will cauase the ureters to get pinched off so you don’t have any retrograde flow of urine from ureters to kidneys

Question 6

Does the ductus deferens cross anterior or posterior to the ureters?

Answer 6

anterior

Question 7

What is ejaculate?

What percent of ejaculate is produced by the seminal vesicles?

Where do they converge?

Answer 7

ejaculate is the fluid for male ejaculation

70%

seminal vesicles converge at the prostate on the neck of the bladder

Question 8

Identify the indicated features of the provided image

Answer 8

Question 9

The rectoprostatic fascia is between what two structures?

It is specific portion of what pelvic fascia?

Answer 9

between the rectum & prostate

endopelvic fascia

Question 10

Identify the indicated features of the provided image

Answer 10

Question 11

Identify the features of the male urethra

Answer 11

Question 12

What are the 3 components of the female external urethral sphincter?

How are they impacted during child birth?

Answer 12

• External sphincter
  
  • sphincter urethrae muscle
    
    • (proper aspect)
  • compressor urethrea muscle urethrovaginal muscle
    
    • (across anterior surface of urethra attaching pubis bone to pubis bone )
  • urethrovaginal muscle
    
    • (wraps around a urethra and a vagina)
    • especially impacted by vaginal birth
• Urethra is fused to anterior wall of the vagina – so, if the vagina is stretched out as in the case with vaginal child birth, this can affect the position of the urethra & function of these muscles

Question 13

What is the least distensible portion of the male urethra?

Answer 13

membranous portion

Question 14

Identify the sections of the male urethra

What is the average length of the male urethra?

Answer 14

20 cm

mostly dependent on the length of the penis

Question 15

Identify the indicated components of the prostatic urethra

Answer 15

Question 16

Describe the process of ejaculation

Answer 16

• During ejaculation, the internal urethral sphincter will be contracted to not let ejaculate up into the bladder
• External urethral sphincter will also be closed
• smooth muscle will be pumping ejaculate into the prostatic urethra (extensible)
  
  • pushing out on prostatic glandular tissue
  • postatic capsule is not distensible, so will increase pressure
• Open external sphincter, and pressurized ejaculate will come shooting out of the system

Question 17

Where is the membranous urethra found?

It is surrounded by what structures?

What landmark signifies the end of the membranous urethra?

Answer 17

• Membranous urethra found at pelvic diaphragm (urogenital diaphragm)
• surrounded by external urethral sphinceter
• surrounded by deep perineal pouch
• boundary is the perineal membrane (inferior aspect of the pelvic diaphragm)

Question 18

What it the name of the urethra located within the penis?

What can can be tricky about the portion when performin a catheterization

Answer 18

spongy urethra

~90 degree turn at bulb of penis

Additonally, immdiately above the spongy urethra is the membranous urethra, which is non-distensible which poses an additional challenge

Question 19

What substance is produced by the bulbourethral glands?

What is the purpose of this substance?

Answer 19

preejculate

ducts open into the superior spongy urethra

Purpose: cleanse the urethra of residual urine that may negatively impact sperm

Question 20

What is the function of urethral glands?

Where are the located?

Answer 20

active at all times

mucous secreting galnds protecting the epithelial lining of the urethra from the acidic aspect of urine

Throughout the length of the spongy urethra

Question 21

Identify the indicated aspects of the spongy urethra

Answer 21

Question 22

What is the lacuna magna?

It can make what procedure challenging?

Answer 22

flap of mucous fold within the navicular fossa

usually on dorsum (roof) of navicular fossa

can be detrimental to attempt at catheterization

Question 23

Describe the path of the ductus deferens

Answer 23

From epididymis of testes

up to spermadic cord through the inquinal canal

into the abdomen through the deep inguinal ring

running just lateal to the inferior epigastric artery across the external iliac vessels into the pelvis

when it reaches the base of the bladder it crosses the ureter anteriorly

on the posterior of the bladder it has a dilation called the ampulla then it will constrict back to a narrow duct

the ductus deferens duct along with the seminal vesicle duct form the ejaculatory duct

Question 25

Where is the seminal vesicle located?

Answer 25

base of the bladder anterior to the rectovesical / rectoprostatic fascia

Question 26

Describe the pathway of the ejaculatory ducts

Answer 26

through more central portion of prostate to enter failry low on the postatic urethra (below the utricle) as a paired set

Question 27

Identify the indicated features of the prostate

Answer 27

Question 28

Whta is BPH and in what zones is it most likely to occur?

Answer 28

1. Benign Prostatic Hypertrophy (BPH) * general growth of the prostate that can occlude urine outpu * Zones * Central * Transitional * Periurethral * High up on periurethral & central zones about where you have the uvula, so extra growth here can cause the uvula to distend & occlude urine outflow

Question 29

What prostatic zone is most prone to carcinoma?

Answer 29

peripheral zone

Question 30

Identify the features of the prostate depicted in black, blue & green Ignore the black boxes

Answer 30

Question 31

What structures are supplied by the Superior Vesicle Artery? Inferior Vesicel Artery? Artery to ductus deferens? What large vessel do each of these arteries arise from?

Answer 31

* Internal Iliac Artery * Umbilical Artery * **Superior Vesicle Artery** * **​**superior aspect of urinary bladder * some ductus deferens * Internal Iliac Artery * **Infeior Vesicle Artery** * **​**inferior aspect of urinary bladder * prostate * seminla vesicles * some ductus deferens * prostatic and membranous urethrae * Internal Iliac * Inferior Vesicle Artery OR Superior Vesicle Artery * **​Artery to Ductus Deferens** * **​**ductus deferens * ejaculatory ducts

Question 32

What arterial branches supply the prostate? Where do these branches come from?

Answer 32

prostatic branches usually from inferior vesicle

Question 33

Describe the route of venous drainage for the male genetalia. Where are the venous plexuses located? What are extra concerns to be aware of with relation to this pathway?

Answer 33

* Plexus of veins surrounding the bladder, vesicle, and prostate * internal iliac * inferior vena cava * internal vertebral venous plexus (outside dura) - vlaveles veing system * \*\* think about prostate cancer metastasizing to the vertebral column * Penis has deep doral vein that will interface with prostatic plexus * \*\* think prostate cancer can metastasize & infections can spread

Question 34

Lymphatics from the external iliac of the bladder drain where? Rest of the bladder through penis? Spongy urethra?

Answer 34

* Superior aspect bladder * external iliac * Rest of bladder through penis * internal iliac * Distal spongy urethra * deep inguinal

Question 35

What nerves make up the prostatic plexus of nerves?

Answer 35

From inferior hypogastric plexus Parasympathetic (S2-S4) & Sympathetic Splanchnic (from sympathetic chain) Nerves