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1
Q

Which structures make up the vulva

A

Mons pubis
Labia majora and minora
Vestibule
Bartholin’s glands
Clitoris

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2
Q

What is the mons pubis

A

Fat pad anterior to the pubic symphysis

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3
Q

What is the embryological origin of the labia majora

A

Labioscrotal swellings

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4
Q

Where does the labia minora extend to

A

Anteriorly - fusing to form the hood of the clitoris
Posteriorly - either side of the vaginal opening

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5
Q

What is the female vestibule

A

The area enclosed by the labia minora
Contains the opening of the vagina and urethra

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6
Q

What is the arterial supply of the vulva

A

Paired internal and external pudendal arteries

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7
Q

Where does lymph from the vulva drain

A

Superficial inguinal nodes

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8
Q

How is the sensory innervation of the vulva divide

A

Anterior and posterior

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9
Q

What innervates the anterior vulva

A

Ilioinguinal nerve
Genital branch of the genitofemoral nerve

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10
Q

What innervate the posterior vulva

A

Pudendal nerve
Posterior cutaneous nerve of the thigh

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11
Q

What are the anatomical relations of the vagina

A

Anterior - bladder and urethra
Posterior - Rectouterine pouch, rectum, anal canal
Lateral - ureters, levator ani muscle

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12
Q

What are the 4 layers of the vagina - superficial to deep

A

Stratified squamous epithelium
Elastic lamina propria
Fibromuscular layer
Adventitia

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13
Q

What is the arterial supply of the vagina

A

Uterine and vaginal arteries
Branches of the internal iliac arteries

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14
Q

What is the venous drainage of the vagina

A

Into the internal iliacs via the uterine vein

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15
Q

What is the lymphatic drainage of the vagina

A

Superior - to external iliac nodes
Middle - to internal iliac nodes
Inferior - to superficial inguinal nodes

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16
Q

Which part of the vagina receives somatic innervation and via which nerve

A

Inferior 1/5
Via the deep perineal nerve (branch of the pudendal)

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17
Q

What are the 2 regions of the cervix

A

Ectocervix
Endocervix

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18
Q

What is the ectocervix

A

Portion of the cervix that projects into the vagina
Lined by stratified sqaumous non keratinising epithelium
Opening is the external os

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19
Q

What is the endocervix

A

‘inner cervix’
Lined by mucus secreting simple columnar epithelium
Ends with the internal os which is where the uterine cavity begins

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20
Q

What is the blood supply to the uterus

A

The uterine artery and uterine veins

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21
Q

Where are the uterine veins found

A

In a plexus in the broad ligament

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22
Q

What is the lymphatic drainage of the uterus

A

Iliac, sacral, aortic, inguinal lymph nodes

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23
Q

What are the 3 parts of the uterus

A

Fundus
Body
Cervix

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24
Q

What is the normal position of the uterus

A

Anteverted and anteflexed
Immediately posterosuperior to the bladder
Anterior to the rectum

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25
What are the 3 layers of the uterus
Peritoneum Myometrium Endometrium
26
What are the 2 layers of endometrium
Deep stratum basalis Superficial stratum functionalis
27
Which layer of the endometrium is shed during mensturation
Superficial stratum functionalis
28
Which 5 ligaments are associated with the uterus
Broad ligament Round ligament Ovarian ligament Cardinal ligament Uterosacral ligament
29
Describe the broad ligament of the uterus
Double layer of peritoneum attaching the side of the uterus to the pelvis Acts a mesentery for the uterus
30
Describe the round ligament
A remnant of the gubernaculum from the uterine horns to the labia majora via the inguinal canal
31
What does the round ligament maintain
Maintains the anteverted position of the uterus
32
What does the ovarian ligament connect
Joins the ovaries to the uterus
33
What is the cardinal ligament
Located at the base of the broad ligament Extends from the cervix to the lateral pelvic walls
34
What is contained in the cardinal ligament
Uterine artery and vein
35
Describe the uterosacral ligament
Extends from the cervix to the sacrum Provides support to the uterus
36
Which structures of the Fallopian tubes facilitate them to assist in the transfer and transport of the ovum from the ovary, to the uterus.
Inner mucosa - ciliated columnar epithelial cell and peg cells, waft the ovum towards the uterus Smooth muscle layer
37
What are the 4 parts of the fallopian tube
Fimbriae Infundibulum Ampulla Isthmus
38
What is the blood supply to the Fallopian tubes
Arterial supply - uterine and ovarian arteries. Venous drainage is via the uterine and ovarian veins.
39
What is the lymphatic drainage of the fallopian tubes
iliac, sacral and aortic lymph nodes
40
Where are the ovaries attached to
Posterior surface of the broad ligament of the uterus by the mesovarium
41
What is the mesovarium
A fold of peritoneum, continuous with the outer surface of the ovaries
42
What are the ligaments associated associated to the ovaries
Suspensory ligament of the ovary Ligament of ovary
43
What is the suspensory ligament of the ovary
Fold of peritoneum extending from the mesovarium to the pelvic wall Contains neurovascular structures.
44
What is the ligament of ovary
Extends to the ovary to the fundus of the uterus Continues from the uterus to the connective tissue of the labium majus, as the round ligament of uterus
45
What is the blood supply of the ovary
Paired ovarian arteries - abdominal aorta Drained by the ovarian veins - IVC
46
What is the lymph drainage of the ovaries
To the para-aortic nodes
47
Which neurovascular structures are contained in the suspensory ligament of the ovary
ovarian artery, ovarian vein, ovarian nerve plexus and lymphatic vessels
48
Where does the cardinal ligament extend between
The side of the cervix and the lateral fornix of the vagina. They provide an extensive attachment on the lateral pelvic wall at the level of the ischial spines.
49
What are the 3 parts of the penis
Root Body Glans
50
Describe the root of the penis
Proximal fixed part of the penis Located in the superficial perineal pouch of the pelvic floor
51
What does the root of the penis contain
3 erectile tissues - 2 crura and a bulb of the penis 2 muscles - ischiocavernous, bulbospongiosus
52
What composes the body of the penis
3 cylinders of erectile tissue - 2 corpus cavernosa and the corpus spongiosum
53
What forms the glans penis
Distal expansion of the corpus spongiosum
54
Where does the male urethra run in the penis and why is this physiologically important
Corpus spongiosum It fills to a reduced pressure as to not occlude the urethra
55
What is the function of the 2x ischiocavernous muscles
Surrounds the left and right crura of the penis Contracts to force blood from the cavernous spaces into the crura of the corpora cavernosa
56
What is the function of the 2x bulbospongiosum muscles
It contracts to empty the spongy urethra of any residual semen and urine The anterior fibres also aid in maintaining erection by increasing the pressure in the bulb of the penis
57
What are the fascial coverings of the penis
External fascia of Colles Deep fascia of the penis - Bucks Tunica albuginea
58
Which 2 ligaments support the root of the penis
Suspensory ligament Fundiform ligament
59
Describe the suspensory ligament of the penis
Condensation of the deep fascia Connects the erectile bodies of the penis to the pubic symphysis
60
Describe the fungiform ligament of the penis
Condensation of the abdominal subcutaneous tissue Runs down from the linea alba and surrounds the penis like a sling
61
What is the arterial supply of the penis and what are they branches of
Dorsal arteries of the penis Deep arteries of the penis Bulbourethral artery All branches of the pudendal artery
62
What is the venous drainage of the penis
Paired veins Deep dorsal vein of the penis Superficial dorsal veins
63
What provides sensory and somatic innervation to the penis
Pudendal nerve
64
Describe the structure of a testicle
They consist of a series of lobules, each containing seminiferous tubules supported by interstitial tissue. The seminiferous tubules are lined by Sertoli cells that aid the maturation process of the spermatozoa. In the interstitial tissue lie the Leydig cells that are responsible for testosterone production.
65
What are the parts of the testicle
Head Body Tail
66
Where is the origin of the vas deferens
The tail of the testicle
67
What are the vascular supply of the testicles
Paired testicular arteries - from the aorta Branches of the cremasteric artery Artery of the vans deferens
68
The artery of the cremasteric artery is a branch of which artery
Inferior epigastric artery
69
The artery of the vans deferens is a branch of which artery
Inferior vesical artery
70
What is the venous drainage of the penis
Via the pampiniform plexus
71
Where does the right testicular vein drain
Directly into IVC
72
Where does the left testicular vein drain
Left renal vein
73
What is the lymphatic drainage of the testes
Lumbar nodes Para aortic nodes
74
What is contained within the scrotum
Testes Epididymis Spermatic cord
75
What are the layers of the scrotum
Skin Superficial “Dartos” fascia External spermatic fascia Cremaster muscle Internal spermatic fascia Tunica vaginalis
76
What is the blood supply of the scrotum
Anterior and posterior scrotal arteries
77
The anterior scrotal artery is a branch of which artery
External pudendal artery
78
The posterior scrotal artery is a branch of which artery
Internal pudendal artery
79
The scrotal veins drain into which main vein
Internal pudendal vein
80
What is the nervous innervation of the anterior scrotum
Genital branch of the genitofemoral nerve Ilioinguinal nerve
81
What is the nervous innervation of the posterior scrotum
Perineal branches of the pudendal nerve Posterior femoral cutaneous nerve
82
What is the lymphatic drainage of the scrotum
Superficial inguinal nodes
83
The spermatic cord enters the scrotum via which structure
Superficial inguinal ring
84
What are the fascial coverings of the spermatic cord
External spermatic fascia Cremaster muscle and fascia Internal spermatic fascia
85
The creamasteric fascia is derived from what
External oblique muscle and fascia
86
The internal spermatic fascia is derived from what
Transversalis fascia
87
What is the afferent and efferent fibres of the cremasteric reflex
Afferent (sensory) - ilioinguinal nerve Efferent (motor) - genital branch of the genitofemoral nerve
88
What are the contents of the spermatic cord
Testicular artery Cremasteric artery and vein Artery to the vas deferens Pampiniform plexus of the testicular veins Genital branch of the genitofemoral nerves Vas deferens Processus vaginalis Lymph vessels
89
What is the vas deferens
Straight, thick muscular tube that conveys sperm from the epididymis to the ampulla and eventually, to the ejaculatory duct
90
What is the anatomical course of the vas deferens
Continuous with the tail of the epididymis Travels through the inguinal canal as part of the spermatic cord Moves down the lateral pelvic wall Travels down the posterior aspect of the bladder Inferior narrow part of the ampulla joins the duct from the seminal vesicle to form the ejaculatory duct.
91
Where is the prostate
prostate is positioned inferiorly to the neck of the bladder superiorly to the external urethral sphincter, with the levator ani muscle lying inferolaterally to the gland.
92
What is posterior to the rectum
Ampulla of the rectum
93
The prostatic ducts open into which part of the urethra
Prostatic urethra
94
What are the 3 zones of the prostate
Central zone Peripheral zone Transitional zone
95
Describe the central zone of the prostate
Surrounds ejaculatory ducts 25% of prostate volume
96
Describe the transitional zone of the prostate
Located centrally and surrounds the urethra 5-10% of normal prostate volume
97
Describe the peripheral zone of the prostate
Main body of gland - 65%
98
In which zone of the prostate does BPH occur
Transitional
99
In which zone of the prostate does cancer develop
Peripheral
100
How do the glands of the peripheral zone of the prostate differ to those of the central zone
Gland in peripheral zone - vertical, therefore reflux of urine can occur Glands in central zone - oblique - therefore reflux of urine cannot occur
101
What is the blood supply of the prostate
Prostatic arteries
102
What are the prostatic arteries derived from
Internal iliac arteries
103
What is the venous drainage of the prostate
Prostatic venous plexus draining into the internal iliac veins
104
Where are the bulbourethral glands found
Posterolateral to the membranous urethra
105
What are Cowper's glands
The bulbourethral glands
106
Which part of the male urethra do the bulbourethral glands open into
The spongy urethra
107
What is the blood supply of the bulbourethral glands
Arteries to the bulb of the penis
108
What is the lymphatic drainage of the bulbourethral glands
Internal and external iliac nodes
109
Where are the seminal vesicles found
Between the bladder fundus and the rectum
110
The seminal vesicles combine with what structure to form the ejaculatory duct
Vas deferens
111
In males what do the mesonephric ducts form
Seminal vesicles Ejaculatory ducts Epididymis Vas deferens
112
What is the 'point and shoot phrase' representative of
Erection (pointing) - parasympathetic innervation Ejaculation (shooting) - sympathetic innervation
113
What is the lymphatic drainage of the seminal vesicles
External and internal iliac nodes

MRCS (17 decks)

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