From what structure does the scrotum arise?
Labioscrotal folds
What are the contents of the scrotum?
Hint: 3
Testis
Epididymis
1st part of the spermatic cord
What surrounds the testis?
Tunica vaginalis
What encloses the testis?
Tunica albuginea
What separates the testis into lobules?
Fibrous septae
Within which structure do the gonads develop?
Mesonephric ridge
During their descent, what do the testis cross over?
The inguinal canal
Approximately how long does the descent of the testis last?
From week 7 to month 9
How are the testis supplied with blood and what is the artery a branch of?
Testicular artery - abdominal aorta
Describe the venous drainage of the testis
R testicular vein - branch of IVC
L testicular vein - branch of L renal vein
What is the epididymis?
A highly convoluted duct behind the testis
What and how does the epididymis connect to?
Seminiferous tubules via efferent ductules and the rete testis
What are the seminiferous tubules?
The site of meiosis of the spermatozoa
What is the spermatic cord?
A strucutre running to and from the testis containing neurovasculature and ducts
From where does the spermatic cord arise?
The deep inguninal ring lateral to the inferior epigastric vessels
At which point does the spermatic cord terminate?
Posterior border of the testis
What are the neurovascular contents of the spermatic cord?
Hint: 5
Testicular artery Cremasteric artery Artery to vas defrens Panpiniform plexus Genital branch of genitofemoral nerve
What are the non-neurovascular contents of the spermatic cord?
Hint: 3
Vas defrens
Lymphatics
Processus vaginalis
What are the coverings of the spermatic cord?
Hint: 3
External spermatic fascia - aponeurosis of external oblique
Creamsteric muscle and fascia - internal oblique and transversalis
Internal spermatic fascia - transversalis fascia
Name the four scrotum related -ocoele’s
Hydrocoele
Haematocoele
Varicocoele
Spermatocoela
What are hydrocoele and haematocoele
Hydrocoele - serous fluid in tunica vaginalis
Haematocoele - blood in tunica vaginalis
What is varicocoele?
Varicosities of the panpiniform plexus
What is spermatocoele and what is it also known as?
Retention cyst within epididymis - Epididymal cyst
What is epididymitis?
Inflammation of the epididymis
What is testicular torsion?
Twisting of the spermatic cord - usually just above the upper pole
Why is testicular torsion a medical emergency?
There is risk of necrosis of the testis - (plus it must be agony)
What is the difference in lymphatic drainage between the testis and the scrotum?
Testis - paraaortic nodes
Scrotum - superficial inguinal nodes
What is the vas deferens?
The duct that conveys sperm from the testicles to the urethra
Briefly describe the course of the vas deferens?
Hint: 4
Ascends through the spermatic cord
Traverses the inguinal canal
Passes between bladder and ureter
Opens into ejaculatory tract
What are the seminal vesicles?
Diverticulum of the vas deferens between the bladder and the rectum
What is the function of the seminal vesicles?
Produce secretions making up 70-80% of the volume of the ejaculate
What does the duct of the seminal vessicles combine with? What does it form?
Vas deferens
The ejaculatory duct
What are the improtant anatomical relationships involving the prostate?
Hint: 4
Base - neck of bladder
Apex - urethral sphincter
Muscular anterior surface - urethral sphincter
Posterior - ampulla of rectum
What are the two zones of the prostate and what structures do they adjoin?
Central - urethra
Peripheral - rectum
What does benign hyperplasia of the middle lobule of the prostate gland cause?
Hint: 3
Dysuria
Nocturia
Urgency
Via what routes and to which destinations do prostatic malignancies travel?
Lymphatic - internal iliac & sacral nodes
Venous - internal vertebral plexus to vertebrae & brain
What are the three parts of the penis?
Root, body , glans
What are the three internal structures of the penis?
Pair of corpora cavernosa dorsally (fill with blood) Corpus spongiosum (contains the urethra)
What is the arterial supply to the penis?
Branches of the internal pudendal artery
What is the internal pudendal itself a branch of?
Anterior division of internal iliac artery
What are the two main structures of the male perineum?
Bulbospongiosum
Ischiocavernosus
What are the functions of the bulbospongiosum?
Hint: 2
Aids in expulsion of the last drops of urine
Helps maintain erection
What is the function of the ischiocavernosus?
Compresses veins to maintain erection
What is the perineum?
The area between the anus and the scrotum in men or vulva in women
Name the parts of the male urethra
Hint: 4
Pre-prostatic
Prostatic
Membranous
Spongy
Which part of the male urethra is least distensible?
Membranous
What is the promontory of the sacrum?
The anterior superior edge of the 1st sacral vertebra
Name the six features of a gynecoid pelvis
Hint: Really Sounds Interesting, Well, Well done, 90 Points
Round inlet Straight side walls Ischial spines not too prominent Well-rounded greater sciatic notch Well-curved sacrum Sub-pubic arch >90 degrees
Describe the difference between the true and false pelvis
False - greater pelvis, no obstetric relevance
True - lesser pelvis forming solid, immobile, bony canal
What are the four pelvic planes?
Inlet
Plane of greatest diameter
Plane of least diameter
Outlet
What is measured in a clinical assessment of the pelvic inlet?
Anteroposterior diameter
What is measured in the clinical assessment of the mid-pelvis?
Hint: 2
Straight side walls
Bispinous diameter
What is measured in the clinical assessment of the pelvic outlet?
Hint: 2
Infrapubic angle
Distance between ischial tuberosities
What is the obstetric conjugate of the anteroposterior diameter of the pelvis?
The minimum AP diameter measured from the sacral promontory to the midpoint of the pubis symphysis
What is the diagonal conjugate of the antero-posterior diameter of the pelvis?
Distance from sacral promontory to inferior border of pubic symphysis - will be shorter than obstetric conjugate
What is olgiozoospermia?
Low sperm count in ejaculate
What, then, is azoospermia?
No sperm in ejaculate
What are cryptorchid testis?
Maldescended
Why are there clinical consequences of cryptorchid testis?
Spermatogenesis is imparied because of elevated temperature
What process ocurring in the testis is unaffected by their maldescent?
Male sex hormone secretion by sertoli and leydig cells
What is maldescent of the testes a risk factor for?
Malignant testicular tumours
What is orchitis and what are its possible effects?
Inflammation of the testis
Leads to impaired spermatogenesis and can lead to seminiferous tubule degredation and even infertillity
Where are sperm stored?
Tail of the epididymis
How does the vas deferens aid in ejaculation?
Rich autonomic innervation resulting in muscular contraction - the duct dilates to allow the passage of sperm
What are the layers of mucle in the vas deferens?
Outer longitudinal smooth
Intermediate layer of circular
Inner layer of longitudinal smooth
What is the panpiniform plexus?
Collection of small vessels surrounding the vas deferens
What is the cremaster?
A discontinuous layer of longitudinally-oriented strands of striated muscle surrounding the spermatic cord
In what order are the secretions associated with ejaculation produced?
Hint: 4
Bulbourethral secretions
Prostate secretions
Spermatozoa
Seminal vesicle secretions
What proportion of ejaculate is produced by the prostate and what are its constituents?
1/3 - prostaglandins, proteolytic enzymes and citric acid
Where is the bulbourethral gland found?
In the urogenital diaphragm
What is the specific blood supply to the penis?
Cavernous arteries from internal pudendal
Describe the venous drainage of the heart
Superficial and deep dorsal veins