Flashcards in Repro 4- male anatomy Deck (97)
What are the coverrings of the spermatic cord and from where do they originate?
-external spermatic fascia (from the aponeurosis of the external oblique)
-cremasteric muscle and it's fascia (from the internal obliqe and it's fascia)
-internal spermatic fascia (From the tranversalis fascia)
What are the features of the cremasteric muscle?
What is the cremasteric reflex?
By stroking the superior-medial aspect of the thigh, there will be an instant lifting of the corresponding testis, due to contraction of the cremasteric muscle
What are the limbs of the cremasteric reflex?
afferent- illioinguinal nerve
Efferent- gential branch of genitofemoral nerve.
What are the contents of the spermatic cord?
-artery to the vas deferens (from inferior vesicle artery)
-genital branch of the genitofemoral nerve
What is the vas deferens?
A stright thick muscular tube that carries sperm from the epididymis to the seminal vesicle, where they combine to from the ejaculatory duct.
What are the wall layers of the vas deferens?
3 muscular layers
Why is a rich autonomic innervation required in the vas deferens?
to permit fast movement of the sperm towards ejaculatory duct.
What is the route of the vas deferens?
-continuous with the tail of the epididymis
-travels through the inguinal canal
-runs along lateral pelvic wall (close to ischial spines)
-turns medially between urethra and bladder
-combines with seminal vesicle to from ejaculatory duct.
What is it called when there is twisting of the spermatic cord upon itself?
/Why is testicular torsion a medical emergency
It can block blood supply of the testicular artery, leading to necrosis of the testes.
When does testicular torsion normally occur?
During physical activity/ exercise.
How do you identify a testicular torsion?
ultrasound and colour doppler scanning.
What is doppler scanning?
The use of high frequency sound waves that bounce of blood flowing through vessels to give you an idea of the blood flow.
What is the function of the prostate?
To secrete proteolytic enzymes which break down clotting factors, keeping the semen in a fluid state during ejaculation and within the female.
What is the size of the prostate?
What proportion of this is glandular/fibromuscular?
the size of a walnut.
What is the prodtate gland surrounded by?
The fibrous capsule of the prostate.
What are some important anatomical relations of the prostate?
-surrounds the urethra
-lies between the neck of the bladder and EUS
-close proximity tot he rectum posteriorly, (DRE)
How and when are the proteolytic enzymes secreted?
Via proteolytic ducts, into the prostatic part of the urethra, just before ejaculation.
Which 2 ways can you divide the prostate gland up?
-zones (more commonly used)
What are the zones of the prostate gland?
-central zone surrounds the ejaculatory ducts, (comes from wollfian duct embryologically)
-transitional zone- surrounds urethra, (embryologically from urogenital sinus)
- peripheral zone- makes up the bulk, found posteriorly, (originates from urogenital sinus)
Which zone of the prostate would you feel best via a DRE?
What is BPH?
Benign prostatic hyperplasia, benign growth of the prostate gland, mainly the transitional zone.
Leads to difficulty initiating urination, frequency and urgency.
Common in older males.
What happens in prostatic carcinoma?
This is cancer of the prostate which affects the peripheral zone mainly, so will be easily felt via a DRE, which will feel hard and irregular.
Symptoms will not present till late, when the carcinoma is of sufficient size to affect the urethra.
What is the arterial supply of the prostate?
prostatic arteries, derived from the internal iliac arteries.
What is the venous return of the prostate?
prostatic venous plexus, which drains into the internal iliac veins.
What is the innervation of the prostate?
inferior hypogastric plexus
provides sympathetic, paraympathetic and sensory innervation.
What is the function of the bulbourethral glands?
And alkaline in nature so help to neutralise any acidic urine left in the distal urethra.
Where do you find bulbourethral glands?
Postero-lateral to the membranous urethra, within the fibers of the external urethral sphincter.