male reproductive tract
DESCRIPTION
Male Reproductive Tract. By Joshua Bower Peer Support 2013/14 [email protected]. 2. 1. 4. 3. 5. 6. 7. 9. 8. OSCE. Identify the following: Urinary bladder Pubic symphysis Sigmoid colon Corpus spongiosus Prostate gland Membranous urethra Epididymis Corpus cavernosus. - PowerPoint PPT PresentationTRANSCRIPT
Male Reproductive Tract
By Joshua BowerPeer Support 2013/14
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Identify the following:- Urinary bladder- Pubic symphysis- Sigmoid colon- Corpus spongiosus- Prostate gland- Membranous urethra- Epididymis- Corpus cavernosus
OSCE
Distinguish spermatocoele and
hydrocoele• Spermatocoele -
cyst forming in the epidydimis
• Hydrocoele - cyst forming in the tunica vaginalis
Describe the descent of the testis
List the THREE coverings of the spermatic cord, and their origin
[3+3]
• Internal spermatic fascia Transversalis fascia
• Cremasteric fascia Internal oblique
• External fascia External oblique
What are the three arteries in the spermatic
cord? [3]
• Testicular artery
• Ductus deferens artery
• Cremasteric artery
What are the three nerves in the spermatic cord? [3]
• Genital n.
• Autonomic n.s
• Ilioinguinal n.
List THREE other contents of the spermatic
cord [3]
• Pampiniform plexus (venous drainage)
• Ductus deferens
• Lymphatics
Remember the rule of 3s
• 3 fascia
• 3 arteries
• 3 nerves
• 3 “everything else”
What is an undescended testis called?
• Cryptorchid testis
• Associated with increased incidence of malignant testicular tumours
Testicular lymphatics drain where?
• Para-aortic lymph nodes
• ~L2
The ductus deferens runs from where to where?
• Tail of epididymis to the ejaculatory duct
Where does the ductus deferens run in relation to
the ureter?• Superior to it
• Water under the bridge
In females?Uterine arteries
What is the dilated portion of the ductus
deferens called?
• Ampulla
Median lobe
Anterior lobe Posterior lobe
Prostatic lymph drains where?
• Internal iliac nodes
What do these produce?
• Seminal vesicles produce alkaline fluid
What is the purpose of the bulbourethral (Cowpers)
glands?• Secrete lubricant into the urethra for sperm
passage
What are the FOUR regions of the urethra?
• Pre-prostatic
• Prostatic
• Membranous
• Spongy
How can urethral development go wrong?
• Epispadias - urinary meatus emerges on dorsum of penis
• Hypospadias - urinary meatus is displaced along the urethral groove
Give THREE indications for catheterisation [3]
• Surgery
• Retention
• Patient incapacitated
What are the FOUR areas of difficulty during
catheterisation? [4]
• Navicular fossa
• Angle at penile bulb and membranous urethra
• Prostate
• Sphincters
What is priapism?
• Persistent, painful, non-stimulated erection lasting >4 hours
Distinguish phimosis from paraphimosis
• Phimosis - prepuce (foreskin) can’t be retracted
• Paraphimosis - prepuce permanently retracted
What nervous systems control erection, emission and
ejaculation?• Point - shoot - score
• Erection = parasympathetic (S2,3,4)
• Emission = sympathetic (L1+L2)
• Ejaculation = somatic (branches of pudendal n.)
Describe the steps leading to erection [3]
• Smooth muscle in helicine arteries relaxes and straightens
• Blood flows into corpus cavernous
• Bulbospongiosus and ischiocavernosus muscles compress venous plexus to retain blood in penis
Describe the steps leading to emission [4]
• Sympathetic nerve supply:
• Closes internal urethral sphincter
• Peristalsis of ductus deferens and seminal vesicles
• Prostate smooth muscle contraction
• Ejaculate is squeezed into the penile bulb