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Male Reproductive Tract

Male Reproductive Tract. By Joshua Bower Peer Support 2013/14 J.Bower@warwick.ac.uk. 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.

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Male Reproductive Tract

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  1. Male Reproductive Tract By Joshua Bower Peer Support 2013/14 J.Bower@warwick.ac.uk

  2. 2 • 1 • 4 • 3 • 5 • 6 • 7 • 9 • 8

  3. OSCE • Identify the following: • Urinary bladder • Pubic symphysis • Sigmoid colon • Corpus spongiosus • Prostate gland • Membranous urethra • Epididymis • Corpus cavernosus

  4. Distinguish spermatocoele and hydrocoele • Spermatocoele - cyst forming in the epidydimis • Hydrocoele - cyst forming in the tunica vaginalis

  5. Describe the descent of the testis

  6. List the THREE coverings of the spermatic cord, and their origin [3+3] • Internal spermatic fasciaTransversalis fascia • Cremasteric fascia Internal oblique • External fascia External oblique

  7. What are the three arteries in the spermatic cord? [3] • Testicular artery • Ductus deferens artery • Cremasteric artery

  8. What are the three nerves in the spermatic cord? [3] • Genital n. • Autonomic n.s • Ilioinguinal n.

  9. List THREE other contents of the spermatic cord [3] • Pampiniform plexus (venous drainage) • Ductus deferens • Lymphatics

  10. Remember the rule of 3s • 3 fascia • 3 arteries • 3 nerves • 3 “everything else”

  11. What is an undescended testis called? • Cryptorchid testis • Associated with increased incidence of malignant testicular tumours

  12. Testicular lymphatics drain where? • Para-aortic lymph nodes • ~L2

  13. The ductus deferens runs from where to where? • Tail of epididymis to the ejaculatory duct

  14. Where does the ductus deferens run in relation to the ureter? • Superior to it • Water under the bridge • In females? • Uterine arteries

  15. What is the dilated portion of the ductus deferens called? • Ampulla

  16. Median lobe • Anterior lobe • Posterior lobe

  17. Prostatic lymph drains where? • Internal iliac nodes

  18. What do these produce? • Seminal vesicles produce alkaline fluid

  19. What is the purpose of the bulbourethral (Cowpers) glands? • Secrete lubricant into the urethra for sperm passage

  20. What are the FOUR regions of the urethra? • Pre-prostatic • Prostatic • Membranous • Spongy

  21. How can urethral development go wrong? • Epispadias - urinary meatus emerges on dorsum of penis • Hypospadias - urinary meatus is displaced along the urethral groove

  22. Give THREE indications for catheterisation [3] • Surgery • Retention • Patient incapacitated

  23. What are the FOUR areas of difficulty during catheterisation? [4] • Navicular fossa • Angle at penile bulb and membranous urethra • Prostate • Sphincters

  24. What is priapism? • Persistent, painful, non-stimulated erection lasting >4 hours

  25. Distinguish phimosis from paraphimosis • Phimosis - prepuce (foreskin) can’t be retracted • Paraphimosis - prepuce permanently retracted

  26. 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.)

  27. 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

  28. 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

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