Anatomy, Pelvis - Lecture 4

Front 1

Where do the testes originally develop?

What structure drags them into their descent during development?

What are the testes pulled towards by this structure?

What structure is carried with the testes?

What abdominal muscle wall derivatives become incorporated into the scrotum?

Back 1

Posterior abdominal wall

The gubernaculum

The deep inguinal ring

processus vaginalis (peritoneal diverticulum)

derivatives: external spermatic fascia and cremaster muscle

Front 2

What does the gubernaculum become in the adult male?

Back 2

The scrotal ligament, from testis to scrotum

Front 3

What are the 3 layers covering the testes?

Back 3

Tunica vaginalis
tunica albuginea
tunica vasculosa

Front 4

What is the tunica vaginalis a remnant of?

Back 4

peritoneal processus vaginalis

Front 5

Does the tunica vaginalis cover the entire testis? What is the name of the pocket it forms?

Back 5

No, the visceral layer does not cover the poserior. The scrotal cavity formed from its reflection is called the cavity of the tunica vaginalis

Front 6

What is the name of the tough collagen capsule of the testis?

Back 6

Tunica albuginea

Front 7

What is the name of the innermost coat of the testis, carrying blood vessels?

Back 7

tunica vasculosa

Front 8

What is the name of the network of straightened portions of the semineferous tubules?

Back 8

rete testis

Front 9

What do the efferent ductules transport, and from where to where?

Back 9

sperm from rete testis to epididymis

Front 10

What portion of the epididymis forms the body and tail?

Back 10

ductus epididymis, which is continuous with the ductus deferens

Front 11

Where are the fascia layers of the spermatic cord derived from, and what passageway does it travel through?

Back 11

The anterolateral abdominal wall, and the inguinal canal.

Front 12

What are the layers of the spermatic cord's fascia and what are each derived from?

Back 12

external spermatic fascia -- external oblique aponeurosis
cremasteric fascia -- superficial and deep surfaces of internal oblique
loops of cremaster muscle -- internal oblique muscle
internal spermatic fascia -- transversalis fascia

Front 13

What 8 structures does the spermatic cord contain, and what do they branch off of?

Back 13

ductus deferens
testicular artery: aorta to testis + epididymis
deferential artery: off of inferior vesical artery
cremaseric artery: off of inferior epigastric artery
pampiniform venous plexus: drains into testicular veins
genitofemoral nerve genital branch
cremasteric nerve (autonomic)
lympathic vessels: drain testis via lumbar lymph nodes

Front 14

What are the 5 layers of the scrotum?

Back 14

skin
dartos muscle
external spermatic fascia
cremasteric fascia
internal spermatic fascia

Front 15

does the scrotum contain fat?

Back 15

no it does NOT!

Front 16

what structure of the scrotum is continuous onto the penis and the anus?

Back 16

the scrotal raphe, which becomes the penile and perineal raphe (the chode)

Front 17

What are the routes of blood supply to the scrotum?

Back 17

anterior: external pudendal artery
posterior: internal pudendal artery
additional: cremasteric branch of the inferior epigastric artery

Front 18

where do scrotal veins empty into? where does lymphatic drainage of the scrotum empty into?

Back 18

external pudendal vein

superficial inguinal lymph nodes

Front 19

how is the scrotum innervated?

Back 19

anterior: ilioinguinal nerve (L1) + genital branches of genitofemoral nerve (L1-2)
posterior: posterior scrotal nerves from perineal nerves + perineal branch of the posterior femoral cutaneous nerve (S2-S4)

Front 20

What are the anterior and posterior scrotum primarily innervated by?

which side requires a more superior or higher injection in order to anesthetize?

Back 20

anterior is L1, posterior is S3

anterior surface

Front 21

What are the names of the cylindrical bodies of tissue in the penis, and how many of each are there?

Back 21

three cylindrical bodies:
two corpus cavernosa and one corpus spongiosum

Front 22

what part of the penis is continuous with the deep perineal fascia?

Back 22

buck's fascia

Front 23

what happens to buck's fascia more proximally?

Back 23

it thickens at the pubic symphysis, splits and becomes a sling that attaches to the deep fascia at the penile root.

this is called the suspensory ligament of the penis.

Front 24

what is the name of the elastic fibers that extend from the linea alba to the pubic symphysis, splitting to surround the penis?

Back 24

fundiform ligament

Front 25

what components make up the root of the penis in the superficial perineal pouch?

Back 25

crura (attached to ischial tuberosities)
bulb
ischiocavernosus muscle
bulbospongiosus muscle

Front 26

what do the crura and bulb become as they enter the body of the penis?

Back 26

crura becomes corpora cavernosa in the body, bulb becomes corpus spongiosum.

Front 27

how is blood supplied to the penis (hint: 3 major structures coming off of 1 greater structure)?

Back 27

mainly internal pudendal artery. dorsal artery of the penis runs between the corpora cavernosa to supply fibrous tissue around the corpora and skin.

deep artery pierces the crura then runs with cc also to supply erectile tissues.

artery of the bulb of the penis supplies the posterior corpus spongiosum and bulbourethral glands.

Front 28

where does the deep dorsal vein of the penis drain into?

lymphatics?

Back 28

the superficial dorsal vein and the superficial external pudendal vein

superficial inguinal lymph nodes

Front 29

which spinal levels innervate the penis?

Back 29

S2-4

Front 30

What is the name of the rounded, fatty prominence that lies anterior to the pubic symphysis?

Back 30

FUPA. j/k

it's called mons pubis

Front 31

besides anatomical location, what are the differences between labia minora and majora?

Back 31

majora has sebaceous glands and hair, minora does not have hair but DOES have sebaceous glands. majora also contains fatty tissue. minora also has more sensory nerve endings.

Front 32

What are the anterior and posterior limits of the labia majora?

Back 32

anterior commissure, as well as the posterior commissure that overlies the perineal body and represents the posterior limit of the vulva.

Front 33

What part of the vagina disappears normally after childbirth?

Back 33

posterior commissure

Front 34

what are the two major tissues of the clitoris?

Back 34

corpora cavernosa and glans clitoris

Front 35

where does the root of the clitoris arise from?

Back 35

crura coming off of the ischiopubic rami. they unite to form the body and terminate as the glans clitoris covered by a prepuce.

Front 36

What is the space between the labia minora?

Back 36

vestibule, containing urethral opening, vagina, paraurethral and vestibular glands

Front 37

What are the vestibular bulbs in the female?

Back 37

elongated erectile tissue that line the sides of the vestibule. they lie along the sides of the vaginal orifice and are covered by bulbospongiosus muscles.

Front 38

What do the vestibular glands do in the female?

What are they analogous to in the male?

Back 38

secrete mucus around the vaginal orifice during sexual arousal.

bulbourethral glands in the male

Front 39

where do the LESSER vestibular glands open into?

Back 39

into the vestibule between the urethral and vaginal orifices, moistening the labia and vestibule.

Front 40

Describe blood supply to the vulva.

Back 40

External genitalia has blood supply from superficial and deep external pudendal branches similar to the male, as well as the internal pudendal artery on each side.

Front 41

How is blood drained from female genitalia?

Back 41

primarily through external pudendal veins. clitoris is via deep dorsal veins to the internal pudendal vein and via superficial dorsal veins to the external pudendal vein.

Front 42

How is the vulva innervated?

Back 42

Anterior labial nerves (like scrotum), come off of ilioinguinal L1.

Posterior: labial branches of the perineal nerve S3.

also genital branch of genitofemoral nerve and the perineal branch of posterior femoral cutaneous nerve of the thigh.

Front 43

What type of innervation produces increased vaginal secretion, erection of the clitoris and engorgement of erectile tissues in the vestibular bulbs?

Back 43

parasympathetic (point and shoot)

Front 44

What are the two layers of the superficial perineal fascia?

How does the superficial layer differ in males and females?

Back 44

fatty superficial layer

membranous deep layer (Colles' fascia).

In females it is more extensive, entering the mons pubis, labia majora, and continuous from perineum to abdominal wall.

in males, it comes down from the UG triangle but stops short of the scrotum and is replaced by dartos fascia.

Front 45

What type of fascia is at the external limit of the superficial perineal pouch, lining the scrotum and labia?

Back 45

Colles' membranous fascia

Front 46

Does colles' fascia extend into the anal triangle? Why not?

What about anteriorly?

Back 46

No because i attaches posteriorly to the perineal membrane and ischiopubic rami. Anteriorly, it continues into the anterior abdominal wall, or Scarpa's fascia.

Front 47

What 3 muscles of the superficial pouch are invested in the DEEP PERINEAL FASCIA?

Is it continuous with buck's fascia?

Back 47

ischiocavernosus
bulbospongiosus
superficial transverse perineal muscles

yes

Front 48

what is a risk about communication between the deep perineal fascia and the buck's fascia?

how is this likely to occur?

Back 48

communication of fluid between the lower abdominal wall and the superficial perineal space

during catheterization, the device can be driven through the back wall of the urethra, passing bloody urine into the space b/w superficial and deep fascia of the penis, passing into the SUPERFICIAL PERINEAL SPACE.

Front 49

Can accumulating fluid (ie blood or urine) pass from the UG triangle to the anal triangle or the medial thigh?

Back 49

No.