S2 Anatomy Exam 1: Male Pelvis Organs

Front 1

Obj.
1. Describe the urinary bladder

Back 1

-pelvic organ
-enters abdomen when full (or always in children)

Front 2

Obj.
1. Describe the urinary bladder parts

Back 2

-apex (median umbilical ligament)
-body
-fundus (base, related to seminal vesicles or uterus/vagina)
-neck (surrounds urethra, attached to prostate)

Front 3

Obj.
1. Describe the urinary bladder surfaces

Back 3

superior
inferolateral (2 surfaces)
posterior ( base)

Front 4

Obj.
1. Describe the urinary bladder related structures.

Back 4

-receives the R & L ureters @ the angles of the smooth-walled trigone
-inferior to peritoneum
-separated from the pubic bones by the retropubic space

Front 5

Obj.
2. Describe the blood supply of the urinary bladder.

Back 5

arteries:
-superior vesical arteries
(branch from umbical artery)
supplies anterosuperior bladder
gives off artery to ductus deferens (in males)
-inferior vesical/vaginal artery
supplies neck & fundus

veins:
-correspond w/ arteries ^

Front 6

Obj.
2. Describe the innervation (sympathetic & parasympathetic) of the urinary bladder.

Back 6

sympathetic: T11-L2

parasympathetic: pelvic splanchnic nerves S2-S4
(via inferior hypogastric plexus)

Front 7

Obj.
3. Identify the parts of the urethra

Back 7

-intramural/preprostatic part (surrounded by internal urethral sphincter
-prostatic urethra (traverses prostate gland)
-membranous part (in deep perineal pouch, surrounded by external urethral sphincter)
-spongy part (penile)

Front 8

Obj.
4. Describe the prostate gland and its gross features and function.

Back 8

features: glandular component enclosed by fibrous capsule

functions: produces milky alkaline fluid containing citric acid & acid phosphatase, to neutralize acidity of vagina

Front 9

How does prostatic fluid empty into the prostatic urethra?

Back 9

through individual openings in the prostatic sinuses (on either side of seminal colliculus)

Front 10

Obj.
5. Describe the testes

Back 10

-sperm produced in seminiferous tubules
-sperms stored in body of epididymis
-tail of epididymis becomes vas deferens
-tunica vaginalis encloses testes, visceral & parietal peritoneal layers, small amount of fluid btwn
-tunica albuinea, tough outer surface

Front 11

Obj.
5. Describe the testes artery supply

Back 11

testicular artery (from aorta @ L2)

Front 12

Obj.
5. Describe the veins draining the testes

Back 12

pampiniform plexus of veins
^becomes testicular vein @ level of deep inguinal ring
^^R testicular v drains into IVC, L drains into left renal v first

Front 13

Obj.
5. Describe the testes lymphatics

Back 13

lateral (paraaortic) nodes
- drains toward abdominal cavity

*testicular cancer most common malignancy in young males

Front 14

Obj.
5. Describe the testes innervation.

Back 14

-sympathetic fibers run w/ testicular artery from renal or aortic sympathetic plexuses
-afferent sensory nerves accompany efferent sympathetic fibers

Front 15

Obj.
6. Name the lobes of the prostate

Back 15

middle lobe = central zone

posterior lobe = peripheral zone

Front 16

Obj.
6. Describe various clinical conditions affecting specific lobes of the prostate.

Back 16

benign prostatic hyperplasia (BPH):
typically the middle lobe/central zone,compression of prostatic urethra resulting in nocturia, dysturia, & urgency to urinate

Prostate cancer:
typically posterior (P) lobe/peripheral zone
tends to obstruct urinary flow late in the disease
metastasis to vertebrae, brain, & spinal cord

Front 17

Obj.
7. Trace the passage of sperm cells from the testes to outside the body.

Back 17

Testes (seminiferous tubules)--> epididymis--> Ductus (vas) deferens--> seminal vesicle--> ejaculatory ducts--> prostates--> urethra-->bulbourethral glands--> spongy (penile) urethra

Front 18

The ureters cross the pelvic brim near _____________________

Back 18

bifurcation of the common iliac arteries

Front 19

In males, the ureters are crossed superiorly by the __________ near the entrance to the bladder

In females, crossed anteriorly & superiorly by ____________ at the base of the broad ligament

Back 19

ductus deferens


uterine artery

Front 20

What inhibits the reflux of urine into the ureter?

Back 20

pressure from a filling bladder & detrusor muscle contraction

* the ureters traverse the wall of the bladder in an oblique direction

Front 21

Autonomic fibers from __-__ are carried in the renal, aortic, superior & inferior hypogastric plexuses

Back 21

T11-L2

Front 22

GVA fibers accompany (sympathetic/parasympathetic) nerves

Back 22

sympathetic

Front 23

Passage of a kidney stone produces ___________________ pain

Back 23

"loin-to-groin"

Front 24

The urinary bladder is supported by the pelvic diaphram and what ligaments (in male & female)?

Back 24

-pubovesical (female, attach neck of bladder to pubic bones)

-puboprostatic (male, attach to prostate)

Front 25

What is the most common type of tumor in urinary tract?

Back 25

tumor of urinary bladder

*can involve prostate, seminal vesicles, rectum or uterus & vagina

Front 26

If a mass is felt on the anterior aspect of the vagina, where is a tumor likely located?

Back 26

bladder

Front 27

In males, a vesical venous plexus, is continuous with the ____________ plexus, draining the fundus of bladder, prostates, seminal vesicles, ductus deferens, & penis

Back 27

prostatic venous plexus

Front 28

The vesical venous plexus mainly drains to internal iliac veins by may also drain into ________ veins into the ___________ plexus

Back 28

sacral veins

vertebral venous plexuses

*route for metastasis to vertebral column, pelvic bones, & skull

Front 29

Muscle fibers toward neck of bladder in males forms an involuntary _________________.

Back 29

internal urethral sphincter

Front 30

Differentiate btwn parasympathetic & sympathetic effects on the internal urethral sphincter

Back 30

parasympathetic-
relaxation of sphincter & contractions of detrusor muscle = bladder emptying

sympathetic-
contraction of sphincter = inhibition of emptying & prevention of retrograde ejaculation of semen into bladder

Front 31

Most undescended testes descend into the scrotum during the first 3 months. If they do not, what is it referred to as and what does it lead to?

Back 31

-cryptorchidism (undescended testes)

-leads to increased incidence of testicular cancer & sterility

*testes 2-7 degrees C lower than body, necessary for spermatogenesis

Front 32

Describe the descent of testes (development)

Back 32

1. primordial testes dvlp in lumbar area, post abdominal wall, ant/inf to dvlping kidneys
2. gubernaculum testes attached to caudal pole guide descent to future scrotum
3. process vaginalis (peritoneal evagination) accompanies testes descent
4. descent creates passageway= inguinal canal w/ inguinal rings
5. testes acquire coverings from external oblique aponeurosis (external spermatic fascia), internal oblique muscles (cremaster muscle & fascia) & transverse fascia (internal spermatic fascia) as they descend
6. Eventually testes become suspended in scrotum by spermatic cords
*3rd-7th month, descend retroperitoneally to deep inguinal rings through inguinal canal

Front 33

What do the spermatic cords contain?

Back 33

-ductus (vans) deferens
-blood vessels
testicular artery
pampiniform plexus of veins (testicular vein)
-nerves
genital branch of genitofemoral nerve
-lymphatics

Front 34

A persistent processus vaginalis leads to what?

Back 34

-accumulation of fluid w/i cavity of tunica vaginalis

-fluid may be:
hydrocoele (serous fluid, appears as reddish glow upon transillumination)
hematocoele (blood)
spermatocoele (sperm-filled cyst, near head of epididymis, usually asymptomatic)

Front 35

What nerve provides the motor component of the "cremaster reflex"?

Back 35

genital branch of genitofemoral nerve

*ilioinguinal nerve = sensory component

Front 36

What causes "bag of worms"?

Back 36

varicocoel of spermatic cord, caused by elongation & dilation of pampiniform plexus of veins, due to defective valves

*usually on left side, adolescents

Front 37

Recognize parts of the epididymis

Back 37

-head
superior, expanded portion, composed of lobules

-body
sperm stored in convoluted duct while they mature

-tail
becomes vas deferens

Front 38

Obj.
4. Describe the gross features and function of vas deferens

Back 38

features:
cordlike-structure in spermatic cord
passes through inguinal canal
enters abdominal cavity
posterior to urinary bladder
supplied by artery to ductus deferens (arising from sup or sometimes in vesical artery)
continuation of tail of epididymis
terminal part is ampulla of ductus deferens

functions:
transmits spermatozoa from epididymis to ejaculatory duct

Front 39

what does a vasectomy/deferentectomy accomplish?

Back 39

prevents sperm from passing to urethra by interrupting vas deferens
-sperm degenerates in epididymis/proximal urethra

Front 40

Obj.
4. Describe the gross features and function of the seminal vesicle

Back 40

features:
distally joins ductus deferens to form ejaculatory duct
functions:
contributes alkaline fluid, containing fructose for spermatozoa nutrition, to seminal fluid

Front 41

The ejaculatory duct is formed by the union of what 2 things?

What does it open into?

Back 41

seminal vesicle & ductus deferens


opens into prostatic urethra through the seminal colliculus (verumontanum) together w/ prostatic utricle opening

Front 42

The ejaculatory duct traverses the posterior prostate, separating what 2 lobes?

Back 42

middle lobe (central zone)
posterior lobe (peripheral zone

Front 43

The prostate's lymphatic drainage is mainly into the _______________________ nodes

Back 43

internal iliac nodes

Front 44

Prostatectomy involves removal of the prostate & seminal vesicles, this may damage the _________________________, which form the cavernous nerves.
What would this nerve damage lead to?

Back 44

parasympathetic fibers (pelvic splanchnic nerves S2-S4) in the prostatic nerve plexus


leads to impotency