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4-External Genitalia


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What is contained in the scrotum?
testis, epididymis, vas or ductus deferens, testicular and epididymal arteries, and pampiniform plexus of veins
What is the purpose of the pampiniform plexus of veins?
countercurrent heat exchange system, keeps testis cooler than body temp
What are the parts of the epididymis?
head (caput); body (corpus); tail (cauda)
Name 5 functions of the epididymis.
sperm maturation
sperm storage
sperm disposal
What surrounds the vas deferens?
3 layers of SM
What does the vas deferens form?
ejaculatory ducts
What is the position of the vas deferens with respect to the seminal vesicles?
it is just superior to seminal vesicles
After a vasectomy where is it thought that sperm are broken down?
within the epididymis
What is cryptorchidism? What else can be affected?
retention of the testes anywhere along the route of descent
What is the insufficient or congenital absence of valves with the spermatic vein? What can this cause? Which side is this more common on? Why?
-blood reflux within pampiniform plexus
-more common on L side
-L testicular vein returns to renal vein which has a higher pressure than the R testicular vein which drains into the IVC
Discuss a congenital hydrocele of the testis.
congenital-processes vaginalis remains open to peritoneal cavity
Discuss an acquired hydrocele of the testis.
abnormal accumulation of serous fluid in the sac of the tunica vaginalis
What is torsion of testis.
twisting of spermatic cord causing strangulation of the blood vessels serving testis and epididymis
Name the layers of the anterior abdominal wall.
skin, Camper's (fatty) & Scarpa's (membranous) fascia, external oblique, internal oblique, transverse abd, transversalis fascia, extraperitoneal fatty tissue, peritoneum
Name the layers of the scrotum. (starting from skin)
skin, dartos fascia (membranous), external spermatic fascia, cremasteric m & fascia, internal spermatic fascia, areolar tissue w/ localized collections of fat, tunica vaginalis
Name the layers of the spermatic cord.
external spermatic fascia, cremasteric muscle & fascia, internal spermatic f, obliterated processus v
What are the 3 parts of the urethra?
prostatic, membranous (intermediate), penile (spongy)
What surrounds the internal urethral orifice as it penetrates the wall of the bladder. What type of muscle is it composed of?
internal urethral sphincter made up of smooth muscle
The midline ridge of the urethral crest rises up to form the seminal colliculus. What embryonic homolgue to the females is this? What functional structure is located here?
prostatic utricle, a blind pouch, equiv to vagina in females
two openings for the ejaculatory ducts
What does the membranous urethra pass through? What is it surrounded by?
passes through levator ani of pelvic diaphragm and perineal membrane
surrounded by muscular fibers
What do the muscular fibers that surround the membranous urethra form?
external urethral sphincter formed of striated muscle of the urogenital diaphragm
Name the least distensible portion of the urethra in males and females. What can be used to forcefully open the urethra?
membranous portion of urethra for both
Where does the bulbourethral gland lie? Where do its ducts open to?
deep to perineal membrane
ducts open into proximal portion of penile urethra
Name the 3 cylinders of erectile tissue.
2 corpora cavernosa on dorsal surface, a single corpus spongiosum
Which cylinder of erectile tissue contains the urethra?
corpus spongiosum
What surrounds each cylinder of erectile tissue?
tunica albuginea
The corpus spongiosum expands diatally to form the _____ and proximally to form the ______.
bulb of the penis
Name the layers of the penis.
skin, superficial fascia of penis, deep f (Buck's) of penis, tunica albuginea of corpus cavernosum erectile tissue
What is the superficial (dartos) fascia of the penis continuous with?
Scarpa's fascia of ant abdomen and Colle's fascia of perineum
Name the blood vessels associated w/ the penis.
superficial dorsal veins, deep dorsal arteries and veins, and deep corpus cavernosum artery
Name the 2 ligaments of the penis.
fundiform and suspensory ligament
Which of the ligaments of the penis is more superficial? What does this ligament attach to?
fundiform ligament-attaches from deep f. (Buck's) to linea alba superiorly
What does the suspensory ligament attach to?
from deep f. of penis to pubic symphysis
If the foreskin is retracted what is exposed?
corona of the glans
The _____ body of the penis is skin, fascia, erectile tissue, blood, blood vessels and nerves.
The ventral surface of the penis has a penile raphe, an embryological remnant of what?
fusion of left and right tissue masses (urogenital folds) that join to form the penis
At the base or root of the penis, each corpora cavernosae attaches where? What does this form?
along inferior ramus of the pubic bone towards the ischial tuberosities
forms the R&L crura of penis
What attach to the superficial surface of the perineal membrane of the penis?
bulb of the penis and crura
What muscles cover the base of the bulb of the penis and the two crura? What type of muscle is this?
bulbospongiosus & ischiocavernosus muscles
both are skeletal muscles
What is the only part of the penis that contains muscle? What is the purpose of the muscle here?
the root
helps restrict venous blood flow out from the penis causing increase in internal penile pressure above arteriolar pressure
What does the bulbospongiosus muscle do in addition to restricting blood flow?
expels both semen and urine from the base of the penile urethra
What is the major artery that supplies the penis? Name the branches of this artery.
internal pudendal A
dorsal penile arteries, deep penile arteries, artery of the bulb of the penis
What do the dorsal penile arteries supply?
area btwn the corpora cavernosa, and mainly to skin and fascia
What do the deep penile arteries supply?
each corpora cavernosa, to erectile tissue
What does the artery of the bulb of th penis supply? (2 things)
the bulb of the penis and the bulbourethral glands
Afferent sensations (GSA) are carried in _____ nerve of the penis, which is a branch of the _____ nerve. Name the corresponding spinal levels.
pudendal N
Parasympathetic fibers (GVE) travel along the _____ nerve and _____ nerves to the deep arteries of the penis.
pelvic splanchnic
Sympathetic fibers innervating the penis come from spinal level(s) _____ and innervate arterial blood vessel walls.
Motor innervation is from the deep branch of the _____ N, which is a branch of the _____ nerve. What is innervated?
bulbospongiosus and ischiocavernosus muscles
Erection of the penis requires (sympathetic or parasympathetic) stimulation? What does this allow for?
What type of innervation is needed for ejaculation? What spinal levels? Name the nerves.
sacral splanchnic N
What is detumescence?
loss of an erection
During ejaculation the internal urethral sphincter must remain closed and the external urethral sphincter must stay open otherwise what can occur?
retroejaculation of seminal contents into bladder
What may be the cause of the refractory period in which men cannot have a second orgasm?
sympathetic discharge
What is the name of the female external genitalia?
What is anterior to the pubic synphysis in females?
mons pubis
What contains the round ligament of the uterus?
labia majora
What are the two parts of the labia majora?
anterior and posterior labial commissure
Where is the anterior labial commissure located?
anterior to the prepuce of the clitoris
Where is the posterior labial commissure located?
posterior to the vestibule, partially on top of the perineal body
What immediately surrounds the vestibule of the vagina?
labia minora
What can the anterior commissure of the labia minora also be called?
frenulum of clitoris
What female tissue is homologous to the penis? What is the function of this tissue?
sexual arousal
Where are the R&L crus of the clitoris located?
along the inferior pubic rami
Name the 3 parts of the clitoris.
angle, body and glans
Where is the angle of the clitoris?
superiorly attached to pubic symphysis
What is the most distal end of the clitoris called?
What is the most innervated part of the clitoris? What is the nerve that innervates it?
glans (distal end)
dorsal nerve of clitoris
What is the partially covered angle and body of the clitoris called?
prepuce of clitoris
What ist he space between the labia minora?
About how far away is the external urethral orifice from the clitoris?
2 cm
What are the thin folds of mucus membrane that may partially surround the vaginal orifice? What does this demarcate?
vulva from vaginal orifice
What is the name of the erectile tissue on either side of the vaginal orifice?
bulbs of vestibule
Name the muscle that covers the bulbs of vestibule.
bulbospongiosus muscles
What are the mucus secreting glands that of the vulva? Where are the openings of the glands located?
greater vestibular (Bartholin's) glands, openings are in the posterior lateral portion of the vestibule
Compare the mucus secreting glands of males and females.
in females the glands are superficial to the urogenital diaphragm
What else is located by the fourchette or posterior commissure of the vulva?
the frenulum of the labia minora inferior to the vaginal opening
Glans of the clitoris may be connected to what?
vestibular bulb
In females, what does the bulbospongiosus muscle attach to?
attaches from perineal body, runs on top of vestibular bulb
In females, what does the ischiocavernosus muscle attach to?
from ischial ramus and partially covers crura of clitoris
In females, what does the superficial transverse perineal muscle attach to?
from ischial ramus to perineal body
Contraction of what muscle forces blood into the clitoris glans and body?
superficial transverse perineal muscle
What is the fibromuscular structure in the midline between the vaginal opening and anal opening? What does it connect?
perineal body
perineal structures to pelvic diaphragm
What part of the nervous system is throught to control desire and arousal phase in women?
Orgasmic muscle contraction includes what muscles?
the superficial perineal skeletal muscles-ischiocavernosus, bulbocavernosus, superficial transverse perineal muscles
smooth muscles of vaginal wall and muscles of pelvic floor or levator ani-pubococcygeus and iliococcygeus
What may actually be located in the G spot?
erectile tissue of the bulb of the clitoris that surrounds the urethra or Skene's glands (mucus secreting glands) that surround the urethra
What type of cut may be done during labor in order to prevent tearing of the vagina and perineal body?
What are the main nerves that innervate the vulva? (2)
pudendal and ilioinguinal
name the branches of the pudendal nerve.
dorsal nerve of the clitoris, posterior labial nerves, superficial and deep perineal nerves
What does the ilioinguinal N provide some innervation to?
mons pubis and anterior labia majors
What is the purpose of a pudendal N block? How can this be done?
provide some relief from the pain of childbirth
the pudendal nerve wraps around the ischial spine so it can be palpated and injects near this location

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