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Genitourinary system Surgical Society | Junior Anatomy Series Lecture 4 14thNovember 2023 Slides By Maya Alazzawi Modified and presented By Kavyesh Vivek Learning Objectives 2 mins Structure of the session Male reproductive system 15 mins Female reproductive system 10 mins Urinary system 5 mins Vasculature and lymphatics 15 mins Practice questions 15 mins Surgical Societyr Anatomy SeriesMale reproductive system - penis Anatomical position: penis is erect: dorsal surface is near the abdomen 2 x corpora cavernosa 1 x corpus spongiosum Surgical Society Junior Anatomy SeriesMale reproductive system - penis ROOT OF PENIS: • Bulb: expanded end of corpus spongiosum. Contains spongy urethra. COVERED BY bulbospongiosus muscles • 2 x Crura. Proximal ends of paired corpora cavernosa. COVERED BY ischiocavernosus muscles Surgical SocietyJunior Anatomy SeriesMale reproductive system - penis Covers BODY OF PENIS: erectile tissue • Hanging from pubic symphysis • Erectile tissue forms 3 columns: • Single corpus spongiosum (ventral) – contains spongy urethra,ending at external urethral meatus. • Paired corpora cavernosa (dorsal). Covered by tunica albuginea Covers corpora cavernosa Surgical SocietyJunior Anatomy SeriesMale reproductive system - penis GLANS PENIS: • Corpus spongiosum expands distally Formed by double layer of skin Connects foreskin to glans penis ventral surface Surgical SocietyJunior Anatomy SeriesMale reproductive system - erection POINT AND SHOOT ERECTION : • On arousal, smooth muscle cells of corpora cavernosa relax • This causes blood to flow into vascular spaces that surround this • Corpora cavernosa distend - compressing the veins so blood is unable to drain.orpora cavernosa has limited expansion due to tunica albuginea • Bulbospongiosus and ischiocavernosus compress veins trapping blood in cavernous spaces, maintaining erection • Corpus spongiosum is more flexible, preventing penile urethra compression. Surgical Society Junior Anatomy SeriesMale reproductive system - ejaculation Edjaculation: • Sympathetic: internal urethral sphincter contracts • Parasympathetic: urethral muscle • Pudendal nerves: contract bulbospongiosus muscles Surgical Society Junior Anatomy SeriesMale reproductive system • Deep arteries of penis supply corpora cavernosa cavernous spaces -> when this fills up, penis becomes erect. • When flaccid, arteries coil up to restrict blood flow Surgical SocietyJunior Anatomy SeriesMale reproductive system Deep dorsal vein: Receives blood from cavernous spaces, drains into prostatic venous plexus Superficial dorsal vein: Receives blood from skin, and drains into external pudendal vein Surgical Society Junior Anatomy SeriesMale reproductive system - testes Suspends testes from abdomen prostatic urethrato Testes: • Site of hormone and sperm production Epididymis: • Storage and maturation of sperm Lubricates testes Surgical SocietyJunior Anatomy SeriesMale reproductive system • Vas deferens: paired tubes that carry MATURE sperm from epididymis to edjaculatory ducts • Starts at tail of epididymis, ascends through spermatic cord then inguinal canal. At bladder, crosses ureter • At bladder, ductus deferens is superior to seminal vesicle, then joins with seminal vesicle ducts, forming edjaculatory ducts What is spermatic cord? Connects testes to abdominal cavity Surgical Society| Junior Anatomy SeriesMale reproductive System Bulbourethral gland: • Produce lubricating mucus secretion in semen • Expels residue of urine from urethra • Neutralise residual acidity in urethra Seminal Vesicle: • Scoagulating agents + fructose (energy for sperm) Surgical Society Junior Anatomy SeriesMale reproductive system Prostate gland: • Secretes proteolytic enzymes into semen • This breaks down clotting factors in ejaculate, allowing semen to remain in a fluid state Prostatic veins forms prostatic venous plexus. This drains into internal iliac veins Surgical Society| Junior Anatomy SeriesMale reproductive system - testes Pampiniform plexus Inferior epigastric artery Left Right testicular testicular Cremasteric artery vein vein Left renal vein Inferior Inferior vesical vena cava artery Originates from Artery of vas deferens abdominal aorta Surgical Society Junior Anatomy SeriesMale reproductive system - scrotum Fibromuscular sac: contains the testes Fuse in midline: scrotal raphe -> continuous with penile raphe Surgical Society| Junior Anatomy SeriesMale reproductive system Ischiocavernosus: Wrap around crura Maintains erection by compressing veins Bulbospongiosus muscles: Wrap around bulb of penis. Contraction pushes residual fluid in spongy urethra out through deep dorsal vein of penistflow of blood Superficial transverse perinea muscle: fixes perineal body and supports pelvic viscera All muscles innervated by deep branch of perineal nerve Surgical Society Junior Anatomy SeriesMale reproductive system Surgical Societyatomy SeriesMale reproductive system Surgical Societyatomy SeriesMale reproductive system Surgical Societyatomy Series PRACTICE QUESTION Male reproductive system 7? Bulb of penis 13? Prostatic urethra 16? Corpus cavernosum 17? Spongy urethra 18? Corpus spongiosum 20? Glans penis Surgical Societyunior Anatomy Series PRACTICE QUESTION Male reproductive system 2? Seminal Vesicle 4? Membranous urethra 8? Epididymis 12? Ductus deferens Surgical Societyunior Anatomy SeriesMale reproductive PRACTICE QUESTION system 5? Tunica Albuginea Surgical Societyunior Anatomy Series PRACTICE QUESTION Male reproductive system 8? Bulbourethral glands 13? Levator ani 7? Membranous urethra 5? Edjaculatory duct 2? Ductus deferens Surgical Societyunior Anatomy Series PRACTICE QUESTION Male reproductive system 2= urinary bladder 3= head of femur 5= Prostate 7= obturator internus 16= bulb of penis Surgical Societynior Anatomy Series PRACTICE QUESTION Male reproductive system 2? Bulbospongiosus 3? Ischiocavernosus 17? Deep transverse perineal Surgical Societyunior Anatomy Series Subcutaneous fat pad Female reproductive system Formed of erectile VULVA = external female genitalia corpora cavernosa Function: - Sensory during sex Contains external - Assists in directing urine flow urethral orifice and - Protects from infection vagina Overlies perineal Fuse anteriorly to body form clitoris hood Surgical Society Junior Anatomy SeriesFemale reproductive system Bulb of vestibule: Covered in bulbospongiosus muscle Greater vestibular glands: Partially covered by bulbospongiosus Clitoris: During sexual arousal, secretes 1. Root: 2 crura, mucus consisting of corpora cavernosa 2. Body 3. Glans Surgical SocietyJunior Anatomy SeriesFemale reproductive system Posterior fornix (dome): natural reservoir for semen after intravaginal ejaculation Surgical Society Junior Anatomy SeriesFemale reproductive system Cervix: gateway between vagina and uterus – allows for passage of sperm Uterus: site for blastocyst implantation Anteverted: rotated forwards with respect to vagina Anteflexed: flexed anteriorly with respect to cervix Layers of uterus: • Peritoneum • Endometrium Surgical Society Junior Anatomy Series Female reproductive system Ligaments: • Broad ligament: double layer of peritoneum, attaching uterus sides to LIGAMENT IS IN AND FORWARDS) • Ovarian ligament: joins ovaries to uterus (SHORT ONE) • Suspensory ligament of ovary: contains neurovascular structure, from ovary to lateral abdominal wall (BACKWARDS) • Round ligament: maintains anteverted position of uterus. Originates at uterine horns, goes through inguinal canal, and connects o labia majora (FORWARDS) Surgical SocietyJunior Anatomy SeriesFemale reproductive system Surgical Societyatomy SeriesFemale reproductive system Widest section – where fertilization occurs Capture ovum Surgical Societyunior Anatomy SeriesFemale reproductive system Bulbospongiosus: Ischiocavernosus: • Constricts vaginal orificeule • Maintains erection by compressing • Compress greater vestibular veins that drain it glands • Contributes to clitoris erection Surgical SocietyJunior Anatomy SeriesFemale reproductive system Surgical Societyatomy SeriesFemale reproductive system Anterior labia majora: external pudendal -> anterior labial arteries perineal artery -> posterior labialjora: internal pudendal -> Surgical Society| Junior Anatomy SeriesFemale reproductive system Surgical Societyatomy SeriesFemale reproductive system Surgical Societyatomy SeriesFemale reproductive system Dorsal nerve of clitoris: During excitement stage of sexual response, clitoris enlarges as it fills with blood Surgical Society | Junior Anatomy SeriesFemale reproductive PRACTICE QUESTION system 3? Fundus of uterus 5? Cervix 12? Ligament of the ovary 15? Suspensory ligament 16? Broad ligament 17? Round ligament Surgical SocietyJunior Anatomy SeriesFemale reproductive PRACTICE QUESTION system 4? Round ligament 5? Ovarian ligament 9? Rectum 12? Recto-uterine pouch 13? Fibrae 14? Suspensory ligament Surgical Societyunior Anatomy Series PRACTICE QUESTION Female reproductive system 11? Mons pubis 2? Labia minora 12? Ischiocavernosus muscle Surgical Societynior Anatomy Series PRACTICE QUESTION Female reproductive system 1? Uterus 34? Anterior labial arteries 14? Internal iliac artery 17? Uterine artery Surgical Societyunior Anatomy Series PRACTICE QUESTION Female reproductive system 16? Uterus 18? Urinary bladder 26? Urethra 8? Uterine/Fallopian tube Surgical Societyunior Anatomy Series PRACTICE QUESTION Spotter Questions 8? Perineal body 9? Pudendal nerve 10? Internal pudendal artery 20? External anal sphincter Surgical Societyunior Anatomy Series PRACTICE QUESTION Spotter Questions 9? Vesico-uterine pouch 23? Recto-uterine pouch 25? Posterior fornix of vagina Surgical Societyunior Anatomy Series Spotter Questions PRACTICE QUESTION 9? Medial umbilical ligament 10? Bladder 1? Fundus of uterus 3? Ligament of the ovary 2? Fallopian tube 11? Round ligament 5? Infundibulum 6? Fimbrae 7? Ureter Surgical Societyunior Anatomy SeriesSurgical Society | Junior Anatomy Series Kavyesh Vivek JAS LEADS Contact kv219@ic.ac.uk Phase 1a: Akshita Ramineni (ar2721 Phase 1b: Chirag Goyal (cg621) CPA Lead: Kavyesh Vivek (kv219) Please fill out the following feedback form in Feedback order to receive a copy of the slides via Medall and bonus questions !, to aid your revision! Form We hope you enjoyed this lecture! See you next term for our next lecture on Thorax 3.
