男性生殖系統(tǒng)專題知識培訓MalereproductiveanatomyThisillustrationrepresentsanaveragenormaladulthumanpenis.Theheadofthepenis(glans)hasacovering,calledtheforeskin(prepuce).Thiscoveringfoldsinonitself,formingadoublelayer.Theforeskinisnota`flap'ofskinontheendofthepenis,anditisnot`useless'or`redundant'skin.Thereissomenaturalvariationinthelengthoftheforeskin,whichoftencoversabitmoreorlessoftheglansthanillustrated.Inanaveragecircumcisedadultman,theareaofskinthatismissingbecauseofpenilereductionsurgerywould,whenerectandunfolded,measureapproximatelythreebyfiveinches,oralittlesmallerthanapostcard.Thatisabouthalfthetotalskinofthepenis.StructuresofthepenisTheouterforeskinlayerisacontinuationoftheskinoftheshaftofthepenis.Theinnerforeskinlayerisnotproperly`skin',butmucocutaneoustissueofauniquetypefoundnowhereelseonthebody.Thefrenarbandistheinterface(join)betweentheouterandinnerforeskinlayers.Whenthepenisisnoterect,ittightenstonarrowtheforeskinopening.Duringerection,thefrenarbandformsaridgethatgoesallthewayaround,abouthalfwaydowntheshaft.Thereddishorpurplishglansorglanspenis(headofthepenis)issmooth,shiny,moistandextremelysensitive.Thefrenulum,orfrenum,isaconnectingmembraneontheundersideofthepenis,similartothatbeneaththetongue.完全型具有正常女性體征，有正常女性外陰且發(fā)育良好（但陰毛稀少或缺如），陰道發(fā)育良好，深度正常。青春期后乳房可發(fā)育。不完全型外陰有不同程度旳畸形，陰蒂增大，陰道短淺或呈尿生殖竇。睪丸多位于腹股溝內。Elephantiasis象皮腫ofthescrotumscrotalhernia

aninguinalhernia腹股溝疝whichhasdescendedintothescrotum.TheProstateGland前列腺Theprostateisawalnut-sizedglandthatformspartofthemalereproductivesystem.Theglandismadeoftwolobes,orregions,enclosedbyanouterlayeroftissue.Asthediagramsshow,theprostateislocatedinfrontoftherectumandjustbelowthebladder,whereurineisstored.Theprostatealsosurroundstheurethra尿道,thecanalthroughwhichurinepassesoutofthebody.Normalurineflow

SeminalVesicle

producesamucoidsecretionthat'sreleasedintothesemen精液Femalereproductiveanatomy

ExternalGenitalia

Externalorgansincludethesensitiveanderoticsexorgans:monspubis,labia唇andclitoris陰蒂(alsoknowncollectivelyasthevulva外陰),andthebreasts.TheMonsPubis

Themonspubis(sometimescalledthemonsvenerisafterVenus,theRomangoddessoflove)istheregionoffattytissueabovethepubicbone.Atpuberty,themonspubisenlargesandbecomescoveredbypubichair.

TheLabia

Oftenreferredtoas"lips,"thelabiaarethefoldoftissuesurroundingthevaginalandurethralopenings,protectingthesensitiveorificesfromdamage.Theouter,fleshyhair-coveredfoldsformthelabiamajoraandtheinnerhairlessfoldsformthelabiaminora.Thelabiaarerichwithnerveendingsandgenerallyrespondwelltostimulation.TheClitoris陰蒂

Thefemaleglans(themaleglansisthepenis),theclitorisisextremelysensitiveandengorgeswithbloodduringsexualarousal.Protectedbytheclitoralhood,theclitorisisabovetheurethralopeningandbelowtheclitoralshaft,whichhastwoarms(calledcrura)thatstretchbackwardsintothewoman'sbody,undertheskinoneithersideabovethevaginalopening.Nervescontrollingclitoralmusclecontractionstravelalongsidethewallsofthevagina陰道,thebladderandurethra,passingalongthesensationsproducedinanypartoftheregion.

InternalStructures

Internalorgansincludetheuterus子宮,Fallopiantubes輸卵管andovaries卵巢,whichcontainthefemale’ssexcells:theova,oreggs.TheOvaries

Theovariesarepairedstructures,approximatelythesizeofawalnut,thatareanchoredtothebodycavityandtotheuterusbystrongcord-likestructuresknownasligaments.Theovariescontaintheovaandproducethefemalesexhormonesestrogenandprogesterone孕酮.TheFallopianTubes

TheFallopiantubes,alsocalledtheuterinetubesoroviducts,extendfromtheuterusuparoundtheovaries.TheFallopiantubesdisplaymuscularcontractionsthathelpdrawtheovumintotheuterus.Theupperportionofthetubesiswherefertilizationofanovumbyaspermcommonlyoccurs;ifthezygotedoesnotmovedownintotheuterus,anectopicpregnancyoccurs,whichcanbefataltothemotherandmustbeterminated.TheFallopiantubesaresurgicallyalteredwhenawomanundergoesthesterilizationprocedureknownasatuballigation.TheUterus

Theuterus(orwomb)isapear-shapedmulti-layeredorganlocatedatthebaseofthepelviccavity.Theopeningoftheuterus,knownasthecervix子宮頸,containsanarrowopeningthatservesasapassagewayformenstrualfloworforafetustoexitthevagina.Theinnermostlayeroftheuterusistheendometrium,whichispartiallyshedwitheachthemenstrualflow.Theuteruscanbehosttoanumberofsexualhealthproblems,includingendometriosis子宮內膜異位,cervicalcanceranduterinecancer.TheVagina

Thevaginaisathreetofour-inchlong,thin-walledmucous-linedtube.Inadditiontoprovidinganexitformenstrualbloodorafetus,thevaginaisthereceptionsiteforthepenisduringintercourse.AnusandRectumExamWHATISANANALFISSURE?

Ananalfissureisasmalltearorcutintheskinliningtheanuswhichcancausepainand/orbleeding.

Athinslit-liketearintheanaltissue,ananalfissureislikelytocauseitching,pain,andbleedingduringabowelmovement.Thetypicalsymptomsofananalfissureareextremepainduringdefecationandredbloodstreakingthestool.Patientsmaytrytoavoiddefecationbecauseofthepain.Howisitdiagnosed?

Thediagnosisofananalfissureismadebyexaminationoftheanusandanalcanal.Thetearusuallyiseasytosee,althoughoccasionallyasmallviewinginstrument,calledananoscope,maybeusedintheevaluation.

WhatAreHemorrhoids痔?Thetermhemorrhoidsreferstoaconditioninwhichtheveinsaroundtheanusorlowerrectumareswollenandinflamed.

Hemorrhoidsmayresultfromstrainingtomovestool.Othercontributingfactorsincludepregnancy,aging,chronicconstipationordiarrhea,andanalintercourse.

Hemorrhoidsareeitherinsidetheanus(internal)orundertheskinaroundtheanus(external).WhatAretheSymptomsofHemorrhoids?

Althoughmanypeoplehavehemorrhoids,notallexperiencesymptoms.Themostcommonsymptomofinternalhemorrhoidsisbrightredbloodcoveringthestool,ontoiletpaper,orinthetoiletbowl.However,aninternalhemorrhoidmayprotrudethroughtheanusoutsidethebody,becomingirritatedandpainful.Thisisknownasaprotrudinghemorrhoid.

Internalhemorrhoidsoccurhigherupintheanalcanal,outofsight.Bleedingisthemostcommonsymptomofinternalhemorrhoids,andoftentheonlyoneinmildcases.Sometimes,internalhemorrhoidswillcomethroughtheanalopeningwhenstrainingtomoveyourbowels.Thisiscalledaprolapsed脫垂internalhemorrhoid;itisoftendifficulttoeasebackintotherectum,andisusuallyquitepainful.Symptomsofexternalhemorrhoidsmayincludepainfulswellingorahardlumparoundtheanusthatresultswhenabloodclotforms.Thisconditionisknownasathrombosedexternalhemorrhoid.Inaddition,excessivestraining,rubbing,orcleaningaroundtheanusmaycauseirritationwithbleedingand/oritching,whichmayproduceaviciouscycleofsymptoms.Drainingmucusmayalsocauseitching.

Externalhemorrhoidsarevisible-occurringoutsidetheanus.Theyarebasicallyskin-coveredveinsthathaveballoonedandappearblue.Usuallytheyappearwithoutanysymptoms.Wheninflamed,however,theybecomeredandtender.Whenabloodclotformsinsideanexternalhemorrhoid,itoftencausesSeverepain.This

thrombosedexternalhemorrhoidcanbefeltasafirm,tendermassintheanalarea,aboutthesizeofapea.ExtremitiesandArticulusKoilonychiamaybecausedbyorfeatureof(sortedbycategory)

?Autosomaldominantconditions

Steatocystoma皮脂腺囊瘤multiplex

?Nutritionalconditions

IrondeficiencyThenailsareflattenedandhaveconcavities.Thisconditionmaybeassociatedwithirondeficiency.acropachy杵狀指

"Clubbing"ofthefingerswiththickeningofskinatthebaseofthenails,oftenwithanincreaseinthecurvatureofthenails.

Acromegaly肢端肥大癥

AcromegalyistheGreekwordfor"extremities"and"enlargement."Whenthepituitaryglandproducesexcessgrowthhormones,thisresultsinexcessivegrowth--calledacromegaly.Theexcessivegrowthoccursfirstinthehandsandfeet,assofttissuebeginstoswell.Acromegalyaffectsmostlymiddle-agedadults.Untreated,thediseasecanleadtosevereillnessanddeath.Acromegaly-Hands-Normalfemalehandforcomparison

genuvalgum膝外翻,

adeformityinwhichthekneesareabnormallyclosetogetherandthespacebetweentheankles踝關節(jié)isincreased;knownalsoasknockknee.genuvarum膝內翻,

adeformityinwhichthekneesareabnormallyseparatedandthelowerextremitiesarebowedinwardly;thedeformitymaybeinthethighorleg,orboth.Knownalsoasbowleg.(A),Genuvarum;(B),genuvalgum.genua[

pluralofgenu]GenuvalgumFlatfoot

Definition

Footmediallongitudinalarchdepressionorloss

Associatedconditions

Heel足跟eversion外翻(valgus)

Forefoot前足abduction外展

Muscularatrophy

Muscularatrophyisthedecreaseinsizeandwastingofmuscletissue.Musclesthatlosetheirnervesupplycanatrophyandsimplywasteaway.SkeletalspineThespineisdividedintoseveralsections.Thecervicalvertebraemakeuptheneck.Thethoracicvertebraecomprisethechestsectionandhaveribsattached.Thelumbarvertebraearetheremainingvertebraebelowthelastthoracicboneandthetopofthesacrum骶骨.Thesacralvertebrae骶椎arecagedwithinthebonesofthepelvis骨盆,andthecoccyx尾骨representstheterminalvertebraeorvestigial殘跡旳tail.Kyphosis脊柱后凸Kyphosisisacurvingofthespinethatcausesabowingoftheback,suchthattheapexoftheanglepointsbackwardsleadingtoahunchback駝背orslouchingposture.Kyphosisisaspinaldeformitythatcanresultfromtrauma,developmentalproblems,ordegenerativedisease.Kyphosiscanoccuratanyage,althoughitisrareatbirth.Adolescentkyphosis,alsoknownasScheuermann'sdisease,resultsfromthewedgingtogetherofseveralconsecutivevertebrae(bonesofthespine).ThecauseofScheuermann'sdiseaseisunknown.Inadults,kyphosiscanbearesultofosteoporoticcompressionfractures(fracturescausedbyosteoporosis),degenerativedisease(suchasarthritis),orspondylolisthesis脊椎前移(slippingofonevertebraforwardonanother).

Symptoms

Mildbackpain

Fatigue

Tendernessandstiffnessinthespine

Roundbackappearance

Difficultybreathing(inseverecases)

Lordosis脊柱前凸Lordosisisexcessivecurvatureinthelumbarportionofthespine,whichgivesaswayback背部過份凹陷appearance.Thespinehasthreetypesofcurves:

Kyphotic,whichtypicallyreferstotheoutwardcurveofthethoracicspine(attheleveloftheribs)

Lordotic,w