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Session History

Reproductive Anatomy & Exceptions

1. Lymphatic Drainage Table

Structure	Primary Lymph Node Group
Testes / Ovaries	Para-aortic (Lateral Aortic)
Scrotum / Labia Majora / Penile Skin	Superficial Inguinal
Glans Penis / Clitoris	Deep Inguinal
Uterine Fundus	Superficial Inguinal (via Round Ligament)
Lower 1/3 Vagina (Distal)	Superficial Inguinal
Upper 2/3 Vagina (Proximal)	Internal and External Iliac
Prostate / Cervix / Corpus Cavernosum	Internal Iliac

2. Vascular Asymmetries & Relationships

Venous Drainage

Right Gonadal Vein: Drains directly to IVC (Acute angle).
Left Gonadal Vein: Drains to Left Renal Vein (90° angle).
Nutcracker Syndrome: SMA and Aorta compress Left Renal Vein -> Left Varicocele.
Right Varicocele: Red flag for IVC obstruction (e.g., RCC).

Arterial Rules

Uterine Artery: Crosses ANTERIOR to the Ureter ("Water under the bridge").
Ovarian Artery: Branch of Aorta (L2); in Suspensory Ligament.
Cremasteric Artery: Branch of Inferior Epigastric.
Internal Pudendal: Source of Deep Artery (Helicine) & Bulbourethral.

3. Nerve Pathways (Autonomics & Somatics)

Action	Nerve Type	Nerve Name (Roots)
Point (Erection)	Parasympathetic	Pelvic Splanchnic (S2-S4)
Squeeze (Emission)	Sympathetic	T11-L2 (Sacral Splanchnic)
Shoot (Ejaculation)	Somatic	Pudendal Nerve (S2-S4)

4. Trauma & Surgical Exceptions

Urethral Injuries

Straddle Injury: Bulbar (Spongy) Urethra crushed against Pubic Symphysis.
Pelvic Fracture: Membranous Urethra sheared; High-riding prostate.

Anatomical Gotchas

Corona Mortis: Aberrant obturator artery from Inferior Epigastric.
Batson’s Plexus: Valveless prostatic to vertebral veins (Spinal mets).
Obturator Nerve: Emerges MEDIAL to psoas muscle.

5. High-Yield Mnemonics & Tips

"S" for Superficial: Scrotum, Skin, Sub-umbilical skin go to Superficial Inguinal.
The Deep Rule: The deepest distal parts (Glans, Clitoris) go to Deep Inguinal.
High Jumpers: Testes/Ovaries start high in abdomen; stay Para-aortic.
Boys are Buried: Bulbourethral glands (Male) are in the DEEP pouch; Bartholin (Female) are SUPERFICIAL.