Male Pelvis

The organs of the male reproductive system include:

Testes
System of ducts, Accessory sex glands, Several supporting structures, including the scrotum and the penis

System of ducts includes

epididymis, ductus deferens, ejaculatory ducts, urethra

Acessory sex glands

seminal vesicles, prostate, bulbourethral glands

prostate

Largest accessory gland of the male reproductive system

The prostate is ___________ shaped gland that surrounds the _____________

chestnut; prostatic urethra

The secretion of the prostate gland aids in

motility & fertility of the sperm

What does the prostate have a close relationship with?

urethra

What does hypertrophy of the prostate interfere with?

passage of urine

Where is the prostate located in?

retroperitoneum

The prostate is bordered anteriorly by what?

pubic bone

The prostate is bordered posteriorly by what?

rectum

The Prostate is bordered superiorly by the what?

urinary bladder

The Prostate is bordered inferiorly by the what?

urogenital diaphragm

inferior vesical artery

arterial supply to the prostate with branches from the internal iliac artery

What does the inferior vesicle artery branch into?

capsular arteries & urethral arteries

capsular arteries supply

2/3 of the glandular tissue

urethral arteries supply

1/3 of the glandular tissue

The venous drainage occurs

laterally to the capsular vessels

What does the venous drainage consists of?

irregular venous chanels

Irregular venous channels leads to

veins of the vasa deferentia and ultimately to the vesicle and internal iliac veins.

Base of prostate

continues with the neck of the urinary bladder (wider)

Apex of prostate

narrow end rests below of the pelvic floor (more inferior)

How does the prostate normally measure?

3 cm from top to bottom and front to back

The prostate gland consists of a

small anterior *fibromuscular* region and a much larger posterior *glandular* region

The anterior fibromuscular stroma is located

anterior to the prostatic urethra

Where does most pathology occur?

Glandular areas

The posterior glandular portion/tissue are divided into

4 anatomically distinct zones

Anatomically distinct zones

Peripheral- PZ
Central- CZ
Transitional- TZ
Periurethral glandular zone-PG

The peripheral zone occupies the area ____________ to the ______________

lateral & posterior; distal prostatic urethra.

What zone is the largest portion of the prostate?

peripheral zone

The peripheral zone makes up

70% of the glandular prostate

_______% of malignancies are found in the peripheral zone

70

The central zone is _____________ to the urethra

posterior

The peripheral zone is _______ to the distal prostatic urethra

lateral

The central zone is a ________ spade structure

pyramidal

The central zone extends from the

base of the prostate

The central zone narrows at the level where

ejaculatory ducts join the urethra

The central zone makes up _____% of the gland

25%

_______% of the malignancies are found in the central zone

5-10%

The transitional zone is situated on

lateral aspects of the proximal prostatic urethra superior to the verumontanum

____________ is the smallest zone account for only about ____%

Transitional zone; 5%

In what zone does BPH (Benign Prostatic Hyperplasia) occur?

transitional zone

______% of malignancies are in the transitional zone

10-20%

Periurethral glandular zone

the tissue that surround the proximal prostatic urethra

Seminal Vesicles

paired accessory glands that consist of coiled tubes
that appear to be twisted to form small pouches

Where are the seminal vesicles located between?

posterior surface of the bladder & anterior to the rectum

The seminal vesicles join with ______________ to form the _______________

associated duct (vas) deferens; ejaculatory ducts

Two ejaculatory ducts pierce the

upper part of the posterior surface of the prostate

Ejaculatory ducts open into the

prostatic urethra at Vernumontanum

Verumontanum

A longitudinal ridge within the urethra in which the orifices of the ejaculatory ducts are located on either side.

Scrotum

Saclike structure that contains the testes, their coverings, and the epididymis

The scrotum consist of

a layer of skin, which covers a thin layer of connective tissue

The scrotum is divided by a

median raphe, or septum into two compartments each containing a testicle

Muscles of the testes

dartos & cremaster

Cremaster muscle

extends through the spermatic cord of the testes

Cremaster muscle functions with the Dartos muscle to

alter the position of the testes to maintain optimum temperature for the production and maturation of spermatozoa

Dartos muscle

A layer of skin, which covers a thin layer of connective tissue

Contraction of the dartos muscle
gives a ____________ appearance to the _________

wrinkled; scrotum

Epididymis

6-7cm flattened and tightly coiled, tubular structures on posterior surface of each testis

The epididymis begins superiorly and then coursing __________ to the testis.

posterolateral

The epididymis becomes the _____________ and continues in the _________

vas deferens; spermatic cord

The epididymis is divided into what 3 parts?

head, body, tail

The tail of the epididymis changes direction and ascends and becomes the ___________ and leaves the ________

vas deferens; scrotal sac

Is the vas deferens a separate structure?

No, it's a continuation of the tail

_________ is the largest part of the epididymis

head

Epididymal Head measures

6-15 mm

Epididymal Head is located

superior to the upper pole of the testis

The epididymal body and tail is much __________ than the head

smaller

The tail of the epididymis is slightly ________ to the epididymal body

larger

How is the tail of the epididymis positioned??

posterior to the lower pole of
the testis

The epididymal body and tail follows the

posterolateral aspect of the
testis from the upper pole to the lower pole

Ductus Deferens

A thick-walled muscular tube that is a continuation of the epididymis.

Where do the ductus deferens begin?

In the tail of the epididymis at the inferior pole of the testis

The ductus deferens ascends in the _____________ and passes through the ____________

spermatic cord; inguinal canal

As the ductus deferens enters the pelvis, it crosses over the

external iliac vessels

From the inguinal canal, the ductus deferens descends ________________, along the ___________ wall of the pelvis and then crosses the ____________

retroperitoneally; lateral; ureter & bladder

The ductus deferens descends _________ to the bladder and ________ to the ureter and seminal vesicles

posterior; medial

The terminal portion of the ductus deferences is joined by the duct from the ______________ to form the __________

seminal vesicles; ejaculatory duct

tunica albuginea

though fibrous connective tissue that covers testis

Extensions of the tunica albuginea project ___________, dividing ea testis into ________ lobules

inward; 300

Tunica vaginalis layers

parietal and visceral

parietal layer of tunica vaginalis

lines the scrotum

visceral layer of the tunica vaginalis

coves the testis & epididymis

The spermatic cord extends from

each testis to the inguinal canal on the same side

What contents makes up the spermatic cord?

structures passing to & from the testis

Contents of spermatic cord

Ductus deferns
Testicular artery
Pampiniform plexis
Lymph
Vessels
Nerves
Connective tissue

Spermatic cord is a tubular structure that connects the

scrotum to pelvis

The vascular supply branches from the

internal iliac artery

The cremasteric and deferential arteries accompany the ____________ to supply ___________

testicular artery within the spermatic cord to supply the extratesticular structures

The cremasteric and deferential arteries anastomoses (connect) with the

testicular artery (gonadal artery) and may provide some flow to the testis

Arteries involved in vascular supply to the scrotum

testicular, deferential, cremasteric

Testicular artery arises from _______ to support the ________

aorta; testes

Deferential artery arises from _________ to supply the ________

vesicular artery; vas deferens & epididymis

Cremasteric Artery arises from ___________ to supply the _________

inferior hypogastric; dartos

Venous drainage

Intratesticular veins come together in rete testis

Drains to pampiniform plexus in spermatic cord

Pampiniform plexus converges to testicular vein

Right testicular vein drains to IVC

Left testicular vein drains to Left renal vein

Pampiniform plexus courses in the

spermatic cord

Pampiniform plexus coverages into

3 sets of anastomotic veins (testicular, deferential, cremasteric)

The right testicular vein drains into the ______________ and joins the _________

IVC & left testicular vein; left renal vein

The deferential vein drains into the

pelvic veins

The cremasteric vein drains into the

tributaries of the epigastric and deep pudenal veins