male reproductive system

Name the layers of the scrotum from outer to inner

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• Skin

• Dartos muscle

• Colle’s fascia

• External Spermatic fascia

• Cremaster musc.

• Internal Spermatic fascia

what nerve is tested in the cremasteric reflex? and what does it test?

genital branch of genitofemoral nerve: tests integrity of spinal segments L1-2

what is the cremaster muscle attached to?

internal obliques

name the 3 spermatic cord coverings

• Internal spermatic fascia

• Cremasteric muscle

• External spermatic fascia

Mnemonic for Spermatic Cord Contents?

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• T: Testicular artery

• C: Cremasteric artery

• D: Ductus deferens (vas deferens)

• V: Venous plexus (pampiniform plexus)

• A: Artery of the ductus deferens

• L: Lymphatic vessels

• N: Nerves (Genitofemoral n. + Ilio-inguinal n.)

• S: Sympathetic nerves

What causes indirect inguinal hernia/hydrocele formation?

Failure of the embryonic processus vaginalis to close properly

what are the two coverings of the scrotum?

1. Tunica vaginalis

2. Tunica albuginea

what is the tunica vaginalis? what is it made of?

outer peritoneal covering made of:

• Parietal layer → attached to scrotum

• Visceral layer → attached to viscera

they are separated by a vaginal cavity

what is the tunica albuginea?

internal capsule projecting fibrous septa into testis which divides into lobules containing seminiferous tubules

what is the Intratesticular Duct Pathway?

1. Seminiferous Tubules: where sperm is created.

2. Straight Tubules: Short, straight hallways that connect the factory to the main hub.

3. Rete Testis: A central, mesh-like collection grid that gathers all the sperm.

4. Efferent Ductules: Small exit exit-tubes that carry the sperm out of the testicle and forward into the epididymis.

what is the blood supply for the testis and epididymus?

a pair of testicular arteries which originate from the abdominal aorta and GOES through the inguinal canal to reach the testis

what is the nerve supply of the testis?

Autonomic fibers are delivered to aortic plexus from T10, T11 segment of spinal cord

what is the venous drainage for the testis, epididymus, and vas deferens?

Pampiniform plexus of veins drains into testicular veins.

Right goes into IVC.

Left goes into left renal vein.

considering the anatomy of the left renal vein, what are the possible locations of a varicocele?

1. Left Suprarenal Vein

2. Left Gonadal Vein

3. Left Lumbar Veins

what is meant by “nutcracker syndrome”?

when the left renal vein is compressed between superior mesenteric artery and aorta

what is the lymph drainage for the testis and epididymus?

Para-aortic (lumbar) lymph nodes

what is the vas deferens?

a thick muscular tube that is 45cm long connecting the epididymus to the seminal vesicle and ejaculatory duct

blood supply of vas deferens?

artery of vas deferens originating from inferior vesical artery

what are the seminal vesicles? location?

5cm sacculated tubes at the base of the urinary bladder that merge with the ampulla of the vas deferens near base of prostate to form ejaculatory duct

what is the autonomic innervation for the Seminal Vesicles & Ejaculatory Ducts?

inferior hypogastric plexus

what is the lymph drainage for for the Seminal Vesicles & Ejaculatory Ducts?

• Internal iliac

• External iliac

• Common iliac lymph nodes

lateral relations of prostate?

the levator ani (levator prostatae) muscle

what are the Posterior Wall Features of Prostatic Urethra?

• prostatic sinuses

• urethral crest

• seminal colliculus

explain what is meant by ‘water under the bridge’

ureter relation is under vas deferens

lobes of prostate and locations?

• Anterior → infront of prostatic urethra

• Posterior → behind prostatic urethra

• Middle → between prostatic prostatic urethra and ejaculatory ducts

• Lateral → lateral to prostatic urethra

mnemonic for prostatic zones?

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• Peripheral

• Periurethral

• Central

• Transition

• Anterior Fibromuscular

name the erectile columns

• Paired corpora cavernosa

• Single corpus spongiosum

what are the fascial layers of the penis?

• colle’s fascia → extension of scarpa’s fascia

• buck’s fascia

what is the suspensory ligament of the penis

Triangular sheet of fibrous tissue attached by its apex to the symphysis pubis, splitting at its base to fuse with the deep fascia of the penis

what is the arterial supply and origin of artery that supplies the penile/scrotal skin?

superficial external pudendal artery which is a branch of the femoral artery

what is the arterial supply that supplies the erectile tissues?

dorsal + deep arteries of the penis

what is the venous drainage of the penis? 2 veins

• superficial dorsal vein

• deep dorsal vein

How does cancer metastasise and spread?

Deep dorsal vein → Santorini venous plexus → Internal iliac vein → IVC → communicates with Batson's vertebral plexus → provides a route for cancer cell metastasis to the spine and lungs

what is the nerve supply of the penis and what is the relation of each to buck’s fascia?

• Dorsal Nerve of Penis: Branch of the pudendal nerve → courses deep to Buck's fascia

• Ilioinguinal Nerve: Branch of the lumbar plexus → courses superficial to Buck's fascia

what is the lymph drainage in the penis?

• Superficial: superficial inguinal lymph nodes

• Deep Structures: Drains to deep inguinal lymph nodes → internal iliac lymph nodes → common iliac lymph nodes

what is peyronie’s disease?

Fibrous plaque formation causing painful curvature/deformation of the penis during erection

what is penile trauma caused by and what does it lead to?

Vigorous sex activity or blunt trauma can cause rupture of the erect penis, leading to fibrosis if untreated

parasympathetic nerve supply for sexual function runs through?

S2-S4