Podcast
Questions and Answers
What is the role of the corona of the glans penis?
What is the role of the corona of the glans penis?
Which artery primarily supplies the glans of the penis?
Which artery primarily supplies the glans of the penis?
What is the primary function of the external urethral sphincter?
What is the primary function of the external urethral sphincter?
Which part of the male urethra runs through the prostate?
Which part of the male urethra runs through the prostate?
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Which ligament is deep to the fundiform ligament of the penis?
Which ligament is deep to the fundiform ligament of the penis?
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What is the primary consequence of not treating testicular torsion within 12 hours?
What is the primary consequence of not treating testicular torsion within 12 hours?
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Which statement about the epididymis is accurate?
Which statement about the epididymis is accurate?
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What is the function of the superior ligament of the epididymis?
What is the function of the superior ligament of the epididymis?
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What is indicated as contraindicated when a testicular tumor is suspected?
What is indicated as contraindicated when a testicular tumor is suspected?
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Which component of the epididymis is primarily responsible for sperm storage?
Which component of the epididymis is primarily responsible for sperm storage?
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Which structure is responsible for transporting spermatozoa to the prostatic urethra?
Which structure is responsible for transporting spermatozoa to the prostatic urethra?
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What is the primary arterial supply for the epididymis?
What is the primary arterial supply for the epididymis?
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What membrane layer separates the testis from the epididymis?
What membrane layer separates the testis from the epididymis?
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Where are the bulbo-urethral glands located?
Where are the bulbo-urethral glands located?
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What percentage of ejaculate fluid is produced by the prostate gland?
What percentage of ejaculate fluid is produced by the prostate gland?
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Which structure courses through the prostate gland?
Which structure courses through the prostate gland?
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Which artery provides arterial supply to the prostate gland?
Which artery provides arterial supply to the prostate gland?
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How does the apex of the prostate relate to surrounding structures?
How does the apex of the prostate relate to surrounding structures?
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What is the primary purpose of the bulbo-urethral gland's secretion?
What is the primary purpose of the bulbo-urethral gland's secretion?
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Which surface of the prostate faces the pubic symphysis?
Which surface of the prostate faces the pubic symphysis?
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Which part of the ductus deferens is continuous with the duct of the epididymis?
Which part of the ductus deferens is continuous with the duct of the epididymis?
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Which lymph nodes are involved in the lymphatic drainage of the prostate?
Which lymph nodes are involved in the lymphatic drainage of the prostate?
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What part of the gland is embedded in the neck of the urinary bladder?
What part of the gland is embedded in the neck of the urinary bladder?
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What is the primary function of the seminal glands?
What is the primary function of the seminal glands?
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Which structure runs beneath the ductus deferens in close proximity to the urinary bladder?
Which structure runs beneath the ductus deferens in close proximity to the urinary bladder?
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What clinical procedure involves palpating the prostate gland?
What clinical procedure involves palpating the prostate gland?
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Which part of the ductus deferens is located within the inguinal canal?
Which part of the ductus deferens is located within the inguinal canal?
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What is formed by the union of the ductus deferens and the excretory duct of the seminal vesicle?
What is formed by the union of the ductus deferens and the excretory duct of the seminal vesicle?
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Which structure contributes to the temperature regulation necessary for sperm maturation within the spermatic cord?
Which structure contributes to the temperature regulation necessary for sperm maturation within the spermatic cord?
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What anatomical location is found caudally to the prostate?
What anatomical location is found caudally to the prostate?
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Which part of the ductus deferens is considered the most distal segment?
Which part of the ductus deferens is considered the most distal segment?
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What anatomical region is situated posteriorly to the urinary bladder?
What anatomical region is situated posteriorly to the urinary bladder?
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Which structure is not considered part of the spermatic cord?
Which structure is not considered part of the spermatic cord?
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What is the most common site for metastasis in prostate cancer?
What is the most common site for metastasis in prostate cancer?
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What anatomical structure remains open during ejaculation after a TURP procedure?
What anatomical structure remains open during ejaculation after a TURP procedure?
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What structure in the scrotum separates it into two independent cavities?
What structure in the scrotum separates it into two independent cavities?
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Which part of the penis contains the external urethral orifice?
Which part of the penis contains the external urethral orifice?
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What is the main function of the scrotum?
What is the main function of the scrotum?
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What are the two erectile tissues that compose the core of the penis?
What are the two erectile tissues that compose the core of the penis?
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Which structure is the remnant of the gubernaculum in the scrotum?
Which structure is the remnant of the gubernaculum in the scrotum?
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What is the function of the cremaster muscle in relation to the scrotum?
What is the function of the cremaster muscle in relation to the scrotum?
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During ejaculation, what does retrograde flow of semen into the urinary bladder result in?
During ejaculation, what does retrograde flow of semen into the urinary bladder result in?
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What is the structure responsible for anchoring the testis to the floor of the scrotum?
What is the structure responsible for anchoring the testis to the floor of the scrotum?
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Study Notes
### Testicular Torsion
- Swelling of the scrotum, intense pain projecting to the inguinal region and nausea are symptoms
- Occurs in adolescent males
- Requires urgent surgical treatment to prevent necrosis of the testis
- Irreversible damage to the testis occurs after 12 hours
- Orchidectomy, the surgical removal of the testis may be required
### Epididymis
- Highly convoluted duct attached to the posterior margin of the testis
- Tail of the epididymis continues as the ductus deferens
- Spermatozoa spend 10-12 days, of a total of 72 days, maturing within the epididymis
- Serves as a reservoir and maturation site for spermatozoa, where they gain the capacity to move and fertilize the ovum
- Provides nutrition for the spermatozoa
- If uncoiled, the ductules of the epididymis would reach a length of six meters
Structure of the Epididymis
- Head (caput): cranial part of the head of the epididymis formed by efferent ductules
- Body (corpus): formed by the convoluted duct of the epididymis
- Tail (cauda): caudal part that connects to the ductus deferens
- Sinus: peritoneal fold; visceral layer of the tunica vaginalis between the testis and epididymis.
Supporting Ligaments of the Epididymis
- Superior ligament of epididymis: connects the upper pole of the testis to the epididymis
- Inferior ligament of epididymis: connects the lower pole of the testis to the epididymis
- Scrotal ligament: connects the epididymis and testis to the caudal aspect of the scrotum
Ducts and Lobules of the Epididymis
- Efferent ductules (ductuli eferentes)
- Lobules of epididymis (lobuli epididymidis)
- Duct of epididymis (ductus epididymidis)
- Ductus/vas deferens
Vascular Supply of the Epididymis
- Arterial supply: testicular artery (from the abdominal aorta)
- Venous drainage: pampiniform plexus (to the testicular veins → to IVC on the right and the left renal vein on the left )
- Lymphatic drainage: lumbar nodes
Ductus Deferens
- Tubular organ that transports spermatozoa from the epididymis to the prostatic urethra
- It passes from the scrotum, through the spermatic cord and inguinal canal, into the lesser pelvis, where it crosses the ureter and enters the prostate
- Peristaltic contractions propel spermatozoa through the ductus deferens
Structure of the Ductus Deferens
- Scrotal part: located in the scrotum, continuous with the duct of the epididymis
- Funicular part: located in the spermatic cord
- Inguinal part: located in the inguinal canal
- Pelvic part: courses through the lesser pelvis, near the urinary bladder and fuses with the excretory duct of the seminal vesicle
- Ampulla of ductus deferens: dilated, most distal segment of the ductus deferens
-
Ejaculatory duct: joint duct formed by the union of the ductus deferens with the excretory duct of the seminal vesicle
- It enters the prostate and joins the prostatic urethra at the seminal colliculus
Spermatic Cord - Funiculus Spermaticus
- Tough, rope-like structure containing the ductus deferens, vessels and nerves
- Courses from the scrotum to the inguinal canal
- The venous pampiniform plexus lowers the temperature inside the spermatic cord, which is necessary for proper spermatogenesis
- Layers of the abdominal wall continue over the spermatic cord and scrotum, forming their coverings
- Layers and content of the spermatic cord are mentioned in the lecture ‘Inguinal canal’.
Seminal Glands - Glandulae Vesiculosae
- Located behind the urinary bladder above the prostate
- Each gland has a single duct with multiple convolutions
- Produce 50-80% of the ejaculate
Structure of the Seminal Gland and Its Ducts
- Seminal gland
- Excretory duct: joins the ductus deferens
- Ejaculatory duct: formed by the union of the excretory duct and ductus deferens
-
Regional anatomy:
- Posterior wall of the urinary bladder: lies anteriorly to the seminal gland
- Rectovesical pouch of the peritoneal cavity: located posteriorly
- Ampulla of the ductus deferens: situated medially
- Prostate: found caudally
Bulbourethral Glands - Glandulae Bulbourethrales
- Located on the inferior surface of the deep transverse perineal muscle
- Empty into the ampulla urethrae
- Produce a viscous liquid that lubricates the urethra during ejaculation
Regional Anatomy of the Bulbourethral Glands
-
Superiorly: the gland lies on the inferior surface of the deep transverse perineal muscle
- Anteriorly: the duct enters the ampulla urethrae
- Inferiorly: the bulb of the penis is located underneath the gland
Prostate - Prostata
- The largest male genital gland
- Produces 30% of the ejaculate fluid
- Located subperitoneally, inferior to the urinary bladder
- The urethra courses through the prostate along with the paired ejaculatory ducts
Structure of the Prostate
-
Base: broad cranial part around the neck of the urinary bladder
- Apex: tip of the prostate, which points toward the pelvic floor
- Prostatic urethra: segment of the urethra coursing through the prostate
- Anterior surface: faces the pubic symphysis and is attached to the pubic symphsis by the puboprostaticus muscle and puboprostatic ligaments
- Posterior surface: faces the rectum
- Right and left inferolateral surfaces: lateral surfaces facing the pelvic floor
- Right, left and middle lobes of the prostate: three lobes of the prostate
Regional Anatomy of the Prostate
-
Cranially: neck of the urinary bladder embedded in the base of the prostate
- Dorso-cranially: seminal glands laterally and ductus deferens medially
- Centrally: urethra
- Dorsally: rectum behind the rectovesical septum
- Caudally: the apex of the prostate is embedded in the pelvic floor
Vascular Anatomy of the Prostate
- Arterial supply: prostatic branches of the inferior vesical artery and middle rectal artery
- Venous drainage: prostatic venous plexus and vesical venous plexus
- Lymphatic drainage: internal and external iliac nodes and sacral nodes
Clinical Correlation: Prostate Examination
- Per rectum palpation of the prostate is a standard part of the clinical examination
- Performed by palpating the prostate through the anterior wall of the rectum
Clinical Correlation: Metastatic Prostate Cancer
- Spread of prostate cancer beyond the true pelvis can occur
- Most common site: bone, especially the vertebrae
- Less common sites: lungs, liver, and adrenal glands
Clinical Correlation: Transurethral Resection of the Prostate (TURP)
- After TURP for benign hyperplasia of the prostate, the neck of the urinary bladder remains open during ejaculation.
- Results in retrograde flow of semen into the urinary bladder, causing the "dry ejaculation".
Scrotum
- Sac located on the outside of the body, containing the testis and epididymis
- The temperature inside the scrotum is 2-4 degrees lower than core body temperature, ensuring optimal spermatogenesis
- Contraction of the cremaster muscle pulls the scrotum upwards, towards the perineum
Structure of the Scrotum
-
Septum of scrotum: composed of CT that separates the scrotum into two independent cavities, each containing one testis
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Raphe of scrotum: seam-like line where the genital (labioscrotal) swellings merged during development, right over the septum of the scrotum
- Continues ventrally as the raphe of the penis and dorsally as the perineal raphe
- Scrotal ligament: remnant of the gubernaculum, attaching the lower pole of the testis and tail of the epididymis to the floor of the scrotum
-
Raphe of scrotum: seam-like line where the genital (labioscrotal) swellings merged during development, right over the septum of the scrotum
Layers of the Scrotum
- Vaginal cavity of testis: serous cavity between the two layers of the tunica vaginalis
Penis
- Functions: urination and release of semen
- Structure: primarily composed of erectile tissue, blood vessels, nerves, and CT
- The core of the penis contains three erectile tissues: two corpora cavernosa and the corpus spongiosum
Structure of the Penis
-
Root of penis (radix penis): composed of the two crura and the bulb
- Crura of penis (crura penis): paired internal part of the corpora cavernosa; attaches to the phalic crest of the inferior pubic ramus and to the pubic symphysis
- Bulb of penis (bulbus penis): unpaired dilated part of the corpus spongiosum underneath the perineum
-
Body of penis (corpus penis): external part of the penis, composed of three erectile bodies
- Glans penis: most distal segment of the corpus spongiosum, location of the external urethral orifice
Components of the Glans Penis
-
Corona of glans: dilated rim of the glans facing the body of the penis
- Neck of glans: groove separating the glans from the body of the penis
- External urethral orifice: the tip of the glans
- Foreskin / prepuce: skin fold of the body of the penis that can be pulled over the glans
- Frenulum: ventrally located skin crease, a transition between the skin of the glans and the skin of the prepuce
- Preputial glands / Tyson's glands: small smegma-producing glands at the inner margin of the foreskin
Ligaments of the Penis
- Fundiform ligament: springs from the lower part of the linea alba and splits into two lamellae, which enclose the proximal part of the body of the penis
-
Suspensory ligament: deep to the fundiform ligament, triangular in shape
- Its narrow upper end is attached in front of the pubic symphysis and broad lower part blends with Buck's fascia on either side of the body of the penis
Vascular Supply of the Penis
-
Arterial supply: internal pudendal artery
- Dorsal artery of penis: supplies the skin and glans of the penis and the foreskin
- Deep artery of penis: inside the corpus cavernosum; gives off the helicine arteries as its branches
- Artery of bulb of penis: inside the bulb of the penis
- Urethral artery: inside the corpus spongiosum
Urethra Masculina - Male Urethra
- Length of the male urethra is about 20 cm
-
Parts:
- Pars intramuralis: runs through the neck of the urinary bladder
- Pars prostatica: runs through prostate
- Pars intermedia (pars membranacea, diaphragmatica): runs through the muscle tissue of the pelvic and urogenital floor
-
Pars spongiosa: runs in the corpus spongiosum of the urethra (bulbourethral glands end here)
- Fossa navicularis: terminal section in the glans of the penis
- Ostium urethrae externum: outer ostium of the urethra
Curvatures and Sphincters of the Male Urethra
-
Curvatures:
- Subpubic curvature: superior-facing concavity at the transition of the membranous and spongy urethra; cannot be straightened
- Prepubic curvature: inferior-facing concavity of the spongy urethra; straightens during erection
-
Sphincters:
- Internal urethral sphincter: weak smooth muscle sphincter
- External urethral sphincter: strong striated muscle
Constricted and Dilated Segments of the Urethra
-
Constricted segments
- Intramural part
- Membranous urethra
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Description
This quiz covers critical information about testicular torsion, its symptoms, and the urgency of surgical intervention. It also explores the anatomy and function of the epididymis, detailing the process of sperm maturation and the structure of its components. Test your knowledge on these important aspects of male reproductive health.
