Anatomy of Male Reproductive System PDF

Anatomy of Male Reproductive System Dr. Mohammed Alshamiri Consultant of Urology  What are the parts of male genital system? 1. External genital organs 1. Penis 2. Scrotum ll. Internal genital organs 1. Testis 2. Vasa efferentia 3. Epididymis 4. Vas...

Anatomy of Male Reproductive System Dr. Mohammed Alshamiri Consultant of Urology  What are the parts of male genital system? 1. External genital organs 1. Penis 2. Scrotum ll. Internal genital organs 1. Testis 2. Vasa efferentia 3. Epididymis 4. Vas deferens 5. Seminal vesicle 6. Ejaculatory duct 7. Prostate  Sctotum Number: One on each side Site: [nside the scrotum. ) Shape: - Oval in shape (2 x I x 1/2 inches). Relations  Relations it has two borders: a. Anterior border: Free & related to tunica vaginalis b. Posterior border: related to epididymis (Laterally) & vas deferens (Medially). The front and lateral sid of surface of the testis are free and lie within a fergus sac ca:led the tunica vaginalis (which teas a visceral and parietal  Identification of the Side 1. The testis is placed anterforly (epididymis is placed posteriorly) 2. The spermatic cord is directed upwards. 3 the sinus of the epididymis-) is lateral. [so, the sinus lies on the Rt.side of the Rt. testis, and Lt.side of the Lt. testis) Coverings of the Side  Coveringe of the sid Three layers of the stratum (skin, dartos muscle, and membranous layer of the superficial fascia). Three coverings from the abdominal wall (external spermatic fascia, cremasteric muscle and fascia, and internal spermatic fascia) Three specific coverings (parietal and visceral layers of the tunica vaginalis + tunica albuginea. Structure  Stricture The testis has a thick fibrous tissue c;apsule called the tunica albuginea which is thickened along the posterior border of the testis to form the mediastinum testis. The mediastinum testis sends fibrous tissue septa to the inner aspect of the capsule which divide the testis into 200-300 lobules. Each lobule contains (1 - 3) U shaped tubules called the seminiferous  The rete testis connects the seminiferous tubules to the vasa efferentia. The testis has three types of cells: a. Germ cells: Produce sperms. b. Sertoli cells: Support sperms and. provide nutrition for them. c. Leydig cells: Secrete testosterone.  Blood Supply Arterial supply. Testicular artery arise from abd aorta  Venouse drainge Venous drainage The veins from both the testis and epididymis drain into a versus plexus called the pampinifarm plexus which gives rise to a "single testicular vein" which drains into:  Lymphatic Drainage Both the testis and epididymis drain into the preaortic and para-aortic lymph nodes.  Functions of the Testis 1. Production of sperms [spermatogenesis) through the seminiferous tubules. 2. Secretion of the male sex hormone (testosterone) through the Leydig  Applied Anatomy Varicocele The veins around the testis become dilated, elongated and tortious leading to varicocele (it is affects the  Vasa Efferentia Where is vasa efferentia? Vasa efferentia Vasa efferentia Number: one on each side. Site : At the upper part of the posterior surface of the testis. Structure: Short tubules. Function: Transmission of sperms from the testis to epididymis  Epididymis, Where is Epididymis  Epididymis Numbcr: One on each side. Site: Postero- lateral to the testis. Shape: Comma shaped.  Structure and function Structure(parts ) it is a coiled tubular structure which is formed of:- a. Head b. Body. C.Tail Function: Vas Deferens  Vas deference it is a musculo-tubular structure 45 cm long. it has a thick muscular wall and a very narrow lumen (felt as a cord like structure). Beginning and Temaination a. Beginning it begins at the tail of the epididymis. b. Terminatiin : it unites with the duct of seminal vesicle to form the ejaculatory duct.  Course of vas deferenc 1. 1ntrascrotal part 2. Intra- inguinal part 3. A part on the side wall of the pelvis 4. A part between the bladder and  1-Intrascrotal part it arises from the tail of the epididymis and ascends behind the posterior border of the testis on the medial side of the epididymis. 2, Intra-inguind part  3-a part on the sid wall of the pelvis (Hooking of the vas deferens over the inferior epigastric artery) 4-apart between bladder and rectum  Blood supply 1-arterial supply -artery of the vas (from inferior vesical artery 2-venouse drainage - it drains its venous blood  Function of vas deference it carries the sperms from epididymis to ejaculatory duct  Spermatic cord Site  Spermatic cord, Constituents 1-Vas deferenc 2-Artery a. Testicular artery from the abdominal aorta at L3 b. Artery of vas from the inferior vesical artery. c. Cremasteric artery, from the inferior  Spermatic Cord 3-Veins drainage 3-Veins drainage The veins form a plexus called pampiniform plexus of vein, They drain the testis and epididymis. At the deep inguinal ring they collect to form a single testicular vein which drains into: a. On the right side to IVC. b. On the left  Lymphatic drainage and nerve supply 4. Lymphatics They drain the testis and epididymis and pass through the deep inguinal ring to terminate in the preaortic and para-aortic lymph nodes. 5. Nerves a. Cremasteric nerve It is the genital branch of the genitofemoral nerve. It is sensory to the tunica vaginalis and the coverings of the spermatic cord.  Spermatic cord Covering 1. Internal spermatic fascia 2. Cremastric muscle and fascia 3. External spermatic fascia  Seminal Vesicle Number and Site Number: One on each side.Site:- Between the urinary bladder and rectum.  Seminal Vesicle Peritoneal Covering The peritoneum covers only the tip (upper end) of the seminal vesicle. Seminal vesicle Relations Medial: Ampulla of the vas deferens. Lateral: Levator ani. Anterior: Base of the urinary bladder. Posterior: Rectum.  Arterial Supply Both the vas and seminal vesicles are supplied by the inferior vesical and middle rectal arteries.  Nerve Supply Both the vas deferens and seminal vesicles are supplied by sympathetic fibers from L1 segment of spinal cord.  Seminal Vesicle Function It produces nutritive secretions which forms the large part of the seminal fluid.  Ejaculatory Duct Number: One on eaclh side. Site: Inside the prostate. Function: Passage of contents of the vas, and the seminal vesicle [sperms, and  Prostate Shape and Site it is conical in shape (which has a base directed upwards and an apex directed downwards) it lies below the neck of the urinary bladder where it surrounds the  Prostate Dimension -it is about 4 X 3 Relations (base X 2 cm (broader than long). + apex + 4 - The urethra surfaces) enters the base of the prostate and passes downwards and forwards to emerge from its anterior surface just above the apex.  Prostate function Secretion of alkaline fluid during ejaculation for neutralization of the vaginal acidity.  Anatomical Lobes 1. Anterior lobe: in front of the urethra. 2. Posterior lobe: Behind urethra and below the ejaculatory ducts. 3. Median lobe: Between the urethra and the ejaculatory ducts.  Structures Inside The Prostate 1. Prostatic urethra 2. Ejaculatory ducts 3. Prostatic utricle  Surgical Lobes 1.Central Zone It represents about 2S% of the glandular substance. It is wedge-shaped forming the base of the prostate, and its apex lies at the seminal colliculus. lts ducts open into the seminal colliculus around  2-Peripheral Zone It represents about 75% of the glandular substance. It surrounds the central zone from behind and below but does not reach the base. It extends downwards to form the lower part of the gland.  Prostatic Capsule 1-True Capsule. it is a layer of connective tissue surrounding the prostate. 2. False calpsulc - it is formed of condensation of the pelvic fascia and lies outside the true capsule.  Blood Supply of prostate 1-Arterial Supply - Inferior vesical, middle rectal and internal pudendal arteries. 2-Veins drainage The veins form the prostatic venous plexus which lies between the true and false capsules. The prostatic plexus communicates with the vesical venous plexus and drains into the internal iliac vein.  Lymphatic Drainage Into the internal and external iliac lymph nodes.  Applied Anatomy Senile enlargement of the prostate In old age, there is enlargement of the median lobe (senile prostatic hyperplasia) which may cause difficulty of micturition [urine retention) and adverse back-pressure elects on the ureters  PENIS A. Root It is the attached part of the penis (situated in the superficial perineal pouch). B. Body - it is the free portion which is completely  Stricture of Penis 1. Erectile tissue a. Corpus spongiosum [single + mid]ine) b. Corpus cavernosum [one on each side) 2. Coverings 1. Skin 2. Superficial fascia  1. Erectile tissue a. Corpus spongiosum (single + midline) It is the continuation of the bulb of penis and ends by a conical enlargement called the glans penis The urethra  b. Corpus cavernosum (one on each side) They are the forwards continuation of the cara of the penis. They lie in close position to each other and end under cover of the gland penis. Each corpus cavernosum is  Covering 1. Skin 3- Superficial fascia, formed of: a. Superficial layer of loose areolar tissue devoid. b. Deep membranous layer (fascia penis).  Arterial Supply of Penis 1. Deep artery of the penis 2. Dorsal artery of the penis 3. Artery of the bulb  Venouse Drainage 1. Superficial dorsal vein of the penis 2. Deep dorsal vein of the penis  Nerve Supply 1. Sensory nerve supply a. Dorsal nerve af the penis (branch from the pudendal nerve). b. llioinguinal nerve. 2. Autonomic nerve supply (important) a. Parasympathetic (erection): Pelvic splanchnic nerve (S. 2, 3, 4) b. Sympathetic (ejaculation): Inferior hypogastric plexus.  Lymphatic Drainage In too the superficial inguinal lymph nodes.  Scrotum 1-Skin 2- Superficial fasca which contains 'dartose muscle ' (which is an involuntary muscle supplied by sympathetic fiber ' and. Cousewrinkling of the scrotal skin in  Arterial Supply 1. Superficial external pudendal a. 3. Scrotal branch of the internal pudendal a. 2. Deep external pudondal a. 4. Inferior epigastric a. Nerve Supply Anterior 1/3 ilioinguinal nerve + Scrotal branches of the pudendal n. Posterior 2/3 Posterior cutaneous nerve of the  Lymphatic drainage Into the superficial inguinal lymph nodes.