SUBJECT: ANATOMY
 
TOPIC: GROSS MALE REPRO
 
LECTURER: DR. JC REYES
 
DATE: NOVEMBER, 2010
 
 
MALE REPRODUCTIVE SYSTEM - Innervated by sympathetic nerves responsible for the
wrinkling of the overlying skin
 System of organs within the organism which work
together for the purpose of reproduction *should be wrinkled –if not, boys have a problem
 It includes non-living substances such as fluids, with their sympathetic nervous system
hormones and pheromones
Pheromones –unique; depends on the person *CAMPER’S FASCIA –converted to DARTOS
MUSCLE in the scrotum innervated by sympathetic
MALE nerves which gives a wrinkled appearance
- Refers to the sex of the organism that can produce small
mobile gametes called spermatozoa *SCARPA’S FASCIA- converted to COLLES’ FASCIA
- Includes: in the scrotum and can even cover the distal part
Testes of the penis aside from the scrotum
Scrotum,
Epididymis, 3. Spermatic fascia (remember: ICE TIE)
Spermatic cord, - 3 layers derived from anterior abdominal wall
Vas deferens, -covers both the testes and the entire length of the
Seminal vesicle, spermatic cord
Ejaculatory duct, - Includes:
Glands, - EXTERNAL SPERMATIC FASCIA  EXTERNAL OBLIQUE
Penis APONEUROSIS
Urethra - CREMASTERIC FASCIA  INTERNAL OBLIQUE MUSCLE
- INTERNAL SPERMATIC FACIA TRANSVERSALIS
**TESTIS  capable of producing sperm and is carried to FASCIA
the ductal system up to area of ejaculatory duct
**CREMASTERIC MUSCLE pulls testes during cold
environments near pelvic brim for the survival of the
SCROTUM developing sperm which is sensitive to temperature.
- Out pouching/out-pocketing of the lower part of the **warm temperature –cremasteric muscle relaxes
anterior abdominal wall
- Extension of the abdominal wall **from this point: 6 layers
- Homologue of Labia majora (female)

**Difference between scrotum and labia majora?

Scrotum: wrinkled; labia majora: not wrinkled

CONTENTS OF THE SCROTAL SAC

-testis
-epididymis
-lower end of spermatic cord

3 LAYERS OF THE SCROTAL SAC

1. Skin
- Thin, wrinkled and pigmented part of scrotum
- Raised ridge in the midline indicates the fusion of the two
lateral labio-scrotal swelling

**LATERAL LABIO-SCROTAL SWELLINGS IN FEMALES–

BLOOD SUPPLY OF THE SCROTAL SAC
remain unfused
1. Posterior scrotal artery
**Fusion is indicated by the midline
- from INTERNAL PUDENDAL ARTERY which is a branch of
the ANTERIOR DIVISION OF THE INTERNAL ILIAC ARTERY
**Color will depend on genetic disposition
- supplies posterior surface of scrotum which is also
responsible in supplying area of the pelvis
2. Superficial fascia
- Continuous with the fatty and membranous layer of the
anterior abdominal wall

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** Common iliac dividing to external and internal; internal
divides to anterior and posterior division; anterior division-
you will see IIOUVM branches
2. Anterior scrotal artery
- from EXTERNAL PUDENDAL ARTERY from FEMORAL
ARTERY
- supplies anterior surface of the scrotum
3. Cremasteric artery
from INFERIOR EPIGASTRIC ARTERY
**majority of male reproductive system is supplied by
INTERNAL PUDENDAL ARTERY
VENOUS DRAINAGE
** scrotal veins accompany the arteries
**inverse order of the arterial drainage
**drains primarily to the external pudendal veins
INNERVATION
1. Anterior scrotal nerve
-from ILIOINGUINAL NERVE and GENITAL BRANCH OF THE
GENITOFEMORAL NERVE
**INLIOINGUINAL NERVE  retroperitoneal nerve that will
cross the transverses abdominis and the loop around iliac
crest and supply MEDIAL part of ANTERIOR SCROTUM
**GENITOFEMORAL NERVEretroperitoneal that will exit
psoas muscle that will divide into genital and femoral
branch genital (more medial branch) and will supply
LATERAL portion of ANTERIOR SCROTUM
2. Posterior scrotal nerve
- from the PUDENDAL NERVE
- supplies the posterior scrotum
**The pudendal nerve is the only nerve that re-enters
through the lesser sciatic foramen to the provide
innervations to the pelvis.
TESTIS
- Firm mobile organ lying within the scrotum
- Surrounded by the TUNICA VAGINALIS except on the
posterior side
- Main testis is covered by the TUNICA ALBUGINEA except
on the mediastinum
-suspended into the scrotum by the SPERMATIC CORD
**Usually, the left testis is LOWER than the right testis for
unknown reasons.
TUNICA VAGINALIS
- Deficient posteriorly (covers the testis except the posterior
surface)
- Located external to the tunica albuginea
- Lower expanded portion of the PROCESSUS VAGINALIS
- With PARIETAL LAYER and VISCERAL LAYER
**TUNICA VAGINALIS  remnant of the embryonic
PROCESSUS VAGINALAS
**PROCESSUS VAGINALIS embryonic peritoneum
*GUBERNACULUM a cord-like structure that guides the
testis to descend in the scrotal sac. Without the
gubernaculums, the testis will not descend into the scrotal
sac.
**processus vaginalis also guides testis into the scrotal
sac. While the testis is descending, the processus vaginalis
is also starting to close, and weeks prior to birth, it should
closed. When closed, it is now called TUNICA VAGINALIS
**PARIETAL LAYER more superficial
VISCERAL LAYER  attached to testis and is in close
contact with the tunica albuginea
**plus 2 more layers added (parietal and visceral layer of
tunica vaginalis) except for posterior aspect
TUNICA ALBUGINEA
- White, tough fibrous outer covering of the testis
- Will invaginate the substance of the testis
- Extends inward to form compartments that will contain the
SEMINIFEROUS TUBULES
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**SEMINIFEROUS TUBULES coiled tubes responsible for
the production of sperm
**TUNICA ALBIGINEA same capsule that will cover the
ovary
SEMINIFEROUS TUBULUES
- Highly coiled structure located in the compartments
formed by the tunica albuginea
- Capable of producing sperm
- Each coiled structure will terminate as a straight duct
called STRAIGHT TUBULE which will then connect the
seminiferous tubules to the RETE TESTES
**straight tubules DIRECTLY connects with the
seminiferous tubules
**RETE TESTES  network of ducts that connects the
semiiferous tubules to epididymis and is located on
mediastinum of the testicle
EPIDIDYMIS
- An elongated structure on the posterior surface of the
testis
- EFFERENT DUCTULES first duct that will leave testes
which connects the rete testes to the epididymis and
transport the newly formed sperm from the rete testes to
the epididymis
3 PARTS OF THE EPIDIDYMIS
1. Head
- Receives 12-14 efferent ductules
2. Body
-Contains highly convoluted ducts
-without efferent ductules
3. Tail
- Single coiled structure which will be continuous with the
VAS DEFERENS/ DUCTUS DEFERENS
BLOOD SUPPLY OF THE EPIDIDYMIS
1. Testicular artery (Gonadal artery)
- Branch of the abdominal aorta which lies inferior to the
renal artery
- Passes retroperitoneally crossing over the ureters
”water under the bridge” configuration
VENOUS DRAINAGE
1. Pampiniform plexus
- Network of veins collecting blood in the testis
- Forms a single vein called testicular vein/gonadal vein
2. Testicular vein
- Collects the paminiform plexus
**Right testicular vein-drains DIRECTLY into IVC
**Left testicular veindrains into the LEFT RENAL VEIN
SPERMATIC CORD
- Collection of structures that pass through the inguinal
canal and from the testis
- Also covered by the layers of the spermatic fascia
CONTENTS OF THE SPERMATIC CORD (MEMORIZE!)
- Vas deferens
- Testicular artery
- Pampiniform plexus
- Testicular lymph vessels
- Autonomic nerves
- Remains of the processus vaginalis
- Genital branch of genitofemoral nerve (for the innervation
cremaster muscle)
**Important structures: VAS DEFERENS, TESTICULAR
ARTERY, PAMPINIFORM PLEXUS
VAS DEFERENS/ DUCTUS DEFERENS
- Cordlike structure that can be palpated between the
fingers and thumb in upper part of scrotum
- Thick walled muscular duct that transports the
spermatozoa from the testes to the urethra
- Begins in the tail of epididymis and ends by joining
seminal vesicle to form the EJACULATORY DUCT
- Terminal portion of vas deferens is positioned POSTERIOR
the bladder and SUPERIOR to the seminal vesicle
** AMPULLA OF THE DUCTUS DEFERENS dilated portion
at the terminal end of the vas deferens
BLOOD SUPPLY OF THE VAS DEFERENS
1. Artery to ductus deferens
- branch of the SUPERIOR and INFERIOR VESICLE ARTERY
**SUPERIOR VESICLE ARTERY embryonic umbilical
artery
**INFERIOR VESICLE ARTERY  direct branch of the
anterior division of the INTERNAL ILIAC ARTERY
VENOUS DRAINAGE
1. Pampiniform plexus
- drains the proximal portion of the ductus deferens
2. Vesicular/ Prostatic venous plexus
- drains the distal part of the ductus deferens
SEMINAL VESICLE
- 2 lobulated organs
- 2 inches long
-Located on the inferior portion of the ampulla of the vas
deferens
- Lies on the posterior surface of the bladder
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- Each vesicle consists of coiled tube embedded in
connective tissue
RELATIONS
Anterior: related to posterior surface of urinary bladder
Posterior: rectum
Medial: terminal part of vas deferens
FUNCTIONS
- Secrete seminal fluid
**SEMINAL FLUID thick alkaline fluid which produces
fructose and a coagulating agent that mixes with the sperm
as they pass to ejaculatory ducts and urethra
EJACULATORY DUCT
- Slender tube that arise from union of two ducts (seminal
vesicle and ampulla of the ductus deferens)
- Passes at the posterior surface of the PROSTATE GLAND
- Pierces the prostate gland before it becomes urethra
which means that the ejaculatory duct is embedded within
the prostate gland
- Ejaculatory ducts converge to open on the SEMINAL
COLLICULUS
-Will ONLY transmit seminal fluid and sperm
**Urethra will transmit both urine and contents of
ejaculatory duct
** movement of sperm is guided by peristalsis
** will open to the PROSTATIC UTRICLE
BLOOD SUPPLY OF THE EJACULATORY DUCT
Inferior vesicle artery
Middle rectal artery
VENOUS DRAINAGE
Inferior vesicle vein
Prostatic venous plexus
PROSTATIC UTRICLE
- Counterpart of the female uterus
- With 2 apertures:
- Opening of the EJACULATORY DUCT (inferior)
- Blind aperture which represents the degenerated
FALLOPIAN TUBE and UTERUS (superior)
CLINICAL SIGNIFICANCE
1. CRYPTORCHIDISM
- Undescended testis
- Either 1 or both testes fails to descend into the scrotal sac
- PROBLEM: Child can become STERILE due to the death of
sperms because the temperature in the testicle is not
regulated. (cremasteric muscles are not functioning well
-Higher risk for the development of TESTICULAR CANCER in
adulthood
-surgical procedure: ORCHIOPEXY which pull the testicle
after incising the scrotal sac
2. VARICOCELE
- Abnormal engorgement of the pampiniform plexus
3. HYDROCELE
- PROBLEM: Processus vaginalis fails to close and fluid
formed in the abdominal cavity will be collected in the
scrotum since there is a direct relationship between the
scrotum and abdominal cavity
- diagnosed using pen light at the posterior scrotal sac
- (+) trans-illumination
- scrotum contains fluid
*HEMATOCELE blood is contained in the scrotal sac
4. INGUINAL HERNIA
- processus vaginalis contains intestines
**MILD FORM OF INGUINAL HERNIA can be reduced by
positioning the patient in the TRENDELENBURG POSITION
so that the abdominal viscera will move upwards and pull
herniated part.
**ICE can also help since it causes the contraction of the
abdominal viscera which pulls the abdominal viscera
upwards
** INCARCERATED TYPE OF INGUINAL small intestine
herniated up to the scrotum which created an obstruction
in the GI tract.
5. TESTICULAR TORSION
- aka TESTICULAR GANGRENE
- Gangrenous tissue is secondary to necrosis since blood
supply it cut off
- Spermatic cord twists on its own axis which cuts off the
blood supply to the testis (testicular artery)
- Common to those people living in cold climates since the
sudden drop of the testicles (when they seek for warmth)
can cause twisting
- MANAGEMENT: spermatic cord should be untwisted
6. TESTICULAR CANCER
- “...a very ugly looking testicle (Doc JC, 2010).”
7. VASECTOMY
- ligation of the vas deferens
- Both sides should be ligated
- Procedure: an incision is made on the mid-portion and
look for the spermatic cord and then the vas deferens.
Afterwards, tie it!
PROSTATE GLAND
- Largest accessory gland of the male reproductive system,
- 3 x 4 x 2 cm
- 2/3 of the prostate gland is glandular and 1/3
fibromuscular (particularly the peripheral part)
- Walnut shaped
- Surrounds both the prostatic urethra and ejaculatory duct
(more posterior)
- CAPSULE fibrous, dense and neurovascular containing
the PROSTATIC PLEXUS and VEINS surrounding the area of
the prostate
- With surfaces, lobes and zones which is important in
surgery
SURFACES OF THE PROSTATE GLAND
1. Base closely related to NECK OF THE BLADDER
2. Apex related to URITHRAL SPHINCTER and deep
perineal muscle
3. Anterior related to transversely oriented muscles of
pelvis
4. Posterior related to RECTUM
5. Inferolateralrelated to LEVATOR ANI muscles
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**bulging prostate gland can be palpated in the anterior
surface of the rectum
LOBES OF THE PROSTATE GLAND
1. Isthmus/Anterior lobe
2. Inferoposterior lobe posterior to EJACULATORY DUCT
and closely related to RECTUM
3. Median/middle lobe between posterior to URETHRA
and anterior to EJACULATORY DUCT
4. Lateral lobes lateral to urethra
ZONES OF THE PROSTATE GLAND
1. Peripheral zone under the capsule (subcapsular)
2. Central zone encloses EJACULATORY DUCT
3. Transitional zone encloses the URETHRA
4. Anterioranterior fibromuscluar zone
**enlargement of the prostate/ hypertrophy at the
TRANSITIONAL ZONE difficulty in urinating
PROSTATIC DUCTS
- 20 to 30 prostatic ducts
- Openings at the side of prostatic sinuses (minute
openings at the side of the utricle; posterior urethra)
PROSTATIC FLUID
- Thin, milky fluid that is alkaline in nature
- Alkalinity helps neutralize acidity of vagina
- Provides 20% of the volume of semen
- Plays role in activating sperm
BLOOD SUPPLY OF THE PROSTATE GLAND
1.Prostatic Artery
- Branch of INFERIOR VESICLE ARTERY, branch of the
INFERIOR DIVISION OF THE INTERNAL ILIAC ARTERY
VENOUS DRAINAGE
1. Prostatic venous plexus
- Located on the capsule of the prostate
- Drain directly into the INTERNAL ILIAC VEIN
CLINICAL SIGNIFICANCE
1. Benign prostatic hypertrophy(BPH)
- Pathological enlargement of the prostate gland
- Direct rectal examination (DRE)
- should be non-palpable
(+) DRE: benign prostatic hypertrophy
(+) distended bladder
- enlarged prostate (hormonal)
- urethra is compressed—difficulty in urinating
- Common to: Middle-aged men with difficulty in urinating;
very distended urinary bladder
- MANAGEMENT: Transurethral resection of the prostate
-remove obstructed part in the urethra
BULBOURETHRAL GLAND
- aka COWPER’S GLAND
- Embedded within external urethral sphincter
- Homologous to BARTHOLIN’S GLAND in females
- Pea-sized shape
- Clear viscous secretion  PRE-EJACULATE
- Capacity to lubricate urethra for passage of sperm and
neutralize acidic urine in urethra
PENIS
- Male copulatory organ contained in urogenital triangle
together with the scrotum
- Covered with Dartos fascia (superficial fascia) which is
equivalent to the Camper’s fascia in the abdomen
- Also contains tunica albuginea
PARTS OF THE PENIS
- Root of the Penis (fixed)
- Body of the penis (free and pendulus)
ROOT OF THE PENIS
- made up of three masses of erectile tissue:
BULB OF PENIS
- situated in the midline and is attached to the under
surface of the urogenital diaphragm
- traversed by the urethra
- covered by BULBOSPONGIOSUS MUSCLE
- continued forward to become the body of the penis and
forms the CORPUS SPONGIOSUM
RIGHT AND LEFT CRURA OF THE PENIS
- each crus is attached to the side of the pubic arch
-covered by ISCHIOCAVERNNOSUS MUSCLE (skeletal
muscle)
- two crura will converge anteriorly and lie side by side in
the dorsal part of the body of the penis as the CORPORA
CAVERNOSA
BODY OF THE PENIS
- essentially composed of three cylindrical erectile tissues
enclosed in Buck’s fascia
- attached to the anterior suspensory ligament of the penis
- suspended from the pubic symphysis
CONTENTS OF THE BODY OF THE PENIS
Thin skin
Connective Tissue
Blood vessels
Erectile tissue:
- Corpora Cavernosa
-two dorsally placed erectile tissue
- Corpora Spongiosum
-single, ventrally placed erectile tissue
-pierced by the urethra posteriorly
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ERECTILE TISSUE
- 3 expandable erectile tissue which is filled with blood
- ERECTION: due to high content of nitric oxide in blood
- 90% of the blood will fill the CORPORA CAVERNOSA while
only 10% of the blood will fill the corpora spongiosum. Less
amount of blood is delivered to the corpora spongiosum as
not to compress the penile urethra which pierces it
posteriorly.
GLANS PENIS
- expanded portion of the CORPORA SPONGIOSUM
- covers the distal ends of the corpora cavernosa
PARTS OF THE GLANS PENIS
1. Corona
- dilated portion which overlies tip of corpora cavernosa
- projected margin of the glans penis overlying the corpora
cavernosa
2. Neck of glans
- constricted portion of the glans penis
3. External urethral orifice
- slit-like orifice of the urethra found on the tip of the glans
penis
4. Prepuce/ Foreskin
- hood-like fold of the skin
5. Frenulum of the prepuce
- median fold on the inferior area of glans penis
BLOOD SUPPLY OF THE PENIS
** mainly from the branches of INTERNAL PUDENDAL
ARTERY which supplies the deep parts of the penis
1. Dorsal artery of penis
- paired left and right dorsal artery of the penis
- run on each side of the deep dorsal vein
- supply the fibrous tissue, corpora spongiosum and penile
urethra, areas in the shaft within the Buck’s fascia;
- pierces the Buck’s fascia to supply everything EXCEPT the
corpora cavernosa
2. Deep artery of penis
- pierces the corpora cavernosa (supplied by
parasympathetic nerves)
- supplies the corpora cavernosa
- during the flaccid state: arteries are coiled
-aka HELCINE ATERIES (only during the flaccid state)
** Deep arteries of the penis sensitive to nitric oxide
which will open up the helcine arteries and fill the arterie
3. Arteries of the bulb of penis
- supply the posterior part of corpus carvernosa
**Branches of superficial and deep branches of EXTERNAL
PUDENDAL ARTERY will supply superficial areas of penile
shaft
VENOUS DRAINAGE
1. Deep dorsal vein
-drains blood from structures confined within the Buck’s
fascia
** Venous plexus -deep dorsal vein-prostatic venous
plexusinternal iliac vein (under the Buck’s facia)
2. Superficial vein
Superficial vein superficial external pudendal vein
(superficial to/outside of the Buck’s fascia)
INNERVATION
- derived from S2-S4
1. Dorsal nerve of penis
-branch of PUDENDAL NERVE
- sensory and sympathetic innervations to supply skin and
glans penis which is responsible for ejaculation
2. Ilioinguinal nerve
Supplies the skin at the root of penis
3. Cavernous nerves
-parasympathetic fibers to helicine arteries responsible for
penile erection
**point and shoot
Point penile erection (parasympathetic nerves)
Shoot ejaculation (Sympathetic nerves)
PENILE ANGLE
Common -60-85 degrees
Lax suspensory ligamentpoint downward
Tense Suspensory ligamentpoint upward
CLINICAL SIGNIFICANCE
1. Phemosis
-prepuce has a small opening that covers the glans penis
fully
-good candidate for circumcision
2. Penile fracture
-Impotent
-Viagra –releases nitric oxide to the helicine arteries
3. Hypospadia
-urethral opening is found dorsal to the glans penis
4. Chanker ulcer secondary to syphilis
-due to herpes secondary to herpes simplex type 2
** Simplex1-found in the oral cavity
** Average penis: 5.1 -5.9 inches in length; 4-5 inches in
girth
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