male reproductive system dr. kumar.k.v associate professor, department of...

Male reproductive system

Dr. kumar.k.vAssociate professor,

Department of anatomy,RAKMHSU(22/O3/2011,24/03/2011,29/03/20

11))

Components• Scrotum• Testes• Duct system• Penis• Accessory

glands

24.1

LAYERS OF SCROTUM

• Scrotum is cutaneous sac consisting of skin and the underlying muscle known as Dortos .

• It is incompletely divides by a septum.• The anterior third of the scrotum is supplied

by the ilioinguinal nerve.• The posterior part is supplied by S3 NERVE

from the sacral plexus

Scrotum

• Skin• Dartos muscle

(smooth)• Septum• Cremaster muscle

(skeletal)

24.2

LAYER OF SCROTUM DEEP TO THE SKIN

• Deep to the skin and dartos muscle there are THREE LAYER which are the real continuation of the layers of ANTERIOR ABDOMINAL WALL.

• 1.External spermatic fascia the continuation of the aponuerosis of the EXTERNAL OBLIQUES ABDOMINAL muscle.

• 2.CREMASTERI MUSCLE with the Cremasteric fascia also continuation of the INTERNAL OBLIQUES ABDOMINUS MUSCLE.

Layers continued……………

• 3.INTERNAL SPERMATIC FASCIA: Continuation of the TRANSVERSALIS FASCIA FROM THE ABDOMEN.

• All the above mentioned layers are being formed during the DESCENT AND MIGRATION OF the developing testis during intra uterine life.

• During the descent-• of the testis as it TRAVEL THROUGH the three

muscular layers of the abdominal wall TO CREATE THE INGUINALCANAL

Descent of the Testes

24.29

3 mos.

7 mos. birth

TESTIS AND ITS LAYERS(from inside to outside).

• Ovoid organ suspended by the spermatic cord.• Testis are covered by a tough fibrous capsule known

as the Tunica albugenia.• The surface of each testis covered by Tunica

vaginalis which is originally an extension of the peritoneum.

• The tunica vaginalis has got a parietal layer which is outside and visceral layer which close to the tunica albugenia. THERE IS POTENTIAL SPACE BETWEEN THIS LAYERS WITH LITTLE FLUID..

Layers continued……………

• 3. INTERNAL SPERMATIC FASCIA: Continuation of the TRANSVERSALIS FASCIA FROM THE ABDOMEN.

• 4. The cremasteric fascia or the muscle is the continuation of the internal oblique

• 5. The external spermatic fascia is the continuation of the External oblique.

• All the above mentioned layers are being formed during the DESCENT AND MIGRATION OF the developing testis during intra uterine life.

• During the descent-• of the testis as it TRAVEL THROUGH the three muscular layers

of the abdominal wall TO CREATE THE INGUINALCANAL

COVRINGS OF THE TESTIS

COVERINGS OF TESTIS

HYDROCELE and VARICOCELE

• Normally small amount of fluid present between the parietal and visceral layers of TUNICA VAGINALIS.

• Due to trauma or injury to scrotom large amount of fluid collects between the layers. Incision and drainage is necessary in these type of cases.

• Dilated veins(varicose veins) are seen abnormally which may lead into STERILITY DUE TO ABNOMAL SPERMATO GENESIS. The left testicular vein drains into the left renal vein and the right to the Inferior vena cava

RADIOGRAPH SHOWIND THE LEFE SIDED TESTICULAR VEIN VARICOSITY

Hydrocele-scrotum

• Note the fluid is being• Collected between• The parietal and• Visceral layers of the• Tunica vaginalis -• testis

Cremaster muscle reflex.

• Cremaster muscle is the continuation of the Internal oblique abdominus muscle .

• It plays an important role in TEMPERATURE REGULATION for normal spermatogenesis.

• Contraction of this muscle PULLS THE TESTIS UP DURIN COLD SEASON.

• DURING HOT SEASON THE MUSCLE RELAXES AND THE SCROTAL SKIN RELAXUS.

• DARTOS muscle of the skin does the same function like cremaster.

Internal anatomy of the testis.

• Cross section of the testis shows 250-350 lobules(compartment) divided by septum which is the inward continuation of the tunica albugenia.

• Each lobules has many highly coiled tubule knows as SEMINIFEROUS TUBULES.

• IN a histological slide the lumen of the tubules shows many maturing spermatocytes in different stages of spermatogenesis

Coverings of the testis

Coverings of testis

TESTIS , EPIDIDYMIS,DUCTUS DIFFERENS

Testes – gross anatomy• ~4 cm long, 2.5 cm wide• Tunica vaginalis• Tunica albuginea (capsule)• Septa– 250-300 lobules– Seminiferous tubules

• Epididymis

24.3

Seminiferous tubules• Spermatogenic cells• Spermatogenesis begins at puberty• ~400 million sperm/day

24.3b

EPIDIDYMIS.

• THE EPIDIDYMIS LIES ON THE POTEROLATERAL SIDE of the testis.

• The many somniferous tubules continues to be the head of the structure.

• The tail of the epididymis continues as spermatic cord. The body is the middle pare of the coiled tubules.

• The epididymis stores the spermatozoa before it is release.

CRYPTORCHIDSM.

• Cryporchidism or un descended testis is due the failure of testis to migrate from the abdominal cavity to the scrotum.

• It happens in3% of full term babies and 30% of premature babies.

• Testis abnormally located most commonly in the INGUINAL CANAL.

• An un descended testis may later develop into a• MALIGNANCY(CANCER)

CRYPTORCHIDISM IN AN INFANT

VARIOUS SITES OF ARREST IN ACASE OF CRYPTORCHIDISM

SPERMATIC CORD.

• Spermatic cord suspends the testis within the scrotum.

• It begins in the DEEP INGUINAL RING and passes through the inguinal canal, comes out through the SUPERFISIAL INGUINAL RING.

• It ends in the scrotun and continues with TAIL OF THE EPIDIDYMIS.

COVERING OF SPERMATIC CORD

• External spermatic fascia derived from the external oblique abdominus.

• Cremasteric fascia derived from the Internal oblique.

• Internal spermatic fascia derived from the Tranversalis fascia of the abdominal cavity.

• NOTE:THES COVINGS CONTINUES TO THE SCROTUM AS ALLREADY MENTIONED

TESTIS AND SPERMATIC CORD

CONTENTS OF SPERMATIC CORD

• 1.Ductus deferens(vas deference):which transport sperm from the epididymis to the EJACULATORY DUCT into the prostatic part of the urethra.

• 2.Testicular artery ,a branch of abdominal aorta.

• 3.Pampiniform plexus of vein: network of vein seen around the cord that becomes the single testicular vein at the deep inguinal ring.

Contents of spermatic cord continued…………………

• 4.cremasteric artery.• 5.Genital branch of genitofemoral nerve which

supplies the cremaster muscle.• Lymphatic's from the testis to the abdominal

lymph node.• NOTE: The lymphatic drainage of skin of

scrotum is into the Superficial lymphnode.But for the testis is to the abdominal lymph node.

Spermatic cord and cremasteric muscle

MALE INTERNAL GENITAL ORGAN(24/3/2011)

Male internal genital organs includes1.Testis2.Epididymis3.Ductus deferens4.Seminal vesicles-within the pelvis5.Ejaculatory duct-within the pelvis6.Prostate.-within the pelvis7.Bulbourethral gland-within perennial pouch.

Sagital section of male reproductive system

Peritoneal relations of the internal genitals

Male reproductive organs and the parts of the male urethra

Genito urinary system

DUCTUS DIFFERENS

• Travels WITHIN spermatic cord through the inguinal canal, then to the deep ring to enter the lateral wall of the pelvic cavity.

• Within the pelvic cavity it crosses over the external iliac vessel.• It ends by to form the EJACULATORY DUCT. uniting with the

duct of the seminal vesicle • Both right and left ejaculatory duct opens into the PROSTATIC

PART OF THE URETHRA.• DUCTUS DIFERENS IS CROSSED BY THE URETER NEAR THE

POSTEROLATERAL PAART OF THE URINARY BLADDER IS AN IMPORTANT RELATION TO REMEMBER.

Ductus (vas) deferens• From scrotum to pelvis• Forms ejaculatory duct

with seminal vesicle duct

• Empties into prostatic urethra

• Thick smooth muscle.• Propels sperm during

ejaculation

24.1

Accessory sexual glands(male)

RELATION OF URETER TO DUCTUS

• The relationship of the ductus deferens to Ureter is similar as the crossing of the UTERINE ARTERY ABOVE THE URETER IN FEMALES (WATER UNDER THE BRIDGE).

• Duct crosses superior to the Ureter then lies posterior to the FUDUS of the bladder and then medial to the seminal vesicle to form the EJACULATORY DUCT.

Genito-urinary system

• Note the Ureter crossing• The vasdefferens at the• Lateral border of the urinary• Bladder.• Also note the three parts • Of the male urethra.

Note the relation of the ductusdeferens with the Ureter.

BLOOD SUPLLY AND INNERVATION OF DUCTUS DEFFERENS

• Avery small artery arises from the Inferior vesicle artery.

• The veins accompany the artery having the same name.

• Nerves:supplied by the autonomous nerves (inferior hypogastric plexus) .They bring about rapid cotraction to transport the sperm into the ejaculatory duct.

SEMINAL VESICLE.

• Located posterior to the base of the bladder.• They are 5-6 cms in length.• Rectum forms its posterior relation. It is

placed superior to the prostate.• They do not store the sperm but has a thick

secretion.• The retro vesicle pouch comes between it and

the rectum.

Note the relation of the ductusdeferens with the Ureter.

SEMINAL VESICLE CONTINUED……..

• The ductus deferens joints the DUCT OF SEMINAL VESICLE to form the ejaculatory duct..At the fundus of the urinary bladder the seminal vesicle comes lateral to the AMPULLA of the vasdeferens.

• The ejaculatory duct is about 2.5 cms long.• Remember there are TWO ejaculatory ducts

which opens into the prostatic urethra.

THE PROSTATE GLAND.

• This is the largest accessory gland of the male reproductive system is about 3cms long.

• It is a combination of fibrous tissue and glandular secreting tissue .

• The firm WALNUT appearance prostate has a base, which comes just inferior to the bladder .The apex is inferior and is just superior to the UROGENITAL DIAPHRAGM.

Location of the prostate.

Prostate Gland• Prostate gland– Surrounds prostatici

urethra–30% of semen– Supports sperm

24.9

LOBES OF THE PROSTATE.

• Not well described ,but divided into an• 1.ANTERIO LOBE• 2.LATERAL LOBES OR SURFACES• 3.POSTERIOR LOBES :inferior to the

ejaculatory duct.• 4.MEDIAN LOBE or middle lobe :lies superior

to the Ejaculatory duct.• Minute prostatic duct opens into the urethra.

ARTERIAL SUPLLY

• Inferior vesicle artery.• Venous drainage : by the net work of veins

called as PROSTATIC VENOUS PLEXUS.• The venous plexus often communicate with

the veins of the vertebral column known as INTERNAL VETEBRAL VENOUS PLEXUS.

• Cancer cells from the prostate may spread into the vertebral canal through this plexus.

ENLAGEMENT OF THE PROSTATE.

• Hyper trophy of the prostate: is common after middle age.

• Hypertrophy can lead the obstruction of the Prostatic part of the urethra. THE MIDDLE lobe is often enlarged.

• Prostate can be examined by the RECTAL EXAMINATION .

• Enlargement of the prostate can produce urgency.nocturia and dysuria of urination.

PROSTATE CANCER

Per-rectal examination of Prostatic cancer

BULBOURETHRAL GLANDS.

• Two pea sized glands located in the posterior part of the membranous urethra and its ducts open into the penile urethra at the bulb of the penis.They secrete the lubricating mucous into the urethra.

• VASECTOMY IN MALES:THE common method of sterilizing males. The vas deferens is cut or ligated through an incision in the superior part of the scrotum so that the seminal fluid contains NO SPERM.

VASECTOMY(MALE STERILIZATION)

VASECTOMY LIGATURE.

Genito-urinary system

• Note the Ureter crossing• The vasdefferens at the• Lateral border of the urinary• Bladder.• Also note the three parts • Of the male urethra.

Urogenital organ.

Urethra

• Shared with urinary system

• Preprostatic urethra• Prostatic urethra• Membranous urethra• Spongy (penile) urethra

24.8

MALE PERINIUM

• THE EXTERNAL GENITELIA OF MALE• THE SUPERFICIAL PERIAL SPACE IN MALE • THE DEEP PERINEAL SPACE IN MALE• CLINICAL SIGNIFICANCE

• DR.KUMAR.K.V• (29.03.2011)

DIFINITION OF PERINEUM

• The narrow region which is diamond shaped located between the symphysis pubis and the coccyx posteriorly.

• Its lateral boundary is the upper medial part of the thighs.

• A narrow region between the proximal part of the upper thigh.

UROGENITAL AND ANAL TRIANGLES OF PERINIUM

BONY BOUNDARIES.

• Anteriorly: pubic symphysis• Anterolarally:inferior pubic rami• Laterally:Ischial tuberosities.• Posterolaterally:Sacrotuberous ligament.• A transverse line joining the anterior ends of the

ischial tuberosities divides the perineum into two triangles.

• ANAL TRIANGLE POSTERIORLY.• UROGENITAL TRIANGLE ANTERIORLLY.

SUPERFICIAL PERINEAL POUCH

• The superficial perineal pouch is a POTENTIAL SPACE between the membranous layer of the the subcutaneous tissue and the PERINEAL MEMBRANE(inferior fascia of the urogenital diaphragm).

• CONTENTS:1.ROOT of the penis(bulb and two crura)

• Proximal part of the spongy urethra

CONTINUED…………………….

• Superficial transverse perineal muscles.• Muscles associated with bulb and two crus of

the penis,.• (Bulbospongiosis,Ischiocavernosis).• Branches of Pudental nerve and INTERNAL

PUDENTAL ARTERY..

SUPERFICIAL AND DEEP PERENEAL SPACE—CORONAL SECTION

• Note the pelvic cavity.• Below the pelvic cavity• The urogenital diaphragm.• Below the diaphragm the• Superficial perineal space• Containing root and the mus• Scles of the penis

CORONAL SECTIONshowing superficial, deep perineal space.

DIAMOND SHAPED PERINIUM SHOWING COLLES FASCIA.(COLLES FASCIA).

CONTENT OF SUPERFICIAL SPACE

ROOT OF PENIS AND SUPERFICIAL PERINEAL POUCH

ROOT OF THE PENIS

• This is the attached part of the penis.• This consists of right and left crus(arms)

covered by the muscle called ischiocavernosus• The posterior part of the corpus spongiosum

with an expanded bulblike dilatation which is covered by BULBOSPONGIOSUM MUSCLE.

• BOTH BULB AND TWO CRURA ARE LOCATED IN THE SUPERFICIAL PERINIAL SPACE.

ROOT OF THE PENIS

• Note the right and left crus attached to the inferior pubic ramus and the muscles covering it.

THE THREE ROOTS

• HERE THE BODY OF THE PENIS REMOVED .

• OBSERVE THE THREE ROOTS OF THE PENIS AND RELATIONS WITH THE INF.PUBIC RAMUS

THREE CORPORA(BODY) OF THE PENIS

Corpus(body) of the penis

• CORPORA CAVERNOSA AND• ITS TWO CRUS.• CORPORA SPONGIOSUM• AND ITS ROOT ALSO• KNOWN AS BULB OF PENIS.• NOTE THE ANTERIOR • EXPANDED PART OF SPONGI• OSUM (GLANSPENIS)

BODY AND THE ROOT OF PENIS

BODY AND THE GLANDS OF PENIS

• The body is the fused part of all three cylinders.

• THE GLANS: The anterior expanded part of the CORPORA SPONGIOSUM.

• The margin of the gland is raised and named as CORONA.

• The glands has the opening of the penile URETHRA.

THE THREE CORPORA(BODY) OF THE PENIS.

• NOTE THE POSTERIOR BULB AND T• AND THE ANTERIOR GLANS –• BOTH BELONGS TO THE• CORPUS SPONGIOSUM.• OBSERVE THE ATTACHMENT• OF TWO CRUS OF CAVERNO• SUM TO THE INFERIOR • PUBIC RAMUS.

CROOSS SECTION SHOWING VESSELS AND NERVES

Testes – gross anatomy• ~4 cm long, 2.5 cm wide• Tunica vaginalis• Tunica albuginea (capsule)• Septa– 250-300 lobules– Seminiferous tubules

• Epididymis

24.3

MUSCLES OF THE SUPERFICIAL PERINEAL SPACE.

• Bulbospongiosus:covers the bulb of the penis and its contraction compress the urethra to completely emptying it of urine and semen. It acts like sphincter to compress the bulb of penis.

• Ischiocavernosus:sorround the two crura.It forces the blood to flow to the cavernous spaces. It also arrest the venous return from the penis to the deep dorsal vein ,and thus maintain erection.

ROOT AND THE MUSCLES SURROUNDING IT.

LAYERS AND BLOOD VESSELS OF PENIS

ARTEIS AND VEINS OF PENIS.

• Internal pudental artery and its branches.• 1.dorsal artery. .2.deep arteries• Deep artery( helicine arteries) of the penis is

the main artery supplying the erectile cavernous spaces of corpora cavernosum.

• VEINS:SUPERFICIAL DORSAL: drains into ext.pudental.

• DEEP DORSAL:DRAINS INTO THE PROSTATIC VENOUS PLEXUS

NERVES AND LYMPHATICS OF PENIS

• LYMPHNODES:Superficial inguinal lymph nodes.

• NERVES:BRANCHES OF PUDENTAL NERVE.(S2,S3,S4)

• The most important is the DORSAL NERVE OF PENIS.

PUDENTAL NERVE AND ITS BRANCHES

PERINEAL MEMBRANE.

PERINEAL MEMBRANE.

DEEP PERINEAL SPACE(POUCH)

• In an anatomical position the pouch is contained within the TWO LAYERS OF UROGENITAL DIAPHRAGM.

• UROGENITAL DIAPHRAGM:IN THE DOUBLE LYER MEMBRANE WHICH PARTITION THE pelvic cavity from the perineum outside. since it is partition ,so named diaphragm.

• Refer the coronal section diagram to under stand its position.

CONTENTS OF DEEP PERINEAL POUCH.

• The urogenital diaphragm is attached laterally to the inferior pubic ramy up to the ischium.

• It is composed of one SUPERIOR LAYER FACING the pelvic cavity and oneINFERIORLAYER forming the ROOF of the superficial perineal pouch.

• CONTENTS:1.DEEP TRANVERSE PERINEAL MUSCLE.2)EXTERNAL URETHRAL SPHINCTOR.

• 3)BULBOURETHRAL GLAND.

DEEP TRANVERSE PERINEAL MUSCLE

Transverse perineal,Bulbospongiosus,and Ischiocavernosus muscles(original)

Perineal membrane(inferior fascia of urugenital diaphragm)

Deep transverse perineal muscle(Deepperineal space)

ANAL TRIANGLE.

• Anteriorly the posteriorly boundary of the urogenital triangle or the line joining the two ISCHIAL TUBEROSITY.

• POSTERIORLY:THE COCCYX BONE.• CONTENTS:1.ANUS

2.VOLUNTARY EXTERNAL ANAL SPHINCTOR.

UROGENITAL AND ANAL TRIANGLE

PERINEAL BODY

• The prineal body is fibrotenditous mass of tissue which lies exactly in the middle in-between the vagina- and the anus posterior.

• In case of males it is located in between the root of the penis and the anus posteriorlly.

• SIGNIFICANCE: The perennial body gives the common attachment for the muscles of perineum both in males and in females.

MODE OF PERINEAL INJURY.

• THANKYOU• AND SEE YOU• AGAIN WITH • FEMALE REPRO• DUCTIVE • SYSTEM.