4- Male Pelvic Organs POWER POINT PRESENTATION

MEDICAL EDUCATION

1. 1
MALE
REPRODUCTIVE
SYSTEM

2. OBJECTIVESOBJECTIVES

By the end of the lecture, students should be able to:By the end of the lecture, students should be able to:

List the different components of the male reproductive List the different components of the male reproductive
system.system.

Describe the anatomy of the primary & the secondary Describe the anatomy of the primary & the secondary
sex organs regarding (location, function, structure, sex organs regarding (location, function, structure,
blood supply & lymph drainage).blood supply & lymph drainage).

Describe the anatomy of the male external genital Describe the anatomy of the male external genital
organs. organs.
2

3. Components of Male Reproductive SystemComponents of Male Reproductive System
I- I- Primary Sex Organ:Organ:

Testis.Testis.
II- Reproductive II- Reproductive
Conducting Tract:Conducting Tract:

EEpididymis.pididymis.

VVas Deferens.as Deferens.

SSpermatic cord.permatic cord.
III- Accessory Sex Glands:III- Accessory Sex Glands:

Seminal vesicles.Seminal vesicles.

Prostate gland.Prostate gland.

Bulbourethral glands.Bulbourethral glands.
IV- External genitalia:IV- External genitalia:

PenisPenis
3

4. ScrotumScrotum

An out pouching of loose skin An out pouching of loose skin
& superficial fascia.& superficial fascia.
The Left scrotum is lower than The Left scrotum is lower than
the right.the right.

Functions:Functions:

Houses & Protects the testisHouses & Protects the testis

It has thin skin with sparse It has thin skin with sparse
hairs and sweat glands.hairs and sweat glands.

It Regulates testicular It Regulates testicular
temperature temperature (no superficial (no superficial
fat)fat)

The Dartos The Dartos muscle lies muscle lies
within the superficial fascia.within the superficial fascia.

& replaces & replaces Scarpa’sScarpa’s fascia fascia

T
L
4

5. TestisTestis

Testis or Testis or Testicle (singular), (singular),
Testes (plural).Testes (plural).

Paired almond-shape gonads Paired almond-shape gonads
that suspended in the scrotum that suspended in the scrotum
by by the the spermatic cordspermatic cord

4 - 5 cm long4 - 5 cm long

Weigh (10.5 – 14) gWeigh (10.5 – 14) g

Its volume is about 20-25 mlIts volume is about 20-25 ml

Functions:Functions:

Spermatogenesis.Spermatogenesis.

Hormone productionHormone production

(Androgens- testosterone).(Androgens- testosterone).
T
5
sc

6. Coverings of the Coverings of the
TestisTestis

Tunica Vaginalis:Tunica Vaginalis:

A Peritoneal covering, A Peritoneal covering,
formed of parietal and formed of parietal and
visceral layers.visceral layers.

It surrounds testis & It surrounds testis &
epididymis.epididymis.

It allows free It allows free
movement of testis movement of testis
inside scrotum.inside scrotum.

Tunica albugeniaTunica albugenia

It is a whitish fibrous It is a whitish fibrous
capsulecapsule
6
TV

7. Internal Structure of Internal Structure of
TestisTestis
Fibrous septae extend from the Fibrous septae extend from the
capsule, divide the testis into a (200-capsule, divide the testis into a (200-
300) 300) lobules.lobules.
Each lobule contains, Each lobule contains, (1-3) (1-3)
seminiferous tubules. seminiferous tubules.

Seminiferous Tubules:Seminiferous Tubules:

They are the site of the They are the site of the
spermatogenesis.spermatogenesis.

They form the bulk of testicular They form the bulk of testicular
tissue.tissue.

Rete testis:Rete testis:

(a network of tubules)(a network of tubules)

It is the Site of merging of the It is the Site of merging of the
Seminiferous tubules.Seminiferous tubules.
7
RT

8. Blood Supply of Blood Supply of
TestisTestis
Testicular artery:Testicular artery:
It is a direct branch from the It is a direct branch from the
abdominal aorta.abdominal aorta.
Venous drainage : Venous drainage :
(Pampiniform plexus of veins.(Pampiniform plexus of veins.
Approximately a dozen veins which Approximately a dozen veins which
forms a network in the forms a network in the
spermatic cord. spermatic cord.

They become larger, converge as They become larger, converge as
it approached the inguinal canal it approached the inguinal canal
and form the and form the Testicular vein.Testicular vein.

Right Vein drains into IVC.Right Vein drains into IVC.

Left Vein drains into Left Renal Left Vein drains into Left Renal
Vein.Vein.

Testicular
Artery
8

9. Testicular Lymphatics:
Follow arteries, veins
End in Lumbar (par aortic) nodes
From scrotum, penis, prepuce:
Terminate in Superficial
Inguinal nodes
9

10. 10
Indication
Evaluation of testicular pain. (Testicular Torsion
Technique
Examiner strokes or pinches upper medial thigh
causes cremasteric muscle contraction
Observe for rise of the Testicle on same side (normal)
Interpretation
Normal:
It is present with Epididymitis
If Cremasteric reflex absent (no Testicle rise):
It is Suggestive of Testicular Torsion
Also absent in 50% of boys under age 30
months
Do not use this test under age 30
months
Efficacy.
Test Sensitivity for Testicular Torsion: 99%
Assumes age over 30 months
Nerve involved: Genitofemoral nerve (GFN), ( L1,2)
Sensory: femoral branch of (GFN) & Ilioinguinal
N.
Motor: genital branch of (GFN).
Cremasteric
reflex

11. EpididymisEpididymis

A Single coiled tubuleA Single coiled tubule

6 M long6 M long

Located on the posterior & Located on the posterior &
superior margins of the testis.superior margins of the testis.

It is divided into:It is divided into:
Head, Body and Tail.Head, Body and Tail.
The The HeadHead receives efferent ductules receives efferent ductules
from testis.from testis.

The The TailTail is continuous with is continuous with Vas Vas
Deferens Deferens

Functions:Functions:
1. Secretes/absorbs the 1. Secretes/absorbs the
nourishing fluid.nourishing fluid.
2. Recycles damaged 2. Recycles damaged
spermatozoa.spermatozoa.
3. Stores spermatozoa3. Stores spermatozoa Up to 2 Up to 2
weeks to allow for maturation.weeks to allow for maturation.
H
B
T
V D
11

12. Vas DeferensVas Deferens
A Muscular tube A Muscular tube
45 cm 45 cm long.long.

Carries sperms Carries sperms
from the from the
Epididymis to Epididymis to
pelvic cavity.pelvic cavity.

Passes through Passes through
the inguinal canal the inguinal canal

It crossesIt crosses the the
ureterureter

Its terminal part Its terminal part
is dilated to form is dilated to form
the the Ampulla of Ampulla of
the vasthe vas

It joins the It joins the
urethra in the urethra in the
prostateprostate
12Prof. Makarem

13. Accessory Accessory
GlandsGlands

Seminal vesicle.Seminal vesicle.

Prostate.Prostate.

Bulbourethral Bulbourethral
glands.glands.

Functions:Functions:
1. Secretion of 1. Secretion of
seminal fluidseminal fluid
2. Nourishing, 2. Nourishing,
Activation &Activation &
Protection of spermsProtection of sperms
13

14. Seminal VesiclesSeminal Vesicles

Paired elongated Paired elongated
glands.glands.

Located posterior Located posterior
& inferior to the & inferior to the
urinary bladderurinary bladder

Secrete (60% of Secrete (60% of
Semen)Semen)
SVSV
BASE OF THE
URINARY
BLADDER
VD
14

15. Ejaculatory Ejaculatory
DuctsDucts
Formed by the union Formed by the union
of theof the lower end of lower end of
the vas deferens and the vas deferens and
the duct of the the duct of the
seminal vesicle.seminal vesicle.
Its length is about 1 Its length is about 1
inch (2.5) cminch (2.5) cm
The 2 ejaculatory The 2 ejaculatory
ducts open into the ducts open into the
prostatic urethra.prostatic urethra.
They drain the They drain the
seminal fluid into the seminal fluid into the
prostatic urethra.prostatic urethra.
15

16. Prostate GlandProstate Gland
The Largest male accessory gland. The Largest male accessory gland.
Walnut sized.Walnut sized.
Located at the neck of bladderLocated at the neck of bladder
Houses prostatic urethraHouses prostatic urethra
Secretes (20-30% of semen)Secretes (20-30% of semen)
Shape:Shape: Conical, It has: Conical, It has:
Base (Sup): Base (Sup): Attached to neck of urinary Attached to neck of urinary
bladderbladder
Apex (Inferior): Apex (Inferior): onon Urogenital diaphragmUrogenital diaphragm..
Four Surfaces: Four Surfaces: Posterior, Anterior, Right Posterior, Anterior, Right
& Left.& Left.
It Secretes enzyme (acid phosphatase) It Secretes enzyme (acid phosphatase)
which has the following functions:which has the following functions:

Aids in activating sperm motilityAids in activating sperm motility

Mucus degradationMucus degradation

AntibioticAntibiotic

Neutralizes acidity of the urine within Neutralizes acidity of the urine within
prostatic urethra.prostatic urethra.
P
U
P
16

17. CapsuleCapsule
InternallInternallyy, it has a , it has a
dense dense fibrous prostatic fibrous prostatic
CapsuleCapsule, ,
ExternallExternally, it is y, it is
surrounded by a surrounded by a fibrous fibrous
prostatic prostatic SheathSheath which which
is continuous with the is continuous with the
puboprostatic puboprostatic
ligaments (levator ligaments (levator
prostate).prostate).
17

18. RelationsRelations
AnteriorAnterior:: Symphysis Symphysis
pubis (SP).pubis (SP).
SuperiorSuperior : Neck of : Neck of
urinary bladder.urinary bladder.
PosteriorPosterior :Rectum ® :Rectum ®
(important for PR(important for PR
Examination)Examination)
InferiorInferior: Urogenital : Urogenital
diaphragmdiaphragm, (UGD)., (UGD).
LateralLateral: Medial margins of : Medial margins of
levator ani muscles levator ani muscles
(levator prostate)(levator prostate)
R
UB
UG
D
SP
SP
R
UB
UG
D
18

19. LobesLobes

AnatomicallyAnatomically : :divided according to their relation divided according to their relation
to the urethra into to the urethra into (5) lobes(5) lobes::

Anterior (IsthmusAnterior (Isthmus): lies anterior to the urethra, it ): lies anterior to the urethra, it
is fibromuscular.is fibromuscular.

PosteriorPosterior ; posterior to the urethra and inferior to ; posterior to the urethra and inferior to
the ejaculatory ducts.the ejaculatory ducts.

Two Lateral Two Lateral : on each side of the urethra.: on each side of the urethra.

Middle (Median) Middle (Median) : between the urethra and : between the urethra and
ejaculatory ducts & closely related to neck of urinary ejaculatory ducts & closely related to neck of urinary
bladder, it elevates fold of mucous membrane bladder, it elevates fold of mucous membrane
(uvulae vesicae).(uvulae vesicae).
It may project into urinary bladder.It may project into urinary bladder.
The Median & Lateral lobes are rich in glandular The Median & Lateral lobes are rich in glandular
tissue.tissue.
19

20. 
Urologists & Urologists &
Sonographers, Sonographers, divide the divide the
prostate into prostate into Peripheral Peripheral
and and Central Central (Internal(Internal) )
zones.zones.

TheThe Central zone Central zone is is
represented by the represented by the
Middle lobe.Middle lobe.

Within each lobe are Within each lobe are
four lobules, which are four lobules, which are
defined by the ducts and defined by the ducts and
connective tissueconnective tissue
20

21. Blood Supply & Blood Supply &
Lymph Drainage Lymph Drainage
Arterial Supply: Arterial Supply:
Inferior vesical arteryInferior vesical artery
Prostatic venous plexusProstatic venous plexus::
Lies between the prostatic fibrous Lies between the prostatic fibrous
capsule and the prostatic sheath.capsule and the prostatic sheath.
It drains into theIt drains into the internal iliac internal iliac
veinsveins..
It is continuous superiorly with It is continuous superiorly with
the vesical venous plexus and the vesical venous plexus and
posteriorly to the internal posteriorly to the internal
vertebral venous plexus vertebral venous plexus
Lymph drainage:Lymph drainage:
Internal iliac lymph nodes. Internal iliac lymph nodes.
21

22. Hypertrophy of the ProstateHypertrophy of the Prostate

Benign Benign

Common after middle age.Common after middle age.

An enlarged prostate projects into the urinary An enlarged prostate projects into the urinary
bladder and distorts the prostatic urethra.bladder and distorts the prostatic urethra.

The middle lobe often enlarges the most and The middle lobe often enlarges the most and
obstructs the internal urethral orifice, this leads to obstructs the internal urethral orifice, this leads to
nocturia, dysuria and urgency.nocturia, dysuria and urgency.

MalignantMalignant::
It is common after the age of 55It is common after the age of 55
The malignant prostate is felt hard & irregular during PR The malignant prostate is felt hard & irregular during PR
The malignant cells metastasize through lymph and veins. The malignant cells metastasize through lymph and veins.
Lymphatic metastasis Lymphatic metastasis to Internal iliac & Sacral to Internal iliac & Sacral
lymph nodes, Later to distant nodes lymph nodes, Later to distant nodes
Venous metastasis Venous metastasis to Bone & Brain through to Bone & Brain through (IVVP)(IVVP)
22

23. Prostatic UrethraProstatic Urethra

Structures seen on its Structures seen on its
posterior wall:posterior wall:
Urethral crestUrethral crest::

A longitudinal elevated ridge.A longitudinal elevated ridge.
Prostatic sinus:Prostatic sinus:

A groove on each side of the A groove on each side of the
crest.crest.

The prostatic gland opens The prostatic gland opens
into the sinuses.into the sinuses.
Prostatic utricle :Prostatic utricle :

A depression on the summit A depression on the summit
of the urethral crest.of the urethral crest.

The ejaculatory ducts open The ejaculatory ducts open
on the sides of the utricle.on the sides of the utricle.


23

24. Bulbourethral Bulbourethral
GlandsGlands

Small paired glandsSmall paired glands

Located at the base Located at the base
of the penisof the penis

Secrete alkaline Secrete alkaline
mucus for:mucus for:
Neutralization of Neutralization of
urinary acids &urinary acids &

LubricationLubrication
24

25. PenisPenis

A Copulatory & A Copulatory &
Excretory organ.Excretory organ.

Excretory:Excretory:

Penile urethra transmits Penile urethra transmits
urine & sperm.urine & sperm.

Copulatory:Copulatory:

Has (3) cylindrical Has (3) cylindrical
masses of erectile tissuemasses of erectile tissue

Two Two Corpora Corpora
CavernosaCavernosa

One One Corpus Corpus
SpongiosumSpongiosum
CCCS
25

26. Corpora Corpora
CavernosaCavernosa

Superior Paired Superior Paired
Right & leftRight & left

They Provide the They Provide the
majority of rigidity majority of rigidity
& length of penis& length of penis

Their Posterior Their Posterior
Expansions: Expansions: form form
CruraCrura (anchor” (anchor”
tissue) against tissue) against
pelvic bonepelvic bone
26

27. Corpus Corpus
SpongiosumSpongiosum

The Inferior massThe Inferior mass

It is Traversed by the It is Traversed by the
Penile urethra Penile urethra

Its Anterior Its Anterior
expansion expansion forms the forms the
GlansGlans

Its Posterior Its Posterior
expansion: expansion: formsforms Bulb Bulb
of penisof penis

Prepuce Prepuce :: Fold of Fold of
skin covering glans skin covering glans
(before circumcision)(before circumcision)
27

28. 28
GOOD LUCKGOOD LUCK