7. Testis, epididymis, spermatic cord Flashcards
What is the processus and tunica vaginalis?
When the testis migrates from the post abdominal wall into the scrotum, though the anterior abdominal wall….
The testis takes with it the vas deferens, the testicular vessels and a peritoneal pouch – the Processus Vaginalis which (after birth) should lie as a closed potential space around the testis - the Tunica Vaginalis
Processus vaginalis= Loop of peritoneum the testes takes with it (tunica vaginalis is the remnant)
Role of gubernaculum during testes movement?
Shrinks to draw the testis down the posterior abdominal wall (outside the peritoneum) to the inguinal canal, then through the canal during the 8th and 9th months, so the testis should be in the scrotum by birth
What is cryptorchidism?
Failure of complete descent
Result of processus vaginalis staying open?
Indirect inguinal hernia
Hydrocele
What are the 3 layers of muscles pushed through by the testes?
TRANSVERSIS ABDOMINIS and INTERNAL OBLIQUE fused as the conjoint tendon.
EXTERNAL OBLIQUE forms inguinal ligament and superficial ring.
Contents of inguinal canal?
Spermatic cord in male/ Round ligament in females
Ilioinguinal nerve
Genital branch of genitofemoral nerve
What forms the internal spermatic fascia?
Transversalis fascia
What forms the cremasteric fascia and muscle?
Transversus abdominus and internal oblique
What forms the external spermatic fascia?
External oblique
Coverings of the spermatic cord (int to ext)
Vestige of processus vaginalis Internal spermatic fascia Cremasteric fascia Cresmasteric muscle External spermatic fascia Dartos muscle/fascia
Scrotum and coverings of testis (int to ext)?
Tunica vaginalis Internal spermatic fascia Cremasteric fascia Cresmasteric muscle External spermatic fascia Subcutaneious tisses (dartos fascia) and dartos muscle Skin
Layers of anterior abdominal wall (int to ext)?
Peritonium Transversalis fascia Transversalis abdominus Fascia of both superficial and deep surfaces of the internal oblique muscle Internal oblique muscle External oblique muscle and fascia Subcutaneous tissue Skin
Spermatic cord contents?
3 Arteries (with accompanying veins or venous plexuses)
- Testicular artery and pampiniform plexus
- Artery to vas
- Cremasteric artery (from inferior epigastric)
3 Tubes
- Vas deferens
- Lymph from testis (to para-aortic nodes)
- Processus vaginalis (obliterated tube)
3 Nerves
- Genital branch of genitofemoral
- Sympathetic (efferent and afferent to testis)
- Ilio-inguinal (supply to the medial thigh)
What nerve supplies cremaster muscle?
Genital branch of genitofemoral nerve
What is L1 cremaster reflex?
Ipsilateral testicular retraction on stroking upper, medial thigh
Referred pain from testis?
As the sympathetic efferents and afferents that supply the testes are derived form the LESSER SPLANCHNIC NERVE (T10 and T11)
–> Peri-umbilical region
Outer structural features of the scrotum?
Rugose skin
No fat
Contains dartos muscles
Has midline raphe and is divided by septum
What is dartos fascia a combination of?
Colles perineal fascia (continuous with Scarpa’s) and Dartos muscle
2 layers of abdominal superficial fascia?
Sits under skin
Camper’s fascia (sup, fatty)
Scarpa’s fascia (deep, memnbranous)
Muscle under (EO, IO, TA)
Changes to the scarpa’s fascia as it descends from abdomen…
Extends into the penis and scrotum as Colle’s/perineal fascia)
then fuses with fascia lata of the thigh below the inguinal ligament and the perineal body
Nervous division of the scrotum?
Anterior 1/3: Ilioinguinal and genitofemoral
Posterior 2/3: S2 and S3 via scrotal branches of the perineal branches of the pudendal nerve
Blood supply to scrotum?
Anteriorly: Deep and superficial external pudendal branches of the femoral artery
Posteriorly: Branches of the internal pudendal branch of the internal iliac posteriorly
Scrotum venous drainage?
Anteriorly: Deep and superficial external pudendal veins to the great saphenous vein
Posteriorly: internal pudendal veins
Scotrum lymph drainage?
To superficial inguinal nodes
What creates sperm?
Seminiferous tubules
Which cells produce testosterone?
Leydig cells
Passage of sperm from tubules to epididymis?
Sperm pass from the tubules, to the rete testis in its mediastinum, then via efferent ductules to the epididymis
Structural features of epididymis?
Head, body and tail becoming vas.
What maintains internal pressure of the tunica albuginea?
Tough capsule of scrotum which helps to transport the sperm
Causes of scrotum pain:
Appendix testis (hydatid of Morgagni) and prostatic utricle are remnants of paramesonephric ducts
Appendix epididymis, mesonephric duct remnat
Testis torsion
Coats/tunics of testis?
- Vaginalis with visceral and parietal layers, a potential space for movement of testis (hydrocele); sinus of epididymis.
- Albuginea, tough, fibrous (internal pressure to help sperm transport); forms mediastinum and septae.
- Vasculosa with branches of the testicular vessels
Nervous supply of the testis?
Sympathetic T 10, 11
Referred pain is peri-umbilical
Blood supply of the testis?
Testicular artery from L2
(plus anastomosis with cremasteric artery and artery to vas)
Testicular vein starts as a pampiniform plexus varicocele which coalesces in the inguinal canal to form the testicular veins.
Left drains to left renal vein
Right to IVC
Lymph drainage of testis?
Para-aortic nodes
What is the vas deferens?
Thick-walled, cord-like tube that carries sperm from the testis and epididymis
Position and role of seminal vesicles?
Lie just above the prostate gland, sandwiched between the bladder and rectum
Secrete seminal fluid to nourish sperm
Formation of ejaculatory duct?
The dilated, ampullary end of the vas unites with the duct from the seminal vesicle to form the Ejaculatory Duct that passes through the prostate to enter the urethra.
3 parts of male urethra?
Prostatic (internal sphincter); membranous (external sphincter); spongy (bulbar and penile) parts.
two structures which prevent compression of male urethra?
Bulbo-urethral (mucous glands)
Corpus spongiosum
How is back flow of semen prevented?
Internal sphincter contracts of urethra
Dartos fascia is combination of…
- Dartos muscle (camper’s)
2. Colles’ (scarpas) membraneous perineal fascia
