Male Anatomy

Question 1

Name the parts along the course of the male genitalia and their relationships to the other parts

Answer 1

The epididymis sits posteriorly atop the testes and connect to the ductus deferens, which travels upward through the inguinal canal then curves around to form the ductus deferens ampulla. Here is where the seminal vesicles empty into the excretory duct and together they form the ejaculatory duct. These ducts open into urethra from between lobes of the prostate.
The urethra, also collecting contents of the bladder, travels down and out through the meatus of the penis.

Question 2

Layers of penile tissue from outer to inner most

Answer 2

1. skin
2. superficial penile fascia (cont. of Colle’s fascia)
3. Deep penile fascia (Buck’s fascia)
4. tunica albuginea (capsule of cavernous bodies)

Question 3

Blood supply to the penis

Answer 3

Branches of the internal pudendal artery:

• deep arteries - w/ corpora cavernosa; responsible for erection
• artery to the bulb - feeds corpus spongiosum and distal urethra
• dorsal artery of the penis - dorsal, btw Buck’s fascia and tunica albuginea; feeds skin and subcu tissue

Venous drainage:
SDV and DDV drain to the internal pudendal vein; lie dorsal mid‐line and are separated by Buck’s fascia

Question 4

Sensory innervation to the penis

Answer 4

provided by dorsal nerve of the penis, the 3rd branch of pudendal nerve, travels with dorsal artery

Question 5

2 ligaments that support the penis

Answer 5

1. Fundiform - derived from linea albea

2. Suspensory - attaches to symphysis pubis

Question 6

Root structure of the penis

Answer 6

• R and L crura: continuous with c. cavernosa; attached to pubic arch and perineal membrane
• bulb of penis: carries urethra; continuous with c. spongiosum, attached to perineal membrane

Question 7

3 muscles of the male perineum

Answer 7

1. Ischiocavernosus - covers crus, assists in erection; perineal br. of pudendal nerve (S2-S4)
2. Bulbospongiosus - covers bulb, assists in emptying urethra; perineal br. of pudendal nerve (S2-S4)
3. Superficial transverse perineal muscle

Question 8

Cowper’s glands

Answer 8

bulbourethral glands - secrete clear mucus into urethra during excitation

Question 9

Contents of spermatic cord

Answer 9

• vas deferens
• testicular artery
• pampiniform plexus (veins)
• cremaster muscle
• genital branch of genitofemoral nerve
• artery to vas deferens

Question 10

Variocele

Answer 10

• formed when the pampiniform plexus of veins surrounding the spermatic cord becomes varicose (enlarged), sometimes from
• aching pain in scrotum with palpable mass (“bag of worms”)
• dx with shining the light at the skin, light doesn’t pass through since it’s coagulated blood
• more often on the L because the left testicular vein drains first into the left renal vein, which is subject to nutcracker syndrome
• tx: surgical or non-surgical

Question 11

Direct and Indirect hernias

Answer 11

• direct (25%) = protrusion through weak posterior wall of inguinal canal
• indirect (75%) = through deep inguinal ring; more likely to end up in scrotal sac

Question 12

Hydrocele

Answer 12

fluid-filled tunica vaginalis (the peritoneum that encapsulates the testes) that is large and painful; light passes through when applied

Question 13

Prostate:

• function
• lobes and associated conditions
• zones

Answer 13

Makes an alkaline liquid that contributes to the volume of ejaculate

Lobes:

1. Median –> BPH
2. Posterior –> cancer
3. Lateral (2)
4. Anterior
   * Ejaculatory duct runs through the posterior lobe (ant/inf direction) and empty into the seminal colliculus

Zones:
central, peripheral, transitional
–> most carcinomas arise in the peripheral zone

Question 14

Innervation of erection, emission, and ejaculation

Answer 14

1. Erection = vascular event generated by PSNS via pelvic splanchnic nerves from S2‐S4
2. Emission = SNS from by L1‐L2
3. Ejaculation = somatic + SNS; pudendal nerve and SNS from L1‐L2