Anatomy books

Wednesday, November 2, 2016

Male reproductive system : easy and brief handout for oral examination

Male reproductive organ
      Epididymis
      It is a coma-shaped body situated along the lateral part of the posterior border of testis
      It is an organ that contains the efferent ductules and the duct of the epididymis
      The efferent ductules are lined with pseudostratified columnar epithelium
      A circular smooth muscle layer 1st appear at the beginning of the efferent ductules
      Duct of epididymis
      It is lined with a pseudostratified columnar epithelium. It contains principal cells and basal cells
      Numerous long, modified microvilli called stereocilia extend from the luminal surface of the principal cells
      Epididymal cells function in both absorption and secretion
      The smooth muscle coat of the duct of epididymis gradually increases in thickness to become three-layered in the tail

        Ductus deferens
   
         is a thick cord-like tubular structure and is about 45 cm. it is lined by pseudostratified columnar epithelium with stereocilia and a lamina propria. The thick outer wall is formed by inner and outer longitudinal and middle circular smooth muscle  cells layers. .

§  SN: In epididymis, the lumen is smooth but in d. deferens the lumen is thrown into deep longitudinal fold due to contraction of the thick muscular coat.
Course and relations of ductus deferens
      It begins from the tail of epididymis then enters the spermatic cord and traverses the inguinal canal
      At the deep inguinal ring the vas leaves the other constituents of the cord & ascend in front of the external iliac artery
      Next the vas crosses above and medial to the terminal part of Ureter & passes behind the base of urinary bladder
      Finally, approaches the base of prostate and joins with the duct of seminal vesicle to form the ejaculatory duct 
Seminal vesicle
      They are paired, elongated and highly folded tubular glands
      It secrete a fluid rich in fructose which is the principal metabolic substrate for sperm 
      It is lined by pseudostratified columnar epithelium which contain tall, nonciliated columnar cells and short, rounded cells that rest on basal lamina
Prostate gland
      This is a pyramidal-shaped, fibromuscular and glandular organ 3cm in long, which surrounds the prostatic urethra
Prostate gland: relations
      Superiorly: it is continuous with the neck of urinary bladder
      Inferiorly, the apex of the prostate rest on external sphincter of the bladder
      Anteriorly, lies the pubic symphysis separated by the extraperitoneal fat of retropubic space
      Posteriorly,lies the rectum separated by the fascia of Denonvilliers
      Laterally, lies levator ani
The prostatic capsules
      These are normally two
      The true capsule – a thin fibrous sheath which surrounds the gland
      The false capsule –condensed extraperitoneal fascia
      Between layers 1 and 2 lies the prostatic venous plexus
      In prostatic operation the true capsule is not disturbed because the prostatic venous plexus lying external to this. 
The prostate gland secretes prostatic acid phosphatase (PAP), fibrinolysin, citric acid & prostate specific antigen
Presenting parts of prostate 

         The apex is directed below
         The base is directed above and surrounds the neck of the bladder. It is pierced by the urethra in the median plane
         Anterior surface is narrow and convex situated behind the lower part of symphysis pubis
         Each infero-lateral surface is related to the anterior fibers of the levator ani
         The posterior surface is broad and flat related to the ampulla of rectum. This surface is palpable by rectal examination about 4 cm.above the anus. 
The penis
         It forms the male organ of copulation and consists of two parts – a root and a body
         The root is situated in the superficial perineal pouch and consists of two diverging crura and a median bulb of the penis
The body of the penis
      The body of the penis consists principally of two dorsal masses of erectile tissue the corpora cavernosa  which are the continuation of two crura and a ventral mass of erectile tissue the corpora spongiosum in which the spongy part of urethra is embedded and it is the continuation of bulb of penis .
                                     
CORPORA  CAVERNOSA
         It is divided into number of intercommunicating cavernous spaces which is lined by endothelium
         These spaces receive the blood from the capillaries of the helicine arteries are the branches of deep artery of penis
         During erection the arterioles dilate and the cavernous spaces are filled with blood, at the same time the venous outflow is diminished by the pressure of the distended cavernous spaces. Therefore, erection is purely a vascular phenomenon
Coverings of penis
         The skin
         The superficial fascia
         Fibrous envelope- the tunica albuginea
Ligaments of penis
         Fundiform ligaments
         Suspensory ligaments
         Erection
          It is a vascular phenomenon which occur by the action of parasympathetic nerve. The parasympathetic nerve ( S2-4 spinal segments) dilate arterioles of the corpora cavernosa
                    
         Ejaculation
         It is stimulated by the sympathetic nerves (L1 spinal segment) which produce contraction of the vas deferens, seminal vesicle, ejaculatory ducts and prostate.
         Contraction of the internal urethral orifice preventing the reflux of semen into the bladder
         At the end of the  ejaculation, the sympathetic nerves produce vasoconstriction of penis and the penis is flaccid.

   The parasympathetic initiates the sexual act by erection & sympathetic finalizes the act by       ejaculation


No comments: