Male Genital OrgansChapter5ejaculatory ducts,urethra and some accessory glandsThe male genital organs include internal and(Fig. II-5-1),external genital organs.The internal genital organsconsist ofgonadtestes,epididymis,deferentductus,uretetesticularurinary bladderductusesticularydeferensseminal vesicleampullaductusdeferentisprostate glandspermaticcordepididymistestispenisFig. II-5-1 The male genital organsThe testes produce sperms stored in the epididy-Section1Internalmis. During ejaculation the sperms pass through thedeferent ducts, ejaculatory ducts and urethra to beGenital Organsexpelled from thebody.Accessory glands includes the seminal vesicles,the prostate gland and the bubourethral glands.TheyI.Testessecrete the fluid to be added to the seminal fluid tomaintain the nutrition and activity of the sperms.The testes are apair of oval-shaped organs. TheyThe external genital organs are the scrotum andaresuspendedithescrombyhespermaticcordpenis.The scrotum houses the testes. And the penis isEsiswxrmitieroradthe copulatory organ by which the sperms are intro-rorextremity wosurfacesleraland amedaduced into the female reproductive tract..168.口扫描全能王创建7
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Chapter5MaleGenitalOrgans169.surface;and twoborders,an anteriorandaposteriorthrough this border to enter or leave the testis (Fig.border.The blood vessels, nerves and lymphatics passII-5-2).AmpullaductusdeferentisMSeminal vesicleEjaculatory ductProstateProstatic utricleOrificeofejaculatoryductSeminal colliculus-Ductus deferensBulbourethral glandHead of epididymisEfferent ductules of testisContorted seminiferoustubulesBody of epididymisSeptula testisRetetestisLobules oftestisTunica albugineaTail ofepididymisCavity of tunica vaginalisFig. II-5-2 Internal genital OrgansEarly in fetal life the testes are situated in the ab-superior portion of the epididymis is known as thehead.The portion posterior to the testes is called thedominal cavity behind the peritoneum. Before birthbody.And the inferior portion is referred to as thethey descend and pass through the inguinal canals toreachthe scrotum.If thetestesdonotdescend into thetailThe head of the epididvmis contains the efferentductules which terminated in a coiled duct of epidid-scrotum, thecondition isreferred to cryptorchidism.ymis within the body and tail. The duct of epididymisAfter puberty the testes produce sperms and se-crete hormones.The testosterone controls the devel-passes upward to connect with the ductus deferens.opmentofmale secondary sexual characteristics,suchas hair pattern,muscular development, voice change,II.Ductus Deferensbone growth,normal sexual behavior and sperm pro-duction.In old age, thetestes atrophy and its functionThe ductus deferens are the continuation of theas well as,decline.epididymis ducts.Each of them is about 50 cm inlength.Generallytheleftoneis longerthanthatoftheII.Epididymisright,Theirwalls arethick,and theduct cavities arefine. It can be touched feeling like a cord in the livingThe epididymis is the principal storehouse forbody.Each ductus deferens is divided into four parts:sperms,adds an essential secretions to the seminalfluid in which the spermatozoa are activated andTesticular partstored.The morphology oftheepididymis isa comma-shaped,and attaches tothesuperiorextremity andthe posterolateral surfaceofthetestes.TheenlargedIt is the shortest part of the duct and begins at the口RT扫描全能王创建D
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·170·PARTIISPLANCHNOLOGYtail of epididymis, and ascends along the posteriorbaseof the prostate tothemedial sideofthe seminalborder of thetestis and the medial side of the epididy-vesicle.Theterminalportionoftheductusdeferens ismis.dilated,and called the ampulla ductus dferens whichbecomes gradually thin and joins theexcretory ductof seminal vesicle to form the ejaculatory duct.Funicular part (Fig.II-5-2)It is the continuation of the testicular part, andIV.Ejaculatory Ductextends from the head of epididymis to the superficialinguinal ring. It lies in the medial and posterior por-The ejaculatory duct (Fig. II-5-3) is formed by thetion of the spermatic cord and can be palpated easilyunion of the end portion of the ductus deferens andin the living body.This portion is the place where thethe seminal vesicle duct.vasectomy is performed.It is about 2.0cm in length and penetrates the baseoftheprostatetoopen intotheprostatic portionofthe3.Lnguinal parturethra.It passes through the inguinal canal from the su-V.Spermatic Cordperficial ring to the deep ring.It is the soft round ropes way which beginnings4.Pelvic partfrom the deep ring passes through the inguinal canal.,and end to the upper extremity ofthe testis. It is aboutIt is the longest part of the ductus deferens. It11-15 cm in length. In the spermatic cord there are theentersthe abdominal cavityfromthe deep ring of theductus derens,testicular artery,pampiniform plexusinguinal canal.And then goes downward and medial-of vein, nervous plexus (Fig. II-5-3), lymphatic ves-ly along the lateral wall of the pelvis. It crosses oversels and the remnants of the vaginal process. Thesethe terminal portion of the ureter anterosuperiorly tostructures are enclosed by the external spermatic fas-its medial side.The end of the ductus deferens lies thecia, cremaster and internal spermatic fascia.Uinary bladderDuctus deferensJreteAmpulla ductusdeferentis(section)Ampulla ductus deferentis0Seminal vesicle(section)Seminal vesicleEjaculatory ductProstateUrethraBulbourethral glandBulb of urethraFig. II-5-3The prostate, seminal vesicle and bulbourethral glandD海扫描全能王创建
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Chapter 5Male Genital Organs·171.attached to the bladder. And its apex points inferi-VI.AccessoryGlandsorly. The urethra passes through the prostate. Theanterior surface of prostate gland is posteriorto thepubic symphasis. There is a shallow sulcus along themidline on the posterior wall of the prostate gland.Seminal vesiclesRThe sulcus,ampulla ductus deferent and seminal ves-icles can be palpated through the anterior wall of theThey are a pair of organs, which lie lateral to therectum in the livingbody.Theprostategland is com-ampulla of the ductus deferens,posterior to thefundsposed of muscular and glandular tissues.It secretesof urinary bladder and in front of the rectum.Eachthe seminal fluid to be added to the spermatozoa deseminal vesicle is composed of coiled blind ducts,liver to the urethra.A single ejaculate usually is aboutwhose thin inferior extremity joins to djaculatory duct30ml(Fig.II-5-2,3)and free superior extremity dilate as the base of theThe prostate consist of five lobes. They are ante-seminal vesicles secrete the yellow seminal fluid torior,posterior,median and two lateral lobe.The an-composespermaticfluid(Fig.II-5-3)teriorlobe is small, lying anteriorto the urethra.Themedian lobe lies above and behind the lateral lobes.The posterior lobes are posterior to the ejaculatory2. Prostate glandduct, covering the median lobe and the posterior wallof the lateral lobes.This is a chestnut-shaped organ lying in the lesserThe prostate gland is pierced by the proximal ure-pelvic cavity below the bladder, above the urogeni-thra (Fig.1I-5-4)tal diaphragm and in front of the rectum, Its base isIntermal orifice ofurethraSeminal vesicleAmpulla of ductusdeferentisEjaculatory ductAnteriorlobeMiddle lobeProstatic part of urethraPosteriorlobeMembranou part ofurethraAnteriorlobeLeftlobeRightlobeUrethraUrethral crestCapsule of prostateProstatic utricleMiddle lobeEjaculatory ductPosteriorlobetThe structures of theprostateFig.I-5-4DPD2扫描全能王创建D
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.172:PARTSPLANCHNOLOGYposteroinferiortothepenisThe wallofscrotumisThe capsule of the prostate completely surroundscomposed of skinand dartos.Theskinof scrotum isthe gland,and a thin sheath ofpelvicfascia surroundsthin, soft and extensible. Its color is dark gray withthe capsule.somehairs inadult.UndertheskinofthescrotumisThe blood supply of the prostate is from the in-dartos which consists of connective tissue and anumferior vesicleartery.Theveins drain to the prostaticber of smooth muscle fibers. The dartos formes theplexus, which eventually drain into the internal iliacseptum of scrotum internally to divide the scrotumveins.intoright and leftcompartments.Eachofthem hous-Prostatic enlargement affects almostall elderlyesatestis,epididymis, thelowerpartofthespermaticmales.It may cause urinary obstruction,The enlargement maybedueto a benign lesion or a prostate carcord and its coverings (Fig.I-5-5,6)cinoma.There are four layers under the dartos to coverthe testis and spermatic cord. The first layer is theexternal spermatic fascia which is the continuation of3.Bulbourethral glandsthe apovearosis of the obliguus enternus abdominis.The second is the cremaster muscle which comesThey are a pair of pea-sized glands located in-from the oblique internus abdominis and transverseferior to the prostate gland (Fig.II-5-3).Each glandabdominis.The muscleis composed of striatedmus-has a longer duct which opens into the bulbar portioncle tissue to elevates the testes with contraction.Theof the urethra. They secrete a thin, clear mucus thatthird is the internal spermastic fascia continuing withdrain into the cavernous portion of the urethra, Thisthe transverse fascia.Under the internal fascia is thesecretion, which is released prior to ejaculation, joinstunica vaginals of testis which covers the testis andtothe spermatic fluidto increase activity of sperms.epididymis coming from peritoneum.The tunica vaginalis consists of visceral layer and perietal layer ofSection2 Externalperitoneum. Between these two layers there is a slit.Genital Organslike cavity which contains a small amount of serousfuid. In normal condition, the upper partof the tunicavaginalis testis is obliterated. If it is not obliterated,I.Scrotumthe serous cavity of testis communicates with the ab-dominal cavity. The communicated hydroperididymiaScrotum is a pendulous sac of the skin situatedand the congenital indirect inguinal hernia is formedSkinscrotumDartos coatBody of penisCremaster,extemal andinternal spermatic fasciaePampiniform plexusParietal layer of tunicavaginalis of testisHead of epididymisTestisHead of penis (Glans)Body of epididymisFig. II-5-5 The coverings of testis and spermatic cord-扫描全能王创建
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Chapter5MaleGenital Organs:173.Parietal peritoneunRectus abdominisRectovesical pouchUrinary bladderSeminal vesicleProstatic part of urethraEjaculatoryductProstateMembranous part of urethraUrogenital diaphragm-AnusSphincter ani externusUrethra (Spongy part)Navicularfossa of urethraTestisScrotunExtemal orifice ofurethraFig.II-5-6The male pelvis (median sagittal section)space ofprepucecausinginflammation,This chronicand herniated with someabdominal contests,such asinflammatron of the prepuce is a risk factor of penisthe loop of ileum or greater omentum will offend intocarcinoma.For these reasons prophylactic circumci-the serous cavity to enclose the testis.sion is commonly performed (Fig. II-5-5, 6).The penis consists of three so-called cavernousII.Penisbodies.Two of them are cavernous body of the penis,and the rest is the cavernous body of urethra. TheIt is divided into three parts: a glans, a body andposterior portion the cavernous body in penis is calleda root.The root is theposterior portion of the penisthe crus penis (Fig. II-5-7, 8).attached to the pubic arch.The body of penis is theThe distal end of the cavernous body of the ure-continuation of theroot which is themovable portion,thra(Fig.II-5-8)is thickened and forms theglansofand covered withskin andfascia.Theskin isthin,softpenis. Each cavernous body is covered with a denseand extensible.The glans is the thickened distal endconnective tissue coating the spongy structure.of the penis. The urethra opens at the tip of the glans.Between the glans and body there is the neck whichII.Male Urethrais the narrowest portion of the penis. At the neck, theskin folded upon itself to form the prepuce. The freeThemale urethra (Fig.-4-10,Fig.I1-5-6)servesborder of the prepuce is named the orifice of prepuce.notonlyforvoiding theurinefromthe bladder,butIn most children, the prepuce is longerthan that in thealso for ejaculating the seminal fluid.It is aboutadult and diameter of orifice is smaller than that in16-20cm long and passes through theprostate,thethe adult. In some cases, when the prepuce islongeruregental diaphragm and the cavernous body of theand the orifice of the prepuce is smaller than normal,the prepuce cannot be retracted over the glans. Inurethra. It can be divided into three portions: the prosthis case some secretions may be accumulated withintatic,membranousandthecavernous.Inthe clinicthe口扫描全能王创建D
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.174·PART IISPLANCHNOLOGYGlans penisExtermal orificeofurethCorona glandisGlans penisFrenulumof preptPrepuce of penisCavermous body of penisCavernous body of urethraBody of penisDeepfasciaofpenisCruspenisBulbofurethrInferiorramusofpaDeepdorsav.ofpenisDorsal a.ofpenisBulbourethral glandCrus peniDorsal n.of penisArteryofpenisFig.-5-7The structures of the penisDorsal superficial vein of penisDorsal deep vein of penisDorsalarteryofpenDorsal nerveof penisSuperficialfascia of penisDeepfascia of penisDeep artery of penisSeptum of penisCavermousbodyofpenisAlbuginea of cavernous bodyof peniAlbuginea ofcavernousUrethrabodyofurethraCavemous bodyofurethraSkinFig. II-5-8 The transverse section of penisfirst and second portions of the urethra are called theriorly into the prostate (Fig, II-5-2).posterior urethra. And last cavernous portion is calledthe anterior urethra.2.Membranous portion1.Prostatic portionIt is the narrowest, shortest and least dilatable por-tionoheurethraItpiercesthesuperorand inferoIt is the widest and most dilatable pant of thefasciaeofthe urogenital diaphragmItis surroundedurethra.It is approximately3 cm long and pierces theby the sphincter ofurethra between the superiorandprostate from its base to its apex.On the midline ofinferior fasciae. The sphincter of urethra is the stiatethe posterior wall, there is a longitudinal ridge,namedmuscle under voluntary control after early infancy.urethral crest. At the middle portion of the urethralerect there is a small prominence,termed seminal col-5Cavernous portionliculus, lateral to which there are two opening of theejaculatory duct. The numerous ducts of the prostateItis about 15cm long and accounts for 75% ofgland open into the prostatic sinuses of the urethra.Inurethral length, which runs through the cavernousthe center of the seminal colliculus, there is a prostat-bodyofurethraandopens totheoutsideattheexteric utricle.It is a blind sac which extends posterosupe-口RD扫描全能王创建D
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Chapter5 MaleGenital Organs175nal urethralorifice.There are two dilated places inprepubic curve lies the anteroinferior portion, whichthis portion.One is at the proximinal portion withinis between the body and root of the penis. The curvethe bulb of penis, which called the bulbous portionmay straighten or disappear upon erection of theof urethra,The straddle injury commonly occurres atpenis.This characteristic can be used in clinic whenthis portion.The other is near the external orifice ofcystoscopy is performed.In addition,therearethreeurethra, which called the navicularfossa (Fig.II-5-6)constrictions in the internal urethral orifice,the mem-There are two curves in the male urethra, thebranous portion and external orificeofurethraprepubic and subpubic curves (Fig.l-5-6). The sub-pubic curve is fixed which could not rectify. TheLuGuangming（吕广明）?扫描全能王创建
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