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Male Genital System (Internal & External) - Anatomy — Transcript

by Taim Talks Med · 4,249 words · 428 segments · language en · Watch on YouTube

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0:03What's up.
0:04Let's go ahead and cover the male genital system.
0:07We will cover the most important aspect of the male genitals, and hopefully, in the end,
0:12you'll have a pretty good understanding about this topic
0:15Alright.
0:16The male genital organs are divided into the internal genital organs and the external genital
0:22organs.
0:23We'll cover both of these in detail, And we'll start with the internal genital
0:27organs So the internal genital organs consist of
0:31the testes, epididymis, ductus deferens, seminal gland, Ejaculatory Duct, Prostate, Male urethra,
0:40and the bulbourethral glands.
0:43Alright, let's follow this arrangement, starting with the testis.
0:47Now, of the whole male reproductive system, the primary functional cells the male has
0:54are Leydig and Sertoli cells.
0:56And both of them are found in the testes.
1:00So the testicle or testis is the male reproductive gland or gonad in all animals, not just humans.
1:07Leydig cells produce testosterone, which is a steroid hormone that binds to intracellular
1:14receptors and regulates protein synthesis.
1:18And what that does is it influences the male development and maturation for developing
1:25muscles, deepening the voice, growing body hair, and promoting the production of red
1:30blood cells.
1:32Testosterone also stimulates the Sertoli cells to provide structural support and secrete
1:38fluid to nourish and support developing sperm cells.
1:43So that means that testosterone is also essential to maintain spermatogenesis and male fertility.
1:51And In the absence of testosterone stimulation, spermatogenesis does not proceed.
1:56It doesn't happen, basically.
1:58The testes are located outside the body, right?
2:02In a pouch called the scrotum.
2:04During prenatal development, they originate in the lumbar region, near the kidneys, and
2:11then they descend through the retroperitoneal space and inguinal canal to reach the scrotum.
2:18As they descend, the layers of the abdominal wall form the layers of the scrotum as the
2:24testes pass through them.
2:26And here's also a fun fact, the testicular vessels descend together with the testes,
2:32and that is why the testicular arteries, or gonadal arteries, come from the lumbar region
2:37of the abdomen as well.
2:39So same goes for females and the ovaries.
2:43Lymphatic drainage is similarly directed to the lumbar nodes.
2:48Ok.
2:49So we're first going to cover the testes external structures,
2:53Then we'll open it up and cover its internal anatomy.
2:57After that, we're going to talk a little bit about the epididymis and finally go through
3:02their coverings and external fixation.
3:04Awesome.
3:06Let's do the external structures first.
3:08Externally, the testicles have an upper pole and a lower pole.
3:12It has an anterior border and a posterior border.
3:16And if you look at the testes from an anterior perspective, you'll also see that it has a
3:21lateral surface and a medial surface.
3:24So the external features of the testes are very simple.
3:28Let's now go ahead and look at the internal structures of it,
3:32And we'll start by removing all other structures we're not interested in for now.
3:37Now first off, we need to identify the most external layer.
3:41And that is a capsule called Tunica Albuginea.
3:45Tunica Albuginea is a dense membrane of connective tissue covering the testis.
3:51And if we remove the lateral wall of the testis, you'll see that Tunica albuginea covers the
3:58external part of the testis.
4:01Right underneath tunica albuginea, you'll find the vascular layer, or tunica vasculosa,
4:07containing primarily blood vessels.
4:09Within the actual testis, you'll find septae.
4:12Or septa of the testis.
4:14They are connective tissue that separates the inner structures of the testes into lobules,
4:20called lobules of testes Now the lobules of the testis are regions
4:25that contain single tubules.
4:27Right?
4:28So each lobule has a single tubule.
4:31And each of these single tubules consists of convoluted seminiferous tubules, which
4:37are coiled.
4:39And once the tubule leaves the lobule, it'll become straight, so straight tubules.
4:45Now, what do these tubules look like underneath the microscope?
4:49Here you can see lobules.
4:51They literally look like pyramids, separated by septae of connective tissue that extend
4:56inwards from the capsule, right?
4:59Seminiferous tubules have a convoluted part that is within the lobule itself and a straight
5:05part that concentrates towards where all the lobules meet.
5:09These seminiferous tubules have Sertoli cells, which are larhe columnar cells as you see
5:16here.
5:17These cells have a very tight junction between them that they form the blood-testis barrier.
5:23This barrier prevents the sperm from entering the bloodstream, which also prevents our body's
5:29immune system from mounting an immune response against the sperm cells.
5:33So this barrier is very, very important.
5:36You can also see the process of spermatogenesis in this slide, which, remember is the process
5:41by which spermatogonia develop into sperm.
5:45You can see some sperm cells located in the lumen of the tubule.
5:49Leydig Cells are also called Interstitial Cells, and they're called interstitial cells
5:54because they're found in the connective tissue, or interstitium, between seminiferous tubules.
6:01Now the Leydig cells are round cells, as you see here, with vesicular nuclei and very eosinophilic
6:08cytoplasm.
6:09Remember earlier I told you that the male reproductive system has two really important
6:14functional cells?
6:15One of them is the Sertoli cells.
6:18The other one is the Leydig cells.
6:20Leydig cells secrete testosterone, the male sex hormone.
6:24Alright.
6:25So that is the lobules and the septae of the testicles.
6:29More posteriorly, we have the mediastinum of the testis.
6:33The mediastinum of the testis has a network of tubules called rete testis.
6:39This network of tubules will give off efferent ductules, which continue into the epididymis.
6:46And this happens in the head of the epididymis, the upper part of it.
6:50So let's go ahead a talk about the epididymis a little bit.
6:53Now I want you to understand something about the epididymis.
6:58It's not really an organ of its own.
7:00It doesn't really have any functional cells.
7:02The epididymis is actually just tubes that are coiled together so tightly that they form
7:08a structure called the epididymis.
7:11Now even though it doesn't really have any functional cells on its own, the epididymis
7:16does something really important for the testes.
7:19And that is that it serves as a reservoir for the spermatozoa.
7:24So the sperm cells mature within the epididymis.
7:28And is provided with nutrition by the epididymis, so that they gain the capacity to move and
7:33fertilise the ovum.
7:34So, in reality, Spermatozoa spend 10–12 of their total 72 days of maturation within
7:42the epididymis.
7:43Awesome.
7:44So externally, the epididymis has a head or caput, and as I mentioned earlier, the cranial
7:51part of the head is formed by the efferent ductules that come from the mediastinum of
7:56the testes; right?
7:58Then we have the body of epididymis, which is formed by the convoluted ducts of the epididymis.
8:04We got the tail of the epididymis, which connects to the ductus deferens.
8:08Another thing we can mention here is that anatomically, there's going to be a pouch
8:13located at the lateral surface between the testis and the epididymis.
8:17That pouch is called the sinus of the epididymis.
8:21And here's an anterior view just to make it easier to visualize it.
8:25Alright, let's go ahead and recap the ducts of the testes and the epididymis.
8:30First, we got the convoluted seminiferous tubules within the lobules of the testes.
8:35Then, we got the straight tubules that form the rete tests.
8:40They continue into the epididymis as the efferent ductules.
8:45Within the epididymis, we got the duct of epididymis, which continues as the ductus
8:50deferens.
8:51So that's really how the tubules are arranged.
8:55Let's now go ahead and look at the coverings and the external fixation of the testes and
8:59the epididymis.
9:00Alright, let's zoom in first.
9:03The layer that is closest to the testes and the epididymis is the Tunica Vaginalis.
9:09Tunica Vaginalis is originally a part of the peritoneum that became one of the layers of
9:15the scrotum during the descent of the testis.
9:19And notice that the tunica vaginalis is composed of two layers with a little space between
9:25them.
9:26We got the visceral layer covering the testis and the epididymis from the anterior and the
9:30lateral aspects.
9:32It fuses with the tunica albuginea, and then posteriorly the visceral layer continues into
9:39the parietal layer.
9:41Between the visceral and the parietal later, there's a little space which contains a small
9:45amount of serous fluid, just like the peritoneum does.
9:49Notice how the tunica vaginalis covers the whole thing as a pouch, except the posterior
9:55ends of the epididymis.
9:57And that is because the visceral layer envelops all but the posterior aspect of the testis,
10:03while the parietal layer lies against the scrotal wall.
10:07Alright.
10:09Remember I told you that the testes descend from the lumbar region in the retroperitoneal
10:14space?
10:15And as they descend, they take with them all layers of the abdominal wall to form the scrotum?
10:21The inner layer comes from the peritoneum, called tunica vaginalis.
10:27Externally to that, there's the internal spermatic fascia, which is a continuation of the transveralis
10:33fascia of the abdominal wall.
10:36Then externally to the internal spermatic fascia, we have a muscle called the cremaster
10:42muscle, which is a skeletal muscle that pulls the scrotum towards the abdominal wall.
10:48So when it gets cold, these muscle fibers contract to pull the testes closer to the
10:53body, and if it gets hot, they relax.
10:58These muscle fibers, the cremaster muscle, consists of muscle bundles from the internal
11:03oblique and transversus abdominis muscles, and it's covered by the cremasteric fascia.
11:10Externally to this muscle, we have the external spermatic fascia, which is a continuation
11:15of the superficial abdominal fascia Now just to complete the picture here.
11:20Externally to this layer, we're going to have the dartos fascia, which is a layer of connective
11:25tissue found in the scrotum and foreskin in males, and the vaginal lips in females.
11:31And then externally to that, we have the skin.
11:34These are basically all the layers of the scrotum.
11:37But now, these layers.
11:39The external spermatic fascia, the cremaster muscle, and the internal spermatic fascia.
11:45They're going to continue upwards and form the spermatic cord.
11:49Or Funiculus Spermaticus.
11:51So here you see a naked testicle covered by tunica vaginalis.
11:56Externally to that, we can see the internal spermatic fascia.
12:01Externally to that, we see the cremaster muscle.
12:03External to that, again, we see the external spermatic fascia.
12:08And again, here we see the spermatic cord.
12:11So let's expose the spermatic cord a little.
12:14Let's cut the external spermatic fascia here.
12:17Let's cut the cremaster muscle here.
12:20Let's cut the internal spermatic fascia here.
12:23And let's cut through the anterior part of the tunica vaginalis, and then look at the
12:28whole thing from this perspective.
12:31We'll see this.
12:32I know I'm repeating myself many times here but I really want you to remember this.
12:36So here we see the external spermatic fascia.
12:39Cremaster muscle, Internal Spermatic fascia, and down here, we can see the tunica vaginalis.
12:46We can also see the testes and the epididymis.
12:49Alright.
12:50So up here, we can see the inguinal canal.
12:52And down here, we can see the scrotum.
12:56Right?
12:57Between the inguinal canal and the scrotum, we can see the spermatic cord.
13:01So the spermatic cord is a tough rope-like structure that goes from the scrotum to the
13:07inguinal canal.
13:08Within the spermatic cord.
13:10We can find the ductus deferens coming from the epididymis.
13:14But we can also find vessels.
13:16We can find the artery to the ductus deferens, which is a branch of the internal iliac artery
13:20that supplies the ductus deferens.
13:23We can find the Testicular artery, which is a branch of the abdominal aorta supplying
13:27the testis and the epididymis.
13:30We have lymph vessels from the testis and the epididymis that flow to the lumbar lymph
13:36nodes.
13:37We have the Pampiniform plexus, which is a venous plexus conveying blood from the testis
13:42and epididymis to the inferior vena cava on the right and to the left renal vein on the
13:48left We got the Testicular plexus which is basically
13:52the nervous plexus of the testis, and the Deferential plexus, which are visceral sensory
13:59nervous plexus of the ductus deferens.
14:02So that was everything I had regarding the spermatic cord and the testes and epididymis
14:08as well.
14:09Let's now go ahead and talk a little bit about the ductus deferens
14:12The ductus deferens is a tubular organ that transports spermatozoa from the epididymis
14:19to the prostatic urethra by peristaltic contractions.
14:23Right?
14:24So It passes from the scrotum through the spermatic cord and inguinal canal into the
14:29lesser pelvis, where it crosses the ureter and enters the Prostate.
14:34Alright.
14:35Now the ductus deferens have different parts according to their location.
14:40If it's in the scrotum, it's called the scrotal part.
14:43After the scrotal part, it goes within the spermatic cord.
14:47Called the funicular part.
14:49Then it enters the inguinal canal through the superficial inguinal ring, getting the
14:54name inguinal part.
14:56Then it leaves the inguinal canal through the deep inguinal ring and enters the pelvis,
15:02called the pelvic part.
15:04The pelvic part of the ductus deferens is going to go through the lesser pelvis, and
15:09pass anterior to the external iliac vessels.
15:13It'll run close to the urinary bladder And dilate to form the ampulla of the ductus
15:19deferens, which is the most distal segment of the ductus deferens.
15:23Then ductus deferens will fuse with the duct of the seminal gland to form the ejaculatory
15:29duct, which will enter the Prostate and join the urethra—the prostatic urethra at the
15:35seminal colliculus.
15:37Alright.
15:38That was all for the ductus deferens.
15:41Let's go through the next segment of the male genital system, which is this one.
15:45The Seminal gland.
15:46The seminal gland is very, very important as well.
15:50The seminal glands are located behind the urinary bladder above the Prostate.
15:56Each seminal gland is a simple tubular gland composed of a single duct with multiple convolutions.
16:04The seminal glands produce 50–80 % of the ejaculate fluid.
16:08So it produces a fluid that makes up semen, which is released during ejaculation.
16:15So the seminal gland has an excretory duct, which joint joins the ductus deferens, as
16:20you see here, to form the ejaculatory duct that empties into the urethra.
16:25Awesome.
16:27Let's continue to the next segment and talk about the Prostate.
16:30Now the Prostate is the largest male genital gland.
16:34And it produces roughly about 30% of the ejaculate fluid.
16:39It is located sub peritoneally, so under the peritoneum.
16:44And also inferior to the urinary bladder.
16:47The urethra goes through the Prostate along with the paired ejaculatory ducts.
16:53Alright.
16:54Externally, there's a base called the base of the Prostate, which is the broad cranial
17:00part of the Prostate located around the neck of the urinary bladder.
17:04We have an apex of the Prostate, which is the tip of the Prostate pointing towards the
17:09pelvic floor There's a posterior surface facing the rectum
17:13and an anterior surface facing the pubic symphysis.
17:17And then, within the Prostate, we got the urethra.
17:20Or, to be specific, the prostate part of the urethra.
17:24Alright, let's zoom in a little bit.
17:26Now the Prostate is divided into zones.
17:30Histological zones, not anatomical.
17:32But I wanna mention them anyway because the Prostate is built differently across the inner
17:38surface of it.
17:40So the outer part of the Prostate, we got the peripheral zone.
17:44This zone is rich in glands that produce seminal fluid.
17:49Around the ejaculatory ducts and the prostatic utricle, there's the central zone.
17:55There's also a transitional zone around the proximal part of the urethra.
17:59The transitional zone is where benign prostatic hyperplasia occurs and can lead to bladder
18:05outlet obstruction when an adenoma grows to a significant size.
18:10Then the rest is usually a non-glandular zone composed of fibromuscular stroma
18:15Again, these are microscopic zones, so histological zones not anatomical.
18:21Just keep in mind that the Prostate has zones.
18:24Some parts have more glands; some parts have more ducts.
18:29Some parts have more muscles and fibers.
18:31Now, if we make a vertical cut like this, then look at the Prostate from this perspective.
18:37We'll see this.
18:38So on the posterior surface of the Prostate.
18:42We can see prostatic ductules, which secrete the prostatic secretions.
18:46We ca see the urethral crest, which is an elevated crest on the posterior surface of
18:51the urethra There's an elevated area on the urethral crest
18:56called Seminal colliculus And on the seminal colliculus, you can find
19:00the prostatic utricle, which is an unpaired remnant of the paramesonephric duct.
19:06And we can find the openings of the ejaculatory ducts on both sides of the seminal colliculus
19:12for the sperma.
19:14So that was all I had for the Prostate.
19:17Let's now do the bulbourethral glands.
19:19The bulbourethral glands are a pair of accessory genital glands.
19:25They lie closely above the bulb of the Penis, and empty their fluid into the beginning part
19:31of the spongious urethra.
19:33These pea-sized glands are located on the inferior surface of the deep, transverse perineal
19:39muscle.
19:40They produce a viscous liquid that lubricates the internal surface of the urethra during
19:46ejaculation.
19:47Awesome.
19:48Let's quickly go through the male urethra.
19:50So here we see the urinary bladder.
19:53The Prostate.
19:54The Perineal muscles and the Penis.
19:56The male urethra is here, going through all of these structures.
20:00So it goes from the internal urethral orifice to the urinary bladder.
20:05To the external urethral orifice, exiting the glans penis.
20:09Now.
20:10The urethra is divided into several parts based on the region they're located in.
20:16In the Prostate It's called the prostatic urethra.
20:19In the perineum, it's called the membranous urethra.
20:23And in the Penis, it goes through the corpus spongiosum so it's called the spongious urethra.
20:29Alright!
20:30That was all the internal make genital organs that we needed to cover.
20:34We went through the testes and the epididymis.
20:37We went through the ductus deferens.
20:38The seminal gland and the ejaculatory duct We went through the Prostate, the male urethra,
20:45and the bulbourethral glands Let's now go through the external genital
20:49organs, which consist of the Penis and the Scrotum.
20:52We'll start with the Penis.
20:54And similar to most things, it has external structures and internal structures.
20:59So let's start by talking about the external structures we'll see looking at the Penis.
21:03So here's a lateral view of the Penis.
21:06But to really be able to cover all external structures, we need to look at it from an
21:11inferior surface as well, so let's go ahead and do that.
21:14So essentially, the Penis consists of 3 pipes, or three erectile bodies, that courses throughout
21:21its entire length.
21:23We have 2 Corpora cavernosa penis, which are erectile bodies that erect the Penis when
21:30engorged with blood, and 1 Corpus spongiosum penis, which is the unpaired erectile body
21:36containing the urethra.
21:38So within the corpus spongiosum, that's where we have the spongy part of the male urethra.
21:45The Penis can be divided as the root of the Penis, which is the inner part covered by
21:50skin and muscles.
21:51We have the body of the Penis, which is the external movable part of the Penis beneath
21:56the pubic symphysis.
21:58And we have the glans penis, which is the anterior end.
22:02Now the root of the Penis, consists mainly of the bulb of Penis, which is the dilated
22:08part of the corpus spongiosum underneath the perineum.
22:12And two crura of Penis, which are the paired internal part of the corpora cavernosa.
22:18Now, the body of Penis is also composed of corpora cavernosa and the corpus spongiosum.
22:25But anatomically, the body of the Penis has surfaces as well.
22:29It has the Dorsum of Penis, which is the "anterior" surface in a flaccid penis in the anatomical
22:35position, And when erect, you know, it becomes the upper to posterior surface.
22:40It has a Urethral surface, which is the surface facing the scrotum
22:45Then we can see Fundiform ligament of Penis, which originates at the linea alba of the
22:51anterior abdominal wall, and makes a loop around the Penis, attaching the Penis to the
22:56pubic symphysis.
22:58And we can see the Suspensory ligament of Penis, which attaches the dorsum of the Penis
23:03to the anterior surface of the pubic symphysis.
23:07Now, there's one more structure that I wanna mention in the body of Penis.
23:12And that is, if we look at the Penis from an inferior perspective.
23:16On the inferior side, there's going to be a line, or a raphe called the raphe of Penis.
23:22So that was the body of Penis.
23:24Now let's do the glans penis.
23:27The glans penis is the most distal segment of the corpus spongiosum.
23:32It's also referred to as the head of the Penis.
23:35Similar to glans clitoris, the glans penis is the most sensitive erogenous zone and primary
23:42anatomical source of male sexual pleasure, due to the number of nerve endings.
23:48Alright, let's zoom in and look at the structures.
23:52The proximal dilated part of the glans that faces the body of the Penis, is called the
23:56corona of glans.
23:58It also has a neck, which is a groove that separates the glans from the body of the Penis.
24:05Around the glans penis, we can find the foreskin or the prepuce.
24:09The foreskin is a fold of skin that originate from the body of the Penis and cover the glans.
24:16It can be pulled over the glans to a variable extent.
24:20Then we can find a frenulum, which is ventrally located.
24:24It's the transition between the skin of glans and the skin of the prepuce.
24:29And lastly, we can also find some preputial glands, which are small smegma-producing glands
24:35at the inner margin of the foreskin.
24:38Smegma is a thick, white, cheesy substance composed of dead skin cells and oil and other
24:44fluids, that collects under the foreskin of the Penis.
24:48It's more common in uncircumcised men who don't clean that area well enough.
24:53Women can also get smegma in their vaginal area
24:57So that was the external surfaces of the Penis.
25:00Let's now make a transverse cut, like this.
25:03Remove some parts of the Penis.
25:05And look at it from this perspective We'll see this.
25:09This image illustrated the penis structures very well,
25:12We can see the Corpus spongiosum down here, containing the urethra.
25:16We can see corpora cavernosa Around the corpora cavernosa, we can see tunica
25:22albuginea, which is a dense layer of connective tissue that from a septum, called septum penis
25:29between the corpora cavernosa.
25:31We can also see the deep fascia of the Penis, which is a layer of connective tissue covering
25:37the erectile bodies.
25:39And we have the superficial fascia of Penis, which enables free sliding of the skin.
25:45So it's located right underneath the skin.
25:47Alright.
25:48Other structures we can see, which are very very important, is the superficial dorsal
25:54vein of the Penis.
25:56This is an unpaired vein that drains through the external pudendal veins into the common
26:01femoral vein.
26:03We also have the deep dorsal vein of the Penis, which is an unpaired vein that bifurcates
26:09into the internal pudendal vein, which converges into the internal iliac vein
26:15On the sides of it, we can see the dorsal artery of the Penis, which supplies the skin
26:20and glans of the Penis and the foreskin.
26:23Then within the corpora cavernosa, we can see cavernous spaces and trabeculae of corpora
26:29cavernosa.
26:30These are spaces that fill with venous blood during an erection.
26:34So they're small cavities inside the erectile bodies lined with endothelium
26:42And in the middle, we can find the Deep artery of Penis, which is inside the corpus cavernosum.
26:48And in corpus spongiosum, we can see the urethral artery.
26:52So that was everything I had for the Penis.
26:55Now lastly, let's talk a little bit about the scrotum.
26:58The scrotum is a sac located on the outside of the body.
27:02Right?
27:03So if we go ahead and look at the scrotum from this perspective, we'll see this.
27:08So again, as we talked about earlier, the scrotum contains the testis and epididymis.
27:15And also the ductus deference on the posterior aspect.
27:18The temperature inside the scrotum is 2–4 degrees lower than the core body temperature.
27:25This ensures optimal spermatogenesis because the optimal temperature for spermatogenesis
27:31is a little colder than our core temperature.
27:35If if it gets too cold outside, the cremaster muscle contracts and pulls the scrotum upwards,
27:41towards the perineum.
27:42Similarl if it gets too hot, the cremaster muscle relaxes.
27:47Alright.
27:48So the layers are as follows.
27:50First, we have the tunica vaginalis.
27:53Which remember comes from the peritoneum.
27:54Externally to that, there's the internal spermatic fascia, which is a continuation of the transveralis
27:56fascia of the abdominal wall.
27:57Then externally to the internal spermatic fascia, we have a muscle called the cremaster
28:01muscle, which consists of muscle bundles from the internal oblique and transversus abdominis
28:08muscles.
28:09Externally to this muscle, we have the external spermatic fascia, which is a continuation
28:15of the superficial abdominal fascia Externally to this layer, we're going to have
28:20the dartos fascia.
28:22This is a 1 – 2 mm thick layer of connective tissue with elastic fibers and smooth muscles.
28:29And it's going to form a septum, or scrotal septum, which divides the scrotal pouch into
28:35two cavities for each testicle.
28:39Outside the dartos fascia is the skin, as you see here.
28:43All of these layers form the scrotum.
28:46So that was everything I had for the anatomy of the male genital system.
28:50I really hope you found this video helpful.
28:53If you did, don't forget to like, comment, and subscribe!
28:56See you next time.

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