💡 Learning Outcomes:
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Identify the parts and joints of the bony pelvis.
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Identify the locations, parts, microscopic structure, and blood supply of male external genitalia:
a. Penis, b. Scrotum, c. Distal urethra.
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Identify the locations, parts, microscopic structure, and blood supply of male internal genitalia:
a. Testis, b. Epididymis, c. Ductus deferens, d. Ejaculatory ducts, e. Seminal vesicle, f. Prostate.
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Identify the organization and relationship of these organs with other structures in sagittal section of male pelvis.
Learning Outcome 1: Identify the parts and joints of the bony pelvis.
Bony Pelvis: The bony pelvis is composed of the following bones and joints:
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Bones:
- Ilium
- Ischium
- Pubis
- Sacrum
- Coccyx
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Joints:
- Sacroiliac joint: Joins the sacrum with the ilium on either side.
- Pubic symphysis: Joins the left and right pubic bones anteriorly.
- Sacro-coccygeal joint: Between the sacrum and the coccyx.
- Lumbosacral joint: Between the fifth lumbar vertebra and the sacrum.
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Ligaments:
- Sacrotuberous ligament
- Sacrospinous ligament
- Anterior sacroiliac ligament
- Iliolumbar ligament
- Anterior longitudinal ligament
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Foramina:
- Greater sciatic foramen
- Nerves: Sciatic nerve, superior gluteal nerve, inferior gluteal nerve, pudendal nerve.
- Lesser sciatic foramen
- Nerve: Pudendal nerve (supplies muscles of the perineum and external anal sphincter).
- Greater sciatic foramen
Learning Outcome 2: Identify the locations, parts, microscopic structure, and blood supply of male external genitalia (Penis, Scrotum, Distal Urethra).
2a. Penis
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Location: Anterior to the scrotum and perineum, attached to the pubic symphysis by suspensory ligaments.
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Parts:
- Root: Located in the superficial perineal pouch, consists of two crura and one bulb.
- Body: Free portion covered by skin. Contains:
- Corpora Cavernosa (2): Dorsal erectile tissues.
- Corpus Spongiosum (1): Ventral tissue surrounding the urethra.
- Glans Penis: Expansion of the corpus spongiosum, distal portion of the penis.
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Microscopic Structure:
- Corpora Cavernosa: Composed of erectile tissue and lined by a tunica albuginea.
- Corpus Spongiosum: Contains the penile urethra and is less tightly surrounded by connective tissue to allow for urethral expansion during ejaculation.
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Blood Supply:
- Arteries: Dorsal artery of the penis, deep artery of the penis (branches of internal pudendal artery).
- Veins: Superficial and deep dorsal veins draining into the internal pudendal vein.
Mechanism of Erection
- Parasympathetic nerves dilate the deep artery of the penis, increasing blood flow into the cavernous spaces, resulting in erection. Blood is drained through the dorsal veins post-erection.
Circumcision and Phimosis
- Circumcision: Incision of the prepuce, exposing the glans.
- Phimosis: Tight preputial skin that cannot retract over the glans.
2b. Scrotum
- Location: Hangs below the penis in the perineum.
- Parts:
- Layers: Skin, Dartos fascia, External spermatic fascia, Cremaster muscle and fascia, Internal spermatic fascia, and Tunica vaginalis.
- Microscopic Structure:
- Dartos Muscle: Smooth muscle responsible for the wrinkled appearance and thermoregulation of the scrotal skin.
- Blood Supply:
- Arteries: Anterior and posterior scrotal arteries (branches of the external pudendal and internal pudendal arteries, respectively).
- Veins: Drain into the external pudendal veins.
2c. Distal Urethra
- Location: Runs through the corpus spongiosum and opens at the external urethral meatus at the tip of the glans penis.
- Microscopic Structure:
- Lined with stratified squamous epithelium near the meatus and pseudostratified columnar epithelium in the spongy part.
- Blood Supply:
- Arteries: Branches from the internal pudendal artery.
- Veins: Drain into the deep dorsal vein.
Learning Outcome 3: Identify the locations, parts, microscopic structure, and blood supply of male internal genitalia (Testis, Epididymis, Ductus deferens, Ejaculatory ducts, Seminal vesicle, Prostate).
3a. Testis
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Location: Inside the scrotum, suspended by the spermatic cord. The left testis is usually lower than the right.
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External Features:
- Poles: Upper and lower poles.
- Borders: Anterior and posterior.
- Surfaces: Medial and lateral.
- Tunica Vaginalis: Double-layered serous covering with parietal and visceral layers.
- Epididymis: Located on the posterior aspect, separated from the testis by the sinus of epididymis.
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Microscopic Structure:
- Tunica Albuginea: Thick fibrous capsule covering the testis.
- Seminiferous Tubules: Site of spermatogenesis.
- Leydig Cells: Found in the interstitial space, responsible for testosterone production.
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Blood Supply:
- Artery: Testicular artery (branch of the abdominal aorta).
- Veins: Testicular vein (right drains into the IVC, left into the left renal vein).
3b. Epididymis
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Location: Lies posterior to the testis.
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Parts:
- Head: Upper end connected to the upper pole of the testis.
- Body: Middle part separated from the testis by the sinus of epididymis.
- Tail: Lower end connected to the lower pole of the testis, continues as the ductus deferens.
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Microscopic Structure:
- Duct of Epididymis: Highly coiled tubule with pseudostratified columnar epithelium and stereocilia for absorption and maturation of spermatozoa.
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Blood Supply:
- Same as the testis.
3c. Ductus Deferens (Vas Deferens)
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Location: Extends from the tail of the epididymis to the ejaculatory duct, passing through the spermatic cord, inguinal canal, and pelvis.
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Microscopic Structure: Thick-walled muscular tube lined by pseudostratified columnar epithelium.
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Blood Supply:
- Artery: Artery to the vas deferens (branch of the superior vesical artery).
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Pathway: Seminiferous tubules → Straight tubules → Rete testis → Efferent Ductules → Epididymis → Vas deferens → Ejaculatory duct → Prostatic urethra.
3d. Ejaculatory Ducts
- Location: Formed by the union of the ductus deferens and seminal vesicle duct. They pass through the prostate and open into the prostatic urethra.
- Blood Supply:
- From nearby vessels such as the inferior vesical artery.
3e. Seminal Vesicle
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Location: Lies posterior to the bladder and lateral to the ductus deferens.
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Parts: Coiled tubular structure embedded in connective tissue.
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Microscopic Structure: Lined by pseudostratified columnar epithelium.
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Function: Secretes fructose-rich fluid, contributing to seminal fluid that forms 70% of semen.
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Blood Supply:
- Artery: Inferior vesical artery.
3f. Prostate
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Location: Situated below the bladder, anterior to the rectum.
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Parts:
- Apex: Directed downward, near the external urethral sphincter.
- Base: Adjacent to the bladder neck.
- Lobes: Median, lateral, anterior, and posterior lobes.
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Microscopic Structure: Consists of fibromuscular stroma and glandular tissue, including the prostatic glands.
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Blood Supply:
- Arteries: Inferior vesical, middle rectal, and internal pudendal arteries.
- Veins: Prostatic venous plexus.
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Function: Secretes fluid that forms 15% of semen, aiding in lubrication and neutralizing vaginal acidity.
Learning Outcome 4: Identify the organization and relationship of these organs with other structures in a sagittal section of the male pelvis.
In a sagittal section of the male pelvis:
- Anterior structures: Pubic symphysis, bladder, and the root of the penis.
- Middle structures: Prostate gland, seminal vesicles, and ductus deferens.
- Posterior structures: Rectum and anal canal.
- Relationships:
- Bladder: Located superior to the prostate and anterior to the seminal vesicles.
- Prostate: Lies inferior to the bladder and anterior to the rectum. The ejaculatory ducts traverse the prostate and open into the prostatic urethra.
- Rectum: Situated posterior to the bladder and prostate.