Scrotum, testes & spermatic cord

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Gubernaculum

fibrous cord connecting the primordial testis to the anterolateral abdominal wall at the site of the future deep ring of the inguinal canal

processus vaginalis

a peritoneal diverticulum
traverses the developing inguinal canal
carries muscular and facial layers of the anterolateral wall into the primordial scrotum
by 12th week of development the testis has migrated to the pelvis
by 28 weeks it lies close to the inguinal ring
at 32 weeks it enters the scrotum

Spermatic cord

suspends the testis and scrotum and contains structures running to and from the testis
begins at the deep inguinal ring to the inferior epigastric vessels
pass through the inguinal canal
exits at superficial inguinal ring
ends in scrotum at posterior border of the testis

Internal Spermatic Fascia

derived from the transversalis fascia

creamsteric fascia

derived from the fascia of both the superficial and deep surfaces of the internal oblique muscle

external spermatic fascia

derived from the external oblique aponeurosis

ductus deferens

muscular tubbe
conveys sperm from the epididymis fo the ejaculatory duct

testicular artery

arises from the aorta
supplies the testis and epididymis

cremasteric artery

branch of inferior epigastric artery

pampiniform plexus

venous network
drains into right or left testicular veins

nerves

point and shoot
point (erection)=parasympathetic
shoot (ejaculation)=sympathetic

nerves T11-L1 (sympathetic)
genital branch of genitofemoral nerve (L1, L2)

Scrotum

cutaneous sac with 2 layers
heavily pigmented skin
dartos muscle/fascia

dartos muscle/fascia

layer of smooth muscle fibers responsible for the rugae
helps to regulate temperature (along with cremaster muscle)

Epididymis

lies on posterior surface of testis
covered by tunica vaginalis (except at its posterior margin

Testis

suspended in scrotum by spermatic cord
left usually hangs lower than right

Hydrocele

accumulation of serous fluid in the tunica vaginalis or in a persistent part of the processus vaginalis

Hematocele

accumulation of blood in the tuncia vaginalis and results from rupture of testicular blood vessels after trauma to the spermatic cord or testis

Spermatocele

cyst containing sperm that develops in the epididymis just above the testis

Varicocele

results from dilations of tributaries of the testicular vein in the pampiniform plexus
can be caused from defective valves in pampiniform plexus of compression of a testicular vein
"bag of worms"

Testicular neoplasm

metastasizes directly to the lumbar nodes
Distinguishes it from a malignancy of the scrotum
Scrotum CA metastesizes to supefricial inguinal nodes
Malignancy is most common cause of a painless testicular mass

Cryptorchidism

Failure of one or both testes to descend completely into the scrotum
most common location is in the inguinal canal
sterility possible
increased risk of testicular cancer

Inguinal canal in females

contains round ligament of the uterus and a remnant of the processus vaginalis
The round ligament is the remnant of the gubernaculum

Metastasis in the round ligament

cancer of the uterus may metastasize to superficial inguinal nodes along lymphatic vessels that course iwth the round ligament

Epididymitis

inflammation of the epididymis
most common cause of tender scrotal swelling
may be associated with std's and mumps

Orchitis

inflammation of the testis
may be associated with std's and mumps

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