MALE GENITAL ORGANS (ORGANA GENITALIA MASCULINA) Organa genitalia interna: Testis Epididymis Ductus deferens Urethra masculina Vesicula seminalis Prostata Organa genitalia externa: Penis Scrotum Development: Wolffian ducts Müllerian ducts TESTIS Facies medialis Facies lateralis Extremitas superior Extremitas inferior Margo anterior Margo posterior Lamina visceralis tunicae vaginalis (Epiorchium) Tunica albuginea Mediastinum testis Septula testis Lobuli testis Hilum testis Tubuli seminiferi contorti Spermatozoa Supporting cells of Sertoli Interstitial cells of Leydig Tubuli seminiferi recti Rete testis Ductuli efferentes testis A. testicularis Plexus pampiniformis - vv. testiculares Nll. lumbales EPIDIDYMIS Caput epididymidis Corpus epididymidis Cauda epididymidis Sinus epididymidis Lig. epididymidis sup. et inf. Lig. scrotale (Gubernaculum testis) Lobuli epididymidis Ductus epididymidis A. testicularis Plexus pampiniformis Plexus testicularis Appendix testis Appendix epidydimidis Ductuli aberrantes DESCENSUS TESTIUM > > > > > Retentio testis (cryptorchidism). Ectopia testis. Gubernaculum testis → Lig. scrotale Processus vaginalis → Tunica vaginalis Lig. vaginale DUCTUS DEFERENS (VAS DEFERENS) Pars epididymica Pars funicularis Pars inguinalis Pars pelvina Ampulla ductus deferentis - diverticula ampullae Ductus ejaculatorius – colliculus seminalis A. ductus deferentis Plexus pampiniformis et vesicalis Nll. iliaci int. et ext. Nn. splanchnici lumbales, plexus hypogastricus inf. FUNICULUS SPERMATICUS: Ductus deferens A. ductus deferentis A. testicularis Plexus pampiniformis Plexus testicularis Plexus deferentialis COVERINGS OF THE TESTIS, EPIDIDYMIS AND SPERMATIC CORD Epiorchium (Lamina visceralis tunicae vaginalis) Periorchium (Lamina parietalis tunicae vaginalis) Cavum serosum scroti > Fascia spermatica interna (Fascia transversalis) Fascia cremasterica - M. cremaster (M. obliquus abdominis internus, M. transversus abdominis) Fascia spermatica externa (Fascia abdominis superficialis) CANALIS INGUINALIS Posterior wall: Fascia transversalis: Falx inguinalis Trigonum inguinale (Hesselbachi) Lig. interfoveolare Anulus inguinalis prof. Tractus iliopubicus Anulus femoralis CANALIS INGUINALIS Inferior wall: Lig. inguinale CANALIS INGUINALIS Anterior wall: Aponeurosis m. obliqui externi abdominis Anulus inguinalis spf. - crus mediale - crus laterale - fibrae intercrurales - lig. inguinale reflexum CANALIS INGUINALIS Superior wall: M. obliquus internus abdominis M. transversus abdominis - M. cremaster Fossa supravesicalis Fossa inguinalis medialis (trig. Inguinale) Fossa inguinalis lateralis (anulus inguinalis prof.) Plica umbilicalis mediana - lig. umbilicale medianum Plica umbilicalis medialis - lig. umbilicale mediale (laterale) (pars occlusa a. umbilicalis) Plica umbilicalis lateralis - vasa epigastrica inf. Fossa supravesicalis - hernia supravesicalis (c) Fossa inguinalis medialis - hernia inguinalis directa (b) Fossa inguinalis lateralis - hernia inguinalis indirecta (a) http://upload.wikimedia.org/wikipedia/commons/4/44/Inguinal_fossae.PNG VESICULA SEMINALIS Ductus excretorius Ductus ejaculatorius PROSTATA Basis Apex Facies anterior Facies posterior Facies inferolaterales Lobus medius Lobus dexter et sinister Isthmus Capsula propria Plexus venosus prostaticus Fascia periprostatica Lig. puboprostaticum Lig. sacrogenitale Septum rectovesicale (Denonvilliersʼ fascia) http://upload.wikimedia.org/wikipedia/commons/e/e0/Digital_rectal_exam_nci-vol-7136-300.jpg http://www.sternurology.com/images/prostate-cancer-illustration.jpg http://lh6.ggpht.com/_cEPdz7M9ILE/TM0nZCFA0UI/AAAAAAAAAfY/CMFUYhdywRU/s800/prostate%20-%20zonal%20a natomy.jpg http://wildiris4.securesites.net/cms_prod/files/course/404/bph.jpg Crista urethralis Colliculus seminalis Utriculus prostaticus Ductus ejaculatorii Sinus prostatici GLANDULAE BULBOURETHRALES Ductus gl. bulbourethralis URETHRA MASCULINA Ostium urethrae internum Ostium urethrae externum Pars intramuralis – M. sphincter vesicae Pars prostatica Pars membranacea – M. sphincter urethrae Pars spongiosa – Ampulla urethrae Corpus spongiosum penis Fossa navicularis Valvula fossae navicularis Glandulae urethrales Lacunae urethrales Curvatura subpubica Curvatura praepubica Urethra mobilis (anterior) Urethra fixa (posterior) EXTERNAL GENITAL ORGANS PENIS: Radix Corpus Glans Praeputium SCROTUM PENIS Glans penis Glandulae praeputiales Collum glandis Smegma praeputii Corona glandis Frenulum praeputii Dorsum penis Corpus cavernosum Facies urethralis Corpus spongiosum Raphe penis Tunica albuginea Praeputium Trabeculae Ostium praeputii Cavernae A. penis prof. → aa. helicinae Corpus cavernosum - crura penis - crista phalica Corpus spongiosum - bulbus penis Glandulae bulbourethrales COVERINGS OF PENIS: Fascia penis profunda (Aa., Nn. dorsales penis, V. dorsalis penis profunda) Fascia penis superficialis (Vv. dorsales penis spf.) Lig. fundiforme penis Lig suspensorium penis SCROTUM Raphe scroti Pubes Tunica dartos scroti Septum scroti Cavitas scroti A.pudenda ext. A. pudenda int. V. femoralis V. pudenda int. Nll. inguinales spf. N. genitofemoralis N. ilioinguinalis N. pudendus N. cutaneus femoris post. Plexus hypogastricus inf. Hydrocele, varicocele ANATOMICAL BASIS OF ERECTION Parasympathetic stimulation – relaxation of smooth muscle in cavernae and aa. helicinae, compression of venous plexuses by bulbospongious and ischiocavernous muscles → erection Sympathetic stimulation - contraction of smooth muscle of aa. helicinae, relaxation of bulbospongious and ischiocavernous muscles, drainage of blood into v. dorsalis penis prof. → detumescence EJACULATION OF THE SEMEN 1. Emission of sperms and genital glands secretion - sympathetic stimulation 2. Expulsion of the semen from the spongy urethra (ejaculation) – parasympathetic stimulation DIAPHRAGMA PELVIS M. levator ani – pars iliaca (M. iliococcygeus) - pars pubica (M. pubococcygeus) (- M. puborectalis) M. coccygeus Hiatus urogenitalis SACCUS PROF. PERINEI/DIAPHRAGMA UROGENITALE M. transversus perinei profundus – Centrum perineale M. sphincter urethrae Lig. transversum perinei Glandulae bulbourethrales M. transversus perinei spf. Membrana perinei/Fascia inf. diaphragmatis urogenitalis V. dorsalis penis prof. M. ischiocavernosus M. bulbospongiosus M. sphincter ani externus Lig. anococcygeum Fascia obturatoria Canalis pudendalis (Alcock) Fascia sup. diaphragmatis pelvis Fascia inf. diaphragmatis pelvis Fossa ischiorectalis Recessus pubicus fossae ischio- rectalis Spatium perinei profundum Membrana perinei Spatium perinei spf. Fascia perinei spf. Illustrations were copied from: Atlas der Anatomie des Menschen/Sobotta. Putz,R., und Pabst,R. 20. Auflage. München: Urban & Schwarzenberg, 1993) Netter: Interactive Atlas of Human Anatomy. Windows Version 2.0 Čihák R: Anatomie 2 (Splanchnologia). Avicenum, zdravotnické nakladatelství, Praha, 1988.