The male reproductive system is a complex network of organs that work together to produce, transport, and deliver sperm, the male reproductive cells. The male reproductive system plays a crucial role in sexual reproduction, producing and delivering sperm for fertilization of the female egg. Hormonal regulation and coordination between various organs ensure the proper functioning of the system.

1. Dr / Ahmed Salah Ashour(Ph.D.)
Associate professor of human anatomy
Dr.Ahmedashour@gmu.ac.ae
USMLE Clinical Anatomy

2. Case report

3. A 16-year-old male patient presented to the Emergency Department (ED) with a
complaint of sudden-onset right testicular pain. The patient reported that the pain
had started the night before and significantly worsened during the day. He noted no
specific trauma.
Upon examination by our insured physician, it was noted that the patient reported
10/10 pain, and no inguinal or abdominal hernias were identified. The scrotal lie
was normal on the right but there was notable swelling and extreme tenderness on
palpation.
When the physician performed a manual counter clockwise rotation of the right
testicle, the patient reported some relief and was subsequently given morphine for
pain management.
He was instructed to follow up with his primary care physician or return to the ED
should he have continuing problems.

4. MALE
REPRODUCTIVE
SYSTEM

5. ILOs
• Describe the anatomy of the testis
• Enlist the layers of the scrotum
• Enumerate the components of the spermatic cord

6. The male reproductive system is a
complex network of organs that work
together to produce, transport, and
deliver sperm, the male reproductive
cells.
The male reproductive system plays a
crucial role in sexual reproduction,
producing and delivering sperm for
fertilization of the female egg.
Hormonal regulation and coordination
between various organs ensure the
proper functioning of the system.

8. MALE REPRODUCTIVE SYSTEM COMPONENTS:
• Scrotum
• Testes.
• Epididymis.
• Vas deferens.
• Seminal vesicles.
• Prostate
• Urethra.
• Penis.

9. Scrotum

10. It is a pouch, containing
• Testis,
• Epididymis
• Lower part of the spermatic cord

11. Layers of scrotum:
• Skin
• Dartos muscle (smooth, replaces fatty
layer of superficial fascia is anterior
abdominal wall).
• Colle’s fascia is membranous layer of
superficial fascia.
• External Spermatic fascia is (extension of
external oblique).
• Cremaster muscle (extension of internal
oblique).
• Internal spermatic fascia (extension of
fascia transversalis).

12. Testis

13. Is the male primary sex organ & oval in shape.
4.5 cm length
3 cm anterior –posterior
2.5 cm thickness.
Testis has 2 poles, 2 borders & 2 surfaces.

14. Coverings:
Tunica vaginalis: It surrounds testis all
around except its posterior border
(related to epididymis).
Tunica albuginea: It is the tough white
fibrous coat which covers the testis all
around & send septa to divide the testis
into lobules, each lobule contains
seminiferous tubules.

15. Structure:
The seminiferous tubules join together to
form 20 - 30 straight tubules.
Straight tubules enter the mediastinum
anastomosing with each other to form a
network of tubules called “rete testis”.
The rete testis gives rise to 12-20 efferent
ductules which emerge from the upper
pole of the testis to form head of
epididymis.

16. Epididymis

17. Structure:
It is the highly coiled, comma shaped tube, which is attached to the postero-lateral
aspect of the testis.
In the comma shaped coiled form, it is about 1.5 inches long (uncoiled, 6 meters in
length).
It is formed of head, body and tail (continues as vas deferens).

18. • Arterial supply of testes:
Testicular arteries from abdominal
aorta.
• Venous drainage:
The veins emerging from the testis and
epididymis form the pampiniform
venous plexus that form the testicular
vein in (inguinal canal) drain into IVC
on the right side & left renal vein on
the left side.

19. • Lymphatic drainage:
Paraoartic (lumbar) lymph nodes.
• Nerve supply:
Testicular plexus from aortico - renal
plexus of nerves which contains:
- Parasympathetic: vagus nerve.
- Sympathetic: from the T10,11 segment of
spinal cord

20. One epididymis, when uncoiled, the
length of the epididymis is
approximately 6 meters.
Length of all seminiferous tubules in
one testes, if uncoiled, would be
around 150 meters

21. Ductus (vas) deferens

22. A thick-walled muscular tube, that connects epididymis to the seminal vesicles & 45
cm in length.

23. Distal part:
Starts from lower pole of testis within the spermatic cord.
Ascends in inguinal canal.

24. Proximal part:
It goes behind the base of urinary bladder where it is enlarged to form ampulla
(sperm stored briefly before ejaculation).
It is joined by the seminal vesicle to form ejaculatory duct that opens into prostatic
urethra.

25. Spermatic cord

26. Group of structures which traverse the
inguinal canal down to the testis.
Coverings:
It has 3 coverings:
• Internal spermatic fascia,
• Cremasteric muscle and fascia &
• External spermatic fascia.

27. Contents:
• Vas deferens.
• Artery of Vas
• Testicular artery.
• Pampiniform plexus of veins.
• Cremasteric artery
• Genital branch of genito- femoral nerve.
• Lymphatic vessels.

28. Seminal vesicles

29. A blind- ended sacculated tube, 5 cm in length.
It is located behind the bladder with the following relations:
Anteriorly: base of the bladder.
Posteriorly: rectum and recto-vesical pouch.
Medially: ampulla of the vas.

30. It unites with vas deferens near base of prostate to form ejaculatory duct.

31. Prostate

32. Shape :
Inverted cone having a base directed upwards &
an apex downwards
Dimensions:
• Its Antero -posterior diameter is about 2 cm.
• Its vertical diameter is about 3 cm.
• The transverse diameter of its base is 4 cm.

33. PR examination
The prostate is easily palpated by a finger in the rectum.
Clinical Insight

34. Transrectal ultrasound
Clinical Insight

35. Male urethra

36. It is about 20 -22 cm long.
• Pre-prostatic part: at the neck of the bladder , 1.5 cm.
• Prostatic part traverses the prostate, 3 cm.
• Membranous part: in the deep perineal pouch, 2 cm.
• Spongy or penile part: traverses the corpus spongiosum, 15 cm .

38. Penis

39. It has thin skin.
It is consisted of 3 erectile bodies
1 Corpus spongiosum on its ventral
surface.
2 Corpora cavernosa on its dorsal
surface.
It is traversed by the spongy urethra (in
corpus spongiosum).

40. Cancers of the penis and scrotum
will metastasize to the superficial
inguinal lymph nodes, and testicular
cancer will metastasize to the aortic
(lumbar) nodes.
Clinical Insight

41. Erectile dysfunction
is the inability to achieve or
maintain penile erection
sufficient for sexual intercourse.
Nitric oxide released by the
pelvic splanchnic
parasympathetic nerve fibers and
endothelial cells normally causes
the dilation of the arteries
supplying blood to the erectile
tissues. When this mechanism is
compromised, erectile
dysfunction results.
Clinical Insight

42. Formative Quiz

43. Q1 A newborn boy is examined in the labor and delivery suite. He had a normal
vaginal delivery from a healthy mother. On physical examination, the scrotum is
enlarged, boggy, and soft bilaterally. There is a nontender testicular mass that
transilluminates with bright light.
A defect in which of the following structures is the most likely cause of these
findings?
Body of the testis
Epididymis
Inguinal lymphatics
Pampiniform plexus
Tunica vaginalis

44. Q2 A 15-year-old boy comes to the emergency department with a 3-hour history of
acute scrotal swelling and pain that is associated with nausea. On physical
examination, the scrotum is swollen and tender to palpation. Light stroking of the
medial thigh does not elicit a reflex response.
The muscle most likely involved in this patient’s absent reflex is derived from
which of the following abdominal wall layers?
External oblique
Internal oblique
Rectus abdominis
Transverse abdominal

45. Q3 A 32-year-old man presents to the clinic because of swelling and mild pain in his
left testicle for the past 3 days. There was no history of trauma, urethral discharge,
or dysuria. He and his wife have been trying to conceive for the past 3 years but
have been unsuccessful. On physical examination, the left testicle feels enlarged
with mild tenderness. The Valsalva maneuver reproduces his pain. The scrotum does
not transilluminate.
Which of the following is the most likely diagnosis?
Hydrocele
Seminoma
Testicular torsion
Varicocele

46. Q4 A 36-year-old man comes to the physician because he and his wife have been
unable to conceive over the past 14 months. He has had bilateral inguinal hernia
repair. He reports moderate alcohol and marijuana use. His blood pressure is 136/94
mm Hg. The physical examination is normal. His serum testosterone level is
normal. Semen analysis shows decreased volume and no detectable sperm.
Testicular fine-needle biopsy findings reveal normal sperm number, morphology,
and motility.
Which of the following is most likely responsible for this patient’s infertility?
Adrenal hyperplasia
Alcohol use
Inguinal hernia repair
Varicocele

47. Q5 A 45-year-old male presents to the urology clinic with a chief complaint of
difficulty achieving and maintaining an erection for the past six months. He reports
no significant past medical history, but he does mention a recent bicycle accident
where he sustained a pelvic injury. On further examination, the patient's physical
health is otherwise unremarkable. Laboratory tests reveal normal testosterone
levels. What could be a potential cause of this patient's erectile dysfunction?
A) Arterial insufficiency
B) Venous leakage
C) Neurogenic etiology
D) Psychological factors
E) Medication side effect

48. Q1 Tunica vaginalis
Q2 Internal oblique
Q3 Varicocele
Q4 Inguinal hernia repair
Q5 Neurogenic etiology

49. List of Texts and Recommended Readings
• Last's Anatomy, Regional and Applied. Chummy S. Sinnatamby. 12th edition 2011, ISBN:13 - 978 0 7020 3394 0
(Available in ClinicalKey: https://www.clinicalkey.com/#!/browse/book/3-s2.0- C2009060533X)
• Estomih Mtui, Gregory Gruener and Peter Dockery. Fitzgerald's Clinical Neuroanatomy and Neuroscience. 7th
edition; 2016, ISBN: 13 - 978-0-7020- 6727-3 (Available in ClinicalKey:
https://www.clinicalkey.com/#!/browse/book/3-s2.0- C20130134113
• Drake, Richard L. Gray's Anatomy for Students, Third Edition, Elsevier Saunders 2015. ISBN-13: 978-0702051319
(Available in ClinicalKey: https://www.clinicalkey.com/#!/browse/book/3- s2.0-C20110061707).
• Sobotta Atlas of Human Anatomy. F. Paulsen. Vol.1, 15th Edition; 2013, ISBN: 9780702052514 (Available in
ClinicalKey: https://www.clinicalkey.com/#!/content/book/3- s2.0-B9780702052514500067)
• Sobotta Atlas of Human Anatomy. F. Paulsen. Vol.2, 15th Edition; 2013, ISBN:13 - 978-0-7020-5252-1 (Available in
ClinicalKey: https://www.clinicalkey.com/#!/browse/book/3- s2.0-C20130046919)

50. Recap