NUR 300 Lecture Notes - Lecture 10: Spermatic Cord, Priapism, Testicular Pain

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7 May 2018
Department
Course
Professor
Anna Giroux
4/18/18
Lecture Week 11
Male Genitalia
(Landmarks include: Penis, scrotum, testicles, epididymis, prostate
gland, seminal vesicles)
Penis
Function: is to excrete end products of renal metabolism and
to ejaculate sperm into the vagina.
Has two corpus cavernosa, which is on the dorsum and
sides
Has the corpus spongiosum in which the urethra is
embodied.
The distal end of the corpus spongiosum is the glans penis.
Urethra orifice is a slit like opening that is about 2 mm
ventral to tip of glans.
Skin of penis is thin and somewhat loose to permit erection.
It is free of subcutaneous fat. Usually more darkly pigmented
than body skin.
Prepuce covers the glans unless male is circumcised.
Smegma: a cheesy white material that forms from epithelial
cells from the prepuce and sebaceous material from the
glans. It collects on the glans and the fornix of the foreskin.
Scrotum:
Tends to more darkly pigmented than body skin and is
divided into two pendulous sacs by a septum.
Each sac contains a testis, epididymis, spermatic cord, and
a muscle layer.
Muscle contracts or relaxes the scrotum therefore helping to
control the temperature of the testes.
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Testes:
Produce spermatozoa and testosterone.
The adult measures 4 x 3 x 2 cms.
Ovoid in shape.
Spermatogenesis (formation of sperm): requires
maintenance of temp lower than 37ºC
Epididymides:
Soft comma shaped structure
Located on the posterior lateral upper aspect of testes in
90% of males.
Other 10% are located on the anterior lateral aspect of
testes.
Stores sperm for maturation and also transports sperm.
Vas deferens begins at the tail of the epididymis and travels
up the spermatic cord through the inguinal canal to the
seminal vesicle to form ejaculatory duct.
Prostate gland:
About the size of a testis
Surrounds the urethra at the bladder neck
The posterior surface lies in close contact with the ant rectal
wall.
It is convex and is divided by a shallow median sulcus into
right and left lateral lobes.
The median lobe is not accessible to palpation.
The prostate gland produces the major part of the
ejaculatory fluid which contains fibrinolysin which liquefies
coagulated semen.
The physiology and function of the prostate gland is not fully
understood.
Seminal vesicles:
Extend outward from the prostate gland.
Sexual physiology:
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Under control of autonomic nervous system.
When a male has an erection:
20-50 ml of blood engorge the corpus cavernosa.
Caused by increased arterial blood supply and
decreased venous outflow.
An erection is a neurovascular reflex induced by
psychogenic and local reflex mechanism.
The local reflex mechanism is involves a spinal reflex
arc and tactile stimuli.
Psychogenic stimuli be can be any type such as
auditory, visual, imagination, etc.
Infants and Children
The external genitalia are identical for males and female until
8 weeks gestation.
During the 8th or 9th week gestation any fetal insult may
result in major genital anomalies.
Can identify gender at about 12th week gestation
Any injury after that period may result in minor morphological
anomalies.
During the third trimester the testes descend into the inguinal
canal.
Sometimes at birth the testes have not descended and may
do so during the postnatal period. (can place individual at
risk for testicular cancer or infertility if testes do not drop,
must get surgery)
Separation of the prepuce from the glans penis is often
incomplete at birth, and may remain so until 3-4 years of
age.
Adolescents
Tanner stages for puberty: done in adolescents to evaluate
the maturation of the sexual organs
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Document Summary

Usually more darkly pigmented than body skin: prepuce covers the glans unless male is circumcised, smegma: a cheesy white material that forms from epithelial cells from the prepuce and sebaceous material from the glans. Infants and children: the external genitalia are identical for males and female until. Intermittent or constant: associated with straining or lifting: change in size or character of mass, pain in groin, character of pain, tearing, sudden searing, cutting. If prepuce, need to retract skin darker in color than glans: essential to detect chancres, or carcinoma. Will see smegma: phimosis: foreskin is tight and cannot be retracted back. Is asymmetry due to lower hanging testicle on lt. because of longer spermatic cord: sebaceous cysts on skin will be seen as lumps, may see edema due to chronic disease. Will be associated with arteries and veins and often cannot differentiate.

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