External structure of the testes Internal structure of the testes Location of the testes Vascular supply to the testes Innervations of the testes Age – related changes of the testes Varicocele

1. External and Internal structure,
location, vascular supply, the
innervations and age – related
changes of the testes. Varicocele
Tural Abdullayev
Group 30

2. External structure of the testes

3. External structure of the testes
• The testes are suspended outside the body in
the sac called Scrotum
• The left testis lies slightly lower than the right

4. External structure of the testes
• The testes is covered with multilayered tunica
• It facilitates blood supply to the testes and
creates partition between sperm producing
regions of the testes
• There are 3 layers to the tunica :
1. Tunica vasculosa
2. Tunica albuginea
3. Tunica vaginalis

5. External structure of the testes
• Tunica vasculosa
– Is the inner layer of the tunica
– Covered by tunica albuginea
– Consist of blood vessels and connective tissue
– Facilitates blood supply to the testes

6. External structure of the testes
• Tunica albuginea
– Dense layer of tissue which encases the testes
– Connect to the layers of fibers which surround the
epididymis
– It also extends into the testis, creating partitions
between seminiferous tubules

7. External structure of the testes
• Tunica vaginalis
– Overlying tunica albuginea
– The are 2 layers of tunica vaginalis:
1. Visceral – overlies the tunica albuginea
2. Parietal – lines the scrotal cavity
 Thin fluid layer separates the 2 sections and reduces
friction between the testes and scrotum

8. External structure of the testes
• Tunica vaginalis is covered with internal spermatic
fascia
• Internal spermatic fascia is covered with cremaster
muscle which arises from the internal oblique muscle
• External spermatic fascia overlies cremaster muscle

9. Internal structure of the testes

10. Internal structure of the testes
Seminiferous
tubule
Straight
tubule
Rete testis
Efferent
ductules
Epindidymis
Ductus
deferens
Ejaculatory duct

11. Internal structure of the testes
• Seminiferous tubule
– Lie within the testes and are separated by
partitions, which are extensions of the tunica
albuginea
– Partitions divide the testes into lobules which
contain the seminiferous tubules

12. Internal structure of the testes
• Mediastinum
– Region of tissue which connects to the rete testis
– Supports the blood vessels and lymphatic system
of the testes

13. Internal structure of the testes
• Straight tubules
– Connect seminiferous tubules to the rete testis

14. Internal structure of the testes
• Rete testis
– Seminiferous tubules open into a series of
channels called the rete testis
– Facilitate the transport of sperm from the testes
to the sperm transport ducts of the penis.

15. Internal structure of the testes
• Efferent ducts
– Located between the rete testes and the
epididymis
– They connect the testes to the male ducts and
facilitate the transport of sperm from the testes.

16. Internal structure of the testes
• Ductus deferens
– Muscular duct that transport spermatozoa from
the tail of the epedidymis to the ejaculatory duct
– Passing through the deep inguinal ring
– Between the ureter and ejaculatory duct it
expands to form the ampulla

17. Internal structure of the testes
• Ejaculatory duct
– Penetrates through the prostate gland to connect
with the prostatic urethra

18. Vascular supply ( arteries )

19. Vascular supply
• Arteries
– Testicular arteries ( a. testicularis )
• Originate from the abdominal aorta and descent into
the scrotum through the inguinal canal to supply the
testes
– Cremasteric arteries ( a. cremaster )
• Originate from the inferior epigastric branch of the
external iliac artery, accompany the spermatic cord into
the scrotum

20. Vascular supply
• Veins
– They accompany the arteries
– The veins join the internal pudental veins that
connect with the internal iliac vein in the pelvis
• Right testicular vein
– Joins the inferior vena cava
• Left testicular vein
– Joins the left renal vein

21. Vascular supply
• Veins
– veins emerge from the back of the testis, and receive tributaries
from the epididymis
– They unite and form pampiniform plexus
– Panpiniform plexus constitutes the greater mass of
the spermatic cord
– Below the subcutaneous inguinal ring, they unite to form three
or four veins, which pass along the inguinal canal, and, entering
the abdomen through the abdominal inguinal ring, coalesce to
form two veins, lying one on either side of the internal
spermatic artery.
– These unite to form a single vein, which opens, on the right side,
into the inferior vena cava, on the left side into the left renal
vein

22. Vascular supply
• Lymphatic drainage
– Testes are the only ones that do not drain to the
inguinal lymph nodes
– Lymphatics course along the route of the
testicular vessels to reach the para-aortic lymph
nodes at the level of the L2 vertebra

23. Innervation
• The testes and epididymis receive innervation from
the testicular plexus – a network of nerves derived
from the renal and aortic plexi.
• They receive autonomic and sensory fibres.
• The T10 spinal segment provides the sympathetic nerve
fibers that innervate the testes.
– They travel by way of the lesser splanchnic nerves and
synapse at the celiac ganglion.
– Post-ganglionic fibers then follow the testicular artery along
its course
– Genital branch (L2) of the genitofemoral nerve (L1, L2) of
the lumbar plexus provides sensory innervation to the
tunica vaginalis of the testes

24. Age – related changes
• Fetal period
– Endocrine function is dominant ( production of androgene hormones )
– Lumen of seminal ducts is absent
• After the birth till the 11 years
– Testis enlargement is slow
• After the 11 – 12 years
– Testis enlargement is fast
– Permanent spermatogenesis is observed
• Adult men
– No visible changes of the testes size
• Old man
– More connective tissue
– Testis decrease in size, it is more hard
– Inside -> Ischemia
– Widening of rete testis canalicles
– Less seminal canalicles
– Production of testosterone is decreased
– Less spermatozoa in the ejaculate fluid
– Decrease in ejaculate fluid amount

25. Varicocele
• Is a collection of dilated veins that arise from pampiniform
plexus
– Idiopathic varicocele
• occurs when the valves within the veins along the spermatic cord do
not work properly
• This results in backflow of blood into the pampiniform plexus and
causes increased pressures
• A majority of idiopathic varicoceles occur on the left side because the
left testicular vein travels superiorly and connects to the left renal vein
– Secondary varicocele
• due to compression of the venous drainage of the testicle
• Cause of a secondary varicocele is the so-called "Nutcracker
syndrome“
– a condition in which the superior mesenteric artery compresses the left renal
vein, causing increased pressures there to be transmitted retrograde into the
left pampiniform plexus