1. Presented by : Dr Gopal G Hargi
PG in FM & T

2. Ref
 Prakasam Reddy.Fundamentals of medical physiology .4th edn.p634,645
 JG McGeown.Master Medicine Physiology.3rd edn . p275-80
 K S N Reddy. 30th edn . p350-53

3.  Vital organs - survival
 Reproductive organs – satisfying basic instincts developed
propagation of race functional

4. Copyright 2008 Allyn & Bacon

6.  The Testes
 Male sex glands, suspended in the scrotum
 Exocrine
 Endocrine
Copyright 2008 Allyn & Bacon

7. ORGAN
Testis
Seminiferous tubules
Interstitial cells
Epididymis
Vas deferens
Seminal vesicle
Prostate gland
Bulbourethral gland
Scrotum
Penis
FUNCTION
Produce sperm cells
Produce and secrete male sex hormones
Stores sperm cells undergoing maturation, conveys
sperm cells to vas deferens
Conveys sperm cells to ejaculatory duct
Secretes an alkaline fluid containing nutrients and
prostaglandins that helps neutralize the acidic
components of semen
Secretes an alkaline fluid that helps neutralize semen’s
acidity and enhances sperm cell motijity
Secretes fluid that lubricates end of penis
Encloses, protects, and regulates temperature of testes
Conveys semen into vagina during sexual intercourse;
glans penis is richly supplied with sensory nerve
endings associated with feelings of pleasure during
sexual stimulation
Summary of the functions of Male Reproductive Organs

8.  BEFORE BIRTH :
 MASCULINIZES - REPRODUCTIVE TRACT AND EXTERNAL
GENITALIA
 DESCENT OF TESTES
 CEASES AT BIRTH
 RETURNS AT PUBERTY

9.  Testosterone
 Male steroid sex hormone
 Interstitial cells(Leydig’s cells)
 Cells that secrete testosterone
1)Responsible for prenatal differentiation of male sex
organs
2)Stimulates the development of secondary sex
characteristics
Copyright 2008 Allyn & Bacon

10. Popad Rep Physiol MRP 10

11. HYPOTHALAMUS
ANTERIOR PITUITARY
GRH +
TESTES SERTOLI
CELL
LEYDIG
CELL
TESTOSTERONEINHIBIN
SPERMATOGENESIS
FSH LH

12.  Thought emotion Stimulation of tactile
 sight, smell & sensory stimuli receptor
 Parasynthetic activation , stimulation of nervi erigentis
release of nitric oxide
formation of cGMP
Penile arterial dilatation
Blood flow to erectile tissue
erection of penis

13. Afferents from genitalia & other structures
carried by pudendal nerve & sacral plexus
integrated at L2-L3 & S2-S4
Efferents through sacral parasympathetic via nervi erigentis
to smooth muscles
Erectile tissue
glands

14.  .Ejacution
 The afferents mostly from receptors in glans –spinal cord – internal
pudendal
 (L1 ,S1-S3, motor pathway S1-S2 & pudendal nerve)
 Emission
 Sympathetic impulses from T12 to L2 travel via hypogastric and pelvis
nerve plexuses to initiate emission
 Contraction of vas deferens , expels sperm into the internal urethra.
 Followed by contraction and fluid addition by the prostate, seminal
vesicles and Cowper’s glands
 This is now semen and the formation of this in the internal urethra is
emission

15.  Ejaculation- Orgasm
 Peak of sexual excitement
 Release of sexual tension that builds up during arousal
 1)Emission phase
 First phase of ejaculation, which involves contractions of the
prostate gland, seminal vesicles, and the upper part of the vas
deferens (the ampulla)
 Fluid is propelled into the urethral tract
 2)Expulsion stage
 The second stage of ejaculation, during which muscles at the
base of the penis and elsewhere contract, forcing out semen and
providing pleasure
Copyright 2008 Allyn & Bacon

17.  Erectile abnormalities
 Peyronie’s disease
 An abnormal condition characterized by an excessive
curvature of the penis that can make erections painful
 Caused by buildup of fibrous tissue in the penile shaft
 Priapism
 Erections that persist for hours or days
 Causes include leukemia, sickle cell anemia, or diseases of
the spinal cord
 Can be dangerous due to loss of oxygen to penile tissues
 Cantharides (cantharadine )
Copyright 2008 Allyn & Bacon

18.  Erectile dysfunction inability to maintain the degree of
penile rigidity until ejaculation
.
 hypoglycemic agents (26%), antihypertensive drugs (14%),
vasodilators (36%), and cardiac drugs (28%)
 Vascular insufficiency most common cause of organic male
sexual dysfunction

19.  Erectile dysfunction
 Psychogenic
 Drugs (antihypertensives, anticholinergics,
psychotropics, cigarette smoking, substance abuse)
 Systemic diseases (cardiac, hepatic, renal, pulmonary,
cancer, metabolic, postorgan transplant, pelvic
irradiation)
 Androgen deficiency (primary or secondary), androgen
resistance, other endocrinopathies

20.  Vascular insufficiency (atherosclerosis, pelvic steal, penile
Reynaud's, venous leakage)
 Neurological disorder (Parkinson’s, Alzheimer’s, Shy-
Drager, encephalopathy, spinal cord or nerve injury)
 Penile disease (Peyronie’s, priapism, phimosis, smooth
muscle dysfunction, trauma)

21.  CYCLIC
 OOGENESIS
 FERTILIZATION
 PREGNANCY
 DELIVERY
 MENOPAUSE

23. ORGAN
Ovary
Uterine tube
Uterus
Vagina
Labia majora
Labia minora
Clitoris
Vestibule
Vestibular glands
FUNCTION
Produces oocytes and female sex hormones
Conveys secondary oocyte toward uterus; site of
fertilization; conveys developing embryo to uterus
Protects and sustains embryo during pregnancy
Conveys uterine secretions to outside of body;
receives erect penis during sexual intercourse;
provides open channel for offspring during birth
process
Enclose and protect other external reproductive organs
Form margins of vestibule; protect openings of vagina
and urethra
Produces feelings of pleasure during sexual
stimulation due to abundant sensory nerve endings
in glans
Space between labia minora that contains vaginal and
urethral openings
Secrete fluid that moistens and lubricates vestibule
Summary of the functions of Female Reproductive Organs

24. 3) Regulation of GnRH
Hypothalam
s
GnRH
Pituitary
FSH, LH
Ovary
E,P
www.freelivedoctor.com

25. Estrogens
 Produced by follicle cells
 Cause secondary sex characteristics
 Enlargement of accessory organs
 Development of breasts
 Appearance of pubic hair
 Increase in fat beneath the skin
 Widening and lightening of the pelvis
 Onset of menses

26.  Function of ovary
1. Reproduction(exocrine)
development and maturation of follicle; ovulation
2. Endocrine
estrogens, progesterone, testosterone

27.  Female reproductive cycle- cyclical fashion
 - 28days
 Ovarian cycle - ovum released middle of cycle
 Uterine cycle - endometrial primed
 sheds - repeats

28. Progesterone
 Produced by the corpus luteum
 Production continues until LH diminishes in the blood
 Helps maintain pregnancy

29.  Female sexual arousal
 Afferents –pudendal nerve to the spinal cord and further to
cerebral cortex
 Integrated at S2,3,4 & L1,2
 Efferents ,the parasympathetic segments travel by nervi
erigentis

30. Intercourse
 Fluid into vaginal walls
 Upper vagina is sensitive to stretch
 Tactile stimulation from labia minora & clitoris add
 During orgasm - pudendal nerves
 Vaginal contn – aid sperm transportation

31. sperm deposited in vagina at ejaculation
 travel to oviduct takes a little over 1/2 hour
 cervical canal is open due to estrogen being high and remains
open two to three days
 sperm enter uterus and are churned around
 when reach oviduct, smooth muscle contractions propell
them onward
 mature egg releases a chemotactic agent- fertilin
 out of several hundred million only a few thousand make it
 tail of sperm maneuvers it for final penetration
 Fertilized ovum – 4-7 days to reach uterus

32.  corpus leuteum degenerates
 estrogen and progesterone levels fall
 menstrual phase involves sloughing of prepared
endometrium
 new cycle starts-new follicles develop and begin secreting
estrogen

33.  Medicolegal imp
 1)Civil--- a)nullity of marriage
 b) divorce
 c) adultery
 d)disputed paternity & legitimacy
 e)suits of adoption
 f)as a result of accident-claim
 2) Criminal---- a) adultery
 b)rape
 c) impotency as a defence –to plead

34.  Penile plethysmography
 Selective investigations for male sexual dysfunction
 Penile imaging.
 Penile biopsy.
 Cavernosal electrical activity.
 Pharmaco-penile duplex ultrasound (PPDU).
 Penile angiography.
 Cavernous oxygen tension

35. THANK YOU