Chapter 14 Med terms

Sperm

A mature sperm has a pear-shaped head and a long tail. The sperm's head contains these three segments The nucleus, which contains 23 chromosomes; The cap, which contains enzymes used to penetrate the egg; and The basal body of the tail. The tail is further divided into three segments and is responsible for movement as the sperm swims up the female reproductive tract.

STD abbreviations

AIDS acquired immunodeficiency syndrome CDC Centers for Disease Control and Prevention HIV human immunodeficiency virus HPV human papilloma virus HSV2 herpes simplex virus 2 Pap Papanicolaou (test, stain) PID pelvic inflammatory disease STD sexually transmitted disease TB tuberculosis

STDs

According to the Centers for Disease Control (CDC), 15 million new cases of sexually transmitted diseases (STDs) are reported annually in the United States. Adolescents and young adults have the greatest risk of contracting STDs. Keynotes Three million cases of chlamydia are recognized annually in the United States and can be prevented by abstinence or by using a condom. Infection with gonorrhea can be prevented by abstinence or by using a condom. Three million cases of trichomoniasis occur annually in the United States and could be prevented by abstinence or by using a condom. Chlamydia is known as the "silent" disease because up to 75% of infected women and men have no symptoms. When there are signs, a vaginal or penile discharge and irritation with dysuria (difficult or painful urination) are common. Highly accurate urine tests and DNA probes are available for diagnosis. Treatment is with oral antibiotics. If left untreated, chlamydia can spread higher into the female reproductive tract and cause pelvic inflammatory disease (PID). It can also be passed on to a newborn during childbirth and cause eye infections or pneumonia. For this reason, newborns receive antibiotic eyedrops. Trichomoniasis ("trich") is caused by the parasite Trichomonas vaginalis. In women, it can produce a frothy yellow-green vaginal discharge with irritation and itching of the vulva. Because it is a "ping-pong" infection that goes back and forth between partners, both individuals should be treated. Gonorrhea is spread by unprotected sex and can be passed on to a baby in childbirth, causing a serious eye infection. As with chlamydia, newborns receive antibiotic eyedrops to prevent eye infections from gonorrhea. Symptoms include a vaginal discharge, bleeding, and dysuria. Lab testing on a swab taken from the surface of the infected area can confirm the diagnosis. DNA probes are also available. Gonorrhea can be treated with a single dose of an antibiotic. However, it is developing resistance to antibiotics. Syphilis is transmitted sexually and can spread through the bloodstream to every organ in the body. Primary syphilis begins 10 to 90 days after infection as an ulcer or chancre at the infection site. Four to ten weeks later, if the primary syphilis is not treated, secondary syphilis appears as a rash on the palms of the hands and the soles of the feet. Swollen glands and muscle and joint pain accompany the rash. Tertiary syphilis can occur years after the primary infection and cause permanent damage to the brain, with dementia. Genital herpes simplex is a disease caused by the virus herpes simplex 2 (HSV2). It manifests with painful genital sores (Figure 14.11), which can recur throughout life (Figures 14.11 and 14.12). There is no cure for genital herpes. Antiviral medications can provide a clinical benefit by limiting the replication of the virus. Herpes of the newborn (Figure 14.12) occurs when a pregnant woman with genital herpes sores delivers her baby vaginally and transmits the virus to the baby. Human papilloma virus (HPV) causes genital warts in both men and women. HPV can also cause changes to the cells in the cervix. Some strains of the virus can increase a woman's risk for cervical cancer. More than 90% of abnormal Pap smears are caused by HPV infections. A vaccine is available that can prevent lasting infections with strains that cause cervical cancers and genital warts. The vaccine can be given to females aged 9 to 26, before they are sexually active. The vaccine can be given to males aged 9 to 26 years to reduce the likelihood of acquiring genital warts. Molluscum contagiosum is a virus that can be sexually transmitted and produces small, shiny bumps that contain a milky-white fluid. They can disappear and reappear anywhere on the body. Human immunodeficiency virus (HIV) is a virus that attacks the immune system and usually leads to acquired immune deficiency syndrome (AIDS). HIV is carried in body fluids and transmitted during unprotected sex. Sharing needles can spread the virus. The virus can also pass from an infected pregnant woman to her unborn child, so she must take medications to protect the baby. There is no cure for HIV or AIDS, but combinations of anti-HIV medications can be taken to stop the replication of the virus in the cells of the body, and to stop the progression of the disease. However, the development of resistance to the drugs is a problem. HIV damages the immune system, allowing infections to develop that the body would normally cope with easily. These are opportunistic infections and include herpes simplex, candidiasis, syphilis, and tuberculosis (TB).

Spermatic Ducts

As the sperm cells mature in the testes over a 60-day period, they move down the seminiferous tubules into the epididymis for storage. The epididymis adheres to the posterior side of the testis. It is a single-coiled duct or tube in which the sperm are stored for 12 to 20 days until they mature and become motile (capable of movement). To be ejaculated, the sperm move into the ductus (vas) deferens, the ejaculatory duct, and finally the urethra to reach the outside of the body. The ductus (vas) deferens is a muscular duct that travels up from the epididymis in the scrotum, passes behind the urinary bladder, and joins with the duct of the seminal vesicle to form the ejaculatory duct, which empties sperm and semen into the urethra.

Abbreviations more

BEP benign enlargement of the prostate BPH benign prostatic hyperplasia EPCA-2 early prostate cancer antigen-2 NIH National Institutes of Health PSA prostate-specific antigen TURP transurethral resection of the prostate

Disorders of the prepuce (foreskin)

Balanitis is an infection of the glans and foreskin with bacteria or yeast. Phimosis is a condition in which the foreskin is tight because of a small opening and cannot be retracted over the glans for cleaning. It can lead to balanitis. Paraphimosis is a condition in which the retracted foreskin cannot be pulled forward to cover the glans.

BMR

Basal Metabolic Rate

Disorders of the prostate gland

Benign prostatic hyperplasia (BPH), also known as benign prostatic hypertrophy or benign enlargement of the prostate (BEP)—a noncancerous enlargement of the prostate—can cause symptoms starting around age 45; by age 80, some 90% of men have symptoms. This enlargement is one of hyperplasia (number of cells) rather than hypertrophy (size of cells), and it compresses the prostatic urethra to produce symptoms including: Difficulty starting and stopping the urine stream. Nocturia (excessive nighttime urination), polyuria (excessive urine production), and dysuria (difficulty or pain in urination).

Abbreviations

DRE digital rectal examination LCC-ST Liaison Council on Certification for the Surgical Technologist mL milliliter

Disorders of the Penis

Disorders involving the penis range from minor injuries to STDs to cancer. These conditions are outlined below. Trauma to the penis can vary from being caught in a pants' zipper to being fractured while erect during vigorous sexual intercourse. Priapism is a persistent, painful erection that occurs when blood cannot escape from the erectile tissue. It can be caused by drugs like epinephrine, by blood clots, or by spinal cord injury. Cancer of the penis occurs most commonly on the glans and is rare in circumcised men. Sexually transmitted diseases (STDs) are discussed in detail in Chapter 15. Erectile dysfunction (ED), or impotence, is the inability to have a satisfactory erection. Treatment is aimed at addressing any underlying disease. Premature ejaculation is more common than erectile dysfunction. It occurs when a man ejaculates so quickly during intercourse that it causes distress or embarrassment to one or both partners.

ED

Erectile dysfunction occurs in some 20 million American men. Erectile dysfunction can be associated with diabetes, stroke, multiple sclerosis, hypertension, cigarette smoking, radiation therapy, drugs such as anti-depressants and cholesterol-lowering medications, and loss of interest in one's sexual partner.

smegma

Greek ointment Oily material produced by the glans and prepuce

More disorders of the prostate gland

In some patients, surgical treatment by transurethral resection (TURP) relieves the symptoms. An endoscope called a resectoscope is inserted into the urethra and used to remove the tissue surrounding and compressing the urethra. Prostatic cancer affects 10% of men over the age of 50, and its incidence is increasing. It forms hard nodules in the periphery of the gland and is often asymptomatic (produces no symptoms) in its early stages, as it does not compress the urethra. Screening for prostatic cancer is performed using the following procedures: A digital rectal exam (DRE), which involves palpating the size and texture of the prostate by inserting a finger into the rectum. A prostate-specific antigen (PSA) test, which measures the PSA level in the blood. Even though cancer can be present when the level is zero, the benefit of this test is that it can show whether levels rise rapidly over time. Some advisory groups now recommend against the use of PSA as a screen for prostate cancer because the benefits are limited and the harms in terms of unnecessary investigations and surgery for cancer are substantial. An early prostate cancer antigen (EPCA-2) test. This is more accurate than the PSA and is now in clinical trials. Several treatment options involving radiotherapy are available for prostate cancer. Brachytherapy involves the insertion of small radioactive rods directly into the tumor. Sometimes, a radical prostatectomy is performed. This involves complete surgical removal of the prostate and surrounding tissues. A vaccine has been introduced that provides some extension of life in men with advanced prostate cancer. Prostatitis is an inflammation of the prostate gland that causes groin pain and difficulty and discomfort when urinating.

Testes

In the adult male, each testis is a small, oval organ that measures about 2 inches long and ¾ of an inch wide (Figure 14.3). Each testis is covered by a serous membrane—the tunica vaginalis—which has outer and inner layers that are separated by serous fluid. Inside the testis are some 250 lobules (small lobes); each contains three or four seminiferous tubules, which produce semen. Within these tubules are several layers of germ cells that are in the process of developing into sperm. Between the seminiferous tubules are the interstitial (occurring between tissues) cells. These cells produce hormones called androgens. Testosterone is the major androgen produced by the interstitial cells of the testes. Its effects include the stimulation of the following activities:

Male infertility

Infertility is the inability of a couple to conceive after one year of unprotected intercourse. Male infertility is the man's inability to produce or deliver fully functioning sperm. The main causes of male infertility are: Impaired sperm production, due to cryptorchidism, anorchism (absence of one or both testes), testicular trauma, testicular cancer, or orchitis after puberty. Impaired sperm delivery, due to infections and blockage of spermatic ducts. Sperm disorders, in which sperm are underdeveloped, abnormally shaped, unable to move properly, produced in abnormally low numbers (oligospermia), or not produced at all (azoospermia). Varicoceles, in which the dilated scrotal veins impair sperm production by preventing proper drainage of blood within the testes. Testosterone deficiency (hypogonadism). Phthalates in plastics and dioxins in paper are examples of environmental endocrine disrupters that can contribute to testosterone deficiency. Each year, in the United States, half a million men choose to be made infertile (sterile) by having a vasectomy (Figure 14.8). Under local anesthesia, the ductus deferens is cut in two places, a 1-cm segment is removed, and the ends of the ductus deferens are cauterized and tied. The site of the surgery makes the man infertile but still able to produce and ejaculate seminal fluid. Should a man choose to reverse his vasectomy, he can undergo a vasovasostomy. This is a microsurgical procedure that reverses a vasectomy by suturing back together the cut ends of the ductus deferens.

glans

Latin acorn Head of the penis or clitoris

corpus corpora (pl)

Latin body Major part of a structure

plexus plexuses (pl)

Latin braid A weblike network of joined nerves

chancre

Latin cancer Primary lesion of syphilis

chlamydia

Latin cloak An STD caused by infection with Chlamydia, a species of bacteria

prepuce (same as foreskin)

Latin foreskin Fold of skin that covers the glans penis

impotence

Latin inability Inability to achieve an erection

libido

Latin lust Sexual desire

frenulum

Latin small bridle Fold of mucous membrane between the glans and the prepuce

torsion

Latin to twist The act or result of twisting

condom

Old English sheath or cover A sheath or cover for the penis or vagina to prevent conception and infection

brachytherapy

P/ R/ brachy- short -therapy treatment Radiation therapy in which the source of radiation is implanted in the tissue to be treated

epididymis

P/ R/ epi- above -didymis testis Coiled tube attached to testis

priapism

Priapus, mythical Roman god of procreation Persistent erection of the penis

syphilis

Principal character in a Latin poem Sexually transmitted disease caused by a spirochete

human papilloma virus (HPV)

R/ S/ R/ human human being -oma tumor papill- pimple virus, Latin poison Causes warts on the skin and genitalia and can increase the risk for cervical cancer

human immunodeficiency virus (HIV)

R/ S/ R/CF R/ human human being -ency condition immun/o- immune response -defici- lacking, inadequate virus, Latin poison Etiologic agent of acquired immunodeficiency syndrome (AIDS)

Trichomonas trichomoniasis

R/CF R/ S/ R/ trich/o- hair -monas single unit -iasis condition -mon- single A parasite causing an STD Infection with Trichomonas vaginalis

gonad gonads (pl) gonadal

S/ Greek seed -al pertaining to Testis or ovary Pertaining to the testis or ovary

transurethral

S/ P/ R/ -al pertaining to trans- across, through -urethr- urethra Procedure performed through the urethra

nocturia

S/ P/ R/ -ia condition noct- night -ur- urine Excessive urination at night

polyuria

S/ P/ R/ -ia condition poly- excessive -ur- urine Excessive production of urine

epispadias

S/ P/ R/ -ias condition epi- above -spad- tear or cut Condition in which the urethral opening is on the dorsum of the penis

hypospadias

S/ P/ R/ -ias condition hypo- below -spad- tear or cut Urethral meatus on the underside of the penis

circumcision

S/ P/ R/ -ion action, condition circum- around -cis- to cut To remove part or all of the prepuce

hypogonadism

S/ P/ R/ -ism condition hypo- deficient -gonad- testis or ovary Deficient gonad production of sperm, eggs, or hormones

infertility

S/ P/ R/ -ity condition in- not -fertil- able to conceive Failure to conceive

paraphimosis

S/ P/ R/ -osis condition para- abnormal -phim- muzzle Condition in which a retracted prepuce cannot be pulled forward to cover the glans

azoospermia oligospermia

S/ P/ R/ R/ P/ -ia condition a- without -zoo- animal -sperm- seed oligo- too few Absence of living sperm in the semen Deficient numbers of sperm in the semen

hyperplasia hypertrophy (Note: See Study Hint below.)

S/ P/ R/ S/ -ia condition hyper- excessive -plas- molding, formation -trophy development Increase in the number of the cells in a tissue or organ Increase in the size of the cells in a tissue or organ

inguinal

S/ R/ -al pertaining to inguin- groin Pertaining to the groin

replication

S/ R/ -ation process of replic- reply Reproduction to produce an exact copy

vasectomy

S/ R/ -ectomy surgical excision vas- duct Excision of a segment of the ductus deferens

Balanitis

S/ R/ -itis inflammation balan- glans penis Inflammation of the glans and prepuce of the penis

epididymitis

S/ R/ -itis inflammation epididym- epididymis Inflammation of the epididymis

cavernosa

S/ R/ -osa like cavern- cave Resembling a cave

phimosis

S/ R/ -osis condition phim- muzzle A condition where the prepuce cannot be retracted

spongiosum

S/ R/ -um tissue spongios- sponge Spongelike tissue

prostate prostatic (adj)

S/ R/ Greek one standing before -ic pertaining to prostat- prostate Gland surrounding the beginning of the urethra Pertaining to the prostate

perineum perineal (adj)

S/ R/ Greek perineum -al pertaining to perine- perineum Area between the thighs, extending from the coccyx to the pubis Pertaining to the perineum

scrotum scrotal (adj)

S/ R/ Latin scrotum -al pertaining to scrot- scrotum Sac containing the testes Pertaining to the scrotum

testicle testicular (adj) testis testes (pl)

S/ R/ Latin small testis -ar pertaining to testicul- testicle Latin testis One of the male reproductive glands Pertaining to the testicle Same as testicle

penis penile (adj)

S/ R/ Latin tail -ile pertaining to pen- penis Conveys urine and semen to the outside Pertaining to the penis

cryptorchism

S/ R/ R/ -ism condition crypt- hidden -orch- testicle Failure of one or both testes to descend into the scrotum

semen seminiferous (adj)

S/ R/ R/ Latin seed -ous pertaining to semin/i- semen -fer- to bear, carry Penile ejaculate containing sperm and seminal fluid Pertaining to carrying semen

molluscum contagiosum (Note: "S" in "sum" added to enable word to flow.) (modern word contagious)

S/ R/ R/CF -um structure mollusc- soft contagi/o- transmissible by contact STD caused by a virus

prostatectomy prostatitis

S/ R/ S/ -ectomy surgical excision prostat- prostate -itis inflammation Surgical removal of the prostate Inflammation of the prostate

erectile erection

S/ R/ S/ -ile pertaining to erect- to set up, straight -ion action, condition Capable of erection or being distended with blood Distended and rigid state of an organ

seminal vesicle

S/ R/ S/ R/ -al pertaining to semin- semen -le small vesic- sac containing fluid Sac of the ductus deferens that produces seminal fluid

motile motility

S/ R/ S/ R/ -ile pertaining to mot- to move -ity condition, state motil- to move Capable of spontaneous movement The ability for spontaneous movement

orchiectomy orchiopexy orchitis (Note: One of the two consecutive "i"s is not used.)

S/ R/ S/ R/CF S/ -ectomy surgical excision orchi- testicle -pexy surgical fixation orchi/o- testicle -itis inflammation Removal of one or both testes Surgical fixation of a testis in the scrotum Inflammation of the testis

ejaculate (can be a verb or a noun) ejaculation (noun) ejaculatory (adj)

S/ R/ S/ S/ -ate composed of, pertaining to ejacul- shoot out -ation process -atory pertaining to To expel suddenly; or the semen expelled in ejaculation Process of expelling semen suddenly Pertaining to ejaculation

tunica vaginalis

S/ R/ tunica, Latin coat -alis pertaining to vagin- sheath, vagina Covering, particularly of a tubular structure The tunica vaginalis is the sheath of the testis and epididymis

hydrocele

S/ R/CF -cele swelling hydr/o- water Collection of fluid in the space of the tunica vaginalis

spermatocele

S/ R/CF -cele swelling spermat/o- sperm Cyst of the epididymis that contains sperm

varicocele

S/ R/CF -cele swelling varic/o- varicosity Varicose veins of the spermatic cord

Androgen

S/ R/CF -gen create, produce andr/o- masculine Hormone that promotes masculine characteristics

gonorrhea

S/ R/CF -rrhea flow, discharge gon/o- seed Specific contagious sexually transmitted infection

resectoscope

S/ R/CF -scope instrument for viewing resect/o- cut off Endoscope for the transurethral removal of lesions

testosterone

S/ R/CF -sterone steroid test/o- testis Powerful androgen produced by testes

vasovasostomy (vasectomy reversal)

S/ R/CF -stomy new opening vas/o- duct Reanastomosis of the ductus deferens to restore the flow of sperm

bulbourethral

S/ R/CF R/ -al pertaining to bulb/o- bulb -urethr- urethra Pertaining to the bulbous penis and urethra

epididymo-orchitis (same as orchitis) (Note: One of the two consecutive "i"s is not used.)

S/ R/CF R/ -itis inflammation epididym/o- epididymis -orchi- testicle Inflammation of the epididymis and testicle

acquired immunodeficiency syndrome (AIDS)

S/ R/CF R/ P/ R/ acquired, Latin obtain -ency condition immun/o- immune response -defici- lacking, inadequate syn- together -drome running Infection with the HIV virus Combination of signs and symptoms associated with a particular disease process

spermicide spermicidal (adj)

S/ R/CF S/ -cide destroy sperm/i- sperm -al pertaining to Agent that destroys sperm Pertaining to the killing of sperm; or destructive to sperm

sperm spermatozoa (pl) spermatic (adj) spermatogenesis

S/ R/CF S/ S/ Greek seed -zoa animal spermat/o- sperm -ic pertaining to -genesis creation, formation Mature male sex cell Sperm (plural) Pertaining to sperm The process by which male germ cells differentiate into sperm

genitalia (Note: Two suffixes) genital (adj)

S/ S/ R/ -ia condition -al- pertaining to genit- primary male or female sex organs External and internal organs of reproduction Pertaining to reproduction or to the male or female sex organs

opportunistic infection (Note: TWO suffixes)

S/ S/ R/ -ic pertaining to -ist- agent, specialist opportun- take advantage of An infection that causes disease when the immune system is compromised for other reasons

SEVEN UP

SEVEN UP is used to remember the pathway of sperm: S = seminiferous tubules E = epididymis V = vas (ductus) deferens E = ejaculatory duct N = nothing U = urethra P = penis

Keynotes

Semen is derived from the secretions of several glands: ◦ 5% comes from the testicles and epididymis (sperm). ◦ 50% to 80%, from the seminal vesicles. ◦ 15% to 33%, from the prostate gland. ◦ 2% to 5%, from the bulbourethral glands. A normal sperm count is in the range of 75 to 150 million sperm per milliliter (mL) of semen. A normal ejaculation consists of 2 to 5 mL of semen.

Testosterone and its activities

Spermatogenesis, (Figure 14.4) which is responsible for testosterone levels peaking at age 20, then declining steadily to one-fifth of that level at age 80. The development of the male secondary sex characteristics at puberty, which include: The enlargement of the testes, scrotum, and penis. The development of the pubic, axillary, body, and facial hair. The secretion of sebum in skin, which can result in acne (Chapter 3). A burst of growth at puberty, including an increased muscle mass, a higher basal metabolic rate (BMR), and a larger larynx (which deepens the voice). Stimulating the brain to increase the male's libido (sex drive).

TSE

Testicular Self-Examination

Disorders of the testes

Testicular torsion is the twisting of a testis on its spermatic cord. The testicular artery in the twisted cord becomes blocked, and the blood supply to the testis is cut off. The condition occurs in men between puberty and age 25. In half the cases, it starts in bed at night, as it did for Joseph Davis in Case Report 14.1. Varicocele is a condition in which the veins in the spermatic cord become dilated and painful as varicose veins. If it is uncomfortable, it can be treated by surgically tying off the affected veins. Hydrocele is a collection of excess fluid in the space between the visceral and parietal layers of the tunica vaginalis of the testis (Figure 14.6). It is most common after age 40. The diagnosis can be confirmed by transillumination, (Figure 14.6), shining a bright light on the scrotal swelling to see the shape of the testis through the surrounding translucent excess fluid. Spermatocele is a collection of sperm in a sac formed in the epididymis, which is the sperm-containing tube attached to a testicle. It occurs in about 30% of men, is benign, and rarely causes symptoms. It does not require treatment unless it becomes uncomfortable. Cryptorchism occurs when a testis fails to descend from the abdomen into the scrotum before a boy is 12 months old. As undescended testicles have a higher risk of infertility and cancer, an orchiopexy is performed to bring the testis into the scrotum. Epididymitis is an inflammation of the epididymis; epididymo-orchitis (orchitis) is an inflammation of the epididymis and testis. Orchitis, an inflammation of the testis, is usually a consequence of epididymitis. In each of these cases, the inflammation is most commonly caused by a bacterial infection spreading from an infection in the urinary tract or prostate. These infections can also be caused by sexually transmitted diseases (STDs), like gonorrhea or chlamydia. A viral cause of orchitis is mumps. In males past puberty who develop mumps, 30% will develop orchitis, and 30% of those will develop resulting testicular atrophy. A bilateral infection can result in infertility. Mumps is avoidable by immunization in childhood. Testicular cancer is the most common cancer in males aged 20-39 years. One of the first signs is often a lump in the testis, which may be found through self-examination of the testes. Metastasis is uncommon, but it can be seen in the lungs, in the abdominal and cervical lymph nodes, and occasionally in the brain. An inguinal orchiectomy is the usual treatment; if metastases are found, chemotherapy and radiotherapy can be used.

Spermatic Cord

The blood vessels and nerves to the testes—which arise in the abdominal cavity—pass through the inguinal, or groin, canal, where they join with connective tissue. This forms the spermatic cord that suspends each testis in the scrotum (Figure 14.3). The left testis is suspended lower than the right. Within the cord exist: an artery a plexus of veins nerves a thin muscle the ductus (vas) deferens into which sperm are deposited when they leave the testis

Perineum

The external genitalia (the penis, scrotum, and testes) occupy the perineum, a diamond-shaped region between the thighs. The perineum borders the pubic symphysis anteriorly and the coccyx posteriorly (Figure 14.2). The anus is also in the perineum.

The Prepuce (Foreskin) and Urethra

The functions of the prepuce (foreskin) are to cover and protect the glans (Figure 14.10(b)), and to produce smegma. Smegma is a lubricant containing lipids, cell debris, and some natural antibiotics. Removal of the foreskin is called circumcision

Male Reproductive System

The male reproductive organ system (Figure 14.1) consists of the primary and secondary sex organs, and the accessory glands. These are categorized as follows: The primary sex organs, or gonads, are the two testes. The secondary sex organs include: The penis; The scrotum; and A system of ducts, including the epididymis, ductus (vas) deferens, and urethra. The accessory glands include: The prostate; The seminal vesicles; and The bulbourethral glands.

Scrotum

The scrotum is a skin-covered sac between the upper thighs. It is divided into two compartments. Each compartment contains a testis. The scrotum's function is to provide a cooler environment for the testes than that inside the body. Sperm are best produced and stored at a few degrees cooler than that of the male's internal body temperature.

The Accessory Glands

The two seminal vesicles, located on the posterior surface of the urinary bladder, hold fluid that mixes with the sperm in the vas deferens. The fluid is rich in sugar to provide nourishment for the sperm and has clotting properties that make the semen sticky. The single prostate gland is close in size and shape to the average walnut. The prostate gland is located immediately below the bladder and anterior to the rectum. It surrounds the urethra and the ejaculatory duct. It is composed of 30 to 50 glands that open directly into the urethra; these glands secrete fluid that nourishes and protects sperm. During ejaculation, the prostate squeezes this fluid into the urethra to form part of semen. The two bulbourethral glands, located one on either side of the membranous urethra. Each gland has a short duct leading into the spongy (penile) urethra. When sexually aroused, the glands produce a fluid that neutralizes any acidity in the urethra to make a more hospitable environment in which the sperm can travel.

Disorders of the penile urethra

Urethritis is an inflammation of the urethra. It can be caused by bacteria, STDs, viruses, and chemical irritants from spermicides and contraceptive gels. Urethral stricture is scarring that narrows the urethra. It results from infection or injury. Hypospadias is a congenital defect in which the opening of the urethra is on the undersurface of the penis instead of at the head of the glans. It can be corrected surgically. Epispadias is a congenital defect in which the opening of the urethra is on the dorsum of the penis.

The health professionals involved in the diagnosis and treatment of problems with the male reproductive system include:

Urologists, who are specialists in the diagnosis and treatment of diseases of the urinary system. Nurse practitioners, physicians' assistants, and technologists with special training and expertise also provide urologic patient care.

c/o

complaining of

ductus deferens (same as vas deferens)

ductus, Latin to lead deferens, Latin carry away vas, Latin vessel, canal Tube that receives sperm from the epididymis

Penis

is an important male external body structure, which is specifically designed to meet its two main functions: To enable urine to flow to the outside. To deposit semen in the female vagina around the cervix. The external, visible part of the penis is composed of the shaft and the more sensitive glans. The external urethral meatus is located at the tip of the glans. The skin of the penis continues over the glans as the prepuce, otherwise known as the foreskin. A ventral fold of tissue called the frenulum attaches the foreskin to the glans. The shaft of the penis contains these three erectile vascular bodies (Figure 14.9(b)): The paired corpora cavernosa (columns of erectile tissue found in the penis) are located dorsolaterally. The single corpus spongiosum is located inferiorly. It contains the urethra and goes on to form the glans. Erection occurs when the corpora cavernosa fill with blood, causing the erectile bodies to distend and become rigid. It is a parasympathetic nervous system response to stimulation. Ejaculation occurs when the sympathetic nervous system stimulates the smooth muscle of the ductus deferens, ejaculatory ducts, and the glands in the prostate to contract.

STD

sexually transmitted disease