Vil External Genitalia

A. The scrotum is an outpouching of the lower abdominal wall whereby layers of the abdominal wall continue into the scrotal area to cover the spermatic cord and testes (see Chapter 6 IV).

B. Penis

1. General features a. Structure. The penis consists of three columns of erectile tissue-one corpus spongiosum and two corpora cavernosa-bound together by the tunica albugínea. It is supported by the suspensory ligament, which arises from the linea alba and inserts into the deep fascia (of Buck).

b. The arterial supply is from the internal pudendal artery via the deep artery of the penis, which is involved in penile erection, and the dorsal artery of the penis.

c. Venous drainage is to the deep dorsal vein of the penis prostatic venous plexus internal iliac vein IVC. Venous drainage is to the superficial dorsal vein of the penis external pudendal vein great saphenous vein femoral vein —► external iliac vein IVC.

d. The penis is innervated by the pudendal nerve via the dorsal nerve of the penis.

2. The corpus spongiosum begins as the bulb of the penis and ends as the glans penis. It is ventrally situated in the penis and transmits the urethra.

3. The corpora cavernosa begin as the crura of the penis and end proximal to the glans. They are situated dorsally in the penis.

4. Clinical considerations a. Hypospadias occurs when the urethral folds do not fuse completely. As a result, the external urethral orifice opens onto the ventral surface of the penis. It usually is associated with a poorly developed penis that curves ventrally (chordee).

b. Epispadias occurs when the external urethral orifice opens onto the dorsal surface of the penis. It usually is associated with exstrophy of the bladder.

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