The spermatic cord refers to a collection of vessels, nerves and ducts that run to and also from the testes. They room surrounded by fascia, developing a cord-like structure.

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This short article will look in ~ the anatomy that the spermatic cord – its anatomical course, contents, and clinical correlations.


Anatomical Course

The anatomical food of the spermatic cord is fairly short, start in the inferior abdomen and ending in the scrotum.

The spermatic cord is created at the opened of the inguinal canal, known as the deep inguinal ring. This opening is located laterally to the inferior epigastric vessels.

The cord passes with the inguinal canal, start the scrotum via the superficial inguinal ring. It proceeds into the scrotum, ending at the posterior border of the testes. Here, its materials disperse to it is provided the various structures of the testes and scrotum.


by TeachMeSeries Ltd (2021)
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Fig 1 – Anatomical course of the spermatic cord.


Fascial Coverings

The materials of the spermatic cord are mainly bound together by three fascial layers. They are all acquired from anterior ab wall:

External spermatic fascia – derived from deep subcutaneous fascia (fascia innominata).Cremaster muscle and fascia – obtained from the interior oblique muscle and also its fascial coverings.Internal spermatic fascia – derived from the transversalis fascia.

The 3 fascial great themselves room covered through a great of superficial fascia, i m sorry lies directly below the scrotal skin.

The cremaster muscle forms the center layer of the spermatic cord fascia. The is a discontinuous layer of striated muscle that is orientated longitudinally.


by TeachMeSeries Ltd (2021)
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Fig 2 – The cremaster muscle. Note the looping structure.


Clinical Relevance: Cremasteric Reflex

The cremasteric reflex can be created by stroking the superior and medial component of the thigh. This produce an immediate contraction that the cremaster muscle, elevating the testis ~ above the next that has actually been stimulated.

This spinal reflex is composed of two parts:

Afferent (sensory) limb – ilioinguinal nerve (innervates the skin that the superomedial thigh). Fibres indigenous this nerve enter the spinal cord in ~ L1.Efferent (motor) limb – genital branch of the genitofemoral nerve (innervates the cremaster muscle).

Contents

The spermatic cord conveys several essential structures that run to and from the testis.

Blood vessels:Testicular artery – branch of the aorta the arises just inferiorly to the renal arteries.Cremasteric artery and also vein – supplies the cremasteric fascia and also muscle.Artery to the vas deferens – branch of the worse vesicle artery, which occurs from the inner iliac.Pampiniform plexus that testicular veins – drains venous blood from the testes into the testicular vein.Nerves:Genital branch the the genitofemoral nerve – supplies the cremaster muscle.Autonomic nervesOther structures:Vas deferens – the duct that transports sperm native the epididymis come the ampulla (a dilated terminal component of the duct), prepared for ejaculation.Processus vaginalis – projection of peritoneum that forms the pathway of descent because that the testes throughout embryonic development. In the adult, it is fused shut.

Pampiniform Plexus

The pampiniform plexus is a network of veins, responsible for the venous drainage that the testes. It has a distinct configuration, wrapping itself approximately the testicular artery

The testes function best in ~ a temperature just listed below that that the body. The pampiniform plexus acts as a heat exchanger, cooling the arterial blood before it reaches the testes. Together it travels with the inguinal canal, the pampiniform plexus condenses right into a single testicular vein.

The right testicular vein drains right into the inferior vena cava and the left testicular vein drains into the left renal vein. However, there are also some anastomotic branches that enable communication with various other veins, such together the cremasteric, scrotal and internal pudendal veins.

Vas Deferens

The vas deferens is a straight, thick muscular tube the conveys sperm from the epididymis to the ampulla and also eventually, to the ejaculatory duct (formed by the convergence of the vas deferens and seminal vesicle duct). From the ejaculatory duct, sperm can pass v to the prostatic urethra.

The wall surface of the vas deferens consists largely of smooth muscle, i ordered it in three muscle layers:

Inner LayerIntermediate Layer

Outer Layer

Longitudinal smooth muscleCircular smooth muscleLongitudinal smooth muscle

There is a rich autonomic innervation of this muscle fibres, i m sorry permits fast movement of sperm towards the ejaculatory duct. This motion is likewise facilitated through the within mucosal great of the vas deferens – i m sorry is inside wall by cells that possess microvilli. Their seaweed-like motion helps advancement spermatozoa v the spermatic tube.

The anatomical food of the vas deferens is as follows:

It is continuous with the tail the the epididymis.Travels v the inguinal canal, as part of the spermatic cord.Moves under the lateral pelvic wall surface close come the ischial spine.Turns medially come pass between the bladder and also the ureter and then travels downward ~ above the posterior surface ar of the bladder.The worse narrow component of the ampulla joins the duct from the seminal vesicle to form the ejaculatory duct.
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Fig 4 – Anatomical course of the vas deferens.


Clinical Relevance: Testicular Torsion

Testicular torsion is a operation emergency, where the spermatic cord twisted upon itself. This have the right to lead come strangulation of the testicular artery, bring about necrosis of the testis.

A common reason of testicular torsion is spasm the the cremasteric muscle fibres i beg your pardon then pressure the testicle to spin around its very own cord. Specific anatomic problems (e.g. A loose testicle in a big peritoneal sac – tunica vaginalis) might facilitate this movement.

Diagnosis can be evidenced via ultrasound and colour doppler scanning. The main clinical feature of testicular torsion is severe, sudden pain in the influenced testis which commonly lies greater (due to the torsion that the cord) in the scrotum.

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Testicular torsion is an pure surgical emergency. A few hours delay can bring about testicular necrosis.