Textbooks
Reproductive
Functions of the Male
Penis
The Penis
Penis: consists of internal root, external shaft, & glans.
Root: the portion of the penis that extends internally into
the pelvic cavity.
Shaft: the length of the penis between the glans and
the body.
Glans: the head of the penis; has many nerve endings.
Cavernous bodies: the structures in the shaft of the
penis that engorge with blood during sexual arousal.
Spongy body: a cylinder that forms a bulb at the base of
the penis, extends up into the penile shaft, and forms
the penile glans. Also engorge with blood during
arousal.
Foreskin: a covering of skin over the penile glans.
(internal, in
pelvic cavity)
(head of the
penis; lots of
nerve endings)
(expands
to form
the glans)
Genital Anatomy
Genital Anatomy
Two paired corpora cavernosa (erectile bodies) and a single corpus
spongiosum surrounding the urethra, all encased within Bucks
fascia
Vascular Supply
The blood supply to the penis is
derived from the pudendal artery
which branches from the internal
iliac (hypogastric) artery.
Cavernosal arteries course through the
center of each corporal body and
give rise to multiple helicine arteries
which open into the lacunar spaces.
Circumcision
Circumcision: surgical removal of the foreskin
of the penis.
Circumcision
Bladder
Urethra
Function: Maintain
temperature of testes approx.
0
3 C below normal body temp.
Muscle:
Cremaster
Dartos
Scrotum
Spermatic cord
Spermatic cord
(inside)
The spermatic cord can be located by palpating the scrotal sac above either testicle
with thumb and forefinger.
(sperm-carrying tube)
This illustration shows portions of the scrotum cut away to reveal the cremasteric
muscle, spermatic cord, vas deferens, and a testis within the scrotal sac.
Testis
body
for sperm
Development
left
left
testis
Seminiferous Tubules
Testis
Interstitial Cells
Produce Testosterone
Testis
Epididymis
Vas
Deferens
Vas Deferens
Seminal
Vesicles
Ejaculatory Duct
Prostate
Cowpers
Gland
Semen
ejaculated during the male sexual activity
composed of the fluid and sperm from the vas deferens (about 10
per cent of the total), fluid from the seminal vesicles (almost 60
per cent), fluid from the prostate gland (about 30 per cent), and
small amounts from the mucous glands, especially the
bulbourethral glands.
bulk of the semen is seminal vesicle fluid, which is the last to be
ejaculated and serves to wash the sperm through the ejaculatory
duct and urethra.
average pH of the combined semen is about 7.5, the alkaline
prostatic fluid having more than neutralized the mild acidity of the
other portions of the semen.
The prostatic fluid gives the semen a milky appearance, and fluid
from the seminal vesicles and mucous glands gives the semen a
mucoid consistency.
Effect of Temperature on
Spermatogenesis
Increase temperature of the testis can prevent
spermatogenesis by causing degeneration of
most cells of the seminiferous tubules besides
the spermatogonia. in these patients is unlikely to
be successful.
The reason the testes are located in the dangling
scrotum is to maintain the temperature of these
glands below the internal temperature of the
body, although usually only about 2C below the
internal temperature.
Thus, the scrotum theoretically acts as a cooling
mechanism for the testes (but a controlled
cooling), without which spermatogenesis might
be deficient during hot weather.
How does
the male
apparatus
work?
.
Male Sexual Act
Neuronal Stimulus for Performance of the Male Sexual Act
glans penis
The most important source of sensory nerve signals for
initiating the male sexual act
contains an especially sensitive sensory end-organ system
that transmits into the central nervous system that special
modality of sensation called sexual sensation.
The slippery massaging action of intercourse on the glans
stimulates the sensory end-organs, and the sexual signals
in turn pass through the pudendal nerve, then through the
sacral plexus into the sacral portion of the spinal cord, and
finally up the cord to undefined areas of the brain.
Impulses may also enter the spinal cord from areas
adjacent to the penis to aid in stimulating the sexual act.
Nocturnal Emissions
Erection
flaccid
erect
Mechanism of Erection
Increased intracorporal pressure expands the trabecular wall against the tunica albuginea
Compression of the subtunical veins along with a reduction of venous blood flow results in elevated
pressures in the lacunar spaces, veno-occlusive mechanism
Viagra Pills
Erectile dysfunction (ED), a form of impotence, is the inability to attain an erection when
desired. What is missing? In two words, nitric oxide
chronic condition
the result of hormonal (DM, Cushings
disease, hypothyroidism, and
elevated levels of prolactin) ,
Vascular (arteriosclerosis, injury to
penile blood vessels, or varicose
veins in the penis, which create
venous leaks that allow blood to leave
the penis prematurely), or
nervous system problems (stroke,
multiple sclerosis, tumors, physical
trauma, or damage to penile nerves
during surgery or radiation therapy)
Lubrication, a Parasympathetic
Function
The parasympathetic impulses cause the urethral
glands and the bulbourethral glands to secrete
mucus. This mucus flows through the urethra
during intercourse to aid in the lubrication during
coitus
However, most of the lubrication of coitus is
provided by the female sexual organs rather than
by the male.
Without satisfactory lubrication, the male sexual
act is seldom successful because unlubricated
intercourse causes grating, painful sensations
that inhibit rather than excite sexual sensations.
Ejaculation
The filling of the internal urethra with semen elicits sensory
signals that are transmitted through the pudendal nerves to the
sacral regions of the cord,giving the feeling of sudden fullness in
the internal genital organs
Also, these sensory signals further excite rhythmical contraction
of the internal genital organs and cause contraction of the
ischiocavernosus and bulbocavernosus muscles that compress
the bases of the penile erectile tissue. These effects together
cause rhythmical, wavelike increases in pressure in both the
erectile tissue of the penis and the genital ducts and urethra,
which ejaculate the semen from the urethra to the exterior
rhythmical contractions of the pelvic muscles and even of some of
the muscles of the body trunk cause thrusting movements of the
pelvis and penis, which also help propel the semen into the
deepest recesses of the vagina and perhaps even slightly into the
cervix of the uterus.
This entire period of emission and ejaculation is called the male
orgasm.
At its termination, the male sexual excitement disappears almost
entirely within 1 to 2 minutes and erection ceases, a process
called resolution.
Male
Sexual
Response
Erection of Male
Male
Sexual
Response
Ejaculation
How fast does it
leave the body?
How far can it go?
How much is
released?
Is it really released
as a stream?
Muscle
contractions are
0.8 seconds apart
Man Posing
The Wrestlers
David
Dionysus
Michelangelo 1504
Marsyas
(Photograph)
Male
Anatomy
Eros 3
Oil on canvas
Thomas
The Penis
Whats
normal?
My penis is too
small!
Two out of
three men
think that
their penis
is too small,
even
though it is
average
size. Why?
A humans
penis is 4-6
inches long
when erect
(3-5 inches
otherwise).
Penis Enlargement
Some men go for the stretch
Penis Enlargement
This is the after photo
Fat injection
Buy a penis
extension
Masturbation
The good thing about masturbation is that you don't
have to dress up for it. Truman Capote
Purchase
some
help!
Can you
break an
erection?
Peyronies Disease
Affects 1 out of 100 men
Usually after age 40
Cause is unknown
Age
Age
Age
Age
Age
It
20:
30:
40:
50:
70:
+10 degrees
+20 degrees
+1 degree
-1 degree
-25 degrees
Erectile Dysfunction
Defined as the inability to maintain or achieve an
erection for satisfactory sexual intercourse.
May include physiologic, organic, or mixed causes
PVD
Drug abuse
Vascular surgery
Smoking
CAD
Endothelial dysfunction
ED
Alcohol abuse
Hypogonadism
Peyronies disease
Trauma/surgery to
pelvis or spine
Endocrine Disorders
Hyperlipidemia
Benet AE, Melman A. Urol Clin North Am. 1995;22:699-709
Physiologic Indicators of ED
Atherosclerosis in narrow
penile arteries may manifest
as ED before becoming
apparent in other arteries.
Detecting atherosclerosis in
1 set of blood vessels
increases the chance of
finding it in other vessels.
smoking
dyslipidemia
hypertension
diabetes
obesity
lack of exercise/sex
Estrogens
Antiandrogens
H2-receptor blockers
Anticholinergics
Ketoconazole
Marijuana
Alcohol
Antihypertensives
Narcotics
-blockers
Psychotropics
Cigarettes
Cocaine
Spironolactone
Lipid-lowering agents
NSAIDs
Cytotoxic drugs
Diuretics
Psychotherapy
Invasive Therapy:
Penile revascularization
Psychosocial Counseling :
First-Line Therapy
Anxiety reduction/desensitization
Cognitive-behavioral interventions
Testosterone Supplementation
Alprostadil Delivery
Intracavernosal Injections
Lowering of Ca++
Smooth muscle relaxation
Viagrawhen taken
with a high fat meal,
the rate of absorbtion
is reduced, and mean
delay in Tmax of 60
minutes
Cialis No effect on
Cmax or Tmax, 36
hour effect
Vardenafil
Tadalafil
Headache 16%
Headache 15%
Headache 15%
Flushing 10%
Flushing 11%
Flushing 3%
Dyspepsia 7%
Dyspepsia 4%
Dyspepsia 10%
Nasal congestion 4%
Nasal congestion 9%
Nasal Congestion 3%
Blue vision 3%
Back pain 6%
Myalgia 3%
Limb pain 3%
PDE11heart, pituitary,
testes (1:780)
PDE5penis (1:1)
Gbekor E, et al. Poster presented at: European Association of Urology; February 23-26, 2002; Birmingham, United Kingdom.
Reproductive
Functions of the Female
Female
Anatomy
and
Physiology
Female Nude Interior No 5
Jim Read
Seated Nude
Bronze
Jean Doyle
Mosby items and derived items 2006 by Mosby, Inc.
Pensamiento
"Awakening"
Oil on Canvas 2005
Audrey Shwidkiy
Mosby items and derived items 2006 by Mosby, Inc.
MONS PUBIS
CLITORIS ANATOMY
CLITORIS
Erectile internal structure
Two 3.5 long branches called crura
Crura contain two corpora cavernosa: hollow
chambers that fill with blood and swell during
arousal
Orgasmic
Enlarges initially, then retracts beneath hood just
before and during orgasm
Follows same pattern with repeated orgasms,
though swelling is less pronounced
COMPARATIVE ANATOMY:
CLITORIS AND PENIS
LABIA MAJORA
Two folds of spongy flesh extending from the mons
pubis toward the perineum
May have hair present
Contain a significant concentration of nerve endings
LABIA MINORA
Small folds within the labia majora that meet above
the clitoris to form the clitoral hood
Significant variation in appearance
Contain a significant concentration of nerve endings
Swell during sexual arousal
Enclose the vestibule
GLANDS
Lesser Vestibular (Paraurethral, Skene's) Male
Homolog = prostate located on the upper wall of the
vagina, around the lower end of the urethra.
They drain into the urethra and near the
urethral opening Function - mucus production
to aid lubrication during intercourse
Greater Vestibular (Bartholin's) Male Homolog =
bulbourethral glands located slightly below and to the
left and right of the opening of the vagina. They
secrete mucus to provide lubrication, especially
when the woman is sexually aroused
INTERNAL STRUCTURES
Vagina
Cervix
Uterus
Fallopian tubes
Ovaries
INTERNAL STRUCTURES
Vagina
VAGINA
HYMEN
Photograph
of
imperforate
hymen
Uterus
FEMALE INFERTILITY
Uterine
muscle
tumor
Benign
(>95%)
25-30%
of women
FIBROID UTERUS
Mullerian
defects (congenital)
Absent uterus
Bicornuate/septate
MULLERIAN DEFECT
Cervix
CERVICAL INTRAEPITHELIAL
NEOPLASIA
Endometrium
Myometrium
ENDOMETRIAL PHASE
Dysmenorrhea
Mechanism of Pain
FUNCTIONS OF COX
COX-1
COX-2
CONSITUTIVELY EXPRESSED
INDUCIBLE
HOUSEKEEPING FUNCTIONS
INFLAMMATORY AND
STOMACH, INTESTINE,
KIDNEY PLATLETS,
VASCULAR ENDOTHELIUM
PRESENT IN KIDNEY,
UTERUS. OVARY
BRAIN, SMALL
INTESTINE
COX-1:
Constitutive
Homeostatic
Protection of gastric
mucosa
Platelet activation
Renal functions
Macrophage
differentiation
COX-2:
Regulated
Pathologic
Information
Pain
Fever
Dysregulated
proliferation
Tissue Repair
Physiologic
Reproduction
Renal functions
Other (see text)
Development
kidney
PGE2
http://elfstrom.com/arthritis/nsaids/actions.html
Copyright 1997 David Elfstrom
Uterine
Tubes
Ovaries
Fimbriae
OTHER STRUCTURES
Urethra: tube through which urine passes
Urethral opening
Perineum: area between genitals and anus
Pelvic floor
OTHER STRUCTURES
BREASTS
BREASTS
Whats
normal?
What are they
made of?
Kaplan
Loulan
excitement
plateau
orgasm
resolution
Desire
Excitement
Orgasm
Vasocongestion
Myotonia
Vaginal Sweating
Tenting
Labia may enlarge or
flatten and separate
Sex flush
ORGASM
As excitement increases
Clitoris retracts beneath clitoral hood
Vaginal opening decreases by about 1/3
Orgasmic platform
STAGES OF
SEXUAL
RESPONSE:
WOMEN
FEMALE
SEXUAL
RESPONSE
FEMALE
SEXUAL
RESPONSE
G-Spot
Ejaculation in Women
It refers to the expulsion of noticeable amounts of clear
fluid or the emission of liquid by human females
from the paraurethral ducts and/or urethra (through
the genitals) during orgasm.
It is also known colloquially as squirting or gushing
or dribbling
Most women ejaculate, although they are variations in
the quantity of the emitted liquid
With great force --- gushing or squirting --6% frequent and 13% infrequent
With little force --- dribble -- 55-60%
Almost-dry orgasm --- don't have any glandular
tissue can't produce anything to ejaculate or
very scarce secretion or the ejection takes
the retrograde direction towards the
bladder, as occurs in the retrograde
ejaculation of some men
BREAST CHANGES
Thinning of vaginal
lining
Increased time for
arousal and
lubrication
Fewer muscle
contractions with
orgasm
Resolution at about
the same rate
Objectives
Define sexual identity, and discuss the major
components of sexual identity, including biology, gender
identity, gender roles, and sexual orientation.
Identify major features and functions of sexual anatomy
and physiology.
Sexual Orientation
Heterosexual
Homosexual
Bisexual
Transsexual
Celibacy
Autoerotic behaviors
Sexual fantasies
Masturbation
Kissing and erotic touching
Manual stimulation
Oral-genital stimulation
Vaginal intercourse
Anal intercourse
Voyeurism
Sadomasochism
Pedophilia
Autoerotic asphyxiation
Do men and
women have
much in
common?
After the Temptation
Kelly Borsheim
Copyright 2006 Pearson Education, Inc., publishing as Benjamin Cummings
Intersex
Breast health
Breast lumps: 3 types
cysts (fluid-filled sacs, benign)
fibroadenomas (solid, round, benign tumors)
malignant tumor (tumor made up of cancer cells)
Breast cancer
Incidence: 1 in 9 women in North America; 190,000 new
diagnoses each year.
Kills 40,000 women in U.S. each year and 370,000
women worldwide each year.
In North America, one woman dies of breast cancer
approximately every 12 minutes.
Breast cancer
Early detection increases survival b/c cancer
is usually found at an earlier stage.
The 5-year survival rate is lower for minority
women than for white women, most likely due
to differences in access to preventive health
care.
Percentage of cancer
diagnosed at this stage
Survival Rate
at 5 years (%)
60
98
31
76
16
Stage of cancer
Axillary Cording
Trunkal Cording