[0:20]Good morning. This is Dr. Adel Bondok, Professor of Anatomy and Neuroscience, Mansoura University, Egypt. Today I will talk about the spermatic cord. I will talk about the formation, the beginning, the end, the covering and the contents of the spermatic cord. Start by the formation of the spermatic cord. This is the spermatic cord. Regarding the formation of the spermatic cord, it is formed by the structures which pass through the inguinal canal to the testis. Okay? So, the structures which pass through the inguinal canal to the testis form the spermatic cord. It begins at the deep inguinal ring. Here. This is the deep inguinal ring and it ends at the posterior border of the testis. Regarding the covering of the spermatic cord, the spermatic cord is surrounded by three layers from outside inward, they are external spermatic fascia is the outer layer. Cremasteric muscle and fascia, the middle layer. And internal spermatic fascia, the inner layer. The external spermatic fascia arises from the external oblique aponeurosis.
[1:51]The cremasteric muscle and fascia is extension from the internal oblique muscle. The internal spermatic fascia is extension from the transversalis fascia. So again, the covering of the spermatic cord, these are the muscles of the anterior abdominal wall. External oblique, internal oblique, transversus abdominis, and it is lined by transversalis fascia and this is the peritoneum. And this is the remains of processus vaginalis and this is tunica vaginalis and this is the testis. So the three layers covering the spermatic cord are the outer layer is the external spermatic fascia. This external spermatic fascia is extension from the external oblique aponeurosis. The second layer or the middle layer is the cremasteric muscle and fascia. This cremasteric muscle and fascia is extension from the internal oblique muscle. And the inner layer is the internal spermatic fascia, which is extension from the transversalis fascia. So the three layers are external spermatic fascia, cremasteric muscle and fascia and internal spermatic fascia. Regarding the contents of the spermatic cord, of course, the first content is the vas deferens and then three arteries. The three arteries are the first one is the testicular artery. And the testicular artery is a branch from the abdominal aorta. Second one is artery of the vas deferens, and artery of the vas deferens is a branch from the inferior vesical artery. The third artery is the cremasteric artery. And this cremasteric artery is a branch from the inferior epigastric artery. And then veins, pampiniform plexus of veins. This pampiniform plexus of veins forms the testicular vein. The right testicular vein ends in inferior vena cava. The left testicular vein ends in left renal vein. And then nerves. The first one is the genital branch of the genitofemoral nerve. And the second one is autonomic plexus, or autonomic fibers around the blood vessels, around the arteries. And number five, lymphatics. Lymphatics from the testis and epididymis. And then remains of processus vaginalis. So the spermatic cord, the structures, which form the spermatic cord are vas deferens. Then three arteries: testicular artery, artery of the vas deferens, cremasteric artery. Then pampiniform plexus of veins, which forms the testicular vein. The right testicular vein ends in the inferior vena cava, the left testicular vein ends in the left renal vein. The nerves, genital branch of the genitofemoral nerve and autonomic plexus, autonomic fibers around the arteries. And then lymphatics from the testis and epididymis and remains of processus vaginalis. So, what are the arteries? What are the three arteries present in the spermatic cord? The three arteries are one, two, three. The first one is the testicular artery. This testicular artery arises from the abdominal aorta. Then artery of the vas deferens. Artery of the vas deferens arises from the inferior vesical artery, which is a branch from the internal iliac artery. And then cremasteric artery. This cremasteric artery is a branch from the inferior epigastric artery. Then pampiniform plexus of veins. This is the pampiniform plexus of veins. Pampiniform plexus of veins forms the testicular vein.
[6:28]The right testicular vein terminates in the inferior vena cava. The left testicular vein terminates in the left renal vein. Okay? Again. This is the pampiniform plexus of veins. It forms the testicular vein. The right testicular vein terminates in the inferior vena cava. The left testicular vein terminates in the left renal vein. Regarding varicocele. What is varicocele? Varicocele is dilated, tortuous pampiniform plexus. It is more common on the left side due to three reasons. The first reason is that the left testicular vein opens against high pressure zone of the left renal vein and it opens at a right angle, which allows reflux from the left renal vein. Second reason is that the loaded sigmoid colon compresses the left testicular vein. And the third reason is that absence of valves in the left testicular vein. Varicocele increases the temperature of the testis and might cause infertility due to low sperm production. So, varicocele is dilated, tortuous pampiniform plexus.
[8:03]It is more common on the left side due to three reasons. The first reason is that the left testicular vein drains against high pressure zone of the left renal vein. Second reason, compression of the left testicular vein by the loaded sigmoid colon. And the third reason, no valves in the left testicular vein. What is the danger of varicocele? Varicocele increases the temperature of the testis and might lead to infertility due to low sperm production. And finally, lymphatics from the testis and scrotum. Lymphatics from the testis and epididymis drain into the paraaortic lymph nodes. Lymphatics from the scrotum drain into the superficial inguinal lymph nodes.
[9:09]And thank you very much. Best wishes and good luck.
