SUMMARY NOTES

Introduction to the Male Genitalia and Rectum

I. External Genitalia

Penis ✓ The penis is the male reproductive organ.

✓ The penis has a role in both reproduction and urination.
✓ Attached to the pubic arch by ligaments, the penis is freely movable.
✓ The penile shaft is composed of three cylindrical masses:
- 2 corpora cavernosa
- Corpus spongiosum (Extends distally to form the acorn-shaped glans)
✓ The base of the glans, or corona, is somewhat larger as compared to the
shaft of the penis.
✓ Foreskin/ Prepuce
- A hood-like fold of skin which covers the glans for uncircumcised man
✓ Urethra
- Found in the center of the corpus spongiosum
- Travels through the shaft and opens as a slit at the tip of the glans
(Urethral meatus)
✓ Frenulum
- A fold of foreskin that extends ventrally from the urethral meatus
Scrotum ✓ The scrotum is a thin-walled sac that is suspended below the pubic bone,
posterior to the penis.
✓ It contains:
- Sweat glands
- Sebaceous glands
- Rugae (Folds of skin)
- Cremaster muscle
✓ Functions:
- Protective covering of the testes, epididymis, and vas deferens
- Helps maintain cooler-than-body temperature for production of sperm
(less than 37°C)
✓ Cremaster muscle
- Helps to the scrotum to maintain temperature control
- The cremaster muscle is sensitive to changes in temperature
✓ Cremasteric Reflex
- The muscle contracts when too cold, raising the scrotum and testes
upward toward the body for warmth
- Causes the wrinkled appearance of the scrotal skin
- When the temperature is warm, the muscle relaxes, lowering the
scrotum and testes away from the heat of the body.
- When the cremaster muscle relaxes, the scrotal skin appears smooth.

II. Internal Genitalia

Testes ✓ Internally the scrotal sac is divided into two portions by a septum, each
portion containing one testis.
✓ The testes are a pair of ovoid-shaped organs, similar to the ovaries in the
woman, that are approximately 3.7 to 5 cm long, 2.5 cm wide, and 2.5 cm
deep.
✓ Tunica Vaginalis
- A serous membrane that covers the testes
- Separated the testis from the scrotal wall
- Double layered and lubricated to protect the testes from injury
✓ Functions:
- Produce spermatozoa
- Produce testosterone

NCM 101: Health Assessment

Topic: Assessment of the Male Genitalia and Rectum
Prepared By: K. Abuan
 Spermatic Cord ✓ The testes are suspended in the scrotum by a spermatic cord.
✓ The spermatic cord on the left side is usually longer; thus the left testis hangs
lower than the right testis.
✓ Secretions from the vas deferens, seminal vesicles, prostate gland, and
Cowper’s (or bulbourethral) glands mix with the sperm and form semen.
✓ It contains:
- Blood vessels
- Lymphatic vessels
- Nerves
- Vas deferens/ Ductus deferens
✓ Vas deferens
- Transports spermatozoa away from the testis
- A firm, muscular tube that is continuous with the lower portion of the
epididymis.
- It travels up within the spermatic cord through the inguinal canal into the
abdominal cavity.
- Provides the passage for transporting sperm from the testes to the urethra
for ejaculation.
✓ Epididymis
- A comma-shaped, coiled, tubular structure that curves up over the upper
and posterior surface of the testis.
- It is within the epididymis that the spermatozoa mature.
✓ Ejaculatory duct
- Empties into the urethra within the prostate gland

III. Inguinal Area

✓ The nurse needs to be familiar with the inguinal or groin area.

✓ Assess for hernias (protrusion of loops of bowel through weak areas of the musculature)
✓ The inguinal area is contained between the anterior superior iliac spine laterally and the symphysis pubis medially.
✓ Inguinal Canal
- Runs diagonally between the anterior superior iliac spine and symphysis pubis.
- A tube-like structure (4–5 cm or 1.5–2 inches long in an adult) through which the vas deferens travels as it passes
through the lower abdomen.
✓ External inguinal ring
- The exterior opening of the inguinal canal, which can be palpated above and lateral to the symphysis pubis.
- It feels triangular and slit-like.
✓ Internal inguinal ring
- Internal opening of the inguinal canal.
- It is located 1 to 2 cm above the midpoint of the inguinal ligament and cannot be palpated.
✓ Femoral Canal
- Potential spot for a hernia.
- Located posterior to the inguinal canal and medial to and running parallel with the femoral artery and vein.

IV. Anus and Rectum

✓ Anal canal
- The final segment of the digestive system.
- It begins at the anal sphincter and ends at the anorectal junction (also known as the pectinate line, mucocutaneous
junction, or dentate line).
- It measures from 2.5 cm to 4 cm long.
- It is lined with skin that contains no hair or sebaceous glands but does contain many somatic sensory nerves,
making it susceptible to painful stimuli.
- The anal canal proceeds upward toward the umbilicus.
✓ Anal opening/ Anal verge
- Can be distinguished from the perianal skin by its hairless, moist appearance.
- Extends interiorly, overlying the external anal sphincter
✓ External Sphincter
- Composed of skeletal muscle and is under voluntary control.
✓ Internal Sphincter
- Composed of smooth muscle and is under involuntary control by the autonomic nervous system.
✓ Intersphincteric Groove
- Dividing the two sphincters.
✓ Anorectal Junction
- Located just above the internal sphincter, not palpable, but may be visualized during internal examination.
NCM 101: Health Assessment
Topic: Assessment of the Male Genitalia and Rectum
Prepared By: K. Abuan
 - The dividing point of the anal canal and the rectum
✓ Rectum
- The rectum is lined with folds of mucosa (columns of Morgagni)
- The lowest portion of the large intestine and is approximately 12 cm long, extending from the end of the sigmoid
colon to the anorectal junction.
- The anal canal and rectum are at approximately right angles to each other.
✓ Anal Crypts
- There are 8 to 12 anal crypts and 5 to 8 papillae.
✓ Valves of Houston
- Three inward foldings inside the rectum
- The function of the valves of Houston is unclear.
- The lowest valve may be felt, usually on the client’s left side.

V. Prostate

✓ The prostate gland is approximately 2.5 to 4 cm in diameter, surrounding the neck of the bladder and urethra
✓ It secretes a thin, milky substance that promotes sperm motility and neutralizes female acidic vaginal secretions.
✓ A chestnut or heart-shaped organ can be palpated through the anterior wall of the rectum.
✓ Median Sulcus
- A shallow groove that separates two lobes of the prostate gland
✓ Seminal Vesicles
- Located on either side of and above the prostate gland
- These are rabbit-ear–shaped structures that produce the ejaculate that nourishes and protects sperm.
- They are not normally palpable.
✓ Cowper’s Glands/ Bulbouretheral Glands
- Mucus-producing, pea-sized organs located posterior to the prostate gland.
- These glands surround and empty into the urethra.
- They are not normally palpable.

NCM 101: Health Assessment

Topic: Assessment of the Male Genitalia and Rectum
Prepared By: K. Abuan