Overview
A tubular structure suspending the testes and epididymis in the scrotum, and conveying neurovascular and reproductive structures to it.
Course
- Formed at the deep inguinal ring of the inguinal canal, located above the midpoint of the inguinal ligament, lateral to the epigastric vessels
- The ring is created by the transversalis fascia, which invaginates to form a covering of the contents of the inguinal canal.
- The cord passes through the inguinal canal, entering the scrotum via the superficial inguinal ring
- Terminates at the posterior border of the testes, where it’s contents are disperses.
Coverings
The contents of the spermatic cord are bound together by three fascial layers derived from the anterior abdominal wall:
- External spermatic fascia – derived from the external oblique aponeurosis
- Cremaster muscle and fascia – derived from the internal oblique muscle and aponeurosis.
- Internal spermatic fascia – derived from the transversalis fascia.
The three fascial layers themselves are covered by a layer of superficial fascia, which lies directly below the scrotal skin.
Contents
Blood vessels
- Testicular artery – branch of the abdominal aorta that arises just inferiorly to the renal arteries at the level of L2
- Cremasteric artery and vein – branch of the inferior epigastric artery (derived from external iliac artery), supplies the cremasteric fascia and muscle
- Artery to the vas deferens – branch of the superior vesicle artery, which arises from the anterior division of the internal iliac artery.
- Pampiniform plexus of testicular veins – drains venous blood from the testes into the testicular vein
- The right testicular vein empties into the inferior vena cava
- The left testicular vein empties into the left renal vein
Nerves
- Genital branch of the genitofemoral nerve (L1, L2) – branch of the lumbar plexus, supplies the cremasteric muscle.
- Cremasteric nerve
- Autonomic nerves
Other structures
- Vas deferens – the duct that transports sperm from the epididymis to the ampulla (a dilated terminal part of the duct)
- Processus vaginalis – projection of peritoneum that forms the pathway of descent for the testes during embryonic development but fuses as an adult.
- Lymph vessels – these drain into the para-aortic nodes, located in the lumbar region.
Anatomical Variants
- Paradidymis
- Persistent processus vaginalis
- Artery to the vas deferens supplied by inferior vesical artery