Testicle

The testicle (from Latin testiculus, diminutive of testis, meaning "witness"

of virility, plural testes) is the male gonad in animals. Like the ovaries to which
they are homologous, testes are components of both the reproductive
system and the endocrine system. The primary functions of the testes are to
produce sperm (spermatogenesis)
and
to
produce androgens,
primarily
testosterone.
Both functions of the testicle are influenced by gonadotropic hormones produced
by the anterior pituitary. Luteinizing hormone (LH) results in testosterone
release.
The
presence
of
both
testosterone
and follicle-stimulating
hormone (FSH) is needed to support spermatogenesis. It has also been shown in
animal studies that if testes are exposed to either too high or too low levels
of estrogens(such as estradiol; E2) spermatogenesis can be disrupted to such an
extent that the animals become infertile.

Structure
External appearance
Almost all healthy male vertebrates have two testicles. They are typically of
similar size, although in sharks, that on the right side is usually larger, and in
many bird and mammal species, the left may be the larger. The primitive jawless
fish have only a single testis, located in the midline of the body, although even
this forms from the fusion of paired structures in the embryo.
The testicles of a dromedary camel are 710 cm (2.83.9 in) long, 4.5 cm (1.8 in)
deep and 5 cm (2.0 in) in width. The right testicle is often smaller than the
left. The testicles of a male red fox attain their greatest weight in December
February. Spermatogenesis in male golden jackals occurs 1012 days before the
females enter estrus and, during this time, males' testicles triple in weight.
In mammals, the testes are often contained within an extension of
the abdomen called the scrotum. In mammals with external testes it is most
common for one testicle to hang lower than the other. While the size of the
testicle varies, it is estimated that 21.9% of men have their higher testicle being
their left, while 27.3% of men have reported to have equally positioned
testicles. This is due to differences in the vascular anatomical structure on the
right and left sides.
In healthy European adult humans, average testicular volume is 18 cm per
testis, with normal size ranging from 12 cm to 30 cm.The average testicle size
after puberty measures up to around 2 inches long, 0.8 inches in breadth, and
1.2 inches in height (5 x 2 x 3 cm). Measurement in the living adult is done in
two basic ways:
comparing the testicle with ellipsoids of known sizes (orchidometer).
measuring the length, depth and width with a ruler, a pair of calipers
or ultrasound imaging.
The volume is then calculated using the formula for the volume of an ellipsoid:
4/3 (length/2) (width/2) (depth/2).

Human testicles are smaller than chimpanzee testicles but larger than gorilla
testicles.

Diagram of male (human) testicles

Internal structure
Duct system
Under a tough membranous shell, the tunica albuginea, the testis of amniotes and
some teleost fish, contains very fine coiled tubes called seminiferous tubules. The
tubules are lined with a layer of cells ( germ cells) that frompuberty into old age,
develop into sperm cells (also known as spermatozoa or male gametes). The
developing sperm travel through the seminiferous tubules to the rete
testis located in the mediastinum testis, to the efferent ducts, and then to
the epididymis where newly created sperm cells mature (see spermatogenesis). The
sperm move into the vas deferens, and are eventually expelled through
the urethra and out of the urethral orifice through muscular contractions.
Amphibians and most fish do not possess seminiferous tubules. Instead, the
sperm are produced in spherical structures called sperm ampullae. These are
seasonal structures, releasing their contents during the breeding season, and
then being reabsorbed by the body. Before the next breeding season, new sperm
ampullae begin to form and ripen. The ampullae are otherwise essentially
identical to the seminiferous tubules in higher vertebrates, including the same
range of cell types.

Primary cell types

Within the seminiferous tubules

Here, germ
cells develop
into spermatogonia, spermatocytes, spermatids and spermatozoon through
the
process of spermatogenesis. The gametes contain DNA for fertilization of an
ovum
Sertoli cells the true epithelium of the seminiferous epithelium, critical for the
support of germ cell development into spermatozoa. Sertoli cells secrete inhibin.
Peritubular myoid cells surround the seminiferous tubules.

Between tubules (interstitial cells)

Leydig cells cells localized between seminiferous tubules that produce and
secrete testosterone and
other androgens important
for sexual
development and puberty, secondary sexual characteristics like facial hair, sexual
behavior and libido, supporting spermatogenesis and erectile function. Testosterone

also controls testicular volume.

Also present are:
Immature Leydig cells
Interstitial macrophages and epithelial cells.
Blood supply and lymphatic drainage
Blood supply and lymphatic drainage of the testes and scrotum are distinct:
The paired testicular arteries arise directly from the abdominal aorta and descend
through the inguinal canal, while the scrotum and the rest of the external genitalia
is supplied by the internal pudendal artery (itself a branch of the internal iliac artery).
The testis has collateral blood supply from 1. the cremasteric artery (a branch of
the inferior epigastric artery, which is a branch of the external iliac artery), and 2.
the artery to the ductus deferens (a branch of the inferior vesical artery, which is a
branch of the internal iliac artery). Therefore, if the testicular artery is ligated, e.g.,
during a Fowler-Stevens orchiopexy for a high undescended testis, the testis will

usually survive on these other blood supplies.

Lymphatic drainage of the testes follows the testicular arteries back to
the paraaortic lymph nodes, while lymph from the scrotum drains to the inguinal
lymph nodes.

Layers
Many anatomical features of the adult testis reflect its developmental origin in
the abdomen. The layers of tissue enclosing each testicle are derived from the
layers of the anterior abdominal wall. Notably, the cremasteric muscle arises from
the internal oblique muscle.

The bloodtestis barrier

Large molecules cannot pass from the blood into the lumen of a seminiferous
tubule due to the presence of tight junctions between adjacent Sertoli cells. The
spermatogonia are in the basal compartment (deep to the level of the tight
junctions) and the more mature forms such as primary and secondary
spermatocytes and spermatids are in the adluminal compartment.
The function of the bloodtestis barrier (red highlight in diagram above) may be to
prevent an auto-immune reaction. Mature sperm (and their antigens) arise long
after immune tolerance is established in infancy. Therefore, since sperm are
antigenically different from self tissue, a male animal can react immunologically
to his own sperm. In fact, he is capable of making antibodies against them.

Injection of sperm antigens causes inflammation of the testis (auto-immune

orchitis) and reduced fertility. Thus, the bloodtestis barrier may reduce the
likelihood that sperm proteins will induce an immune response, reducing fertility
and so progeny.

Temperature regulation
The testes work best at temperatures slightly less than core body
temperature. The spermatogenesis is less efficient at lower and higher
temperatures than 33 C. This is presumably why the testes are located outside
the body. There are a number of mechanisms to maintain the testes at the
optimum temperature.

Cremasteric muscle
The cremasteric muscle is part of the spermatic cord. When this muscle contracts,
the cord is shortened and the testicle is moved closer up toward the body, which
provides slightly more warmth to maintain optimal testicular temperature. When
cooling is required, the cremasteric muscle relaxes and the testicle is lowered
away from the warm body and is able to cool. It also occurs in response to stress
(the testicles rise up toward the body in an effort to protect them in a fight).
There are persistent reports that relaxation indicates approach of orgasm.There
is a noticeable tendency to also retract during orgasm.
The cremaster muscle can reflexively raise each testicle individually if properly
triggered. This phenomenon is known as the cremasteric reflex. The testicles can
also be lifted voluntarily using the pubococcygeus muscle, which partially
activates related muscles.

Inner workings of the testicles.

Clinical significance
Protection and injury
The testicles are well-known to be very sensitive to impact and injury. The pain
involved travels up from each testicle into the abdominal cavity, via the spermatic
plexus, which is the primary nerve of each testicle. This will cause pain in the hip
and the back. The pain usually goes away in a few minutes.
Testicular torsion is a medical emergency. Treatment within 46 hours of onset can
prevent necrosis of the testis.
Testicular rupture is a medical emergency caused by blunt force impact, sharp
edge, or piercing impact to one or both testicles, which can lead to necrosis of
the testis in as little as 30 minutes.
Penetrating injuries to the scrotum may cause castration, or physical separation
or destruction of the testes, possibly along with part or all of the penis, which
results in total sterility if the testicles are not reattached quickly.
Some jockstraps are designed to provide support to the testicles.

Diseases and conditions that affect the testes

Some prominent conditions and differential diagnoses include:

Testicular cancer and other neoplasms To improve the chances of catching possible
cases of testicular cancer or other health issues early, regular testicular selfexamination is recommended.
Varicocele, swollen vein(s) from the testes, usually affecting the left side, [ the

testis usually being normal

Hydrocele testis, swelling around testes caused by accumulation of clear liquid
within a membranous sac, the testis usually being normal
Endocrine disorders can also affect the size and function of the testis.
Certain inherited conditions involving mutations in key developmental genes also
impair testicular descent, resulting in abdominal or inguinal testes which remain
nonfunctional and may become cancerous. Other genetic conditions can result in
the loss of the Wolffian ducts and allow for the persistence of Mllerian ducts.
Bell-clapper deformity is a deformity in which the testicle is not attached to the
scrotal walls, and can rotate freely on the spermatic cord within the tunica
vaginalis. It is the most common underlying cause of testicular torsion.
Epididymitis, a painful inflammation of the epididymis or epididymides frequently
caused by bacterial infection but sometimes of unknown origin.

Ovary

The ovary (From Latin: ovarium, literally "egg" or "nut") is an ovum-producing

reproductive organ, often found in pairs in the female as part of
the vertebrate female reproductive system. Birds have only one functional ovary
(the left), while the other remains vestigial. Ovaries in females are analogous
to testes in males, in that they are both gonads and endocrine glands. Although
ovaries occur in a wide variety of animals, both vertebrate and invertebrate, this
article is primarily about human ovaries.

Structure
In the case of human ovaries, each one is whitish in color and located alongside
the lateral wall of the uterus in a region called the ovarian fossa. The fossa usually
lies beneath the external iliac artery and in front of theureter and the internal iliac
artery. It is about 4 cm x 3 cm x 2 cm in size.[1]
Usually, ovulation occurs in one of the two ovaries (at random) releasing a
fertilizable egg each menstrual cycle; however, if there was a case where one
ovary was absent or dysfunctional then the other ovary would continue providing
eggs to be released without any changes in cycle length or frequency.

ovarian arteries".

Ligaments
In humans the paired ovaries lie within the pelvic cavity, on either side of the uterus, to
which they are attached via a fibrous cord called the ovarian ligament. The ovaries are
uncovered in the peritoneal cavity but are tethered to the body wall via the suspensory
ligament of the ovary which is posterior extension of broad ligament of the uterus. The
part of the broad ligament of the uterus that covers the ovary is known as
the mesovarium. The ovary is thus considered an intraperitoneal organ.

Extremities
There are two extremities to the ovary:
The end to which the fallopian tube attaches is called the tubal extremity and
ovary is connected to it by infundibulopelvic ligament.
The other extremity is called the uterine extremity. It points downward, and it is
attached to the uterus via the ovarian ligament.

Function
Gamete production
The ovaries are the site of production and periodical release of egg cells, the female
gametes. In the ovaries, the developing egg cell (or oocyte) grows within the
environment provided by follicles. Follicles are composed of different types and number
of cells according to the stage of their maturation, and their size is indicative of the stage
of oocyte development.[4]:833
When the oocyte finishes its maturation in the ovary, a surge of luteinizing
hormone secreted by the pituitary gland stimulates the release of the oocyte through the
rupture of the follicle, a process called ovulation.[5] The follicle remains functional and
reorganizes into a corpus luteum, which secretes progesterone in order to prepare
the uterus for an eventual implantation of the embryo.[4]:839

Endocrine function
Ovaries
secrete estrogen, testosterone[6][7] and progesterone.[8] In
women,
fifty
percent of testosterone is produced by the ovaries and adrenal glands and
released directly into the blood stream. [9] Estrogen is responsible for the
appearance of secondary sex characteristics for females at puberty and for the
maturation and maintenance of the reproductive organs in their mature
functional state. Progesterone prepares the uterus for pregnancy, and the
mammary glands for lactation. Progesterone functions with estrogen by
promoting menstrual cycle changes in the endometrium.

Ovarian aging
As women age, they experience a decline in reproductive performance leading
to menopause. This decline is tied to a decline in the number of ovarian follicles.
Although about 1 million oocytes are present at birth in the human ovary, only
about 500 (about 0.05%) of these ovulate, and the rest are wasted. The decline
in ovarian reserve appears to occur at a constantly increasing rate with age, ] and
leads to nearly complete exhaustion of the reserve by about age 52. As ovarian
reserve and fertility decline with age, there is also a parallel increase in
pregnancy failure and meiotic errors resulting in chromosomally abnormal
conceptions.

Women with an inherited mutation in the DNA repair gene BRCA1 undergo
menopause prematurely, suggesting that naturally occurring DNA damages in
oocytes are repaired less efficiently in these women, and this inefficiency leads
to early reproductive failure. The BRCA1 protein plays a key role in a type of DNA
repair termed homologous recombinational repair that is the only known cellular
process that can accurately repair DNA double-strand breaks. Titus et al. showed
that DNA double-strand breaks accumulate with age in humans and mice in
primordial follicles. Primordial follicles contain oocytes that are at an
intermediate (prophase I) stage of meiosis. Meiosis is the general process in
eukaryotic organisms by which germ cells are formed, and it is likely an
adaptation for removing DNA damages, especially double-strand breaks, from
germ line DNA. (see Meiosis and Origin and function of meiosis). Homologous
recombinational repair is especially promoted during meiosis. Titus et al. also
found that expression of 4 key genes necessary for homologous recombinational
repair of DNA double-strand breaks (BRCA1, MRE11, RAD51 and ATM) decline
with age in the oocytes of humans and mice. They hypothesized that DNA
double-strand break repair is vital for the maintenance of oocyte reserve and
that a decline in efficiency of repair with age plays a key role in ovarian aging.

Clinical significance
Ovarian diseases can be classified as endocrine disorders or as a
disorders of the reproductive system.
If the egg fails to release from the follicle in the ovary an ovarian
cyst may form. Small ovarian cysts are common in healthy
women. Some women have more follicles than usual (polycystic
ovary syndrome), which inhibits the follicles to grow normally and
this will cause cycle irregularities.