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XI.Splanchnology.3c.TheMaleGenitalOrgans.Gray,Henry.1918.AnatomyoftheHumanBody.

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HenryGray(18211865).AnatomyoftheHumanBody.1918.

3c.TheMaleGenitalOrgans

(OrganaGenitaliaVirilia)
Themalegenitalsincludethetestes,theductusdeferentes,thevesiculseminales,the
ejaculatoryducts,andthepenis,togetherwiththefollowingaccessorystructures,viz.,
theprostateandthebulbourethralglands.

1.TheTestesandtheirCoverings(Figs.1143,1144,1145)Thetestesaretwo
glandularorgans,whichsecretethesementheyaresuspendedinthescrotumbythe
spermaticcords.Atanearlyperiodoffetallifethetestesarecontainedintheabdominal
cavity,behindtheperitoneum.Beforebirththeydescendtotheinguinalcanal,along
whichtheypasswiththespermaticcord,and,emergingatthesubcutaneousinguinalring,
theydescendintothescrotum,becominginvestedintheircoursebycoveringsderived
fromtheserous,muscular,andfibrouslayersoftheabdominalparietes,aswellasbythe
scrotum.
Thecoveringsofthetestesare,the
Skin
Cremaster.
Scrotum.
Dartostunic
Infundibuliformfascia.
Intercruralfascia.
Tunicavaginalis.

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XI.Splanchnology.3c.TheMaleGenitalOrgans.Gray,Henry.1918.AnatomyoftheHumanBody.

FIG. 1143Thescrotum.Ontheleftsidethecavityofthetunicavaginalishasbeenopened

ontherightsideonlythelayerssuperficialtotheCremasterhavebeenremoved.(Testut.)
(Seeenlargedimage)

TheScrotumisacutaneouspouchwhichcontainsthetestesandpartsofthespermatic
cords.Itisdividedonitssurfaceintotwolateralportionsbyaridgeorraph,whichis
continuedforwardtotheundersurfaceofthepenis,andbackward,alongthemiddleline
oftheperineumtotheanus.Ofthesetwolateralportionsthelefthangslowerthanthe
right,tocorrespondwiththegreaterlengthoftheleftspermaticcord.Itsexternalaspect
variesunderdifferentcircumstances:thus,undertheinfluenceofwarmth,andinoldand
debilitatedpersons,itbecomeselongatedandflaccidbut,undertheinfluenceofcold,
andintheyoungandrobust,itisshort,corrugated,andcloselyappliedtothetestes.
Thescrotumconsistsoftwolayers,theintegumentandthedartostunic.
TheIntegumentisverythin,ofabrownishcolor,andgenerallythrownintofoldsor
rug.Itisprovidedwithsebaceousfollicles,thesecretionofwhichhasapeculiarodor,
andisbesetwiththinlyscattered,crisphairs,therootsofwhichareseenthroughtheskin.
TheDartosTunic(tunicadartos)isathinlayerofnonstripedmuscularfibers,
continuous,aroundthebaseofthescrotum,withthetwolayersofthesuperficialfascia
ofthegroinandtheperineumitsendsinwardaseptum,whichdividesthescrotalpouch
intotwocavitiesforthetestes,andextendsbetweentheraphandtheundersurfaceof
thepenis,asfarasitsroot.

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FIG. 1144Thescrotum.Thepenishasbeenturnedupward,andtheanteriorwallofthe

scrotumhasbeenremoved.Ontherightside,thespermaticcord,theinfundibuliform
fascia,andtheCremastermusclearedisplayedontheleftside,theinfundibuliform
fasciahasbeendividedbyalongitudinalincisionpassingalongthefrontofthecordand
thetesticle,andaportionoftheparietallayerofthetunicavaginalishasbeenremovedto
displaythetesticleandaportionoftheheadoftheepididymis,whicharecoveredbythe
viscerallayerofthetunicavaginalis.(Toldt.)(Seeenlargedimage)

Thedartostuniciscloselyunitedtotheskinexternally,butconnectedwiththe
subjacentpartsbydelicateareolartissue,uponwhichitglideswiththegreatestfacility.
TheIntercruralFascia(intercolumnarorexternalspermaticfascia)isathin
membrane,prolongeddownwardaroundthesurfaceofthecordandtestis(seepage411).
Itisseparatedfromthedartostunicbylooseareolartissue.
TheCremasterconsistsofscatteredbundlesofmuscularfibersconnectedtogetherinto
acontinuouscoveringbyintermediateareolartissue(seepage414).
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TheInfundibuliformFascia(tunicavaginaliscommunis[testisetfuniculispermatici])
isathinlayer,whichlooselyinveststhecorditisacontinuationdownwardofthe
transversalisfascia(seepage418).
TheTunicaVaginalisisdescribedwiththetestes.

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FIG. 1145Transversesectionthroughtheleftsideofthescrotumandthelefttestis.The

sacofthetunicavaginalisisrepresentedinadistendedcondition.(Diagrammatic.)
(Delpine.)(Seeenlargedimage)

13
VesselsandNerves.Thearteriessupplyingthecoveringsofthetestesare:the
superficialanddeepexternalpudendalbranchesofthefemoral,thesuperficialperineal
branchoftheinternalpudendal,andthecremastericbranchfromtheinferiorepigastric.
Theveinsfollowthecourseofthecorrespondingarteries.Thelymphaticsendinthe
inguinallymphglands.Thenervesaretheilioinguinalandlumboinguinalbranchesofthe
lumbarplexus,thetwosuperficialperinealbranchesoftheinternalpudendalnerve,and
thepudendalbranchoftheposteriorfemoralcutaneousnerve.
14
TheInguinalCanal(canalisinguinalis)isdescribedonpage418.
TheSpermaticCord(funiculusspermaticus)(Fig.1146)extendsfromtheabdominal
inguinalring,wherethestructuresofwhichitiscomposedconverge,tothebackpartof
thetestis.Intheabdominalwallthecordpassesobliquelyalongtheinguinalcanal,lying
atfirstbeneaththeObliquusinternus,anduponthefasciatransversalisbutnearerthe
pubis,itrestsupontheinguinalandlacunarligaments,havingtheaponeurosisofthe
Obliquusexternusinfrontofit,andtheinguinalfalxbehindit.Itthenescapesatthe
subcutaneousring,anddescendsnearlyverticallyintothescrotum.Theleftcordisrather
longerthantheright,consequentlythelefttestishangssomewhatlowerthanitsfellow.

StructureoftheSpermaticCord.Thespermaticcordiscomposedofarteries,veins,
lymphatics,nerves,andtheexcretoryductofthetestis.Thesestructuresareconnected
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XI.Splanchnology.3c.TheMaleGenitalOrgans.Gray,Henry.1918.AnatomyoftheHumanBody.

togetherbyareolartissue,andinvestedbythelayersbroughtdownbythetestisinits
descent.
Thearteriesofthecordare:theinternalandexternalspermaticsandthearterytothe
ductusdeferens.
Theinternalspermaticartery,abranchoftheabdominalaorta,escapesfromthe
abdomenattheabdominalinguinalring,andaccompaniestheotherconstituentsofthe
spermaticcordalongtheinguinalcanalandthroughthesubcutaneousinguinalringinto
thescrotum.Itthendescendstothetestis,and,becomingtortuous,dividesintoseveral
branches,twoorthreeofwhichaccompanytheductusdeferensandsupplythe
epididymis,anastomosingwiththearteryoftheductusdeferens:theotherssupplythe
substanceofthetestis.
Theexternalspermaticarteryisabranchoftheinferiorepigastricartery.It
accompaniesthespermaticcordandsuppliesthecoveringsofthecord,anastomosing
withtheinternalspermaticartery.
Thearteryoftheductusdeferens,abranchofthesuperiorvesical,isalong,slender
vessel,whichaccompaniestheductusdeferens,ramifyinguponitscoats,and
anastomosingwiththeinternalspermaticarterynearthetestis.

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FIG. 1146Thespermaticcordintheinguinalcanal.(PoirierandCharpy.)(Seeenlarged

image)

Thespermaticveins(Fig.1147)emergefromthebackofthetestis,andreceive
tributariesfromtheepididymis:theyuniteandformaconvolutedplexus,theplexus
pampiniformis,whichformsthechiefmassofthecordthevesselscomposingthis
plexusareverynumerous,andascendalongthecordinfrontoftheductusdeferens
belowthesubcutaneousinguinalringtheyunitetoformthreeorfourveins,whichpass
alongtheinguinalcanal,and,enteringtheabdomenthroughtheabdominalinguinalring,
coalescetoformtwoveins.Theseagainunitetoformasinglevein,whichopensonthe
rightsideintotheinferiorvenacava,atanacuteangle,andontheleftsideintotheleft
renalvein,atarightangle.
Thelymphaticvesselsaredescribedonpage713.
Thenervesarethespermaticplexusfromthesympathetic,joinedbyfilamentsfromthe
pelvicplexuswhichaccompanythearteryoftheductusdeferens.
Thescrotumformsanadmirablecoveringfortheprotectionofthetestes.Thesebodies,
lyingsuspendedandlooseinthecavityofthescrotumandsurroundedbyserous
membrane,arecapableofgreatmobility,andcanthereforeeasilyslipaboutwithinthe
scrotumandthusavoidinjuriesfromblowsorsqueezes.Theskinofthescrotumisvery
elasticandcapableofgreatdistension,andonaccountoftheloosenessandamountof
subcutaneoustissue,thescrotumbecomesgreatlyenlargedincasesofedema,towhich
thispartisespeciallyliableasaresultofitsdependentposition.
TheTestesaresuspendedinthescrotumbythespermaticcords,thelefttestishanging
somewhatlowerthanitsfellow.Theaveragedimensionsofthetestisarefrom4to5cm.
inlength,2.5cm.inbreadth,and3cm.intheanteroposteriordiameteritsweightvaries
from10.5to14gm.Eachtestisisofanovalform(Fig.1148),compressedlaterally,and
havinganobliquepositioninthescrotumtheupperextremityisdirectedforwardanda
littlelateralwardthelower,backwardandalittlemedialwardtheanteriorconvexborder
looksforwardanddownward,theposteriororstraightborder,towhichthecordis
attached,backwardandupward.
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Theanteriorborderandlateralsurfaces,aswellasbothextremitiesoftheorgan,are
convex,free,smooth,andinvestedbytheviscerallayerofthetunicavaginalis.The
posteriorborder,towhichthecordisattached,receivesonlyapartialinvestmentfrom
thatmembrane.Lyinguponthelateraledgeofthisposteriorborderisalong,narrow,
fiattenedbody,namedtheepididymis.

26

FIG. 1147Spermaticveins.(Testut.)(Seeenlargedimage)

FIG. 1148Therighttestis,exposedbylayingopenthetunicavaginalis.(Seeenlarged

image)

Theepididymisconsistsofacentralportionorbodyanupperenlargedextremity,the 27
head(globusmajor)andalowerpointedextremity,thetail(globusminor),whichis
continuouswiththeductusdeferens,theductofthetestis.Theheadisintimately
connectedwiththeupperendofthetestisbymeansoftheefferentductulesofthegland
thetailisconnectedwiththelowerendbycellulartissue,andareflectionofthetunica
vaginalis.Thelateralsurface,headandtailoftheepididymisarefreeandcoveredbythe
serousmembranethebodyisalsocompletelyinvestedbyit,exceptingalongitsposterior
borderwhilebetweenthebodyandthetestisisapouch,namedthesinusofthe
epididymis(digitalfossa).Theepididymisisconnectedtothebackofthetestisbyafold
oftheserousmembrane.

AppendagesoftheTestisandEpididymis.Ontheupperextremityofthetestis,just 28
beneaththeheadoftheepididymis,isaminuteoval,sessilebody,theappendixofthe
testis(hydatidofMorgagni)itistheremnantoftheupperendoftheMllerianduct.On
theheadoftheepididymisisasecondsmallstalkedappendage(sometimesduplicated)it
isnamedtheappendixoftheepididymis(pedunculatedhydatid),andisusually
regardedasadetachedefferentduct.
29
Thetestisisinvestedbythreetunics:thetunicavaginalis,tunicaalbuginea,and
tunicavasculosa.
30
TheTunicaVaginalis(tunicavaginalispropriatestis)istheserouscoveringofthe
testis.Itisapouchofserousmembrane,derivedfromthesaccusvaginalisofthe
peritoneum,whichinthefetusprecededthedescentofthetestisfromtheabdomeninto
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thescrotum.Afteritsdescent,thatportionofthepouchwhichextendsfromthe
abdominalinguinalringtoneartheupperpartoftheglandbecomesobliteratedthelower
portionremainsasashutsac,whichinveststhesurfaceofthetestis,andisreflectedonto
theinternalsurfaceofthescrotumhenceitmaybedescribedasconsistingofavisceral
andaparietallamina.
31
Theviscerallamina(laminavisceralis)coversthegreaterpartofthetestisand
epididymis,connectingthelattertothetestisbymeansofadistinctfold.Fromthe
posteriorborderoftheglanditisreflectedontotheinternalsurfaceofthescrotum.
32
Theparietallamina(laminaparietalis)isfarmoreextensivethanthevisceral,
extendingupwardforsomedistanceinfrontandonthemedialsideofthecord,and
reachingbelowthetestis.Theinnersurfaceofthetunicavaginalisissmooth,andcovered
byalayerofendothelialcells.Theintervalbetweenthevisceralandparietallamin
constitutesthecavityofthetunicavaginalis.
Theobliteratedportionofthesaccusvaginalismaygenerallybeseenasafibrocellular 33
threadlyinginthelooseareolartissuearoundthespermaticcordsometimesthismaybe
tracedasadistinctbandfromtheupperendoftheinguinalcanal,whereitisconnected
withtheperitoneum,downtothetunicavaginalissometimesitgraduallybecomeslost
onthespermaticcord.Occasionallynotraceofitcanbedetected.Insomecasesit
happensthatthepouchofperitoneumdoesnotbecomeobliterated,butthesacofthe
peritoneumcommunicateswiththetunicavaginalis.Thismaygiverisetooneofthe
varietiesofobliqueinguinalhernia(page1187).Inothercasesthepouchmaycontract,
butnotbecomeentirelyobliterateditthenformsaminutecanalleadingfromthe
peritoneumtothetunicavaginalis.
TheTunicaAlbugineaisthefibrouscoveringofthetestis.Itisadensemembrane,ofa 34
bluishwhitecolor,composedofbundlesofwhitefibroustissuewhichinterlaceinevery
direction.Itiscoveredbythetunicavaginalis,exceptatthepointsofattachmentofthe
epididymistothetestis,andalongitsposteriorborder,wherethespermaticvesselsenter
thegland.Itisappliedtothetunicavasculosaovertheglandularsubstanceofthetestis,
and,atitsposteriorborder,isreflectedintotheinteriorofthegland,formingan
incompleteverticalseptum,calledthemediastinumtestis(corpusHighmori).
Themediastinumtestisextendsfromtheuppertonearthelowerextremityofthe
gland,andiswiderabovethanbelow.Fromitsfrontandsidesnumerousimperfectsepta
(trabecul)aregivenoff,whichradiatetowardthesurfaceoftheorgan,andareattached
tothetunicaalbuginea.Theydividetheinterioroftheorganintoanumberofincomplete
spaceswhicharesomewhatconeshaped,beingbroadattheirbasesatthesurfaceofthe
gland,andbecomingnarrowerastheyconvergetothemediastinum.Themediastinum
supportsthevesselsandductofthetestisintheirpassagetoandfromthesubstanceof
thegland.
TheTunicaVasculosaisthevascularlayerofthetestis,consistingofaplexusof
bloodvessels,heldtogetherbydelicateareolartissue.Itclothestheinnersurfaceofthe
tunicaalbugineaandthedifferentseptaintheinteriorofthegland,andthereforeforms
aninternalinvestmenttoallthespacesofwhichtheglandiscomposed.

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XI.Splanchnology.3c.TheMaleGenitalOrgans.Gray,Henry.1918.AnatomyoftheHumanBody.

FIG. 1149Verticalsectionofthetestis,toshowthearrangementoftheducts.(See

enlargedimage)

37
Structure.Theglandularstructureofthetestisconsistsofnumerouslobules.Their
number,inasingletestis,isestimatedbyBerresat250,andbyKrauseat400.They
differinsizeaccordingtotheirposition,thoseinthemiddleoftheglandbeinglargerand
longer.Thelobules(Fig.1149)areconicalinshape,thebasebeingdirectedtowardthe
circumferenceoftheorgan,theapextowardthemediastinum.Eachlobuleiscontainedin
oneoftheintervalsbetweenthefibrousseptawhichextendbetweenthemediastinum
testisandthetunicaalbuginea,andconsistsoffromonetothree,ormore,minute
convolutedtubes,thetubuliseminiferi.Thetubulesmaybeseparatelyunravelled,by
carefuldissectionunderwater,andmaybeseentocommenceeitherbyfreececalendsor
byanastomoticloops.Theyaresupportedbylooseconnectivetissuewhichcontainshere
andtheregroupsofinterstitialcellscontainingyellowpigmentgranules.Thetotal
numberoftubulesisestimatedbyLauthat840,andtheaveragelengthofeachis70to80
cm.Theirdiametervariesfrom0.12to0.3mm.Thetubulesarepaleincolorinearlylife,
butinoldagetheyacquireadeepyellowtingefromcontainingmuchfattymatter.Each
tubuleconsistsofabasementlayerformedoflaminatedconnectivetissuecontaining
numerouselasticfiberswithflattenedcellsbetweenthelayersandcoveredexternallyby
alayerofflattenedepithelioidcells.Withinthebasementmembraneareepithelialcells
arrangedinseveralirregularlayers,whicharenotalwaysclearlyseparated,butwhich
maybearrangedinthreedifferentgroups(Fig.1150).Amongthesecellsmaybeseenthe
spermatozoaindifferentstagesofdevelopment.(1)Liningthebasementmembraneand
formingtheouterzoneisalayerofcubicalcells,withsmallnucleisomeoftheseenlarge
tobecomespermatogonia.Thenucleiofsomeofthespermatogoniamaybeseentobe
inprocessofindirectdivision(karyokineses,page37),andinconsequenceofthis
daughtercellsareformed,whichconstitutethesecondzone.(2)Withinthisfirstlayeris
tobeseenanumberoflargerpolyhedralcells,withclearnuclei,arrangedintwoorthree
layersthesearetheintermediatecellsorspermatocytes.Mostofthesecellsareina
conditionofkaryokineticdivision,andthecellswhichresultfromthisdivisionform
thoseofthenextlayer,thespermatoblastsorspermatids.(3)Thethirdlayerofcells
consistsofthespermatoblastsorspermatids,andeachofthese,withoutfurther
subdivision,becomesaspermatozon.Thespermatidsaresmallpolyhedralcells,the
nucleusofeachofwhichcontainshalftheusualnumberofchromosomes.Inadditionto
thesethreelayersofcellsothersareseen,whicharetermedthesupportingcells(cellsof
Sertoli).Theyareelongatedandcolumnar,andprojectinwardfromthebasement
membranetowardthelumenofthetube.Asdevelopmentofthespermatozoaproceeds
thelattergroupthemselvesaroundtheinnerextremitiesofthesupportingcells.The
nuclearportionofthespermatid,whichispartlyimbeddedinthesupportingcell,is
differentiatedtoformtheheadofthespermatozon,whilepartofthecellprotoplasm
formsthemiddlepieceandthetailisproducedbyanoutgrowthfromthedoublecentriole
ofthecell.Ultimatelytheheadsareliberatedandthespermatozoaaresetfree.The
structureofthespermatozoaisdescribedonpages42,43.
Intheapicesofthelobules,thetubulesbecomelessconvoluted,assumeanearly
straightcourse,andunitetogethertoformfromtwentytothirtylargerducts,ofabout0.5
mm.indiameter,andthese,fromtheirstraightcourse,arecalledtubulirecti(Fig.1149).

38

FIG. 1150Transversesectionofatubuleofthetestisofarat.X250.(Seeenlargedimage)

39
Thetubulirectienterthefibroustissueofthemediastinum,andpassupwardand
backward,forming,intheirascent,aclosenetworkofanastomosingtubeswhichare
merelychannelsinthefibrousstroma,linedbyflattenedepithelium,andhavingno
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properwallsthisconstitutestheretetestis.Attheupperendofthemediastinum,the
vesselsoftheretetestisterminateinfromtwelvetofifteenortwentyducts,theductuli
efferentestheyperforatethetunicaalbuginea,andcarrytheseminalfluidfromthetestis
totheepididymis.Theircourseisatfirststraighttheythenbecomeenlarged,and
exceedinglyconvoluted,andformaseriesofconicalmasses,theconivasculosi,which
togetherconstitutetheheadoftheepididymis.Eachconeconsistsofasingleconvoluted
duct,from15to20cm.inlength,thediameterofwhichgraduallydecreasesfromthe
testistotheepididymis.Oppositethebasesoftheconestheefferentvesselsopenat
narrowintervalsintoasingleduct,whichconstitutes,byitscomplexconvolutions,the
bodyandtailoftheepididymis.Whentheconvolutionsofthistubeareunravelled,it
measuresupwardof6metersinlengthitincreasesindiameterandthicknessasit
approachestheductusdeferens.Theconvolutionsareheldtogetherbyfineareolartissue,
andbybandsoffibroustissue.

FIG. 1151Sectionofepididymisofguineapig.X255.(Seeenlargedimage)

Thetubulirectihaveverythinwallslikethechannelsoftheretetestistheyarelinedby 40
asinglelayerofflattenedepithelium.Theductuliefferentesandthetubeofthe
epididymishavewallsofconsiderablethickness,onaccountofthepresenceinthemof
musculartissue,whichisprincipallyarrangedinacircularmanner.Thesetubesarelined
bycolumnarciliatedepithelium(Fig.1151).

Peculiarities.Thetestis,developedinthelumbarregion,maybearrestedordelayedin 41
itstransittothescrotum(cryptorchism).Itmayberetainedintheabdomenoritmaybe
arrestedattheabdominalinguinalring,orintheinguinalcanaloritmayjustpassoutof
thesubcutaneousinguinalringwithoutfindingitswaytothebottomofthescrotum.
Whenretainedintheabdomenitgivesrisetonosymptoms,otherthantheabsenceofthe
testisfromthescrotumbutwhenitisretainedintheinguinalcanalitissubjectedto
pressureandmaybecomeinflamedandpainful.Theretainedtestisisprobably
functionallyuselesssothatamaninwhombothtestesareretained(anorchism)issterile,
thoughhemaynotbeimpotent.Theabsenceofonetestisistermedmonorchism.Whena
testisisretainedintheinguinalcanalitisoftencomplicatedwithacongenitalhernia,the
funicularprocessoftheperitoneumnotbeingobliterated.Inadditiontothecasesabove
described,wherethereissomearrestinthedescentofthetestis,thisorganmaydescend
throughtheinguinalcanal,butmaymissthescrotumandassumesomeabnormal
position.Themostcommonformiswherethetestis,emergingatthesubcutaneous
inguinalring,slipsdownbetweenthescrotumandthighandcomestorestinthe
perineum.Thisisknownasperinealectopiatestis.Witheachvarietyofabnormalityin
thepositionofthetestis,itisverycommontofindconcurrentlyacongenitalhernia,or,if
aherniabenotactuallypresent,thefunicularprocessisusuallypatent,andalmost
invariablysoifthetestisisintheinguinalcanal.
Thetestis,finallyreachingthescrotum,mayoccupyanabnormalpositioninit.Itmay 42
beinverted,sothatitsposteriororattachedborderisdirectedforwardandthetunica
vaginalisissituatedbehind.
43
Fluidcollectionsofaserouscharacterareveryfrequentlyfoundinthescrotum.To
thesethetermhydroceleisapplied.Themostcommonformistheordinaryvaginal
hydrocele,inwhichthefluidiscontainedinthesacofthetunicavaginalis,whichis
separated,initsnormalcondition,fromtheperitonealcavitybythewholeextentofthe
inguinalcanal.Inanotherform,thecongenitalhydrocele,thefluidisinthesacofthe
tunicavaginalis,butthiscavitycommunicateswiththegeneralperitonealcavity,its
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XI.Splanchnology.3c.TheMaleGenitalOrgans.Gray,Henry.1918.AnatomyoftheHumanBody.

tubularprocessremainingpervious.Athirdvarietyknownasaninfantilehydrocele,
occursinthosecaseswherethetubularprocessbecomesobliteratedonlyatitsupperpart,
atorneartheabdominalinguinalring.Itresemblesthevaginalhydrocele,exceptas
regardsitsshape,thecollectionoffluidextendingupthecordintotheinguinalcanal.
Fourthly,thefunicularprocessmaybecomeobliteratedbothattheabdominalinguinal
ringandabovetheepididymis,leavingacentralunobliteratedportion,whichmay
becomedistendedwithfluid,givingrisetoaconditionknownastheencystedhydrocele
ofthecord.
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