The scrotum is a wrinkled sac composed of skin externally and the superficial fascia of the abdominal wall internally. Its contents include the testis, the epididymis and the distal portion of the spermatic cord. The scrotal raphe is a rough line which runs down the midline of the sac and is the fusion of the bilateral labioscrotal swellings that form during gestation.
The layes of the scrotum are given below, from superficial to deep:
- Superficial ‘Dartos’ fascia
- External spermatic fascia
- Cremaster muscle and fascia
- Internal spermatic fascia
- Parietal layer of tunica vaginalis
- Testis, which is covered by a visceral layer of tunica vaginalis
The anterolateral surface of the scrotum is supplied by the genital branch of the genitofemoral nerve. The anterior scrotal nerves which follow on from the ilioinguinal nerve cover the anterior aspect of the scrotum.
On the opposing posterior surface, the perineal nerves give of the posterior scrotal nerves. Lastly, on the inferior surface of the scrotum, the perineal branches of the posterior femoral cutaneous nerve can be found.
The scrotum is supplied by the superficial and deep external pudendal branches of the femoral artery, the superficial perineal branch of the internal pudendal artery, and the cremasteric branch from the inferior epigastric artery.
These larger vessels give off smaller branches known as:
- Anterior scrotal artery from deep external pudendal artery
- Posterior scrotal artery from internal pudendal artery
The veins follow the course of the corresponding arteries.
The lymphatic drainage is managed by the superficial inguinal lymph nodes, as well as the superficial subinguinal glands and the deep subinguinal glands.