By Roger P. Smith, Paul J. Turek
Netter assortment Reproductive approach
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Extra info for The Netter Collection of Medical Illustrations, Vol. 1 Reproductive System
Sample text
As the major leaf of Colles fascia nears the upper scrotal cavity, it divides near the anterior margin of the Tunica albuginea of corpus spongiosum scrotum, with a portion extending inward (see Plate 2-3). This so-called deep layer passes posteriorly, deep to the bulbospongiosus muscles, whereas the major leaf of Colles fascia in the perineal region is entirely superficial to the bulbospongiosus and ischiocavernosus muscles. The deep leaf of Colles fascia lying beneath the bulbospongiosus muscle, together with the superficial or major layer of fascia, forms a compartment for the bulbospongiosus muscle.
The perineal branch supplies somatic motor function to the bulbospongiosus and ischiocavernosus muscles and also to the muscles of the urogenital diaphragm, including the sphincter urethrae (external sphincter). These muscles are important for somatic nervous system control of expulsion of the ejaculate that occurs with ejaculation. Sensory branches of this nerve are distributed to the skin of the penis (dorsal nerve of the penis), perineum, and posterior scrotum (see Plate 2-11).
Females with clitoral enlargement mature normally and have normal fertility, as there is almost total regression of the genital anomaly. Surgical correction of labioscrotal fusion is also a relatively simple procedure if needed. A much rarer cause of clitoromegaly is Fraser syndrome, characterized by defects including underdevelopment of the eyes (cryptophthalmos) and linked to the gene FRAS1, which may be involved in skin epithelial morphogenesis. Müllerian agenesis (Mayer–Rokitansky–Küster– Hauser [MRKH] syndrome) is a congenital malformation characterized by a failure of the müllerian ducts to develop, resulting in a missing uterus and variable malformations of the vagina.