Cremaster muscle

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Cremaster muscle
Gray1143.png
The cremaster muscle appears as a thin layer just superficial to the tunica vaginalis
Details
Origin Internal oblique
Insertion Tunica vaginalis
Artery Cremasteric artery
Nerve Genital branch of genitofemoral nerve
Actions Raise and lower the scrotum
Identifiers
Latin musculus cremaster
TA98 A04.5.01.018M
A09.3.04.003
TA2 2374, 3617
FMA 21531
Anatomical terms of muscle

The cremaster muscle is a paired structure made of thin layers of striated and smooth muscle that covers the testicles and the spermatic cords in human males. It consists of the lateral and medial parts. Cremaster is an involuntary muscle, responsible for the cremasteric reflex; a protective and physiologic superficial reflex of the testicles. The reflex raises and lowers the testicles in order to keep them protected. Along with the dartos muscle of the scrotum, it regulates testicular temperature, thus aiding the process of spermatogenesis. [1]

Contents

Structure

In human males, the cremaster muscle is a thin layer of striated muscle found in the inguinal canal and scrotum between the external and internal layers of spermatic fascia, surrounding the testis and spermatic cord. The cremaster muscle is a paired structure, there being one on each side of the body. [1]

Anatomically, the lateral cremaster muscle originates from the internal oblique muscle, just superior to the inguinal canal, and the middle of the inguinal ligament. The medial cremaster muscle, which sometimes is absent, originates from the pubic tubercle and sometimes the lateral pubic crest. Both insert into the tunica vaginalis underneath the testis.

Blood supply

The cremaster muscle is supplied by the cremasteric artery, a branch of the inferior epigastric artery, along with anastomotic flow from the other arteries supplying the scrotum. [1]

Nerve supply

The cremaster muscle is innervated from the sensory and motor fibers of the genitofemoral nerve that originates from the L1 and L2 spinal nerve nuclei. It receives distinctly different innervation and vascular supply in comparison to the internal oblique.

Development

The cremaster muscle develops to its full extent only in males; in females, the muscle is smaller and is found on the round ligament, where it is represented by only a few muscle loops.

In rats, it has been shown that cremaster muscles developed from the gubernacular bulb. [2]

Function

Retraction

The cremaster muscle's function is to raise and lower the testes in order to regulate scrotal temperature for optimal spermatogenesis and survival of the resultant spermatozoa. The ideal temperature for human sperm development is around 34 degrees Celsius, which is about 4 degrees Celsius below body temperature. [3] Temperature is regulated by increasing or decreasing the exposed surface area of the surrounding tissue, allowing faster or slower dissipation of body heat. The amount of retraction or relaxation is directly related to how far the environmental temperatures are from the ideal. [3] Cremaster works alongside the dartos muscle in order to maintain homeostasis for the reproductive organs and protect them from physical damage. When a man is cold or sexually stimulated, the dartos muscle causes the scrotum to become more wrinkled and smaller as it is retracted closer to the body. In warmer conditions, the dartos allows for less wrinkling and the scrotum becomes looser. [4]

The cremaster muscle is an involuntary muscle and contraction can occur during arousal which can prevent injury to the testicles during sexual intercourse. [3] Contraction also occurs during orgasm and ejaculation. [5] The muscle may contract during moments of extreme fear, possibly to help avoid injuring the testes while dealing with a fight or flight situation. [1]

Clinically, a reflex arc termed the cremasteric reflex can be demonstrated by lightly stroking the skin of the inner thigh downwards from the hip towards the knee. This stimulates the sensory fibers of the ilioinguinal nerve, which enters the spinal cord at L1. The sensory fibers stimulate the motor fibers of the genital branch of the genitofemoral nerve (also at spinal level L1), which provides innervation to the cremaster muscles causing the contraction of the muscle and elevation of the testes. This causes the cremaster muscle on the same side to rapidly contract, raising the testicle. [6]

The cremaster can also be contracted voluntarily, by performing Kegels (which somehow contracts the cremaster), or by flexing and tightening the abdominal muscles. [3]

Clinical significance

The cremaster muscle occasionally experiences painful spasms or cramps in adult males which can be chronic and debilitating. Treatment for these spasms ranges from minor surgery to injection with Botulinum A toxin to the regular application of heat to relax the muscle. Surgery, including the excision of the cremaster muscle, has apparently been able to provide complete relief from this condition without significant side effects. [7] [8]

Etymology

The name of the cremaster muscle is derived from the Ancient Greek noun κρεμαστήρ (kremastḗr), meaning "suspender"; its plural, κρεμᾰστῆρες (kremastēres), was used by Galen in the sense of "cremaster muscle". [9]

Additional images

Related Research Articles

<span class="mw-page-title-main">Testicle</span> Internal organ in the male reproductive system

A testicle or testis is the male gonad in all bilaterians, including humans. It is homologous to the female ovary. The functions of the testicles are to produce both sperm and androgens, primarily testosterone. Testosterone release is controlled by the anterior pituitary luteinizing hormone, whereas sperm production is controlled both by the anterior pituitary follicle-stimulating hormone and gonadal testosterone.

Articles related to anatomy include:

<span class="mw-page-title-main">Testicular torsion</span> Medical condition

Testicular torsion occurs when the spermatic cord twists, cutting off the blood supply to the testicle. The most common symptom in children is sudden, severe testicular pain. The testicle may be higher than usual in the scrotum and vomiting may occur. In newborns, pain is often absent and instead the scrotum may become discolored or the testicle may disappear from its usual place.

<span class="mw-page-title-main">Spermatic cord</span> Structure in the human male reproductive system

The spermatic cord is the cord-like structure in males formed by the vas deferens and surrounding tissue that runs from the deep inguinal ring down to each testicle. Its serosal covering, the tunica vaginalis, is an extension of the peritoneum that passes through the transversalis fascia. Each testicle develops in the lower thoracic and upper lumbar region and migrates into the scrotum. During its descent it carries along with it the vas deferens, its vessels, nerves etc. There is one on each side.

<span class="mw-page-title-main">Inguinal canal</span> Human abdominal anatomy

The inguinal canal is a passage in the anterior abdominal wall on each side of the body, which in males, convey the spermatic cords and in females, the round ligament of the uterus. The inguinal canals are larger and more prominent in males.

<span class="mw-page-title-main">Cremasteric reflex</span> Human reflex affecting the testicles

The cremasteric reflex is a superficial reflex observed in human males.

<span class="mw-page-title-main">Genitofemoral nerve</span>

The genitofemoral nerve is a mixed branch of the lumbar plexus derived from anterior rami of L1-L2. It splits a genital branch and a femoral branch. It provides sensory innervation to the upper anterior thigh, as well as the skin of the anterior scrotum in males and mons pubis in females. It also provides motor innervation to the cremaster muscle.

<span class="mw-page-title-main">Dartos fascia</span> Layer of tissue

The dartos fascia, dartos tunic or simply dartos is a layer of connective tissue found in the penile shaft, foreskin and scrotum. The penile portion is referred to as the superficial fascia of penis or the subcutaneous tissue of penis, while the scrotal part is the dartos proper. In addition to being continuous with itself between the scrotum and the penis, it is also continuous with Colles' fascia of the perineum and Scarpa's fascia of the abdomen.

<span class="mw-page-title-main">Orchiopexy</span> Surgery to fix a testicle into the scrotum

Orchiopexy is a surgery to move and/or permanently fix a testicle into the scrotum. While orchiopexy typically describes the operation to surgically correct an undescended testicle, it is also used to resolve testicular torsion.

<span class="mw-page-title-main">Hydrocele</span> Accumulation of fluid in a body cavity

A hydrocele is an accumulation of serous fluid in a body cavity. A hydrocele testis, the most common form of hydrocele, is the accumulation of fluids around a testicle. It is often caused by fluid collecting within a layer wrapped around the testicle, called the tunica vaginalis, which is derived from peritoneum. Provided there is no hernia present, it goes away without treatment in the first year. Although hydroceles usually develop in males, rare instances have been described in females in the canal of Nuck.

<span class="mw-page-title-main">Male reproductive system</span> Reproductive system of the human male

The male reproductive system consists of a number of sex organs that play a role in the process of human reproduction. These organs are located on the outside of the body, and within the pelvis.

<span class="mw-page-title-main">Lumbar plexus</span> Web of nerves in the lower spine

The lumbar plexus is a web of nerves in the lumbar region of the body which forms part of the larger lumbosacral plexus. It is formed by the divisions of the first four lumbar nerves (L1-L4) and from contributions of the subcostal nerve (T12), which is the last thoracic nerve. Additionally, the ventral rami of the fourth lumbar nerve pass communicating branches, the lumbosacral trunk, to the sacral plexus. The nerves of the lumbar plexus pass in front of the hip joint and mainly support the anterior part of the thigh.

<span class="mw-page-title-main">Ilioinguinal nerve</span> Branch of the first lumbar nerve

The ilioinguinal nerve is a branch of the first lumbar nerve (L1). It separates from the first lumbar nerve along with the larger iliohypogastric nerve. It emerges from the lateral border of the psoas major just inferior to the iliohypogastric, and passes obliquely across the quadratus lumborum and iliacus. The ilioinguinal nerve then perforates the transversus abdominis near the anterior part of the iliac crest, and communicates with the iliohypogastric nerve between the transversus and the internal oblique muscle.

<span class="mw-page-title-main">Testicular artery</span> Branch of the abdominal aorta that supplies blood to the testicle

The testicular artery is a branch of the abdominal aorta that supplies blood to the testicle. It is a paired artery, with one for each of the testicles.

<span class="mw-page-title-main">Cremasteric artery</span>

The cremasteric artery is a branch of the inferior epigastric artery which accompanies the spermatic cord to supply the cremaster muscle as well as other coverings of the spermatic cord in the male.

The cremasteric fascia is a fascia in the scrotum. As the cremaster descends, it forms a series of loops which differ in thickness and length in different subjects. At the upper part of the cord the loops are short, but they become in succession longer and longer, the longest reaching down as low as the testis, where a few are inserted into the tunica vaginalis. These loops are united together by areolar tissue, and form a thin covering over the cord and testis, the cremasteric fascia.

<span class="mw-page-title-main">Genital branch of genitofemoral nerve</span>

The genital branch of the genitofemoral nerve, also known as the external spermatic nerve in males, is a nerve in the abdomen that arises from the genitofemoral nerve. The genital branch supplies the cremaster muscle and anterior scrotal skin in males, and the skin of the mons pubis and labia majora in females.

The development of the gonads is part of the prenatal development of the reproductive system and ultimately forms the testicles in males and the ovaries in females. The immature ova originate from cells from the dorsal endoderm of the yolk sac. Once they have reached the gonadal ridge they are called oogonia. Development proceeds and the oogonia become fully surrounded by a layer of connective tissue cells. In this way, the rudiments of the ovarian follicles are formed.

<span class="mw-page-title-main">Scrotum</span> Sac of skin that protects the testicles

In most terrestrial mammals, the scrotum or scrotal sac is a part of the external male genitalia located at the base of the penis. It consists of a sac of skin containing the external spermatic fascia, testicles, epididymides, and vasa deferentia. The scrotum will usually tighten during penile erection and when exposed to cold temperatures.

<span class="mw-page-title-main">Scrotal ultrasound</span> Medical ultrasound examination of the scrotum.

Scrotalultrasound is a medical ultrasound examination of the scrotum. It is used in the evaluation of testicular pain, and can help identify solid masses.

References

  1. 1 2 3 4 Mellick, L. B.; Mowery, M. L.; Al-Dhahir, M. A. (2022). "Cremasteric Reflex". StatPearls. PMID   30020720.
  2. Hrabovszky, Z.; Pilla, N. D.; Yap, T.; Farmer, P. J.; Hutson, J. M.; Carlin, J. B. (2002). "Role of the gubernacular bulb in cremaster muscle development of the rat". The Anatomical Record. 267 (2): 159–165. doi:10.1002/ar.10092. PMID   11997885.
  3. 1 2 3 4 Snodgrass, Christie. "What is the Cremaster Muscle?". study.com. Retrieved 2022-12-25.
  4. "Dartos muscle of scrotum - e-Anatomy - IMAIOS". www.imaios.com. Retrieved 2022-12-25.
  5. Shafik, A. et al. J. Sexual Medicine 4:1022–1027, 2007
  6. Mellick, Larry B.; Mowery, Myles L.; Al-Dhahir, Mohammed A. (2022), "Cremasteric Reflex", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID   30020720 , retrieved 2022-12-25
  7. Baty, John A. (5 May 1956). "Cremasteric cramp with testicular retraction". British Medical Journal . 1 (4974): 1014–1015. doi:10.1136/bmj.1.4974.1014. ISSN   0959-8138. PMC   1979762 . PMID   13304412.
  8. Mori, Ryan; Sandip Vasavada; Diana Baker; Edmund Sabanegh Jr (July 2011). "Treatment of debilitating cremasteric synkinesia With intracremasteric botulinum-a toxin injections". Urology . 78 (1). Cleveland, OH: Glickman Urological and Kidney Institute: 214–216. doi:10.1016/j.urology.2011.03.011. ISSN   0090-4295. PMID   21601247 . Retrieved 11 March 2012.
  9. κρεμαστήρ, in Liddell & Scott (1940), A Greek–English Lexicon , Oxford: Clarendon Press.