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Phys II Unit III > 1 Male Reproduction > Flashcards

1 Male Reproduction Flashcards

1
Q

The primary reproductive organs where gametes are produced in males

A

Testes

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2
Q

What are the accessory structures of the male reproductive system?

A 
Penis
Scrotum
Vas deferens (ductus deferens)
Epididymis
Accessory glands
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3
Q

What are the male secondary sexual characteristics?

A

Facial and body hair
Larger muscle mass
Masculine jaw
Body height

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4
Q

Testes have what 2 compartments and what 3 cell types

A

Compartments: Seminiferous tubules, Connective tissue

Cell types: Germ cells, Sertoli cells, Leydig cells

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5
Q

The seminiferous tumbles make up _____% of the testes, while the connective tissue makes up ______%.

A

ST = 80% vs CT = 20%

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6
Q

Which compartment of the testes is the site of spermatogenesis?

A

Seminiferous tubules

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7
Q

What do Sertoli cells produce?

A

Antimüllerian hormone
Androgen binding protein
Inhibin
Seminiferous tubule fluid

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8
Q

What do Leydig cells secrete?

A

Testosterone

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9
Q

Spermatogenesis is a ___________-mediated process that occurs along the length of the seminiferous tubules

A

Testosterone

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10
Q

The process by which undifferentiated diploid germ cells (___________) become haploid __________.

A

Spermatogonia —> spermatozoa (sperm)

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11
Q

How long does spermatogenesis take?

A

~74 days

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12
Q

What are the three stages of spermatogenesis?

A
  1. Mitosis (proliferation —> 4 diploid primary spermatocytes)
  2. Meiosis (2 divisions —> 16 single strand DNA spermatids)
  3. Spermiogenesis (packaging)
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13
Q

What occurs during the Mitosis stage of spermatogenesis?

A

Proliferation of diploid germ cells

Two divisions to create 4 diploid primary spermatocytes

Each has double strands of DNA

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14
Q

What happens during the Meiosis stage of spermatogenesis

A

Undifferentiated diploid germ cells are converted to haploid spermatocytes

Two divisions to create 16 spermatids

Each spermatids has single strand of one chromosome

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15
Q

During embryonic development, germ line cells help form the gonad and become ….

A

Spermatogonia

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16
Q

At puberty, spermatogonia undergo mitosis divisions and greatly expand their numbers. Some spermatogonia enter the first meiosis division, at which point they become…

A

Primary spermatocytes

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17
Q

Each primary spermatocyte becomes ________________.

A

Two secondary spermatocytes

Each secondary spermatocyte ends the second round of meiosis, producing two spermatids

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18
Q

Developing sperm cells do not complete cytokinesis (full cytoplasmic division) during meiosis, therefore the four daughter cells remain connected, forming a __________.

A

Syncytium

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19
Q

_________ ensures the haploid cells that contain either an X or a Y chromosome have access to all the gene products available in a complete diploid genome

A

Syncytium

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20
Q

Further maturation of the spermatids create the _________.

A

Spermatozoa

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21
Q

What establishes the blood-testes barrier?

A

Tight junctions between Sertoli cells

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22
Q

What is the point of the blood-testes barrier?

A

Developing sperm move between tight junctions between the Sertoli cells to the lumen, preventing immune cells from accessing genetically variant spermatozoa

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23
Q

Spermatocytes and Sertoli cells form __________ and _________.

A

Tight junctions and Gap junctions

Gap junctions permit transfer of nutrients

Final release of spermatids requires breakdown of these connections

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24
Q

Early spermatids remain joined by ___________, allowing XY sperm to transport necessary gene products to XX sperm.

A

Cytoplasmic bridges

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25
Q

What are the functions of Sertoli cells?

A

Protect sperm and provide nourishment to developing sperm

Absorb excess cytoplasm and wastes from developing sperm

Secrete seminiferous tubule fluid to aid in flushing sperm to the epididymus

Produce androgen binding protein to sequester Testosterone

Release Inhibin, anti-Müllerian factor

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26
Q

Sertoli cells secrete __________ to aid in flushing sperm to epididymus

A

Seminiferous tubule fluid

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27
Q

Sertoli cells produce __________ to sequester testosterone

A

Androgen binding protein

Allows for 100x more T in testes than in circulation

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28
Q

Sertoli cells are stimulated by _______ and ________ but release _________

A

Stimulated by T and FSH

Release Inhibin (negatively feedback to reduce FSH)

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29
Q

During development, Sertoli cells secrete _________.

A

Anti-Müllerian Factor

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30
Q

Process by which spermatids mature into spermatozoa

A

Spermiogenesis

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31
Q

What happens to the head of spermatids as they mature into spermatozoa?

A

Head elongates, most of the cytoplasm is lost

Nucleus remodels —> chromatin condensation

Lysosomes aggregate to form ACROSOME

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32
Q

What happens to the midpiece of spermatids as they mature into spermatozoa?

A

Mitochondria sequester to midpiece —> powering spearman’s

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33
Q

What happens to the tail of spermatids as they mature into spermatozoa?

A

Microtubules create the flagellum tail

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34
Q

The process by which mature sperm are extruded from the Sertoli cells into the lumen of the seminiferous tubules

A

Spermiation

From here they pass through the Rete testes for final processing and storage

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35
Q

What propels spermatozoa into the vas deferens?

A

Contraction of myoepithelial cells

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36
Q

Maturation area located close to the upper portion of each testicle

A

Epididymus

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37
Q

What do the sperm in the epididymus look like?

A

Not yet capable of movement or fertilization - require further maturation

Concentrated

Sperm are transferred to here under pressure and by smooth muscle contractions

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38
Q

What are the three steps in spermatogenesis?

A
  1. Spermatogenesis: spermatogonia —> spermatozoa
  2. Spermiogenesis: packaging and maturation of spermatozoa
  3. Spermiation: release of spermatozoa from Sertoli cells into the lumen of seminiferous tubules
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39
Q

Temporal organization of the spermatogonia cycle for continuous production

A

Spermatogonia wave

Rate is constant and not accelerated by hormones

Germ cells that fail to differentiate will degenerate and be reabsorbed

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40
Q

Full cycle of spermatogenesis takes ________ and luminal migration to ejaculatory ducts takes ________.

A

74 days

14 days

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41
Q

How many spermatogonia begin the spermatogenesis process each day

A

~2 million 😳

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42
Q

How many mature sperm are produced daily?

A

~128 million

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43
Q

_______ seminiferous tubules per testis allow for _______m of tubule length with different waves of spermatogenesis occurring simultaneously

A

~500 tubules

~300m

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44
Q

The average sperm count in the western world today is …

A

Between 20-40 million per ml of ejaculate

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45
Q

When do testes descend into the scrotum?

A

At ~7th month of gestation

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46
Q

Why does spermatogenesis require cooler temperature (1-2˚C below body temp)?

A

Prevents lysosomal destruction

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47
Q

Testes are kept cooler than body temp by…

A

Air around scrotum

Contraction/relaxation of muscles (rugae)

Venous blood flow (countercurrent)

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48
Q

What is the most widespread environmental factor producing low sperm counts?

A

Interference with ability of the scrotum to cool the testes

Tight clothing, hot tubs, sitting too long (ie truck drivers)

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49
Q

What is the medical term for undescended testes?

A

Cryptorchidism

Affected individuals are unable to produce viable sperm

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50
Q

Hormonal control of spermatogenesis is through the pulsatile release of _______.

A

GnRH - Gonadotropin-releasing hormone

Stimulates release of FSH and LH from Anterior Pituitary

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51
Q

What is the primary target of FSH in males?

A

Follicle Stimulating Hormone sensitized Sertoli cells to testosterone

Promotes Inhibin and Androgen binding protein (ABP) secretion from Sertoli cells

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52
Q

What is the primary target of LH in males?

A

Luteinizing hormone stimulates cholesterol desmolase within Leydig cells to produce testosterone

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53
Q

Testosterone regulates __________ by negative feedback

A

LH and LSH

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54
Q

Inhibin selectively regulates ________.

A

FSH

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55
Q

How does testosterone impact embryonic/fetal development

A

Masculinization of the reproductive tract and external genitals

Promotes descent of testes into scrotum

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56
Q

How does testosterone effect sex-specific tissue after birth?

A

Promotes maturation of reproductive system at puberty

Required for spermatogenesis

Maintains reproductive tract throughout life

57
Q

What are the reproduction-related effects of testosterone?

A

Increases sex drive

Controls secretion of gonadotropins

58
Q

What are the effects of testosterone on secondary sex characteristics?

A

Male-pattern hair growth

Deepening of voice

Promotes muscle growth and male adiposity

59
Q

What are the non-reproductive effects of testosterone?

A

Increased protein anabolic effect

Promotes bone growth at puberty

Closes epiphyseal plates (via aromatase conversion to estrogen)

May induce aggressive behavior

Male-specific brain development (preoptic area, hippocampus, amygdala - via aromatase conversion to estrogen)

60
Q

Testosterone is produced in …

A

Leydig cells of the testes

61
Q

The rate limiting step in the biosynthesis of testosterone

A

Conversion of cholesterol to pregnenolone (via cholesterol desmolase)

Regulated by LH

62
Q

Testosterone can be peripherally converted to what two things?

A

Dihydrotestosterone (DHT) via 5a reductase

Estradiol (E2) via aromatase

63
Q

What allows for the concentration of testosterone in the seminiferous tubules?

A

Binding to androgen-binding protein (ABP) produced by the Sertoli cells

64
Q

How does testosterone circulate within the peripheral circulation?

A

Bound to sex-hormone binding globulin (SHBG)

65
Q

Which hormone: Testosterone, DHT, Estradiol

Beard growth
Prostate growth
Sebum formation

A

DHT

66
Q

Which hormone: Testosterone, DHT, Estradiol

Development of penis, scrotum, urethra, prostate

A

DHT

67
Q

Which hormone: Testosterone, DHT, Estradiol

Development of epididymis, vas deferens, seminal vesicles

A

Testosterone

68
Q

Which hormone: Testosterone, DHT, Estradiol

Feedback suppression of gonadotropin secretion

A

All three

69
Q

Which hormone: Testosterone, DHT, Estradiol

Imprint male pattern of gonadotropins, sex drive, behavior

A

All three

70
Q

Which hormone: Testosterone, DHT, Estradiol

Deepening of voice

A

Testosterone

71
Q

Which hormone: Testosterone, DHT, Estradiol

Skeletal development

A

Testosterone, Estradiol

72
Q

Which hormone: Testosterone, DHT, Estradiol

Abdominal visceral fat

A

Testosterone

73
Q

Which hormone: Testosterone, DHT, Estradiol

Increasing muscle mass

A

Testosterone

74
Q

Which hormone: Testosterone, DHT, Estradiol

Red blood cells

A

Testosterone

75
Q

Which hormone: Testosterone, DHT, Estradiol

Increased VLDL, LDL and decreased HDL

A

Testosterone

76
Q

Which hormone: Testosterone, DHT, Estradiol

Sperm production

A

All three

77
Q

Which hormone: Testosterone, DHT, Estradiol

Pubertal development of penis and seminal vesicles

A

Testosterone and DHT

78
Q

Androgen effects of Testosterone

A

Differentiation of epididymis, vas deferens, and seminal vesicles (inner sex organs)

Increased muscle mass

Pubertal growth spurt

Growth of penis and seminal vesicles during puberty

Deepening of voice

Negative feedback on anterior pituitary

Libido

79
Q

Androgen effects of DHT on target tissues

A

Differentiation of penis, scrotum, and prostate (outer sex organs)

Male hair pattern

Male pattern baldness

Sebaceous gland activity

Growth of prostate

**DHT is twice as potent as testosterone

80
Q

In the prepubertal phase, secretion of LH and FSH is …

A

Low, due to hippocampal inhibition of GnRH

81
Q

During puberty, there is _________ secretion of GnRH

A

Increased secretion —> increased LH and FSH —> increased testosterone and spermatogenesis

82
Q

Decreased production of testosterone and sperm with aging

A

Senescence

83
Q

What are the symptoms of Androgen Deficiency in the Aging Male (ADAM)?

A 
Decreased bone formation
Decreased muscle mass
Decreased sex drive
Decreased body height
Decreased hematocrit
Decreased facial hair
INCREASED CVD risk (incl ED)
Changes in mood/energy
Changes in appetite
84
Q

Endocrine consequence to testosterone replacement therapy

A

Reductions in LH, FSH through negative feedback

Reduced sperm production —> infertility

Increase in free estrogens b/c exogenous T will free estrogens from binding proteins (b/c T has a higher affinity)

Increased peripheral conversion of T to estrogens

85
Q

Risks of testosterone replacement therapy

A 
CVD
Visceral obesity
Erythrocytosis
Fluid retention
BPH
Prostate cancer
Acne
Hepatotoxicity
Infertility
Obstructive sleep apnea
Gynecomastia and breast cancer
Psychosis/aggression
Depressed immunity —> cancer
86
Q

_____________ is sufficient to stimulate pubic and axial hair growth in both men and women

A

DHEA from the adrenal cortex

87
Q

_________ stimulates hair growth in men and is the cause of male pattern hair loss

A

DHT (male androgenetic alopecia)

88
Q

What happens to castrated males and eunuchoidal patients with androgen-insensitivity syndrome and those with a 5a-reductase deficiency

A

They don’t go bald, b/c they can’t produce DHT

89
Q

Beard growth is stimulated by…

A

Synergism between DHT and IGF-1 in those cells

90
Q

Scalp hair growth is attentuated by…

A

DHT and transforming growth factor ß1 (TGF-ß1)

91
Q

What exactly happens to lead to male pattern baldness?

A

Hair follicle miniaturization occurs with 5a-reductase conversion of T to DHT

92
Q

Propecia (finasteride) is used for the treatment of…

A

Androgenetic alopecia or enlarged prostates

It’s a 5a-reductase antagonist —> binds IRREVERSIBLY to the enzyme and doesn’t let it convert T to DHT

93
Q

Why shouldn’t women handle propecia?

A

Could impact fetal development of males due to it being a non-competitive inhibitor of 5a-reductase

94
Q

Side effects of propecia (finasteride)

A

ED

Loss of libido

Reduced ejaculate

95
Q

What are the different accessory organs for semen production?

A

Seminal vesicles
Prostate
Bulbourethral glands

96
Q

Seminal vesicles produce _____% of the total ejaculate

A

60%

97
Q

What are the different products of the seminal vesicles?

A

FRUCTOSE to nourish sperm

PROSTAGLANDINS to stimulate male and female reproductive tract

CLOTTING FACTORS

98
Q

Prostatic fluid makes up _____% of total ejaculate

A

20%

99
Q

Which accessory organ secretes alkaline fluid to counter acidic vaginal environment and pH triggers clotting to keep sperm in vagina?

A

Prostate

100
Q

Bulbourethral gland secretions make up ____% of the ejaculate

A

10%

101
Q

What is the purpose of the bulbourethral gland?

A

Secrete mucus for lubrication

102
Q

What are the main components of semen by percentage?

A

Seminal fluid from seminal vesicles (60%)

Prostatic fluid (20%)

Bulbourethral fluid (10%)

Spermies (10%)

103
Q

Walnut sized structure that surrounds the neck of the bladder and the urethra

A

Prostate

104
Q

Bacterial infection of the prostate

A

Prostatitis

Can cause problems with urination

105
Q

Enlarged prostate which may restrict oral urination or cause increased frequency of urination

A

Benign Prostatic Hyperplasia BPH

No relationship between BPH and prostate cancer

106
Q

What do we need to know about prostate cancer?

A

It responds to treatment when detected early

No relationship between BPH and prostate cancer

107
Q

How is male erection achieved?

A

Due to VASOCONGESTION of the penis with blood (NOT due to skeletal muscle contraction)

108
Q

What are the three compartments of the penis important for the male erection?

A

Two corpus cavernosa
One corpus spongiosum

Arterioles in these compartments dilate during sexual arousal and constrict in the absence of arousal

109
Q

How does thinking about sex —> erection?

A

The amygdala, medial preoptic area, paraventricular nucleus of the hypothalamus, and peri aqueductal gray matter coordinately affect penile erections

110
Q

What is the integration site for the central nervous system control of erections?

A

Medial Preoptica Area (MPOA)

Receives sensory input from the amygdala and sends impulses to the paraventricular nuclei and then the periaqueductal gray matter in sacral spinal cord

111
Q

How does the erection reflex work?

A
  1. Higher brain activity (thinking about sex)
  2. Mechanical stimulation of the glans —> sensory feedback to the sacral erection generating center (sacral S2-4)
  3. Periodic parasympathetic impulses from the sacral erection generating center
112
Q

How to make an erection:

Parasympathetic stimulation —> _______ release —> production of _________ —> lowering _______

Mechanical compression of _________

Parasympathetic stimulation of _______ glands

A

NO release —> production of cGMP —> lowering intracellular Ca2+

Mechanical compression of veins by skeletal muscles at the base of the penis

Parasympathetic stimulation of the bulbourethral glands

113
Q

Tonic sympathetic stimulation results in…

A

Flaccid penis

114
Q

Concurrent sympathetic inhibition and parasympathetic stimulation can create an erection in…

A

As little as 5 seconds

115
Q

In the flaccid state, blood flow into penile tissue is limited by…

A

Contraction of helicine arteries and trabecular smooth muscle

116
Q

In the erect state, relaxation of _________ by NO released from nerve terminals allows blood flow into the cavernous spaces to induce penile engorgement

A

Helicine arteries

117
Q

Compression of __________ reduces venous outflow, sustaining erection

A

Subtunical venules

118
Q

What are the two phases of ejaculation?

A

Emission

Expulsion

119
Q

What does the emission phase of ejaculation entail?

A

SNS impulses from L1 and L2

Semen enter urethra from the contraction of the accessory glands

SNS stimulation of smooth muscle and contraction of accessory glands

120
Q

What does the expulsion phase of ejaculation entail?

A

Filling of the urethra triggers somatic nervous impulses with rhythmic activation of skeletal muscles at the base of the penis

121
Q

What is the volume of ejaculation?

A

2-6 ml total, after several days of abstinence

100 million sperm/ml

122
Q

What is the pathway for ejaculation?

A

Vas deferens —> ampulla —> urethra —> out

123
Q

The ________ contracts to prevent retrograde ejaculation into bladder

A

Internal urethral muscle (sphincter)

124
Q

What happens during the excitement phase and how is it driven?

A

Flushed skin and increased muscle tone, nipples harden, blood flow to genitals increases, scrotum tightens, some lubricating emissions from the penis

Driven by parasympathetic NS

125
Q

What is the plateau phase?

A

Testicales are withdrawn into the scrotum, conditions of excitement phase intensify, leading to the orgasm stage

126
Q

What is orgasm?

A

The intense pleasure associated with the culmination of expulsion of semen

Involuntary muscle contractions, rhythmic contractions at base of penis result in ejaculation of semen.

Heightened emotions, pleasure, HR, perspiration

127
Q

What happens during the resolution phase following orgasm?

A

Sympathetic vasoconstrictor impulses return body to normal function

Blood flow into the penis slows

Temporary refractory period of variable duration

128
Q

The failure to achieve an erection despite appropriate stimulation

A

Erectile dysfunction

129
Q

What are the different pathophysiologies of ED?

A 
Psychological 
Age
Nerve damage
Blood flow disturbance (atherosclerosis)
Low testosterone
DM
Medications

All can result in inadequate filling of the corpus cavernosa

130
Q

How do you treat ED?

A

Phosphodiesterase inhibitors (PDE5) sustain NO stimulated cGMP levels in the penis

Sildenafil (Viagra), Tadalafil (Cialis), Vardenafil (Levitra)

131
Q

At high doses, PDE5 inhibitors can also activate PDE6, which does what?

A

PDE6 in the retina —> visual changes

132
Q

Alternative therapies for ED if the dude doesn’t want viagra

A

Prostaglandin E (alprostadil) - self-administered intraurethral therapy or needle-injected

Hormone replacement therapy

Penis pumps

Vascular surgery

Penile implants

Psychological counseling and sex therapy

133
Q

What are the different forms of birth control available to men?

A

Condoms
“The Withdrawal Method”
Vasectomy

134
Q

How do vasectomy’s work?

A

Surgical cut of each vas deferens with ligation of the ends

Sperm can no longer move through the ejaculatory tract and out the penis

Accessory gland function unaffected but semen contain no sperm

Testosterone levels unaffected

Sperms are removed from the epididymis through phagocytosis

135
Q

What is the vasectomy reversal procedure called?

A

Vasovasostomy

136
Q

What is Vasalgel?

A

A polymer gel that is injected into each vas deferens, thus blocking movement of sperm

Proposed to be effective for several years, reversible with subsequent injection

Currently in human trials but still several years away from FDA approval

137
Q

Why do the little bitch ass men complain about endocrine methods of birth control?

A

Acne
Increased body weight
Decreased HDL

And just like that, it’s not available in the US

138
Q

What does marijuana do to male fertility?

A

Reduces it

Endocannabinoid receptors are present in the HPG axis —> suppressive effect

Endocannabinoid receptors also present in sperm —> decreased numbers, altered morphology, and reduced activity

Phys II Unit III (5 decks)

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