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BioMed S2 > 12. Reproductive System > Flashcards

12. Reproductive System Flashcards

1
Q

Reproduction: definition

A

The production of new offspring

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2
Q

What does sexual reproduction involve?

A

Meiosis
Fertilisation

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3
Q

What happens in meiosis?

A

This produces male (sperm) and female (ova) gametes

These are haploid so have 23 chromosomes each

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4
Q

What is genetic variability?

A

Offspring having a mix of genes inherited from each parent

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5
Q

What does fertilisation produce?

A

A zygote (46 chromosomes)

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6
Q

Functions of female reproduction system:

A

Formation of ova (female gametes)

Reception of spermatozoa (male gametes)

Provide suitable environment for fertilisation/foetus

Parturition (childbirth)

Lactation

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7
Q

Functions of male reproduction system:

A

Production of spermatozoa (male gametes)

Transmission of spermatozoa to the female

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8
Q

What are breasts?

A

Accessory glands of the female reproductive system

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9
Q

What is a mammary gland?

A

A modified sweat gland that produces milk

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10
Q

What does each mammary gland consist of?

A

15-20 lobes separated by adipose tissue

Each lobe contains small, grapelike clusters of glands called alveoli

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11
Q

What are suspensory ligaments?

A

These support the breast between the skin and the underlying fascia

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12
Q

What happens during lactation?

A

Myoepithelial cells surrounding the alveoli contract and propel milk into the lactiferous ducts

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13
Q

Where can milk be stored?

A

In the lactiferous sinuses

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14
Q

What does prolactin do?

A

Stimulates the production of milk

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15
Q

What does oxytocin do?

A

Causes milk ejection during suckling

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16
Q

What does the uterus do?

A

Pathway for sperm

Site of zygote implantation

Location for foetal development

Contracts to initiate labour

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17
Q

What is a zygote?

A

Fertilised ovum

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18
Q

Uterus walls: layers

A
  1. Perimetrium
  2. Myometrium
  3. Endometrium
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19
Q

Perimetrium

A

The outer layer of the uterus wall

Visceral peritoneum

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20
Q

Myometrium

A

The middle layer of the uterus wall

With three layers of smooth muscle

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21
Q

Endometrium

A 
The inner layer of the uterus wall
High vascular (rich supply of blood vessels)
Divided into the:
1. Stratum functionalis
2. Stratum basalis
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22
Q

Stratum functionalis

A

Layer of the endometrium that sloughs off during menstruation

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23
Q

Stratum basalis

A

Permanent deeper layer of the endometrium

Regenerates the stratum functionalis ready for the implantation of a fertilised egg (zygote)

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24
Q

Uterus: uterine regions

A

Fundus (top bit)
Body (hollow bit)
Cervix (narrow bit)

Size and shape of a pear

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25
Q

What holds the uterus and ovaries in place ?

A

The broad ligament

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26
Q

Uterus: location

A

Posterior to the bladder
Anterior to the rectum

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27
Q

What is an embryo?

A

The developmental stage following a zygote.
Lasts until ~8 weeks

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28
Q

What is a foetus?

A

Developmental stage following an embryo
After around 8 weeks

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29
Q

Placenta: functions

A

Allows oxygen and nutrients to diffuse from maternal blood into foetal blood

Allows carbon dioxide and waste to move in the opposite direction

Produces hormones that are needed to maintain the pregnancy

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30
Q

What is the placenta attached to?

A

The endometrium

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31
Q

Why is the placenta unique?

A

By the beginning of the 12th week, it contains 2 distinct regions from two individuals

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32
Q

What is the umbilical cord?

A

Connects the placenta to the embryo/foetus

Around 50-60cm long

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33
Q

What can’t pass through the protective barrier in the placenta?

A

Blood cells

Most micro-organisms

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34
Q

What can pass through the protective barrier in the placenta?

A 
HIV
Measles
Polio
Chicken pox
Alcohol
Drugs
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35
Q

What mediates the transfer of nutrients to the foetus?

A

Proteins called nutrient transporters

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36
Q

Placenta: hormones

A 
Progesterone
Oestrogen
Human Chorionic Gonadotrophin (hCG)
Human Placental Lactogen (hPL)
Relaxin
Corticotrophin Releasing Hormone (CRH)
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37
Q

Progesterone

A

Maintains endometrial lining to sustain and nourish the foetus

Produced by corpus luteum until 8 weeks

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38
Q

Oestrogen

A

Promotes growth of breast tissue and myometrium

Produced by corpus luteum until 8 weeks

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39
Q

Human Chorionic Gonadotrophin (hCG)

A

Only produced during pregnancy

Maintains corpus luteum for 8 weeks and increases transfer of nutrients to foetus

Initially produced by the embryo then by the placenta after a few weeks

Related to morning sickness

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40
Q

Human Placental Lactogen (hPL)

A

Increases the amount of glucose and lipids in the maternal blood

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41
Q

Relaxin

A

Targets ligaments and relaxes them

Produced by the corpus luteum and then placenta

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42
Q

How is Corticotrophin Releasing Hormone (CRH) involved in pregnancy ?

A

Triggers release of cortisol from the adrenal glands

Prevents rejection of foetus/placenta (as seen as ‘foreign invaders’)

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43
Q

Risks of placenta praevia

A

Obstructing the opening of the cervix (more risk with multiple births as more placentas present)

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44
Q

When is it possible for placenta praevia to resolve itself?

A

During 1st trimester

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45
Q

What can happen in placenta praevia during the 2nd and 3rd trimester?

A

Prone to haemorrhage

Wall of cervix stretches and can detach from placenta

Uterine vessels rupture and cause ante-partum vaginal bleeding

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46
Q

What is the treatment for placenta praevia in the later stages?

A

C-section

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47
Q

Placenta Accreta

A

Abnormally deep attachment of the placenta through the endometrium into the myometrium

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48
Q

Increta

A

If the placenta invades the myometrium

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49
Q

Percreta

A

If the placenta goes through the uterine wall to surrounding viscera e.g. the bladder

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50
Q

What causes placenta accreta?

A

Thin, inadequate stratum basalis in endometrium
Placenta has to dig deeper when implanting

Due to previous C-section, curettage (scraping procedure), fibroid removal, placenta praevia

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51
Q

Risks of placenta accreta

A

Post-partum haemorrhage

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52
Q

Placenta Abruption

A

When the blood vessels adhering the placenta to the uterine wall rupture, leading to separation of the placenta from the uterus

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53
Q

Risk factors for placenta abruption

A

Smoking
Maternal hypertension (pre-eclampsia)
Considered obstetric emergency after 20 weeks

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54
Q

Signs and symptoms of placenta abruption

A

Abdominal pain
Ante-partum bleeding

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55
Q

Placenta abruption: epidemiology

A

Occurs in 1% of pregnancies worldwide

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56
Q

In placenta abruption, what happens to the baby <30 weeks?

A

Monitor vitals until baby is old enough to deliver safely

Foetal lungs matured with corticosteroids

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57
Q

In placenta abruption, what happens to the baby >30 weeks?

A

Delivery

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58
Q

Twins: definition

A

Siblings that result from same pregnancy

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59
Q

Monozygotic twins

A

Identical twins with same genetic information

Originate from a single fertilised ovum
One egg, one sperm

The zygote splits into two embryos but share same placenta

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60
Q

Dizygotic twins

A

Non-identical

Release of two ova with both being fertilised and implanted independently
Two eggs, two sperm

Two different placentas

(Two separate pregnancies in one)

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61
Q

Fallopian tubes

A

These extend laterally from the uterus to the ovaries

Provide a route for sperm to meet the ova - and for the ova to reach the uterus

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62
Q

What are fimbriae?

A

Finger-like projections that surround the ovary and sweep the ova into the fallopian tubes

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63
Q

How does the fallopian tube move the ova from the ovary to the uterus?

A
  1. Tubes are lined with ciliated columnar epithelium that help move the ova towards the uterus
  2. Smooth muscle layer performs peristalsis to assist in ova movement
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64
Q

Ovaries

A

The female gonads

Paired glands

Resemble size and shape of almonds

Atrophy after menopause

65
Q

What is the ovarian ligament?

A

This anchors the ovaries to the uterus

66
Q

Which hormones do the ovaries secrete?

A

Oestrogen
Progesterone

67
Q

Oogenesis

A

The formation of an egg (female gamete) in the ovaries

68
Q

Where does oogenesis begin?

A

In the foetus

69
Q

Primary oocytes

A

Immature ova - formed by germ cells during foetal development
Formation stops at birth (20K to 2M primary oocytes)
Surrounded by a layer of follicular cells

70
Q

Primordial follicle

A

A primary oocyte surrounded by a layers of follicular cells

71
Q

How many follicles will mature and ovulate during a woman’s reproductive lifetime?

A

Around 400
Meaning around 400 secondary oocytes formed and ovulated during a reproductive lifespan.

72
Q

Which hormones are involved in oogenesis post-puberty?

A

Follicle stimulating hormone (FSH)
Luteinising hormone (LH)

From the anterior pituitary

73
Q

What happens in oogenesis post-puberty?

A

FSH and LH are released by the anterior pituitary gland

FSH stimulates the maturation process of the primordial follicles (several will begin the process, normally only one will become dominant)

Surge of LH triggers ovulation - the release of the ovum (secondary oocyte)

The remains of the follicle becomes the corpus luteum

74
Q

Primordial follicle maturation process

A 
Primordial follicle 
>> primary follicle 
>>> secondary follicle 
>>>> mature follicle (containing secondary oocyte)
75
Q

Corpus luteum

A

“Yellow body”

The remains of the ovarian follicle once the secondary oocyte has been released

This produces progesterone and some oestrogen

Human chorionic gonadotrophin prevents the corpus luteum from degrading if fertilisation has occurred

76
Q

Corpus albicans

A

What the corpus luteum becomes if fertilisation does not occur

77
Q

How long does the follicle maturation process take?

A

1 year
Rapid maturation = 14 days
but process has begun 10-12 cycles previously

78
Q

How long does the menstrual cycle generally last?

A

24-35 days

79
Q

What is the average length of the menstrual cycle?

80
Q

What are the four phases of the menstrual cycle?

A
  1. Menstrual phase (1-5)
  2. Pre-ovulatory phase (6-13)
  3. Ovulation (14)
  4. Post-ovulatory phase (15-28)
81
Q

When does the menstrual phase happen?

82
Q

What happens during the menstrual phase?

A

Uterus: endometrium (stratum functionalis) is shed in a response to drop in progesterone

Ovaries: primordial follicles mature under the influence of FSH

83
Q

When does the pre-ovulatory phase happen?

84
Q

What happens during the pre-ovulatory phase?

A

Uterus: endometrium thickens in response to rising oestrogen levels

Ovaries: one follicle starts to mature and inhibin is secreted which decreases the secretion of FSH (stops other follicles developing)

85
Q

When does the ovulation phase happen?

86
Q

What happens during the ovulation phase?

A

Ovaries: high oestrogen levels create a positive feedback loop, stimulating LH secretion

LH causes rupture of the mature follicle and expulsion of the egg

87
Q

When does the post-ovulatory phase happen?

A

Days 15-28

88
Q

What happens during the post-ovulatory phase?

A

The corpus luteum forms from the follicle wall

It produces progesterone and some oestrogen to maintain the endometrium for pregnancy

89
Q

Which hormones control the ovaries?

A

Pituitary hormones:
FSH
LH

Under the control/release of GnRH

90
Q

Which hormones control the uterus?

A

Ovarian hormones:
Oestrogen
Progesterone

91
Q

In what order do the hormones dominate during the menstrual cycle?

A

FSH
Oestrogen
LH
Progesterone

92
Q

What happens to a fertilised ovum (zygote)?

A

Zygote embeds in the uterine wall

Embryo produces human chorionic gonadotrophin (hCG) which maintains and stimulates the corpus luteum to produce progesterone and some oestrogen

After a few weeks the placenta takes over the role of producing hCG and progesterone to maintain the pregnancy

93
Q

What happens if an ovum is not fertilised ?

A

After 14 days, the corpus luteum degenerates into the corpus albicans

Progesterone and oestrogen levels drop and a new menstrual cycle begins

94
Q

What is puberty?

A

The period when the potential for sexual reproduction is reached

Internal reproductive organs mature and the first period happens (menarche)

95
Q

When does puberty typically occur?

A

Between 10-14 years old

96
Q

What happens as puberty starts?

A

The start of puberty is marked by pulses of LH and FSH, each triggered by a burst of GnRH

97
Q

What happens as puberty advances?

A

The hormone pulses occur during the day as well as at night

These increase over 3-4 years

98
Q

What are the secondary characteristics of puberty (females)?

A

Breast development
Hair growth (pubic/axillary/legs)
Hips widen
Voice deepens

99
Q

What is the menopause?

A

Persistent cessation of menstruation for 12 consecutive months

100
Q

At what age does menopause usually happen?

A

45-55 years old

101
Q

What happens physiologically when menopause occurs?

A

The number of follicles becomes exhausted:
~~~
> Oestrogen production decreases
» Decline in ovulation
»> Progesterone production decreases
~~~

102
Q

What affect does low oestrogen and progesterone have on other hormones?

A

Negative feedback leads to an increase in
FSH and LH levels

103
Q

Which procedure can induce the menopause?

A

Hysterectomy

104
Q

Menopause: signs and symptoms

A 
Hot flushes and increased sweating
Mood changes, irritability, anxiety
Increased risk of UTIs
Breast shrinkage, sparse pubic/axillary hair
Osteoporosis
Deceased libido
Vaginal dryness
Painful intercourse
105
Q

Menopause: allopathic treatment

106
Q

How can HRT help during the menopause?

A

It can be used to relieve menopausal symptoms
Reduce risk of osteoporosis
But it only delays the actual menopause

107
Q

What risks does taking HRT bring?

A

Breast and endometrial cancer
DVT
Stroke
Heart disease

108
Q

What does the male reproductive system consist of?

A

Two of the following:
* Testes
* Epididymides
* Vas deferens
* Spermatic cords
* Seminal vesicles
* Ejaculatory ducts

One of the following:
* Prostate gland
* Penis

109
Q

What does the penis consist of?

A

Root (within pelvic cavity)

Body

110
Q

What does the penis body consist of?

A 
Three cylindrical masses of erectile tissue
Glans penis (the enlarged ending)
111
Q

When does the penis fill with blood?

A

During sexual arousal

During REM sleep

112
Q

Which nervous system are the erectile tissue and involuntary muscle stimulated by?

A

Parasympathetic

113
Q

Which substance causes vasodilation of the penis?

A

Nitric oxide

114
Q

Where do the testes develop?

A

In the pelvic cavity (near kidneys)

They descend into the scrotum via the inguinal canals between around 2 months before birth

115
Q

What are seminiferous tubules?

A

Area in the testes that produce sperm

116
Q

How long does it take to produce sperm?

A

Around 70 days

117
Q

Which hormone is involved in sperm production?

118
Q

What is the role of the testes?

A
  1. Produce sperm
  2. Produce and secrete testosterone
119
Q

Which hormone is involved in testosterone production?

120
Q

From which substance is testosterone made?

A

Cholesterol

121
Q

Where in the testes is testosterone made?

A

Leydig cells

122
Q

What are lobules?

A

Areas in the testes that contain the seminiferous tubules

123
Q

How many lobules are there per testicle?

124
Q

What is the epididymis?

A

Area in the testes where mature sperm is stored

125
Q

How does sperm get from the seminiferous tubules to the epididymis?

A

Through muscle contraction

126
Q

How many sperm are produced each day?

A

300 million

127
Q

How long can sperm live for in the epididymis?

A

Several months

128
Q

How many sperm are ejaculated?

A

Around 100 million per ml

129
Q

What temperature is best for the production of sperm?

A

3 degrees C below body temperature

130
Q

Sperm: anatomy

A

Head
Acrosome
Body
Tail

131
Q

What does the head of the sperm contain?

132
Q

What is the acrosome?

A

Vesicle covering the head of the sperm

Contains enzymes to penetrate the egg

133
Q

What is the body of the sperm filled with?

A

Mitochondria to fuel the tail

134
Q

What is the function of the sperm tail?

A

To help it swim

135
Q

What happens to sperm after it leaves the epididymis?

A

It’s expelled through the vas deferens into the ejaculatory duct

136
Q

What happens to sperm in the ejaculatory duct?

A

Semen is secreted and mixed with the sperm

137
Q

Which glands produce semen?

A

Seminal vesicles
Prostate gland

138
Q

What are the seminal vesicles?

A

Pair of glands located behind the bladder

They produce an alkaline fluid that makes up 60% of semen

139
Q

What does the semen produced by the seminal vesicles contain?

A

Nutrients (e.g. fructose) to nourish sperm

140
Q

What is the prostate gland?

A

Wraps around the male urethra

Secretes a thin, milky fluid that makes up 30% of semen

141
Q

What does the seminal fluid produced by the prostate gland contain?

A

Nutrients for ATP production
Anticoagulants to increase fluidity

142
Q

Which anticoagulants are included in the semen secreted by the prostate gland?

A

Citric acid
Proteolytic enzymes
Prostate specific antigen (PSA)
Pepsinogen

143
Q

What is semen?

A

Alkaline fluid that protects sperm from urethral and vaginal acidity

144
Q

What is the vas deferens?

A

Duct that transports sperm from the testicle to the urethra

145
Q

What are the Cowper’s Glands?

A

They secrete an alkaline, mucous fluid that neutralises urinary acids in the urethra prior to ejaculation

Also lubricate the end of the penis

146
Q

Describe muscular activity and the pathway of semen during sexual arousal?

A

Smooth muscle in the epididymis and vas deferens propel sperm into the ejaculatory ducts

Muscles surrounding the base of the urethra cause semen to eject out of the penis during orgasm

147
Q

Considerations when taking reproductive case histories (male and female)

A

Menstruation - cycle/bleeding time/amount of blood/quality
Breasts - tenderness, galactorrhoea
Relationship of symptoms to cycle
Hirsutism (male hair pattern growth) and acne
Altered libido and impotence
Problems with intercourse
Past and present fertility plans
Methods of contraception
Operations
Additional symptoms e.g. urinary problems
Family history

148
Q

Menarche

A

The age of the first period

149
Q

Metrorrhagia

A

Mid-cycle bleeding

150
Q

Menorrhagia

A

Increased menstrual bleeding

151
Q

Amenorrhoea

A

Absence of periods

152
Q

Dysmenorrhoea

A

Painful periods

153
Q

Polymenorrhea

A

Short cycle, frequent periods

154
Q

Oligomenorrhea

A

Infrequent cycles

155
Q

Galactorrhoea

A

Lactation without pregnancy

156
Q

Dyspareunia

A

Pain on intercourse (f)

157
Q

Gynaecomastia

A

Presence of enlarged breast tissue in a male

158
Q

What is inhibin ?

A

A hormone that inhibits the secretion of FSH

BioMed S2 (34 decks)

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