12. Reproductive System Flashcards
What 2 things does sexual reproduction involve?
Meiosis
Fertilisation
What does fertilisation produce?
A zygote containing 46 chromosomes
What are the 5 functions of the female reproductive system?
- Formation of ova
- Reception of spermatozoa
- Provide suitable environment for fertilisation
- Parturition (childbirth)
- Lactation
What are the 2 functions of the male reproductive system?
- Production of spermatozoa
- Transmission of spermatozoa to the female
What is the gland called within the breasts?
Mammary glands
What supports the breast between the skin and underlying fascia?
Suspensory ligaments
Briefly describe how the two main hormones are involved in lactation.
Prolactin stimulates milk synthesis whilst suckling stimulates oxytocin causing milk ejection.
What are the 3 functions of the uterus?
- Pathway for sperm
- Site for zygote implantation,
- Location for foetal development
Briefly describe the 3 layers of tissue found in the uterus.
- Perimetrium - outer layer
- Myometrium - inner layer of 3 smooth muscle layers
- Endometrium - highly vascular inner layer
Briefly describe the 2 layers of the endometrium
- Stratum functionalis - the changing layer which sheds during mentruation
- Stratum basalis - permanent deeper layer that regenerates the stratum functionalis
Name the 3 regions of the uterus
Fundus , body, and cervix
Describe the 3 roles of the placenta
- Site of exchange of nutrients and waste between mother and foetus
- Produces hormones
- Protective barrier to most micro-organisms
How are the mother and foetus connected through the placenta?
Umbilical cord which is 50-60cm long
Briefly describe the 6 main hormones produced by the placenta
Progesterone - maintains the endometrium lining
Oestrogen - promotes growth of the breast tissue and myometrium.
Human Chorionic Gonadotropin (hCH) - maintains corpus luteum for 8 weeks and increases transfer of nutrients
Human placental lactogen (hPL) - increases glucose and lipids in maternal blood
Relaxin - relaxes ligaments
Coricotropin releasing hormone (CRH) - triggers release of cortisol and prevents rejection of foetus
What is Placenta Praevia?
Occurs when the placenta attaches to the lower part of the uterine wall, potentially blocking the opening of the cervix
What are the risks of Placenta Praevia?
After 20 weeks is prone to haemorrhage.
Wall of cervix stretches and can detach from the placenta. Uterine vessels rupture often presenting as painless, ante-partum vaginal bleeding.
What is Placenta Accreta?
Abnormally deep attachment of the placenta through the endometrium into the myometrium. Due to inadequate endometrium so placenta has to dig deeper when implanting.
What are the two types of Placenta Accreta?
Increta = invades myometrium
Percreta = Through uterine wall to viscera (such as bladder)
Name 2 potential causes of Placenta Accreta?
- C-section
- Fibroid removal
- Placenta Praevia
What is Placenta Abruption and how does it present?
Rupture of blood vessels adhering the placenta to the uterine wall leading to separation of the placenta from the uterus.
Presents as abdominal pain and ante-partum bleeding.
What are the terms used for the two types of twins and how many placentas do they have?
Monozygotic / identical - 1 placenta
Dizygotic / non-identical - 2 placentas
Describe how the ova leaves the ovary and travels to the uterus.
Finger-like projections called fimbriae sweep the ova into the fallopian tubes.
Cilia line the tubes and help move the ova towards the uterus along with smooth muscle layers performing peristalsis.
What sex hormones do the ovaries produce?
Oestrogen and progesterone
What is the term used for the formation of female gametes (ova) in the ovaries?
Oogenesis
What is the term for an immature egg cell?
Oocyte
When does oogenesis begin and end?
Begins in the foetus and the formation of primary oocytes stops at birth leaving approximately 2 million oocytes.
What is a primordial follicle?
Primordial follicles are the entire structure of a primary oocyte surrounded by a layer of follicular cells.
Briefly describe the process of maturation of oocytes that occurs each month after puberty.
Anterior pituitary releases FHS and LH.
FHS stimulates the maturation of the primordial follicles to secondary follicles, and then mature follicles.
A surge of LH triggers ovulation - the release of a secondary oocyte from a mature follicle.
The remains of the ovarian follicle that has ovulated becomes the corpus luteum which produces progesterone and oestrogen.
What is the average length of the menstrual cycle?
28 days
What are the 4 phases of the menstrual cycle and when do they occur?
Menstrual phase (1-5 days)
Pre-ovulatory phase (6-13 days)
Ovulation phase (day 14)
Post-ovulatory phase (days 15 - 28)
Briefly describe what occurs in the uterus during the phases of the menstrual cycle.
Menstrual phase - the endometrium is being shredded in response to the sudden drop in progesterone.
Pre-ovulation - The endometrium thickens in response to the rising oestrogen levels
Briefly describe what occurs in the ovaries during the phases of the menstrual cycle.
Menstrual phase - follicles are developing under the influence of FSH
Pre-ovulation - Follicles start to mature, secreting oestrogen. Follicles secrete inhibin which decreases FSH and prevents other follicles developing.
Ovulation - High oestrogen stimulates LH secretion. LH causes rupture of the mature follicle and expulsion of the egg.
Post-ovulation - the corpus luteum forms from the follicle wall and produces progesterone and some oestrogen. These maintain endometrium in preparation for pregnancy.
Describe the early stage of a fertilised egg.
Zygote embeds in the uterine wall.
Human chorionic gonadotropin (hCG) maintains and stimulates the corpus luteum to produce progesterone and oestrogen.
After a few weeks, the placenta takes over.
Describe what occurs during puberty (female)
Occurs typically between 10-14yrs of age.
Burst of GnRH triggers pulses of LH and FSH increasing over 3-4 years.
Internal reproductive organs mature and menarche occurs.
Breasts develop, hair growth, hips widen and voice deepens.
What is the menopause
The menopause is the permanent cessation of menstruation for 12 consecutive months.
What occurs in the body during the menopause?
Naturally occurs at 45-55 years of age as a result of ovarian aging whereby the number of follicles becomes exhausted.
Oestrogen and progesterone production decreases creating a negative feedback leading to high FSH and LH.
List 4 common signs / symptoms of the menopause.
- Hot flushes and sweating
- Vaginal dryness
- Mood changes
- Decreased libido
- Breast shrinkage
- Osteoporosis
What drawbacks / risks are there with treating menopause with HRT?
Although relieves the symptoms it only delays the menopause.
HRT increases the risk of breast and endometrial cancer, heart disease, stroke and DVT.
What are the two main functions of the testes?
1) Site of spermatogenesis in the seminiferous tubules
2) Siteof testosterone production and secretion from the Leydid cells.
Where are spermatozoa produced and stored?
Produced in the testes.
Stored in the epididymis.
How many spermatozoa are produced?
300 million every day
What temperature is best for spermatogenesis?
3C below body temperature.
Describe the anatomy of sperm.
Head filled with the nucleus.
Acrosome is a vesicle covering the head containing enzymes t penetrate the egg.
Body filled with mitochondria to fuel the tail.
Tail to swim
What are the two glands that produce seminal fluid and what are their functions?
1) Seminal vesicles - located behind the bladder and secrete alkaline seminal fluid providing nutrients to nourish the sperm
2) Prostate gland - secretes a thin milky fluid containing nutrients for ATP production and anticoagulants to increase fluidity. Prostate-specific antigen (PSA) also present.
Why is seminal fluid alkaline?
To protect sperm from urethral and vaginal acidity
Describe what occurs during ejaculation
Bulbourethral gland secretes an alkaline, mucous fluid that neutralising urinary acid in the urethra and lubricates the end of the penis.
Contraction of the smooth muscle in the epididymis and vas deferens propels sperm into the ejaculatory ducts.
Muscles surrounding the base of the urethra contract causing semen to eject out of the penis.
Terminology: The age of the first period
Menarche
Terminology: Mid-cycle bleeding
Metrorrhagia
Terminology: Increased menstrual bleeding
Menorrhagia
Terminology: Absence of periods
Amenorrhoea
Terminology: Painful period
Dysmenorrhoea
Terminology: Short cycle / frequent periods
Polymenorrhoea
Terminology: Infrequent periods
Oligomenorrhoea
Terminology: Painful intercourse
Dyspareunia
What are the two types of amenorrhoea?
Primary amenorrhoea is the failure of the menses to occur by expected onset (16/17 yrs) mostly caused by congenital defects
Secondary amenorrhea is the lack of menstruation for 3 months in a previously menstrual woman. (Pituitary tumour, stress, PCOS etc)
What are the two types of dysmenorrhoea?
Primary dysmenorrhoea has no association with identifiable pelvic disease. There is an excessive release of uterine prostaglandins during menstruation causing the myometrium to contract.
Secondary dysmenorrhoea is associated with specific identifiable pelvic diseases such as endometriosis, fibroids and pelvic inflammatory disease.
What is PMS and what causes it?
PMS = Premenstrual Syndrome
Characterised by cyclic physiological, psychological and behavioural changes during the luteal phase (second half)
No definitive cause.
Hormone imbalance
Drop in progesterone.
List 6 common signs/symptoms of PMS
Anxiety
Depression
Confusion
Fatigue
Headaches
Bloating
Hot flushes
Constipation
Cravings
Pimples
What is pelvic inflammatory disease (PID)?
An infectious and inflammatory disorder of the upper female genital tract including the uterus, fallopian tubes, and ovaries.
List 2 common causes of PID
1) infection typically resulting from spead of bacteria.
2) Sexually transmitted infective causes including gonorrhoea and chlamydia.
3)Insertion of IUD
List 2 signs/symptoms of PID
- Lower abdominal pain
- Deep dyspareunia (painful sex)
- Occasional dysuria, fever, nausea.
What is endometriosis?
Where endometrial tissue is found outside of the uterine cavity.
List 3 common places affected by endometriosis.
- Ovaries
- Fallopian tubes
- Pelvic cavity
- Intestines
List 2 possible causes of endometriosis
- Oestrogen dominance
- Altered immune surveillance in pelvis affecting ability to recognise ectopic endometrial tissue.
- Primordial cells lining other cavities/organs differentiate into endometrial cells
- Transfer of tissue through blood and lymph
What occurs with endometriosis to cause inflammation and pain?
ectopic endometrial tissue follows the menstrual cycle but there is no exit point for the blood that accumulates during menstruation.
List 4 signs/symptoms of endometriosis
- Dysmenorrhoea (painful periods)
- Menorrhagia (heavy bleeding)
- Pelvic pain during menstruation
- Dyspareunia
- Bloating
- Infertility
How can endometriosis cause infertility?
Recurrent inflammation leads to the formation of fibrous tissue which can produce adhesions.
Adhesions can obstruct the uterus or fallopian tubes contributing to infertility.
What are the two main allopathic treatments for endometriosis?
Combined oral contraceptive pill (if oestrogen dominant, this will contribute to the problem)
Surgery (45% grows back within a Year)
What are fibroids?
Benign tumours of the myometrium of the uterus consisting of smooth muscle cells and connective tissue.
What are potential causes/risk factors for fibroids?
- Linked to levels of oestrogen and progesterone.
- Obesity
- Family history
- Contraceptive pill
List some signs/symptoms of fibroids
50-80% asymptomatic.
- Menorrhagia
- Iron deficiency anaemia from menorrhagia
- Constipation if pressing on rectum
- Frequent urination if pressing on bladder
- Bloating and heaviness in abdomen
What are the 3 allopathic treatments for fibroids?
NSAIDs
Hormone therapy (including OCP)
Surgery
What are ovarian cysts and their most common type?
Fluid-filled sacs within the ovary.
Follicular cysts occur when failure to ovulate and instead fill with fluid.
What is PCO and PCOS? And how do they differ?
PCO = Polycystic ovaries
The presence of many cysts within the ovaries
PCOS = Polycystic ovary syndrome
An endocrine metabolic condition associated with:
1. Menstrual dysfunction
2. Ovulatory dysfunction
3. Hyperandrogenism
4. Metabolic disturbances (hyperinsulinemia)
What are the 2 main risks for developing PCOS?
Genetic link (first degree relative)
Obesity
Describe the 2 pathological features of PCOS
Dysfunction of the hypothalamic-pituitary axis -
Imbalance of LH/FSH - high LH promotes increased ovarian androgen formation
Insulin resistance occurs in approx 40% irrespective of weight.
Suppresses sex hormone-binding globulin (SHBG) causing increase in free circulating androgen and suppression of ovulation
List 5 symptoms of PCOS
- Amenorrhoea / oligomenorrhoea
- Lack of ovulation
- Infertity
- Hirsutism
- Acne and oily skin
- Weight gain
- Baldness
- Anxiety / depression
What blood test results might be present in PCOS
- Increased androgens
- Low sex hormone-binding globulin
- High LH with normal or low FSH
- Hyperinsulinemia and elevated blood glucose
List 2 possible causes of infertility each in men, women, and both
Men:
- Low sperm count
- Poor sperm viability or motility
- Blocked sperm ducts
Women:
- PCOS
- Endometriosis
- Fibroids
- PID
Both:
- Toxicity
- Radiation
- Malnutrition
- Smoking and alcohol
List 3 signs or symptoms for breast cancer
- Painless, unilateral fixed lump
- Overlying skin changes
- Inverted nipple and discharge
- Enlarged axillary lymph nodes
List 3 risk factors for breast cancer
Family history
BRCA 1 and 2 gene
Poor diet
Smoking
Alcohol
Oestrogen excess
What’s balanitis? Name 1 infection and 1 non-infectious cause.
Inflammation of the glans penis
Infectious - candida albican
Non-infectious - autoimmune, eczema, poor hygiene
List 2 signs/symptoms of testicular cancer
Hard, painless, unilateral mass
Dragging sensation and dull ache
What is prostatitis?
Inflammation of the prostate gland that can be infectious or non-infectious.
What is BPH?
Benign Prostatic Hyperplasia - enlargement of prostate tissue leading to compression of the urethra.
Very common in over 60’s (men!)
What causes are there for BPH?
Abdominal obesity
Genetics
Sedentary
Pesticides
Discuss the role of 5-alpha-reductase in BPH
For testosterone to affect the prostate, it must be converted to dihydrotestosterone (DHT) by the enzyme 5-alpha-reductase. DHT has twice the effect on the prostate as testosterone.
Associated with an increase in activity of 5-alpha-reductase.
List 4 signs/symptoms of BPH
Obstructed/poor urinary flow
Increased urinary frequency
Dribbling of urine
Nocturia
Recurrent cystitis
What are the 3 characteristic symptoms of prostate cancer
Haematuria
Nocturia
Back pain can indicate bone metastases
What is elevated in both prostate cancer and BPH?
PSA in blood
What herb can support prostate cancer patients?
Boswellia
