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8 Flashcards

1
Q

What is the SRY gene?

A

The sex-determining part of the Y chromosomes.

Acts during early development; signals to produce testis.

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2
Q

How are can individuals with the gametes XY possess primary and secondary female characteristics?

A

They have a missing/mutated SRY gene

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3
Q

How many autosomes do oocytes and spermatozoons contain?

A

22

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4
Q

Where do embryonic gonads develop from?

A

Bipotential primordia – called genital ridge primordia

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5
Q

What type of tissue forms the structure of the gonads but doesn’t contain the germ cells?

A

Mesenchymal tissue

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6
Q

Where do gametes originate?

A

Embryonic yolk sac

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7
Q

What do gametes originate as?

A

PGC – primordial germ cells

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8
Q

Where to germ cells migrate from and to?

A

From hindgut.

To gonad rudiment.

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9
Q

In normal males, what do the primordial germ cells (PGC) colonise?

A

The medulla

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10
Q

In normal females, what do the PGCs colonise?

A

The cortex

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11
Q

What do PGCs expand by?

A

Mitosis

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12
Q

Do PGCs differ in both sexes?

A

No

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13
Q

What are coelomic epithelia?

A

Epithelium lining surface of body and abdominal organsIt constitutes the outermost layer of the male and female gonads, thus forming the germinal epithelium of the female / male.

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14
Q

In males, what does the coelomic epithelia form?

A

A network of cords which surround and envelop the PGCs

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15
Q

Why doesn’t coelomic epithelium not form cords in females?

A

Because they lack SRY

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16
Q

What does PGCs in the cortex form?

A

Most tissues of ovaries

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17
Q

What does PGCs in the medulla form?

A

Most tissues of testis

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18
Q

In females, what happens to the medulla?

A

Degenerates

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19
Q

What does the sex cords lack in females?

A

Structure, they condense and cluster around PGCs (forming primary oogonia)

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20
Q

Once SOX9 is present what happens?

A

SRY is no longer needed as SOX9 is self-sustaining.

SOX9 initiates expression of PGD2

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21
Q

What does PGD2 drive production of and what does that do?

A

FGF9;

Drives migration of mesonephric cells

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22
Q

What do sertoli cells produce?

A

AMH (Anti-Mullerian hormone).

Which prevents Mullerian duct development (they differentiate to form the fallopian tubes, uterus, the uterine cervix, and the superior aspect of the vagina)

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23
Q

Name 2 hormones essential for male development

A

AMH and androgen

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24
Q

Which cells maintain the Wolffian duct?

A

Leydig cells

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25
Q

What does lack of androgen lead to in male development?

A

Wolffian duct regression

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26
Q

What do mesonephric primordia make in males and females?

A

Males – myoid cells, vascular tissue, Leydig cells.

Females – theca cells, vascular tissues

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27
Q

How do reproductive tracts of females and males differ?

A

Females – vagina, uterus, oviduct.

Males – vas deferens, seminal vesicles

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28
Q

What does androgen exposure after birth lead to?

A

Defeminisation; no change in internal or external genitalia

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29
Q

What does castration after birth lead to?

A

Demasculisation; no change in genitalia

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30
Q

What does removal of foetal ovaries lead to?

A

WD degenerate and MD develop

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31
Q

What role does the hypothalamus play in sex?

A

Role in secondary sexual characteristics

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32
Q

What is Turner’s syndrome?

A

X unpaired,

Infertile
Female

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33
Q

Describe Klinefelter’s syndrome

A

XXY.

Essentially maleInfertile

Underdeveloped testes

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34
Q

What is AIS?

A

Androgen insensitivity syndrome.

Androgen secreted by testes but target issues doesn’t respond

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35
Q

What determines the male phenotype (external appearance and secondary sexual characteristics)?

A

Testosterone levels and testosterone receptors.

Testis produce testosterone

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36
Q

What is congenital adrenal hyperplasia?

A

XX.

Foetal adrenal hyperactivity to overcome low production of corticosteroids which leads to WD and MD being retainedE.

xternal male genitalia

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37
Q

If Y chromosome is not present, what does the gonad become?

A

Ovaries

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38
Q

Which disease is the most common cause of erectile dysfunction?

A

Vascular – atherosclerosis

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39
Q

In the male reproductive system which embryological ducts remain in place and which degrade?

A
  • Mesonephric (Wolffian) ducts remain

* Paramesonephric (Mullerian) ducts degrade

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40
Q

What is the embryological origin of the prostate?

A

Urethra

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41
Q

What are the muscles of the pelvic diaphragm?

A

Levator ani
• Ileococcygeus
• Pubococcygeus
• Puborectalis(Ischio)coccygeus

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42
Q

Nerve supply to levator ani (pelvic floor muscles)?

A

S3, S4

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43
Q

Describe the histology of the male urethra

A

Prostatic urethra
• Transitional epithelium

Membranous urethra
• Pseudostratified columnar epithelium

Penile urethra
• Pseudostratified columnar epithelium

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44
Q

What is found in the superficial perineal pouch?

A

Erectile tissue
• Corpus cavernosum
• Corpus spongiosum

Muscles
• Ischiocavernosus
• Bulbospongiosum
• Superficial transverse perineal muscle

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45
Q

What muscles are in the deep perineal pouch?

A
  • External urethral sphincter
  • Deep transverse perineal muscle
  • Sphincter urethrovaginalis (Only in women)
  • Compressor urethrae (Only in women)
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46
Q

What structure travels through the opening in the perineal membrane?

A

Urethra

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47
Q

What are the characteristics of Turner’s syndrome (X)?

A
  • Ovaries present but infertile
  • Poor breast development
  • No menstruation
  • Low hairline
  • Short stature
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48
Q

What do the medulla and cortex of the gonads develop into in males?

A

Males

  • Medulla develops into testis
  • Cortex degenerates
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49
Q

What do the medulla and cortex of the gonads develop into in females?

A

Females

  • Cortex develops into ovary
  • Medulla degenerates
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50
Q

What do primary follicles consist of?

A

Oocyte surrounded by granulosa cells

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51
Q

What is the allantois?

A

Small sausage-shaped outpouching from the caudal wall of the yolk sac of the early embryo

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52
Q

Which 3 pairs of tubes drain into the bladder in the embryo?

A

Pronephros, mesonephros, metanephros

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53
Q

Which embryological tubes that drain into the bladder are the ones we keep in the adult urinary system?

A

Metanephros

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54
Q

Via which ducts does the gonads drain into the bladder?

A

Mesonephric (Wolffian) duct

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55
Q

What drains the kidneys into the bladder?

A

Ureters

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56
Q

What duct system is left behind for the gonads (testes)?

A

Epididymis (collecting tubules within testicles)

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57
Q

What is the mesonephric duct now called in adult males?

A

Ductus deferens (runs from epididymis into bladder)

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58
Q

What runs from the epididymis into the bladder?

A

Ductus deferens

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59
Q

Where are the testes located?

A

Between posterior abdominal wall and peritoneum

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60
Q

What do the testes descend through and into?

A

Inguinal canal into scrotal sac

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61
Q

What does the vas deferens loop over?

A

Ureter

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62
Q

Where do the ductus deferens from R and L testes come together?

A

Ejaculator duct

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63
Q

What does the ejaculatory duct pass into?

A

Prostate gland (at base of bladder)

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64
Q

Which 2 accessory glands open into the prostate?

A

Seminal vesicles

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65
Q

What are the 2 regions of the prostate gland?

A

Central zone – inner part; where ducts are located.

Peripheral zone – cortex layer on outside

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66
Q

Which part of the prostate tends to enlarge in benign prostatic hypertrophy?

A

The central zone of the prostate gland

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67
Q

What type of epithelium is found in the glans penis?

A

Stratified squamous

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68
Q

What is the perineum?

A

A diamond shaped region at the pelvic outlet

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69
Q

What is the perineal diamond subdivided into?

A

2 triangles:

  • anterior urogenital triangle
  • posterior anal triangle
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70
Q

What forms the roof of the perineum?

A

The pelvic diaphragm muscles

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71
Q

What is the deep perineal pouch?

A

A space enclosed by the perineal membrane and pelvic diaphragm

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72
Q

What are the major hormones involved in regulating female reproductive cycle?

A

LH, FSH, GnRH

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73
Q

What is the precursor of cholesterol?

A

Acetate

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74
Q

Name the structural unit in which oocytes develop.

A

Follicle

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75
Q

At what state in development are oocytes at birth?

A

Arrested in prophase 1, termed primary oocytes, residing in primordial follicles

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76
Q

What is the pattern of GnRH release in the prepubertal female and post-pubertal females?

A

Pre- Irregular.

Post - Regular pulses at approx. hourly intervals

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77
Q

At what stage of follicle development does ovulation occur?

A

Tertiary, preovulatory stage

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78
Q

What triggers follicle growth?

A

LH and FSH

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79
Q

What does oestrogen stimulate?

A

The secretion of LH by the anterior pituitary

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80
Q

What does progesterone promote?

A

Thickening of the endometrium

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81
Q

What does progesterone inhibit?

A

Secretion of FSH and LH by the anterior pituitary

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82
Q

What gonadotropins act at the ovary?

A

FSH and LH

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83
Q

What does inhibin do?

A

Inhibits FSH secretion from the anterior pituitary

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84
Q

What do sertoli cells secrete?

A

ABP – stimulates spermatogenesis

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85
Q

Define primordial follicle

A

Single layer of squamous granulosa cells; oocyte non-growing

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86
Q

Which gonadotrophin acts on granulosa cells?

A

FSH

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87
Q

What is the main hormone produced by the corpus luteum?

A

Progesterone

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88
Q

Function of progesterone.

A

Maintains pregnancy and supports luteal phase of the cycle

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89
Q

What are the main functions of the ovary?

A

Oogenesis

Folliculogenesis .

Corpus luteum formation

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90
Q

What is the effect of LH action at theca cells?

A

Androgen production

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91
Q

What is the effect of FSH at granulosa cells?

A

Oestrogen production

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92
Q

What cells does LH act on?

A

Theca cells

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93
Q

During what phase of meiosis is an oocyte released?

A

Metaphase II

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94
Q

How long does the corpus luteum last?

A

10 days

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95
Q

What do luteal cells produce?

A

Progesterone primarily and bits of oestrogen

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96
Q

After ovulation, what do the granulosa cells become?

A

Luteal cells

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97
Q

From day 1-14 of the menstrual cycle what phase occurs?

A

Follicular phase

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98
Q

What is the stimulus for the retention of the corpus luteum?

A

Beta HCG (pregnancy)

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99
Q

What are therapies for hot flashes in menopause?

A

HRT, SSRIs

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100
Q

What is the cell that implants in the uterine wall?

A

Blastocyst

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101
Q

When is premature menopause?

A

Below age 40

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102
Q

What do sertoli cells secrete?

A

ABP – stimulates spermatogenesis

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103
Q

If a woman has a uterus, what do you give her for HRT? What about if she doesn’t have a uterus?

A

Uterus: oestrogen and progesterone Hysterectomy: oestrogen

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104
Q

What are negative complications of HRT?

A

Increased MI, blood clots, breast cancer, stroke risk

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105
Q

In males, when is the initiation of spermatogenesis?

A

Puberty

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106
Q

What does ovulation normally occur?

A

14 days before the onset of menses

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107
Q

What is the source of HCG in the body?

A

Trophoblast

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108
Q

What is done in a male sterilisation?

A

Ligation/cauterisation of the vas deferens

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109
Q

What are some risks of vasectomy?

A

Soreness/bruising.

Not immediately effective

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110
Q

What techniques are used for female sterilisation?

A

Laparoscopic rings, clips or cautery.

Mini-laparotomy.

Tubal ligation at the time of the C-section.

Essentially mechanical blockage of the tubes

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111
Q

What is a copper IUD used for?

A

EC and normal contraceptive

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112
Q

How long is a copper IUD used for?

A

10 years

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113
Q

What is the mechanism of a copper IUD?

A

Copper ions inhibit the motility of sperm

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114
Q

What are the risks of using the levonorgestrel system?

A

Perforation, expulsion, infection

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115
Q

What are the non-contraceptive benefits of the IUS?

A

Decreased risk of PID, amenorrhea

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116
Q

What are the disadvantages of the implant?

A

Irregular bleeding

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117
Q

What are contraindications for a copper IUD?

A

Pelvic infection, uterine anomalies

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118
Q

How long is the implant used for?

A

3 years

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119
Q

What are contraindications for the implant?

A

Hepatic tumour, liver disease, breast cancer, allergies

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120
Q

What are contraindications of the progesterone only oral contraceptives?

A

Breast cancers

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121
Q

What are the non-contraceptive benefits of depo?

A

Decreases risk of seizuresAmenorrhea

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122
Q

How many times per month do you place a vaginal ring?

A

Once

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123
Q

How many times per month do you use the patch?

A

3 times (once a week and none for 1 week)

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124
Q

What type of lubricant can you use w/ latex condoms and why?

A

Water-based or silicone-based because oil-based lube will degrade the condom

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125
Q

How soon after unprotected coitus do you have to take levonorgestrel?

A

Within 72 hours

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126
Q

What is the mechanism of spermicides?

A

Destroys the sperm cell membrane

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127
Q

To have effectiveness w/ fertility awareness, what is a requirement?

A
  1. Abstaining on fertile days

2. Regular menses to predict fertile days

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128
Q

What are the advantages of the barrier methods?

A

STI protection

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129
Q

What is the axis that Is involved w/ the production of testosterone?

A

HPT axis:

  • Hypothalamus
  • Pituitary
  • Testis
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130
Q

What is the axis that Is involved w/ the production of oestrogen?

A

HPO axis:

  • Hypothalamus
  • Pituitary
  • Ovaries
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131
Q

Where does LH act at the testis?

A

Leydig cells

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132
Q

Which cells produce testosterone?

A

Leydig cells (stimulated by LH)

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133
Q

Where does FSH act in the testis?

A

Sertoli cells

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134
Q

What is the function of FSH?

A

Regulate spermatogenesis

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135
Q

What is the function of the sertoli cells?

A

Spermatogenesis regulation

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136
Q

How is testosterone transported from the testes to circulation?

A

Through diffusion

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137
Q

What is the effect of testosterone and its metabolites on the: kidney, bone marrow, bone, skin and liver?

A

Kidney – stimulation of EPO

Marrow – stimulation of stem cells

Bone – accelerated linear growth and closure of epiphyses

Skin – hair growth, balding, sebum

Liver – synthesis of serum proteins

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138
Q

What is the action of testosterone in the male sexual organs?

A

Penile growth, spermatogenesis, prostate growth and function

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139
Q

What are the metabolites of testosterone?

A

DHT: dihydrotestosterone oestradiol

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140
Q

When is the 1st meiotic division completed?

A

Upon ovulation

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141
Q

When is the 2nd meiotic division completed?

A

Upon fertilisation

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142
Q

What does the corpus luteum become is there is no fertilisation?

A

Corpus albicans

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143
Q

What are the functions of oestradiol?

A

Breast tissue and bone formation

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144
Q

What enzyme is responsible for the production of DHT?

A

5 alpha reductase

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145
Q

What is the effect of testosterone on bone density and what mediates this effect?

A

Increases bone density Oestradiol mediates this

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146
Q

Where is the adrenal glands in the body?

A

Small, conical organs on top of kidneys

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147
Q

What do adrenal glands produce?

A

Variety of hormones including adrenaline, aldosterone, cortisol

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148
Q

What is the functional unit of the ovary?

A

Single ovarian follicle

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149
Q

What are the developmental steps that occur in the transformation of primordial germ cells to primary oocytes?

A

Primordial germ cell

  • mitosis
  • oogonia
  • enter prophase of meiosis I
  • primary oocyte
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150
Q

What are the stages in the development of the primordial ovarian follicles to mature follicle?

A

Primordial ovarian follicle

  • primary follicle (remains until puberty)
  • secondary follicle
  • graafian follicle
  • ovulation
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151
Q

Why can’t theca cells produce oestradiol?

A

Contain cholesterol desmolase (stimulated by LH) thus can produce testosterone, but not androgen aromatase

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152
Q

How is oestradiol produced in the ovaries?

A

LH stimulates theca cells to produce androgens.

Androgens diffuses to granulosa cells and is converted to 17 beta-oestradiol using androgen aromatase (stim by FSH).

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153
Q

What cells produce inhibin B and what affect does this have on the anterior pituitary?

A

Granulosa cell; -ve feedback on FSH production in anterior pituitary

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154
Q

What does low and high oestrogen conc. do?

A

Granulosa cell; -ve feedback on FSH production in anterior pituitary

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155
Q

What does low and high oestrogen conc. do?

A

Low – inhibits LH secretion.

High – stimulates LH secretion from anterior pituitary this triggers ovulation and granulosa cells to produce progesterone

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156
Q

How does oestrogen conc. increase in the follicular phase of the menstrual cycle?

A

Androgen acts on granulosa cells to cause proliferation.

As granulosa cell numbers increase they produce more oestrogen collectively

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157
Q

What increases granulosa cell numbers?

A

Androgen

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158
Q

What does the LH spike stimulate?

A

Ovulation of the most mature follicle in the ovary

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159
Q

What enzyme does granulosa cells express?

A

Androgen aromatase in response to FSH

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160
Q

What are abdominal cramps caused by?

A

The contraction of the uterine and abdominal muscles to expel the menstrual fluid

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161
Q

After ovulation levels of what drops?

A

LH drops

FSH and GnRH will also decrease

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162
Q

What does corpus luteum secrete?

A

Oestrogen, inhibin, progesterone

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163
Q

What does an increase in progesterone do?

A

Negative feedback on hypothalamus which inhibits GnRH secretion

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164
Q

What happens once the corpus luteum has fully degenerated?

A

Progesterone decreases so GnRH levels increases then new menstrual cycle can occur

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165
Q

What happens to the endometrial lining in decreased levels of progesterone and oestrogen?

A

Lining not maintained and sheds

166
Q

Which hormone prepares the endometrium lining of the uterus for implantation?

A

Progesterone

167
Q

What are the stages of the uterine cycle?

A

Proliferative and secretory

168
Q

What are the 2 types of HRT?

A

E2 (oestrogen) only and Combined E2/P4 (progesterone)

169
Q

What causes menopause?

A

Falling E2 levels due to follicle depletion

170
Q

What are the major hormones regulating the female reproductive cycle?

A

GnRH, FSH, LH, E2, P4, Inhibin, AMH

171
Q

What are the phases of the ovarian cycle?

A

Follicular and luteal stages

172
Q

What is the hormone profile of the ovarian cycle?

A

Rising levels of LH and FSH lead to E2 surge causing LH surge which induces ovulation then LH levels falling again and P4 levels rise

173
Q

What is the purpose of menstruation?

A

Shed the lining of the endometrium in the absence of pregnancy

174
Q

What is oocyte maturation?

A

Progression from PI to MII, resulting in haploid gamete

175
Q

How does DEPO (progesterone only injection) work?

A

Inhibits ovulation

176
Q

What happens in the follicular phase?

A

Maturation of follicles in ovary due to FSH being released from pituitary gland

177
Q

What should you warn patients about if they are using the coitus interruptus method?

A

Pre-ejaculate contains sperm

178
Q

What is the MoA of the combined oral contraceptive?

A

Inhibits ovulation via action on hypothalamo-pituitary-ovarian axis to decrease LH and FSH; alters cervical mucus and endometrium

179
Q

What is migraine w/ aura a contraindication of?

A

Oestrogen containing contraceptive

180
Q

What is thelarche?

A

Breast development as part of puberty

181
Q

Define pubarche

A

Pubic hair development as part of puberty

182
Q

Define adrenarche

A

Adrenal development towards puberty

183
Q

What is menopause defined as?

A

The last menstrual bleed (12 months ago)

184
Q

How does menopause affect FSH and LH hormone levels and why?

A

They increase; because there is no negative feedback from the ovaries

185
Q

What is the critical weight for onset of menarche?

A

46 kg

186
Q

How has age of menarche change and why?

A

Decreased due to health and nutrition improvement

187
Q

Where is oestradiol produced?

A

Granulosa cells around each oocyte

188
Q

List 5 menopausal symptoms

A

Hot flushes, menstrual irregularity, mood swings, forgetfulness, dry skin and vagina

189
Q

How does blindness affect menarche?

A

Lack of sunlight leads to later menarche

190
Q

What is precocious puberty?

A

Menarche <9 yrs

191
Q

What is delayed puberty?

A

Menarche >16 yrs

192
Q

Why can puberty be delayed?

A

Low body weight

E.g. athletes, congenital, chromosomal abnormalities

193
Q

Where is oestradiol produced?

A

Granulosa cells around each oocyte

194
Q

List 5 menopausal symptoms

A

Hot flushes, menstrual irregularity, mood swings, forgetfulness, dry skin and vagina

195
Q

What can unopposed oestrogen(s) stimulate?

A

Endometrial hyperplasia and carcinoma

196
Q

How does smoking affect fertility?

A

Negatively; reduces number of oocytes

197
Q

What happens to the pronephros in embryo?

A

Degenerates; only leaves behind mesonephros (males)

198
Q

Which ducts are lost in males?

A

Paramesonephric ducts

199
Q

Which ducts are lost in females?

A

Mesonephric ducts

200
Q

What are the collecting tubules within each testicle called?

A

Epididymis

201
Q

What does the mesonephric duct become eventually in men?

A

Ductus deferens

202
Q

What slips down between the abdominal wall and peritoneum to the floor of the pelvis and emerge from the anterior abdominal wall?

A

The testes

203
Q

What does the kidneys use to drain into the bladder?

A

Ureters (metanephros in embryo)

204
Q

Name the 2 histological zones of the prostate gland

A

Central zone (inner part where all ducts are located).

Peripheral zone (cortex layer on the outside)

205
Q

Where is the prostate relative to the bladder?

A

Inferior

206
Q

Where does the superficial perineal pouch lie?

A

Between perineal membrane and (superficial fascia and skin)

207
Q

Which nerve provides most of the somatic motor and sensory innervation of the dorsal penis and scrotum?

A

Pudendal nerve

208
Q

Where does autonomic fibres for vasodilation and stimulation of erection come from?

A

Parasympathetic fibres; inferior hypogastric plexus; from S2,3,4

209
Q

Where does sympathetic fibres for smooth muscle contraction, internal urethral sphincter, reproductive tract, glands and muscle come from?

A

T10-L2

210
Q

Which spinal levels does the pudendal nerve come from?

A

S2,3,4

211
Q

Where does autonomic fibres for vasodilation and stimulation of erection come from?

A

Parasympathetic fibres; inferior hypogastric plexus; from S2,3,4

212
Q

Where does sympathetic fibres for smooth muscle contraction, internal urethral sphincter, reproductive tract, glands and muscle come from?

A

T10 - L2

213
Q

What does the internal pudendal artery supply?

A

Everything except the testes

214
Q

Where does the testes get their blood supply?

A

Anterior division of internal iliac A (abdo vessels) because they developed from posterior abdominal wall

215
Q

Where to the testes drain to and via what?

A

Testicular/spermatic vein from testis to IVC via pampiniform plexus

216
Q

What is the pampiniform plexus?

A

A network of small veins found in human male spermatic cord and female ovaries

217
Q

Where does the right ovary drain blood to?

A

From pampiniform plexus to ovarian vein to IVC

218
Q

What does the left ovary drain blood to?

A

From pampiniform plexus to ovarian to L renal vein to IVC

219
Q

What hormone raises uterine threshold to contractile stimuli during pregnancy?

A

Progesterone – until foetus is ready to be delivered

220
Q

What hormone affects body temperature during what part of the menstrual cycle?

A

Progesterone raises body temp during the luteal phase

221
Q

Where is the pancreas located?

A

Across the back of the abdomen, behind the stomach

222
Q

What is the pancreas connected to?

A

Duodenum and spleen

223
Q

What regions is the pancreas divided into?

A

Exocrine – 98%

Endocrine – 2% (arranged in Islets of Langerhans)

224
Q

What does the exocrine pancreas secrete?

A

Bicarbonate – pH buffering

Zymogens – inactive precursor of enzyme

Enzymes – food digestion

225
Q

Describe the structure of the exocrine pancreas?

A

Acinus – clusters of cells that resembles lobed berries Intercalated ducts – lead directly from acinus to striated duct, lined by ductal cells

Striated duct – gland duct which connects intercalated duct w/ intralobular duct

226
Q

What do ductal cells secrete?

A

Bicarbonate

227
Q

Where is secretin produced?

A

Small intestines

228
Q

Describe the secretion of bicarbonate?

A

Secretin from SI changes levels of ATP produced in duct cells.

This increased ATP acts in ATP sensitive CFTR ion channels and changes potential of the cell which induces a movement of ions

229
Q

Which hormones control secretions of the exocrine pancreas and how?

A

Secretin – released from s cell of duodenum; binds to ductal cells leading to secretion of HCO3-CCK – digestion of fat and protein, binds to acinus cells, triggers enzyme release

230
Q

What does the endocrine pancreas secrete?

A

Insulin, glucagon, somatostatin – regulate blood glucose.

Pancreatic polypeptide, ghrelin – increases appetite

231
Q

Describe beta cell

A

Secrete insulin which decreases blood glucose.

Found in the centre of the islets

232
Q

Describe alpha Islets of Langerhans cells

A

Secrete glucagon which increases blood glucose.

Found on outer ridges of the islets; less numerous than beta cells

233
Q

Describe delta cells?

A

Less common than alpha and beta cells.

Secrete somatostatin which inhibits insulin and glucagon secretion; dotted around islets

234
Q

Describe epsilon cells

A

Uncommon; secrete ghrelin which increases appetite

235
Q

Describe PP cells

A

Secrete pancreatic polypeptide which promotes satiety and inhibits pancreatic secretions

236
Q

What is the pituitary gland attached to?

A

Base of brain (hypothalamus) by infundibulum

237
Q

How many lobes does the pituitary gland have?

A

2 – anterior and posterior

238
Q

What is the main function of the pituitary gland?

A

Master endocrine gland, secretes several hormones that control other endocrine glands

239
Q

Describe the histology of the anterior pituitary lobe

A

Cell types based on staining:

  • Chromophobes (unstained)
  • Chromophils (stained) - subdivisions: acidophils and basophils
240
Q

List the 5 basic secretory cells in the anterior pituitary lobe

A

Somatotrophs, mammotrophs, corticotrophs, thyrotrophs, gonadotrophs

241
Q

List the acidophils in the anterior pituitary lobe

A

Somatotrophs and mammotrophs

242
Q

List the basophils in the anterior pituitary lobe

A

Corticotrophs, thyrotrophs, gonadotrophs

243
Q

What do corticotrophs secrete?

A

ACTH – which stimulates secretion of glucocorticoids from the adrenal cortex via the HPA axis

244
Q

What does thyrotrophs secrete?

A

Thyroid stimulating hormone (TSH)

245
Q

What does gonadotrophs secrete?

A

FSH and LH

246
Q

What does mammotrophs secrete?

A

Prolactin which initiates lactation in mammary glands

247
Q

Describe the histology of the posterior pituitary lobe

A

Essentially neural tissue, mainly non-myelinated axons, pituicytes – glial cells of posterior pituitary lobe

248
Q

What is the arterial supply of the thyroid gland?

A

Superior and inferior thyroid artery (from common carotid)

249
Q

What is the venous drainage of the thyroid gland?

A

Superior, middle, inferior thyroid vein

250
Q

What is the importance of the venous drainage of the thyroid gland?

A

It’s how secretory products are put into the body

251
Q

Describe the histology of the thyroid gland

A

Composed of many follicles, stores part of the secretory product.

Follicular cells are a single layer of epithelium around follicles.

Parafollicular cells secrete calcitonin

252
Q

What do parafollicular cells of the thyroid gland secrete?

A

Calcitonin

253
Q

What do follicular cells in thyroid produce and secrete?

A

Thyroid hormones thyroxine (T4) and triiodothyronine (T3)

254
Q

Where are the parathyroid glands located?

A

On the posterior surface of the thyroid gland

255
Q

What are parathyroid glands contained within?

A

Connective tissue capsule

256
Q

How many parathyroid glands are there?

A

42 superior and 2 inferior

257
Q

What do the ovaries produce?

A

Gametes and hormones (progesterone, oestrogen, inhibin, relaxin)

258
Q

What ligaments are associated w/ the ovaries?

A

Broad ligament, suspensory ligament, ovarian ligament, round ligament, transverse cervical ligament

259
Q

When do testes begin to descend into scrotum?

A

7th month of foetal development

260
Q

What do the testes produce?

A

Sperm and testosterone

261
Q

What does the tunica albuginea surround?

A

Layer of connective tissue covering the testicles and ovaries

262
Q

What are seminiferous tubules lined w/?

A

Sertoli cells (columnar type cell)

263
Q

What does the scrotum contain?

A

A pouch that contains 1 testis

264
Q

What does the spermatic cord connect?

A

Testis to abdominal cavity

265
Q

Where is the epididymis found?

A

Posterior border of each testis

266
Q

Where is the site for sperm maturation?

A

Epididymis

267
Q

What is the histology of the epididymis?

A

Pseudostratified columnar epithelium

268
Q

What does the ductus deferens loop over?

A

The ureter and passes down the posterior side of the urinary bladder

269
Q

What do the seminal vesicles store and produce?

A

Some of the liquid portion of semen

270
Q

What do the seminal vesicles secrete?

A

Alkaline fluid, fructose, prostaglandins, clotting proteins

271
Q

What is the function of fructose secreted by seminal vesicles?

A

ATP production

272
Q

What is the function of prostaglandins secreted by seminal vesicles?

A

Contribute to sperm motility and viability

273
Q

What is the function of alkaline secreted by seminal vesicles?

A

Help sperm survive acidic environment of the vagina

274
Q

What is the function of clotting proteins secreted by seminal vesicles?

A

Help semen coagulate after ejaculation

275
Q

What are the 2 main muscles of the scrotum?

A

Dartos – smooth muscle Cremaster – skeletal muscle

276
Q

What do the muscles of the scrotum do?

A

Act to regulate temperature of the testes

277
Q

What does the ductus deferens loop over?

A

The ureter and passes down the posterior side of the urinary bladder

278
Q

What do the seminal vesicles store and produce?

A

Some of the liquid portion of semen

279
Q

What is the ejaculatory ducts formed from?

A

Union of the seminal vesicles and ampulla of the ductus deferens

280
Q

Where does the ejaculatory ducts pass through?

A

Inferiorly through prostate

281
Q

What is the blood supply to the reproductive system?

A

Testes/ovaries – gonadal arteries from abdominal vessels.

Rest – internal pudendal artery from internal iliac artery

282
Q

What is the corpus spongiosum?

A

Contains and spongy urethra and keeps it open during ejaculation

283
Q

What are the corpus cavernosa?

A

Erectile tissue which contains most of the blood in the penis during an erection

284
Q

What does the perineum contain?

A

Anal canalDistal urethra.

External genitaliaSpaces between

285
Q

What is the bulb?

A

Posterior continuation of the base of the corpus spongiosum

286
Q

What encloses the bulb?

A

Bulbospongiosus muscle

287
Q

Describe the venous drainage of the male repro system.

A

Internal pudendal vein (except deep dorsal vein drains into prostate plexus)

288
Q

What are the 2 pouches in the peritoneal cavity?

A

Recto-uterine pouch.

Vesico-uterine pouch

289
Q

What is the endometrium made up of?

A

Stratum basale – provides base.

Stratum functionale – changes depending on phase

290
Q

What is myometrium?

A

The smooth muscle layer of uterus

291
Q

Describe the arterial supply to the uterus

A

Aorta – Supplies ovarian branch for ovariesInternal iliac – Gives off uterine, vaginal, and internal pudendal arteries for vagina/uterus

292
Q

Describe the histology of the cervix

A

Epithelial transformation zone

  • Lower part of cervix – stratified squamous epithelium.
  • Upper part – simple columnar epithelium.
293
Q

In females, what does the internal iliac artery give off?

A

Uterine, vaginal and internal pudendal arteries

294
Q

Which artery supplies the ovaries?

A

Ovarian branch from aorta

295
Q

Via which nerve is most somatic, motor and sensory info of the uterus transmitted?

A

Pudendal nerve

296
Q

Describe the autonomic innervation of the uterus

A

Parasympathetic – S2-4

Sympathetic – T10-L2

297
Q

What does the mesonephric duct become?

A

Ductus deferens

298
Q

In females, what does the paramesonephric ducts become?

A

Uterine tubes and uterus

299
Q

What is the hymen?

A

A thin membranous covering at distal end of vaginal canal;

Remnant of connection between vaginal canal and urogenital sinus

300
Q

What is the broad ligament?

A

2 layers of peritoneum that drapes over the uterus and underneath uterine tubes

301
Q

What is the significance of the gap between the ovary and infundibulum?

A

The zygote (after fertilisation) can fall between these cracks and attach to the abdominal cavity rather than the uterus.

Ectopic!

302
Q

What sits inside the infundibulum?

A

Ovary

303
Q

Where does the round ligament attach?

A

Ovary It runs along rim of the pelvic and passes through inguinal canal, ending up in the labia majora

304
Q

What does the words ‘anteflexed’ and ‘retroflexed’ mean in relation to the uterus?

A

Anteflexed – uterus flopped forward to the cervix.

Retroflexed – uterus flopped backwards towards rectum

305
Q

What is the fornix?

A

Little gully that goes around edge of cervix

306
Q

What does the external iliac artery supply?

A

Lower limbs

307
Q

Name the 2 openings in the perineal membrane in females

A

Vaginal opening and urethral opening

308
Q

How is BMI calculated?

A

kg/m2

309
Q

What is obesity linked to?

A

Poor socio-economic class; deprivation; men; ‘thrifty’ gene

310
Q

What health conditions is obesity associated w/?

A

High BP, high glucose, high insulin (insulin resistance), low HDL, high plasma triacylglycerol, high LDL

311
Q

What is leptin associated w/?

A

Reducing appetite

312
Q

Where is leptin secreted from?

A

Adipose tissue

313
Q

What is associated w/ increased appetite?

A

Ghrelin

314
Q

What is a satiety hormone?

A

Hormone which is released once you’re fed; reduce appetite

315
Q

Which structure releases satiety hormones after a meal?

A

GIT; it reduces appetite

316
Q

Name 2 satiety hormones

A

PYY and GLP-1

317
Q

What does direct calorimetry measure?

A

Heat output from the body

318
Q

What does indirect calorimetry measure?

A

Oxygen consumption

319
Q

What is type 1 diabetes caused by?

A

Damage of beta pancreatic cells leads to no insulin production

320
Q

What is type 2 diabetes?

A

Insulin resistance.

Efficacy of insulin is reduced and glucose not taken up by muscles and organs leading to hyperglycaemia

321
Q

What is the benefit of the genes related to type 2 diabetes?

A

Enabled people in famine environments to survive

322
Q

Name 2 factors which are key factors for the basis of type 2 diabetes

A

Foetal and early nutrition – greater extent

Genetic (Mt16189 gene associated w/ insulin resistance) – smaller extent

323
Q

What forms in the hypophyseal diverticulum?

A

The pituitary gland

324
Q

What is the embryonic origin of the anterior pituitary lobe?

A

Oral ectoderm from roof of mouth

325
Q

What is the embryonic origin of the posterior pituitary lobe?

A

Neuro-ectoderm from diencephalon

326
Q

What is the isthmus?

A

Where the R and L lobe of the thyroid gland joins

327
Q

How does the posterior and anterior pituitary gland differ in the way they release products into the bloodstream?

A

Anterior – neurohormones from hypothalamus enter arterial supply of the lobe, endocrine cells within the anterior lobe secretes products from endocrine cells into venous drainage, e g GH, PR, ACTH, MSH, TSH, FSH, LH.

Posterior – made of neural tissue not endocrine tissue; serves as a site for the secretion of neuro-hypophysial hormones directly into venous blood to body, e g oxytocin, ADH

328
Q

What do chief cells of parathyroid glands secrete?

A

PTH – parathyroid hormone

329
Q

What are parafollicular cells aka and what do they secrete?

A

Calcitonin, C cells

330
Q

How does the parathyroid glands differ from the thyroid?

A

Structurally – para doesn’t have follicles, 4 glands rather 1 bi-lobed glandVasculature usually same

331
Q

What does the follicular cells of the thyroid secrete?

A

T4 93%

T3 7%

332
Q

What are the physiological effects of thyroid hormones on the CV system?

A

Increased HR, contraction force, CO, peripheral vasodilation

333
Q

What are the physiological effects of thyroid hormones on the CN system?

A

Needed for normal brain development (cerebellar growth and nerve myelination), normal intellectual development in infants, emotional stability in adults

334
Q

What is the effects of thyroid hormone on RR?

A

Increases RR and depth of respirations

335
Q

How do thyroid hormones effect growth?

A

Indirectly promotes growth formation by actions on the pituitary gland; acts synergistically w/ growth hormone and other growth factors that promote bone formation

336
Q

What effects do thyroid hormones have on the GI?

A

Increases appetite, secretion of digestive juices, gastric motility

337
Q

What effect does PTH have on the intestine, kidney and bone?

A

Intestine – increases calcium absorption from food Kidney – promotes activation of vitamin D and ↑ Ca reabsorptionBone – activates osteoclasts; Ca2+ and K+ released into blood

338
Q

What hormone is released in response to hypocalcaemia?

A

Parathyroid hormone (PTH)

339
Q

Where are parathyroid glands located relative to thyroid gland?

A

Posterior, 2 on each side

340
Q

Where is the thyroid gland located?

A

Anterior to the trachea, below and lateral to thyroid cartilage, wraps around the cricoid cartilage

341
Q

What is the arterial supply of the thyroid gland?

A

Superior thyroid artery – a branch of external carotid artery.

Inferior thyroid artery – a branch of thyrocervical trunk

342
Q

What is the venous drainage of the thyroid gland?

A

Superior and middle thyroid vein – into internal jugular vein.

Inferior thyroid vein – drains into L and R brachiocephalic veins

343
Q

How does PTH act on the renal system?

A

Promotes renal Ca2+ and PO43- reabsorption

344
Q

How are thyroid hormones synthesised?

A

In follicles, iodine added into tyrosine residues at thyroglobulin (where synthesis of TH takes place)

345
Q

What is thyroid peroxidase?

A

Catalyses ionisation of tyrosine residues (production of TH)

346
Q

What would happen is thyroid peroxidase is inhibited?

A

Autoimmune hypothyroidism

347
Q

List the signs of hypothyroidism

A

Dry and scaly skin, dry and thin hair, puffy eyes, anaemia

348
Q

What is the thyroid gland composed of?

A

Follicles (main secretory cells) – functional units of thyroid; secrete thyroid hormones and store TH in colloid within follicles.

C cells – less numerous and larger (secrete calcitonin)

349
Q

What hormone inhibits osteoclast activity in bone?

A

Calcitonin – from follicular cells of thyroid gland

350
Q

How does calcitonin act on the renal system?

A

Inhibits renal Ca2+ and PO43- reabsorption

351
Q

What is diabetes insipidus?

A

Low levels of vasopression leading to polyuria.

Treat with desmopressin (vasopressin analogue)

352
Q

Which 2 hormones control growth hormone secretion?

A

GHRH – increases GH from anterior pituitary.

Somatostatin – inhibits GHRH-mediated GH release

353
Q

What is Addison’s disease?

A

Autoimmune primary adrenal insufficiency leading to.

Hypocortisolism

354
Q

What is Cushing’s disease?

A

Secondary hypercortisolism (due to pituitary tumour)

355
Q

What is Cushing’s syndrome?

A

Primary excess cortisol (hypercortisolism)

356
Q

What is primary hyperparathyroidism?

A

Overactive parathyroid glands –> hypercalcaemia

357
Q

How does carbimazole (treats hyperthyroidism) work?

A

Reduces TH synthesis by inhibiting thyroperoxidase which normally iodinates tyrosine residues in thyroglobulin to give the precursors of T3 and T4

358
Q

What is the epidemiology of hypothyroidism and hyperthyroidism?

A

More prevalent in. women

359
Q

How is hyperthyroidism treated?

A

Medication – carbimazole (thionamides) interfere w/ thyroid hormone production

Radioactive iodine – Destroys part of the gland by emitting X rays and beta radiation that is cytotoxic to local thyroid cells.

Surgery – reduces amount of functioning thyroid tissue

360
Q

What controls the regulation of thyroid hormone secretion?

A

HPT – axis controls thyroid hormone releaseH - secretes TSH.

Anterior pit - secretes THT - secretes T3 and T4; inhibits hypothalamus and anterior pit secretions

361
Q

How does hyperthyroidism affect TSH, T4 and T3 levels?

A

TSH – decrease and T4 and T3 – increase

362
Q

What usually causes primary hyperparathyroidism?

A

Single benign parathyroid adenoma

363
Q

What is the tail of the pancreas also known as?

A

Splenic end

364
Q

What is the head of the pancreas also known as?

A

Duodenal end

365
Q

What happens when pancreas is removed from the body?

A

It digests itself within 30 seconds

366
Q

What causes insulin dependent diabetes mellitus?

A

Destruction of beta pancreatic cells

367
Q

What is the endocrine pancreas surrounded by?

A

Exocrine pancreas

368
Q

Which type of pancreas has large nuclei?

A

Endocrine

369
Q

What does exocrine pancreas secrete?

A

Bicarbonate (pH buffer).

Zymogens – inactive precursor to enzymes

E.g. pepsinogen, trypsinogen Enzymes – food digestion

370
Q

What does endocrine pancreas secrete?

A

Insulin, glucagon, somatostatin – regulate blood glucose levels.

Pancreatic polypeptide – induces hunger

371
Q

What are intercalated ducts?

A

Portion of the exocrine gland leading directly from the acinus to striated ducts. Forms part of the intralobular duct

372
Q

What is the function of intercalated ducts?

A

Makes and released bicarbonate into the duct via ductal cells which buffers acidic environment to optimal pH for enzyme function

373
Q

What is secretin?

A

A hormone that regulates water homeostasis and secretions in the stomach and duodenum

374
Q

Which cells produce secretin?

A

S cells in duodenum

375
Q

What causes cystic fibrosis?

A

Frameshift mutation in the CFTR channel gene

376
Q

What does CF cause?

A

No movement of Cl- into cell and expulsion of HCO3- and H2O

  • Forms thick, viscous secretions that block exocrine movement of digestive enzymes Leads to LT fibrosis (collagen in pancreas)
377
Q

What is CCK?

A

Cholecystokinin.

A hormone released from duodenum; acts on the pancreas; responsible for digestion of fat and protein

378
Q

Which hormone binds to acinus cells and triggers digestive enzyme release?

A

CCKProduced when food is in stomach

379
Q

What is pancreatin?

A

Drug used as substitute to natural enzymesIt is used for digestion of fat and protein

380
Q

What do pancreatic delta cells produce?

A

Somatostatin – growth hormone

381
Q

What do pancreatic alpha and beta cells produce?

A

Alpha – glucagonBeta – insulin

382
Q

What do pancreatic epsilon cells produce?

A

Ghrelin which increases appetite

383
Q

What do PP cells secrete?

A

Pancreatic polypeptide

384
Q

Which endocrine pancreatic cells are more common?

A

Insulin-secreting beta-cells

385
Q

Which organ doesn’t have insulin receptors?

A

Brain.

Glucose uptake not controlled by insulin

386
Q

Upon release from the pancreas where does insulin travel and act?

A

Enters portal circulation and is carried to the liver Liver – prime target organ

387
Q

Where does the proportion of insulin not broken down in the liver go?

A

Kidneys

388
Q

In which 2 forms does insulin exist in?

A

Hexametric (inactive) and monomeric (active)

389
Q

Where is hexametric insulin stored?

A

Secretory granules

390
Q

In hexametric insulin, what holds together the 6 insulin molecules?

A

Central zinc moleculeHistidine bonds

391
Q

Why does monomeric insulin have a high diffusion rate?

A

Because it’s a small molecule

392
Q

What is insulin synthesised as?

A

A single 22aa polypeptide chain called pre-proinsulin

393
Q

What does CCK do to hunger?

A

Suppresses it

394
Q

What signal releases insulin from granules to blood?

A

Vagal nerve stimulation

395
Q

Name the 29aa polypeptide produced by alpha cells

A

Glucagon

396
Q

What is glucagon cleaved into in intestinal L cells?

A

GLP-1 (an incretin), GLP-2 (promotes intestinal growth), IP-2

397
Q

What is GLP-1?

A

Glucagon like peptide 1

398
Q

What is the function of incretin hormones?

A

Reduce appetite by acting on hypothalamus, Slow gastric emptying,Reduce glycogenolysis, Stimulates insulin secretion

399
Q

How is type 2 diabetes controlled?

A

Anti-hyperglycaemic agents:

  • Metformin
  • Sulphonylureas
  • Glitazones- GLP-1 agonist
  • DPP-4 inhibitor
  • Insulin analogues
400
Q

What does incretin promote?

A

Satiety and reduces appetite

401
Q

What is metformin?

A

Biguanide

402
Q

How does metformin work?

A

Improves insulin resistance in skeletal muscles and liver so more glucose uptake In GIT prevents glucose absorption leading to lowering blood glucoseDecreases gluconeogenesis and glycolysis

403
Q

What are side-effects of metformin?

A

Lactic acidosis – rare but 50% mortality rate once acquired.

Vitamin B12 deficiency – LT

404
Q

What are PPAR γ agonists?

A

Peroxisome proliferator-activated receptor agonists.

Nuclear receptor that modulates transcription of insulin sensitising genes and insulin sensitised in liver, muscles and adipose tissue

405
Q

What is the pampiniform plexus?

A

Venous network in the scrotum; drains testes to testicular vein

406
Q

What do theca cells correspond to in males?

A

Leydig cells (found in males)

407
Q

What do sertoli cells correspond to in females?

A

Granulosa (found in females)

408
Q

How does sildenafil work?

A

Phosphodiesterase (E5) inhibitor PDE5 is inhibited in cavernosal smooth muscles through 2nd messengers he smooth muscle contracts and penis becomes erect

409
Q

Name 3 drugs for erectile dysfunction

A
  1. Phosphodiesterase (E5) inhibitors – sildenafil
  2. Prostaglandin-E1 agonists – alprostadil
  3. Dopamine receptor agonists – apomorphine
410
Q

Why is oxytocin important in pregnancy?

A

Contracts uterine muscles (delivery), and breast muscles (milk)

A** (19 decks)

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