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12- REPRO > Anatomy > Flashcards

Anatomy Flashcards

1
Q

Peritoneum and coverings of the testis

A
  • tunica vaginalis
  • skin
  • superficial fascia (dartos in scrotum)
  • flat muscles
  • fascia transversalis
  • parietal peritoneum
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2
Q

What is the processus vaginalis?

A

Peritoneal tube dragged by the testis during descent and is obliterated in development (may leave a dimple)

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3
Q

What is the spermatic fascia?

A

Extension of external oblique aponeurosis. It has a thin fibrous covering attached to the superficial inguinal ring

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4
Q

What is the cremaster muscle?

A

Extension of external oblique muscle, bundles of skeletal muscle and is involved in lifting the testis.

Supplied by the genitofemoral nerve

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5
Q

What is the internal spermatic fascia?

A

Extension of fascia transversalis, a thin fibrous tube that is attached to deep inguinal ring

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6
Q

Blood supply of the testis

A

Testicular artery from the aorta

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7
Q

Venous drainage of the testis

A

Pampiniform plexus - like tendrils

Form two veins or one in abdomen

Lead to IVC - the R testicular goes directly, left goes into renal vein then IVC

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8
Q

Where is testicular pain referred to?

A

Visceral - lateral to umbilicus in T10 dermatome

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9
Q

What is the epididymus?

A

Single highly coiled structure that is posterior to the testis and has a narrow tail continuing as ductus deferens

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10
Q

Location of prostate gland

A

Surrounds prostatic urethra
Single median lobe
Posterior, lateral and anterior lobes

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11
Q

Commonest site of fertilisation

A

Ampulla

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12
Q

What are the angles of version and flexion?

A

Version: vagina cervix angle
Flexion: cervix body angle

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13
Q

What is the fornix

A

Circular groove between cervix and vaginal wall, deeper posteriorly

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14
Q

Describe the peritoneum of the uterus

A
  • Uterovesical pouch (UV)
  • Rectovaginal pouch (RV)

Broad ligament
o Mesometrium
o Mesosalpinx
o Mesovarium

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15
Q

What supports the uterus?

A

Pelvic diaphragm

  • transverse cervical ligament
  • uterosacral ligament
  • pubocervical ligament
  • round ligament
  • broad ligament
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16
Q

Blood supply of female reproductive organs

A
  • Uterine – internal iliac
  • Ovarian – aorta
  • Anastomoses tube
  • Vaginal – independent and from uterine
  • Uterine artery in pregnancy – supports extra musculature and foetus
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17
Q

Relations of the cervix:
Anterior
Posterior
Lateral

A 
Posterior: rectum
Anterior: bladder
Lateral:
•	Uterine artery 
•	Ureter 
•	Cross in a narrow region
•	Dangerously close – cancer of cervix/surgery
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18
Q

Where do the uterine artery and ureter cross each other?

A

Very close to the cervix - lateral

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19
Q

Location of the pregnant uterus at 12, 24, 36 and 40 weeks

A
  • Above symphysis at 12 weeks
  • 24 weeks – umbilicus
  • 36 weeks – xiphersternum
  • 36-40 weeks – engagement and descent
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20
Q

What are the ‘3 set of kidneys’ at the beginning of development?

A

o Pronephros, mesonephros and metanephros

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21
Q

Where is the pronephros located?

A

In the neck and thorax of the embryo

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22
Q

What does the mesonephric duct open into?

A

Cloaca - common exit chamber for GIT and UG

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23
Q

Describe the development of the metanephros

A
  • Metanephros develops in sacral pelvic region
  • Duct for metanephros – offshoot of mesonephric duct
  • New duct (ureteric bud) ureter, calyces, collecting ducts

Metanephros nephrons
• As it develops, metanephros migrates cranially (ascent of kidney)

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24
Q

What develops from the ureteric bud?

A

It dilates as the renal pelvis and then further branches into major and minor calyces, finer branches into the collecting duct

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25
Q

What develops from the metanephros?

A

• Form nephron parts up to DCTs

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26
Q

What does the gonadal ridge develop from?

A

Intermediate mesoderm

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27
Q

Ducts which male and female reproductive organs develop from:

A

Male: mesonephric duct ductus deferens
Female: paramesonephric duct
• Cranial parts uterine tubes
• Fused caudal part uterus, part of vagina

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28
Q

The ureteric bud is an offshoot of which duct?

A

Mesonephric

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29
Q

Describe the decent of the ovaries

A

Ovary in pelvis: Gubernaculum elongates
• From ovary to labium majus
•

Interrupted by the uteris two parts
o Ovary to uterus: ligament of ovary
o Uterus to labium: round ligament of uterus (via inguinal canal)

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30
Q

Chromosomes in somatic cells

A
  • 23 pairs
  • each pair homologous, maternal and paternal
  • chromatids not seen in a non-dividing cell
  • visible once they have already replicated
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31
Q

The goal of meiosis

A

Cell with haploid number - 23 chromosomes

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32
Q

When does crossing over occur?

A

Meiosis 1

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33
Q

End product of meiosis 1

A

2 cells, haploid replicated chromosomes but with mixed genes

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34
Q

End of meiosis 2

A

Chromatids separate and so 4 haploid cells are left

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35
Q

What proportion of the ovary is covered by peritoneum?

A

Entire ovary

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36
Q

What makes up a follicle in an ovary?

A

Oogenic cell + supporting cells

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37
Q

Oogenesis

A
  • begins in fatal life
  • meiosis is not completed
  • suspended until puberty
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38
Q

Follicular maturation and terminology

A
  • primordial follicle (oocyte + 1 layer flat cells)
  • primary follicle (flat cells become cuboidal)
  • granulose cells multiply and develop a cavity called a follicular antrum
  • filled with fluid = liquor follicle
  • egg placed on cumulus oophorus
  • zone pellucide clearly visible
    Mature follicle = graafian follicle about 1cm in diameter

Ovulation: oocyte released into peritoneal cavity and surrounded by 1 or 2 layers of cells = corona radiata

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39
Q

Theca

A

Theca interna: immediately surrounds follicle

Theca externa: surrounding fibrous layer

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40
Q

Corpus luteum

A

Granulosa + theca interna

Yellow body = temporary endocrine structure

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41
Q

Why are both meiotic divisions unequal in oogenesis?

A
  • At the end of meiosis 1: one large secondary oocyte + one tiny polar body
  • At the end of meiosis 2: secondary oocyte fertilizable egg + second polar body
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42
Q

When is meiosis 2 in females completed?

A

After entry of sperm

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43
Q

Uterine tube epithelium

A
  • Pseudostratified columnar
  • Ciliated cells
  • NO GOBLET CELLS – the columnar cells secrete a watery fluid
  • Cilia create a current in the fluid
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44
Q

Endometrial phases

A
  1. Menstrual – bases of glands, stumps of blood vessels
  2. Proliferative – epithelium continues, later glands develop
  3. Secretory: coiled glands, glycogen, spiral arteries
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45
Q

Start and end product of meiosis 1 in males

A

Primary spermatocyte becomes a secondary spermatocyte

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46
Q

Changes undergone from spermatids to spermatozoa

A 
•	Spermatids lose a lot of cytoplasm
•	Develop a tail 
•	Head: almost entirely occupied by nucleus 
o	Acrosomal cap – enzymes
•	Neck – spiral mitochondrion
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47
Q

Sertoli cells

A
  • Columnar cells
  • spermatogenic cells fit into depressions
  • blood testis barrier
  • phagocytose XS cytoplasm
  • produce androgen binding protein
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48
Q

What are the interstitial cells in the seminiferous tubules and what do they produce?

A

Lydia - testosterone

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49
Q

Epithelium of epididymus

A

• Pseudostratified columnar epithelium: with stereocilia – long microvilli

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50
Q

Anterior, lateral and posterior boundaries of the perineum

A

Anterior
o Pubic symphysis
o Ischiopubic rami

Lateral
o Ischial tuberosities

Posterior
o Sacrotuberous ligaments
o Coccyx

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51
Q

How does the urogenital tract differ between males and females?

A

o Male: long penile urethra (common U-G passage)

o Female: short urethra (vagina is a separate opening)

52
Q

Inferior and superior limit of the perineal pouches (vertical extent of perineum)

A

Inferior: scrotal + perineal skin with fascia

Superior: pelvic diaphragm and fascia

53
Q

What does the perineal membrane separate?

A

Superficial and deep pouches

54
Q

Structure of the penis

A

• 2 long cylindrical bodies
• Corpus cavernosum x2
o Large blood filled spaces (caverns)
• Single corpus spongiosum, contains urethra
• All 3 made of highly vascular dense fibrous tissue (especially cavernosa) = erectile tissue
• All 3 begin in the superficial pouch
• Each one associated with a muscle

55
Q

Corpus cavernosa

A
  • Begins as crura
  • Attached to ischiopubic ramus
  • Each crus covered by a muscle – ischiocavernosus (ischium to corpus cavernosum)
56
Q

Corpus spongiosum

A

Begins as the bulb of the penis and contains urethra

At the tip of the penis the spongiosum expands –> conical glans penis

57
Q

Regions of the urethra

A
  • Prostatic in the pelvis
  • Membranous
  • Bulbar
  • Penile
58
Q

Skin over the glans and its layer

A

Prepuce: 3 layers

  • innermost is attached to glans
  • two outer layers slide to retract
59
Q

Which muscle makes the anorectal junction?

A

Puborectalis

60
Q

Sphincters in the perineum of the anal triangle

A

Internal: thickening of circular smooth muscle
External: skeletal muscle below levator ani

61
Q

What does the pudendal nerve supply? (S2,3,4)

A
  • All of the perineum
  • exits through greater sciatic foramen
  • enters perineum through lesser sciatic foramen
62
Q

Chromosomes in mitosis in somatic cells

A
  • 23 pairs of chromosomes
  • Each pair (homologous chromosomes) – one maternal and one paternal
  • Chromosomes not seen in a non-dividing cell
  • When visible – already replicated
  • Here shown in metaphase of mitosis
  • Chromatids identical – each chromatid = a chromosome in a resting cell
63
Q

What is the goal of meiosis?

A

Cell with haploid number - 23 chromosomes

64
Q

Meiosis 1 and 2

A

1: replication of chromosomes and crossing over resulting in two haploid cells with replicated chromosomes and mixed genes
2. chromatids separate, at the end there are 4 haploid cells

65
Q

Peritoneal epithelium surrounding the ovary

A

Cuboidal cells but with each ovulation, the damage is repaired with squamous cells

66
Q

What is the follicle in an ovary comprised of?

A

Oogenic cell and supporting cells = follicle

67
Q

Oogenesis in the ovary

A

• Begins in fetal life – primordial germ cells
• Meiosis 1 begins but not completed
• Remains suspended for many years
• Resumed at puberty, however:
o Cyclical, few cells puruse the path to maturity in a cycle
o Generally only one is released for fertilization
• Thus:
o Some cells are in suspended division for 12 years +-
o Some may remain suspended for as many as 45 years+

68
Q

Cells surrounding the oocyte through maturation ?

A

Granulosa cells

69
Q

Primordial follicle

A

Oocyte + 1 layer of flat cells

70
Q

What is the first sign go course to maturation (from primordial follicle to primary follicle)?

A

Flat granulosa cells become cuboidal

71
Q

What is the cavity that the granulosa cells develop and what is it filled with?

A

Follicular antrum - filled with liquor folliculi

72
Q

Mound of cells that the oocyte is placed on?

A

Cumulus oopohorus

73
Q

4 facts on the mature follicle

A

o Graafian follicle – about 1cm in diameter
o Protrudes on the surface
o Pale spot on the stretched wall = stigma
o Oocyte with few layers of cumulus separate before ovulation

74
Q

What surround the oocyte when it ruptures and is released into the peritoneal cavity?

A

Corona radiata

75
Q

How is stroma involved in the follicle?

A

• Compressed by enlarging follicle
• Forms a container around the follicle = theca
• Two parts:
o Immediately around the follicle – theca interna (temporary endocrine organ)
o Surrounding fibrous layer: theca externa

76
Q

After ovulation

A
  • Large empty follicle collapses
  • Granulosa + theca interna = corpus luteum

Persists for a few weeks if oocyte fertilized
• If not, it degenerates within 2 weeks – corpus luteum of menstruation

77
Q

Cell populations of the corpus luteum

A

o Granulosa lutein cells

o Theca lutein cells

78
Q

Oogenesis:
At the end of meiosis 1:

At the end of meiosis 2:

A
  • At the end of meiosis 1: one large secondary oocyte + one tiny polar body
  • At the end of meiosis 2: secondary oocyte fertilizable egg + second polar body
79
Q

Epithelium of uterine tube

A
  • Pseudostratified columnar
  • Ciliated cells
  • NO GOBLET CELLS – the columnar cells secrete a watery fluid
  • Cilia create a current in the fluid
80
Q

Epithelium of the endometrium

A

• Columnar epithelium + glands

81
Q

Endometrial phases

A
  1. Menstrual – bases of glands, stumps of blood vessels
  2. Proliferative – epithelium continues, later glands develop
  3. Secretory: coiled glands, glycogen, spiral arteries
82
Q

Cervix epithelium

A

o Columnar in canal

o Stratified squamous from external os

83
Q

Epithelium of vagina

A

Stratified squamous

84
Q

Fibrous coat surrounding testes

A

Tunica albuginea

85
Q

Spermatogenesis

A 
Spermatogonia
•	Small, round and peripheral
•	Divide mitotically – some reserve, some mature
Spermatogonia  primary spermatocyte
•	Primary spermatocyte undergoes meiosis 1  secondary spermatocyte
Secondary spermatocyte: short lived
•	Meiosis 2  spermatid
Meiosis produces four spermatids
86
Q

Changes when spermatids become spermatozoa

A 
•	Spermatids lose a lot of cytoplasm
•	Develop a tail 
•	Head: almost entirely occupied by nucleus 
o	Acrosomal cap – enzymes
•	Neck – spiral mitochondrion
87
Q

Structure and function of sertoli cells

A 
•	Supporting cells 
•	Columnar 
•	Spermatogenic cells fit into depressions 
•	Form tight junctions 
o	Isolate ‘genetically different’ cells
o	Blood-testis carrier 
•	Phagocytose XS cytoplasm
•	Produce androgen binding protein
88
Q

Epithelium of epididymis

A

• Pseudostratified columnar epithelium: with stereocilia – long microvilli

89
Q

Anterior, lateral and posterior boundaries of the perineum

A

Anterior
o Pubic symphysis (1)
o Ischiopubic rami (2)

Lateral : ischial tuberosities (3)

Posterior:
o Sacrotuberous ligaments (4)
o Coccyx (5)

90
Q

What is contained in the deep perineal pouch?

A

Bulbourethral glands - ducts pass through perineal membrane –> urethra in superficial pouch

Blood vessels - internal pudendal, from internal iliac

91
Q

Structure of the penis

A

2 x corpus cavernosum

single corpus spongiosum containing urethra

92
Q

Development of the corpus cavernosa

A
  • Begins as crura
  • Attached to ischiopubic ramus
  • Each crus covered by a muscle – ischiocavernosus (ischium to corpus cavernosum)
  • Corpus and muscle attachment
93
Q

Corpus spongiosum

A

Begins as the bulb of the penis
• Contains urethra
• Muscle – bulbospongiosus
• Muscle fibres:
o Begin at the perineal membrane
o Go around the bulb
o Meet at a raphe on the inferior surface
• At the tip of the penis: spongiosum expands conical glans penis
• Three structures converge under the pubis – enclosed in fascia and skin

94
Q

Prepuce

A

o 3 layers
o innermost attached to the glans
o two outer layers slide to retract
o Small fold on the ventral side (Y) – frenulum

95
Q

What encloses the reproductive vestibule in females?

A

Labia minora

96
Q

Ischiorectal fossa

A

Angular space between ischium and pelvic diaphragm

97
Q

Sphincters in the perineum

A

Internal: thickening of the circular muscle
External: skeletal muscle, below levator ani

98
Q

Nerve and blood supply of perineum

A

Pudendal nerve (S2, 3, 4) supplies all of perineum except root of penis

  • exits greater sciatic foramen
  • enters perineum through lesser sciatic foramen

Internal pudendal blood vessels (internal iliac system)

99
Q

Which structures do not drain to the inguinal lymph nodes

A

Testis - para-aortic

Proximal anal canal - pre-aortic

100
Q

What is breast composed of?

A

Glandular tissue, fibrous supports, fat

101
Q

Female breast size and extent

A

Size determined by fat (except during lactation)
Vertical extent: 2nd to 6th rib
Horizontal: lateral border of sternum to midaxillary line

102
Q

What does the female breast rest on?

A

Adjacent parts of:
♣ Pectoralis major.
♣ Serratus anterior.
♣ External oblique.

103
Q

Internal anatomy of the breast

A 
♣	Masses (lobes) of glandular tissue.
♣	Fat distributed amongst 
and within these.
♣	Fibrous tissue between skin
and deep surface.
•	Cooper’s ligaments 
(“suspensory” ligaments).
•	 Not fixed to muscles!
104
Q

Arterial supply of the breasts

A

Internal thoracic artery (branch of subclavian)
o Perforating cutaneous branches.
o Larger in spaces 2 – 4 / 5. : Main supply to the breast.
o Branches from axillary – More to superficial parts.

105
Q

Venous drainage of the breasts

A
  • More towards axillary.
  • Superficial veins often visible, especially in pregnancy and lactation
  • Subclavian (internal thoracic).
106
Q

Lymphatics and lymph nodes of the breast

A

♣ Most lymphatics plexus deep to areola.
♣ Lateral part of plexus axillary nodes.
• Mainly nodes under pect. major.
• Other nodes : infra- and supraclavicular.
♣ Medial part nodes along the internal thoracic vessels (parasternal).
• May cross midline.

107
Q

Age related changes of the breasts: prepubertal and pubertal

A

Prepubertal.
• Ducts, no secretory units.
• Little branching, growth of fibrous + adipose tissue.

Puberty.
• Ducts branch, new adipocytes form.
• Projection of nipple, enlargement of areola, smooth contour.
• Changes during menstrual cycle. Some cell proliferation, blood supply, stromal water content.

108
Q

Post menopausal breast changes

A

Involution of glandular tissue but some ducts may remain

109
Q

Histology of nipple

A
  • Thin skin, no hair.
  • Smooth muscle.
  • Sebaceous glands (Seb).
  • Lactiferous ducts.
110
Q

Histology of areola

A

Glands : modified glands.

Enlarge during pregnancy : Montgomery’s tubercles (M).

111
Q

Melanocytes in nipple and areolar

A

Pigmentation after puberty, darkening after pregnancy

112
Q

Activity of the breasts: prepubertal and post-pubertal

A

Prepubertal:
• Rudimentary ducts
• Very little fat

Post-pubertal, non-lactating
•	Fat increases 
•	Plenty of connective tissue 
•	Longer ducts 
•	No secretory units
113
Q

Activity of the breasts during pregnancy

A 
•	Ducts proliferate in early pregnancy 
(number and branching).
•	Secretory units (alveoli) develop at tips.
•	Lobules in each gland.
•	Myoepithelial cells grow larger.
(Flat epithelial cells, contractile like smooth muscle. Surround secretory units.)
•	CT: Lymphocytes, plasma cells.
•	In late pregnancy :
♣	Secretory activity increases.
114
Q

Activity of the breasts during lactation

A

• Large secretory units (alveoli) filled with secretion.
• Columnar cells, flattened somewhat by secretions.
♣ Contain membrane bound protein and lipid droplets.
• Secretory cells also take in IgA from plasma cells.
• Myoepithelial cell contraction pushes secretions into ducts.
• Vasculature and smooth muscle causes swelling of areola and erection of nipple.
♣ Also during sexual arousal.

115
Q

Male breast anatomy

A
  • Smaller nipple and areola
  • Small ducts or solid cords of cells
  • Slight enlargement in the neonate and at puberty
  • Gynaecomastia
  • Cancer can occur in the male breast, though rare
116
Q

Gynacomastia

A

Benign growth of the male breast with possible hormonal cause or drug cause

117
Q

What is in the spermatic cord?

A 
Testicular artery 
Testicular veins 
Ductus deferens 
Lymphatics 
Nerves
118
Q

What is in the inguinal canal?

A

In men, the spermatic cord passes through the inguinal canal, to supply and drain the testes. In women, the round ligament of uterus traverses through the canal

119
Q

What forms the superficial and deep rings of the inguinal canal

A

Superficial: external oblique (marks the end of the inguinal canal, and lies just superior to the pubic tubercle)
Deep: Trasversalis fascia (above the midpoint of the inguinal ligament)

120
Q

4 Features marking the differences between male and female pelvis

A

Male:
v shaped suprapubic angle
heart shaped pelvic inlet

Female
u shaped suprapubic angle
Round pelvic inlet
Acetabular distance from pubis symphysis > acet diameter
Greater sciatic notch much wider in female

121
Q

Features of ischiopubic rami in males and females

A

In the male the edges
are thick and everted due to the attachments of the bigger and stronger ischiocavernosi muscles. In the female the edges are not so prominent.

122
Q

Ischial spines in males and females

A

In a typical male pelvis they point inwards, in the female they are vertical or point outwards.

123
Q

Oblique diameter of the pelvic inlet

A

The oblique diameter is measured from one sacroiliac joint to the opposite iliopubic eminence.

124
Q

Anterior posterior diameter of the pelvic inlet

A

The anteroposterior diameter is measured from the centre of the sacral promontory and the anterior end of the pubic symphysis.

125
Q

Pelvic outlet measurements

A

 The anteroposterior diameter is from the posterior edge of the pubic symphysis to the tip of the coccyx. There is a joint between the sacrum and the coccyx, which is slightly movable, so during childbirth this diameter can be increased slightly.

 The transverse diameter is between the ischial tuberosities.

The oblique diameter is from the middle of one ischiopubic ramus to the middle of the opposite
Sacrotuberous ligament.

126
Q

Which measurements are greatest in the female pelvis at the inlet and outlet

A

In a typical female pelvis, transverse diameter is the greatest diameter at the inlet; at the outlet the anteroposterior diameter is the greatest.

12- REPRO (7 decks)

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