ch33/34: alterations of the reproductive systems Flashcards
characteristics of delayed puberty?
can differ with ethnicity, can resolve on its own (for the most part)
can be a hypothalamus-pituitary gonad issue
precocious puberty (pp)
early puberty
- can vary in gender and ethnicity, medical intervention not needed
complete pp
full development of secondary sex characteristics
incomplete pp
some secondary sex characteristics develop
isosexual pp
development of secondary sex characteristics that are consistent with gender
heterosexual (mixed) pp
- give an example
development of secondary sex characteristics NOT consistent with gender
ex. female might have hypersecretion of testosterone
what are some sex chromosome disorders?
- turners syndrome
- klinefelters syndrome
- trisomy x
- jacob’s syndrome
can you get pregnant with a sex chromosome disorder?
no - you can’t get pregnant by yourself, but can give birth
- issue with gamete production, but still anatomically able to give birth
turner’s syndrome
- genotype
- appearance
- genetic fault
- barr body?
- XO (no second sex chromosome)
- -> the ONLY monosomic disorder that human’s can tolerate
- female anatomy bc lack of Y
- missing X chromosome bc of mom
- no barr bodies
klinefelter’s syndrome
- genotype
- appearance
- genetic fault
- barr body?
- XXY (extra X because of nondisjunction)
- gynecomastia in men, incomplete gonadal development, sterile
- fault either mom OR dad
- 1 barr body
trisomy x
- genotype
- appearance
- genetic fault
- barr body?
- XXX (super female)
- normal female appearance, does not realize she has it until she tries to get pregnant
- fault at mom?
- 2 barr bodies
jacob’s syndrome
- genotype
- appearance
- genetic fault
- barr body?
- XYY (super male)
- low IQ, aggressive, sterile
- fault bc 2 Ys from dad
- no barr bodies
can lead to intersex develpopment
t/f: the reason why an XX female develops as a female is because of the presence of X chromosome
false - it is bc of the lack of Y
androgen insensitivity syndrome
the ability of some women to have a Y chromosome; receptor cells are mutated so that androgen’s can’t bind = hormone resistance
–> still look female
partial androgen insensitivity syndrome (PAIS)
cells are somewhat responsive to androgens, but not fully
complete androgen insensitivity syndrome (CAIS)
cells completely don’t respond to androgens = develop as a female
what is an easy way to clinically check if a woman has androgen insensitivity syndrome?
take cells –> go under microscope –> NO BARR BODY (bc XY genotype)
dysmenorrhea
bad and painful period
primary dysmenorrhea
hormonal component leads to painful period
secondary dysmenorrhea
physical anatomical pelvic problem –> leads to painful menstruation
amenorrhea
lack of period
what age should condition be considered amenorrhea?
when a female reaches 13-15 years old and does not have menarche
primary amenorrhea
does not have period at all
secondary amenorrhea
happens after you already had your period, then lose it (PCOS)
abnormal/dysfunctional uterine bleeding (DUB)
bleeding of the uterus that can happen even without disease
polycystic ovarian syndrome (PCOS)
- no other hormones to counter increased androgen production
- scant menstrual cycles
- large ovaries
- insulin resistance
- benign
- difficulty conceiving, usually overweight, extra hair growth
what are some premenstrual disorders and what stage of the cycle do they occur?
premenstrual syndrome (PMS): physical hormonal component premenstrual dysphoric disorder (PDD): more psychological and emotional
part of the luteal phase of cycle
why do premenstrual disorders happen?
it is the result of dramatic changes in hormone concentrations
pelvic inflammatory disease
acute, generalized, inflammation of the female reproductive duct
what are some pelvic inflammatory diseases?
- salpingitis
- oophoritis
- vaginosis/vaginitis
- cervicitis
- vulvitis
- bartholinitis (bartholin cyst)
what are pelvic inflammatory diseases caused by?
STI or imbalance of vaginal flora
salpingitis
fallopian tube inflammation, can lead to scarring
what can scarred fallopian tubes lead to a higher risk of?
ectopic pregnancy (bc cilia cannot move egg to uterus)
oophoritis
inflammation of the ovaries
vaginosis and vaginitis
irritation/inflammation of the vagina
vaginosis vs vaginitis
vaginosis: irritation without WBCs in labs
cervicitis
cervix inflammation
vulvitis
inflammation of the labia majora and minora
bartholinitis (bartholin cyst)
inflammation of the bartholin glands (responsible for secreting fluid for intercourse)
what is the role of lactobacillus acidophilus?
keeps vaginal pH low and keeps candida in check to prevent yeast infection
vaginal prolapse
uterus can prolapse into vagina OR vagina itself protrudes out because of weakened cervix
pelvic relaxation disorders usually result in _____
stress incontinence
cystocele
bladder prolapse
urethrocele
urethral prolapse
rectocele
rectal prolapse
enterocele
intestines prolapse
uterine prolapse
can accompany vaginal prolapse (uterus prolapse into vagina or further)
what to use to treat prolapse/pelvic relaxation disorders?
pessary: mechanical device used to help keep structures in place
what are some benign growths and proliferative conditions of the female repro system?
- benign ovarian cysts
- endometrial polyps
- leiomyomas (uterine fibroids)
- adenomyosis
- endometriosis
3 types of benign ovarian cysts?
- follicular cysts
- corpus luteum cysts
- dermoid cysts
follicular cysts
cysts where follicle hasn’t ruptured yet, ovum still inside
corpus luteum cysts
cysts where the follicle has ruptured, ovum released, cells in follicle keep proliferating
dermoid cysts
may or may not involve the follicles at all, usually teratomas
teratoma: redifferentiated cells = tumor can grow hair, nails, teeth
ovarian torsion
ovary becomes twisted (fallopian tubes and blood vessels) –> need to surgically untwist
endometrial polyps
polyp in the inner lining of the uterus
- can be found and treated easily
leiomyomas (uterine fibroids)
proliferative condition affecting the myometrium (muscular layer)
- can get large enough to where they push other tissues aside
three different types of leiomyomas?
- intramural
- submucous
- subserous
adenomyosis
endometrial tissue starts growing into myometrium
endometriosis
little functioning islands of endometrium grow into peritoneal cavity + other places
- painful menstrual cycles
what symptom is associated with endometriosis?
dyschezia (painful poops)
what are some types of cancers of the female repro system?
- cervical cancer
- vaginal cancer
- vulvar cancer
- endometrial cancer
- ovarian cancer
cervical cancer
- if it originated in cervix, you can assume that…
cancer of the cervix
- if originated from cervix, can assume that pt has been exposed to HPV
how to know if a pt has true cervical cancer?
when tumor is
- extravasating (branching out
- metastasizing (spreading in bloodstream through small pieces)
what is the precancerous condition that precedes cervical cancer?
cervical intraepithelial neoplasia (CIN)
vaginal cancer
usually rare; disease in which malignant (cancer) cells form in the vagina
vulvular cancer
usually rare; type of cancer that occurs on the outer surface area of the female genitals
endometrial cancer
- surgical treatment?
most common cancer; presents with obvious pain and has the ability to extend to other tissues
- surgical treatment: hysterectomy
ovarian cancer
not as common as cervical/endometrial; by the time you know there’s a problem, it’s already extravasated/metastasized
what some disorders of the female reproductive system?
- vaginismus
- anorgasmia
- dyspareunia
- infertility
vaginismus
muscles of the vagina spasm; won’t allow penetration to happen (if it does allow, will be very painful)
anorgasmia
inability to have an orgasm/reach climax
dyspareunia
painful intercourse
infertility
- what can cause it?
inability to reproduce
- can be caused by PCOS, sex chromosome disorders, immuneprivilege dysfunction
immunoprivilege and what it has to do with infertility?
reproductive system is normally immunoprivileged = means barrier to lymphatic tissue –> very hard for drugs and microbes to get past
if they do get past/own immune system attacks = VERY HARD TO TREAT
after ______ of unprotected sex, a couple is deemed to be infertile
one year
what are some disorders of the female breast?
- galactorrhea
- benign breast disease (BBD)
- breast cancer
galactorrhea
inappropriate lactation (can also happen in men)
benign breast disease (BBD)
can present with fibrocystic changes or lipomas
lipoma
fatty growths
atypia and its relation to benign breast disease
BBD may be with or without atypia; when biopsy shows that cells have beginnings of dysplasia
breast cancer (what are some factors)
- genetic mutations
- lifestyle (smoking, diet, dramatic hormonal imbalances)
what are some male urethral disorders?
- urethritis
- urethral stricture
urethritis
inflammation of the urethra
- usually due to STDs
- can present with dysuria
what two STDs are mostly responsible for urethritis?
gonorrhea and chlamydia
urethral stricture
- it is a suspect of _____
constriction of the diameter of the urethra (can be with or without urethritis)
- suspect of male infertility
what are some penile disorders?
- phimosis
- paraphimosis
- peyronie disease
- priapism
- balanoposthitis
- condyloma acuminatum
- penile cancer
what penile disorders can arise when the patient is uncircumcised?
phimosis and paraphimosis
phimosis
foreskin can’t retract (head of penis looks pointed)
paraphimosis
foreskin is able to retract but can’t return after retraction
peyronie disease
“bent nail disease”
penis bends to one side –> issue with blood flow –> penis bends toward side with obstruction of blood flow
priapism
erection that lasts for a long period of time (needs quick medical intervention)
what can cause priapism?
- erectile dysfunction drugs
- nitric oxide
balanoposthitis
balantitis (inflammation of the head of the penis) + posthitis (inflammation of the shaft)
condyloma acuminatum
wart like growths that grow due to exposure to HPV
penile cancer
- more often with men exposed to _____
more often with men exposed to HPV
what are some scrotum/testis/epididymis disorders?
- varicocele
- hydrocele
- spermatocele
- cyrptorchidism
- testicular torsion
- orchitis
- testicular cancer
- epididymitis
- infertility
varicocele
persistent dilation of blood vessels
“bag of worms”
hydrocele
layers surrounding testicles can fill up with water or lymph
spermatocele
ductwork that brings sperm out of testes become dilated and distended = hypofunctional
cryptorchidism (ectopic testis)
testes don’t descend into scrotum during development (can affect one or both)
ectopic testis: migration of testis somewhere else –> might have to surgically pull down if not descended during puberty
testicular torsion
when a testicle rotates, twisting the spermatic cord that brings blood to the scrotum
orchitis
inflammation of the testes
testicular cancer
nontender lump on the testes, usually painless
why is testicular cancer easier to catch than female repro cancers?
men have more external genitalia
epididymitis
inflammation of the epididymis
male infertility
scarring of network bringing sperm out, infectious disease, sperm cells are morphologically dysfunctional
what are some prostate disorders?
- benign prostate hyperplasia
- prostatitis
- prostate cancer
benign prostatic hyperplasia (BPH)
enlargement of the prostate that leads to reduced urethral lumen = bladder outflow obstruction
what to test for to see if there is BPH?
PSA: prostate specific antigen
- levels of these = hyperplasia of the prostate
prostatitis
infectious disease mostly from STD –> inflammation of the prostate
bacterial and nonbacterial
prostate cancer
most common cancer in male in the US
gynecomastia
abnormal breast development in men, has a link to breast cancer
what conditions may lead to gynecomastia?
- klinefelters syndrome
2. liver dysfunction (bc enzyme in liver converts testosterone –> estrogen)
what enzyme converts testosterone to estrogen and can result in the development of gynecomastia?
aromatase
