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Analysis of Urine and Other Body Fluids > Chapter 13 - Semen > Flashcards

Chapter 13 - Semen Flashcards

1
Q

Reasons for seminal fluid analysis

A

Fertility testing, post vasectomy semen analysis, forensic analysis (alleged rape)

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2
Q

Composition of semen:

____% spermatozoa
____% seminal fluid
____% prostate fluid
____% bulbourethral gland

A

5%
60-70%
20-30%
5%

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3
Q

Production site of spermatozoa (spermatogenesis)

A

Seminiferous tubules (testes)

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4
Q

Nurse cells for developing sperms

A

Sertoli cells

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5
Q

Where does sperm maturation (sperm becomes motile) occur?

A

Epididymis

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6
Q

Provide nutrients for sperm & fluid

A

Seminal vesicles

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7
Q

Seminal vesicles are rich in ____ necessary for sperm motility

A

Fructose

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8
Q

Acidic fluid that contains ACP, zinc, citric acid and other enzymes

A

Prostate fluid

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9
Q

Secretes thick alkaline mucus that neutralizes acidity from the prostatic secretions and vagina

A

Bulbourethral gland

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10
Q

In humans, it takes an average of ____ days to form a mature sperm from a primitive germ cell by this orderly process of spermatogenesis

A

74 days

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11
Q

Spx collection: abstinence for how long?

A

2-3 days but not >7 days

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12
Q

Effects of prolonged abstinence to spx

A

Inc vol, dec motility

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13
Q

It is necessary to collect the entire ejaculate. When a part of the first portion of the ejaculate is missing, what happens with the ff (inc or dec):

  1. Sperm ct
  2. pH
  3. Spn liquefaction
A
  1. Dec
  2. Inc
  3. Will not liquefy
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14
Q

It is necessary to collect the entire ejaculate. When a part of the last portion of the ejaculate is missing, what happens with the ff (inc or dec):

  1. Volume
  2. Sperm ct
  3. pH
  4. Spx clotting
A
  1. Dec
  2. Inc
  3. Dec
  4. Spx will not clot
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15
Q

Best method of spx collection of semen

A

Masturbation

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16
Q

Semen spx should be delivered to the lab within _____ of collection

A

Within 1 hr

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17
Q

Semen spx temp during transport

A

Room temp

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18
Q

Analysis of semen should be done when after collection

A

After liquefaction (30-60 mins)

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19
Q

Semen spx that do not liquefy must be treated w/ _____ to break up mucus in order to obtain accurate sperm ct

A

Amylase or bromelain or alpha-chymotrypsin

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20
Q

Semen spx awaiting analysis should be kept at ____ temp

A

37 deg C

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21
Q

Normal semen appearance

A

Gray-white, translucent

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22
Q

Odor of semen

A

Musty or bleach

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23
Q

Inc white turbidity in semen is assoc w/?

A

Infection (inc WBCs)

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24
Q

Brown (or red) coloration of semen is assoc with?

A

Blood (inc rbcs)

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25
Q

Yellow coloration of semen is assoc w/?

A

Urine contam, medication, prolonged abstinence/continence, inc flavin

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26
Q

Normal volume of semen

A

2-5 mL

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27
Q

Volume of semen is inc or dec in the ff:

  1. Incomplete collection
  2. Infertility
  3. Prolonged abstinence
A
  1. Dec
  2. Dec
  3. Inc
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28
Q

Normal viscosity of semen is described as

A

Pour in droplets

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29
Q

Increased viscosity is assoc w/?

A

Dec sperm motility

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30
Q

Abnormal semen viscosity is defined as having a presence of thread that is ____ long

A

> 2 cm

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31
Q

Viscosoty of semen reporting:

____ watery
____ gel like

A

0

4

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32
Q

True or false: semen viscosity may also be reported as low, normal, high

A

True

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33
Q

Normal semen pH

A

7.2-8.0

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34
Q

Inc semen pH is assoc w/?

A

Infection

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35
Q

Dec semen pH is assoc w/?

A

Inc prostatic fluid

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36
Q

Normal value for sperm conc

A

> 20 million sperms/mL

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37
Q

Methods in counting sperm conc

A

Improved Neubauer counting chamber, Makler counting chamber

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38
Q

Dilution for sperm conc using neubauer

A

1:20

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39
Q

Alternative diluent for sperm conc

A

Cold tap water

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40
Q

Diluents that can be used for sperm conc

A

Formalin-sodium bicarb soln, saline, distilled water, cold tap water

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41
Q

Dilution used in Makler counting chamber

A

None. Undiluted spn is used

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42
Q

Makler counting chamber uses ____ to immobilize sperms

A

Heat

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43
Q

Why is there a need to dilute semen during sperm conc?

A

To immobilize sperm cells

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44
Q

Regarding sperm conc, both sides of the hemocytometer are loaded and allowed to settle for ____ (how long); then they are counted and the counts should agree within ___%

A

3-5 mins; 10%

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45
Q

Sperm conc computation formula using shortcut method

A

2 wbc squares = # sperms counted x 100 000

5 rbc squares = # sperms counted x 1 000 000

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46
Q

Sperm conc formular using log method

A

Sperm conc per mL = (no of sperms counted x dilution) / (area x depth or 0.1)

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47
Q

1 wbc square has an area of?

A

1 mm^2

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48
Q

1 rbc square has an area of?

A

0.04 mm^2

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49
Q

Solve the ff problem:

1 sperm counted using 2 wbc squares

A

100 000

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50
Q

Solve the ff problem:

1 sperm counted using 5 rbc squares

A

1 000 000

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51
Q

Normal value for sperm count

A

> or = 40 million per ejaculate

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52
Q

Formula for sperm count

A

Sperm conc x spx volume

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53
Q

Solve the ff:

Compute sperm count for a sample w/ a volume of 2 mL/ejaculate and a sperm conc of 20M sperms/mL

A

40 M sperms/ejaculate

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54
Q

Sperm motility is read in what objective, under how many total manification, and how many fields?

A

20 fields of HPF which has 1000 total magnification

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55
Q

Normal value for sperm motility

A

> 50%

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56
Q

Qualitative normal value for sperm motility

A

2+

57
Q

Sperm motility grading:

  1. No forward progression
  2. No movement
  3. Rapid straight line motility
  4. Slower speed some lateral movement
  5. Slow forward progression, noticeable lateral movement
A
  1. 1.0 (c)
  2. 0 (d)
  3. 4.0 (a)
  4. 3.0 (b)
  5. 2.0 (b)
58
Q

CASA stands for

A

Computer-assisted semen analysis

59
Q

CASA provides objective determination of both sperm ____ and ____

A

Velocity and trajectory (direction of motion)

60
Q

____ and ____ are also included in the analysis of CASA

A

Sperm conc & morphology

61
Q

Routine criteria normal value sperm morphology

A

> 30% normal forms

62
Q

Kruger’s strict criteria normal value sperm morphology

A

> 14% normal forms

63
Q

Stain of choice for sperm morphology

A

Papanicolau’s stain

64
Q

Stains for sperm morphology

A

Wright’s stain, Giemsa stain, Papanicolau’s stain

65
Q

Normal head shape

A

Oval shaped

66
Q

Abnormal head shape will result to

A

Poor ovum penetration

67
Q

In which part of sperm does it contain mitochondria?

A

Midpiece or neck

68
Q

Abnormal tail will result to

A

Poor motility

69
Q

Size of sperm head

A

5 x 3 um

70
Q

Size of midpiece

A

7 um

71
Q

Size of tail (neck included)

A

45 um

72
Q

Size of tail (neck excluded)

A

38 um

73
Q

The acrosomal cap covers ____ (how much) of the head

A

1/2

74
Q

The acrosomal cap covers ____ (how much) of the nucleus

A

2/3

75
Q

Hardening of veins that drain the testes

A

Varicocele

76
Q

Sperm head in varicocele

A

Tapered head

77
Q

Most common cause of male infertility

A

Varicocele

78
Q

Test for sperm viability

A

Modified Bloom’s test

79
Q

Reagents for modified Bloom’s test

A

Eosin and Negrosin

80
Q

In modified Bloom’s test, spx is tested within ____ of ejaculation

A

1 hr

81
Q

Regarding modified Bloom’s test, living sperms will stain ___ while dead sperms will stain ____

A

Unstained or bluish white

Red

82
Q

Normal value for modified Bloom’s test

A

50% living sperms

83
Q

Seminal fluid fructose is tested within ___

A

2 hrs

84
Q

If spx for seminal fluid fructose testing cannot be tested within 2 hrs, ____ to prevent fructolysis

A

Frozen

85
Q

Screening test for seminal fluid fructose

A

Resorcinol / Seliwanoff’s test

86
Q

Positive resorcinol test or Seliwanoff’s test result for seminal fluid fructose

A

Orange-red color

87
Q

2 tests for antisperm antibodies

A

Mixed agglutination rxn and immunobead test

88
Q

Antisperm antibodies are detected in which spx?

A

Semen, cervical mucosa, serum

89
Q

Mixed agglutination rxn detects the presence of ___

A

IgG Ab

90
Q

Immunobead test detects the presence of ___

A

IgG, IgM and IgA Abs

91
Q

Normal result for mixed agglutination rxn

A

<10% motile sperm attached to the particles

92
Q

Normal result for immunobead test

A

Presence of beads on <50% of the sperm

93
Q

Which test demonstrates what area of sperm the autoAb are affecting

A. Immunobead test
B. Mixed agglutination rxn

A

A. Immunobead test

94
Q

Dec values of fructose indicate?

A

Lack of seminal fluid

95
Q

Dec value of neutral alpha glucosidase indicate

A

Epididymis disorder

96
Q

Identify the normal values of the ff

  1. Zinc
  2. Citric acid
  3. Fructose
  4. Neutral alpha-glucosidase
  5. Acid phosphatase
A
  1. > or = 2.4 umol/ejaculate
  2. > or = 52 umol/ejaculate
  3. > or = 13 umol/ejaculate
  4. > or = 20 umol/ejaculate
  5. > or = 200 umol/ejaculate
97
Q

Dec value of ACP and citric acid indicate

A

Lack of prostatic fluid

98
Q

Dec value of zinc indicate

A

Lack of prostatic fluid

99
Q

Dec levels of ____ and ____ aside from neutral alpha-glucosidase also indicate an epididymis disorder

A

Glycerophosphpcholine and L-carnitine

100
Q

Dec value of ____ also indicates a lack of prostatic fluid besides zinc, ACP and citric acid

A

Glutamyl transpeptidase level

101
Q

Enumerate the stages of sperm maturation (youngest to oldest)

A 
Spermatogonium
Primary spermatocyte
Secondary spermatocyte
Spermatid
Spermatozoon
102
Q

Refers to wbcs and spermatids

A

Round cells

103
Q

Microbial testing round cells normal value

A

> 1 M / mL

104
Q

> 1 M wbcs / mL of round cells indicate

A

Infection

105
Q

> 1 M spermatid / mL ofnround cells indicate

A

Disruption of spermatogenesis

106
Q

Microbial testing of semen spx tests for

A

C. trachomatis, M. hominis, U. urealyticum

107
Q

Medico-legal tests (tests for detection of semen)

Hint: there are 8 of them

A

Microscopic exam, fluorescence under UV light, ACP determination, glycoprotein p30, florence test, barbiero’s test, ABO blood grping, DNA analysis

108
Q

Color of living sperm and dead sperm in fluorescence under uv light

A

Green -living

Red -dead

109
Q

More specific method to detect semen

A

Glycoprotein p30 (PSA)

110
Q

Florence tests for ___

A

Choline

111
Q

Barbiero’s tests for

A

Spermine

112
Q

Reagents of florence test

A

Iodine crystals plus potassium iodide

113
Q

Positive result for florence test

A

Dark brown rhombic crystal

114
Q

Rgts of Barbiero’s test

A

Saturated picric acid plus trichloroacetic acid

115
Q

Positive result for Barbiero’s test

A

Yellow leaf-like crystal

116
Q

Very specific

A. Florence
B. Barbiero

A

B. Barbiero

117
Q

Cutting of vas deferens so that the ejac will not contain any sperm cell

A

Vasectomy

118
Q

The only concern for post vasectomy semen analysis

A

Presence or absence of sperm

119
Q

Post vasectomy semen analysis is done ____ after vasectomy and continued until ____ spx show no sperm

A

2 mos after; 2 consecutive monthly spx

120
Q

Regarding post vasectomy semen analysis, a negative wet prep is followed by spx centrifugation for ___ (how long) and exam of sediment

A

10 mins

121
Q

Identify the ff terms described:

  1. Absence of sperm cells
  2. No ejaculate
  3. Dec sperm conc
  4. Immotile or dead sperm cell
A
  1. Azoospermia
  2. Aspermia
  3. Oligospermia
  4. Necrospermia
122
Q

Fill in the normal values for semen analysis

  1. Volume
  2. Viscosity
  3. pH
  4. Sperm conc
  5. Sperm count
  6. Motility
  7. Quality
  8. Morphology
  9. Round cells
A
  1. 2-5 mL
  2. Pour in droplets
  3. 7.2-8.0
  4. > 20 million / mL
  5. > 40 million / ejaculate
  6. > 50% within 1 hr
  7. > 2.0 or a, b, c
  8. > 30% normal forms (routine criteria); >14% normal forms (strict criteria)
  9. <1.0 million/mL
123
Q

Assessment of sperm cells (describe procedures to assess the ff)

  1. Sperm morphology
  2. Sperm viability
  3. Sperm count
  4. Sperm motility
A
  1. Make a smear in slide, stain w/ Papanicolau’s, Wright’s or Giemsa
  2. Stain w/ Eosin-Negrosin
  3. Dilute w/ chilled tapwater or formalin-bicarb soln then charge in a Neubauer counting chamber
  4. Place a drop of semen in a slide and cover it with coverslip
124
Q

Alternative sperm motility criteria semen analysis

  1. No movement
  2. Sperm moving linearly or in a large circle
  3. Sperm moving w/ an absence of progression
A
  1. Immotility
  2. Progressive motility (PM)
  3. Nonprogressive motility (NP)
125
Q

Additional testing for abnormal semen analysis: identify possible abnormality and give the test to use

  1. Dec motility w/ normal count
  2. Dec count
  3. Dec motility w/ clumping
  4. Normal analysis w/ continued infertility
A
  1. Viability; Eosin-nigrosin stain
  2. Lack of seminal vesicle support medium; fructose level
  3. Male antisperm Ab; MAR and immunobead and sperm aggl’n w/ male serum
  4. Female antisperm Ab; sperm aggl’n w/ female serum
126
Q

Identify the ff sperm fxn tests:

  1. Observing sperm penetration ability of partner’s midcycle cervical mucus
  2. Evaluation of the acrosome to produce enzymes essential for ovum penetration
  3. Sperms are incubated w/ species-nonspecific hamster eggs and penetration is observed microscopically
  4. Sperms exposed to low sodium conc are evaluated for membrane integrity and sperm viability
A
  1. Cervical mucus penetration
  2. In vitro acrosome rxn
  3. Hamster egg penetration
  4. Hypo-osmotic swelling
127
Q

What are tested by each test?

  1. Cervical mucus penetration
  2. In vitro acrosome rxn
  3. Hamster egg penetration
  4. Hypo-osmotic swelling
A
  1. Sperm penetration
  2. Enzyme production of acrosome for ovum penetration
  3. Penetration
  4. Membrane integrity & sperm viability
128
Q

_____ secrete testosterone

A

Leydig cells

129
Q

_____ secrete inhibin (inhibits FSH synthesis)

A

Sertoli cells

130
Q

Shortly after ejaculation, the semen coagulates bec of the action of a clotting enzyme, formed in the ____, on a fibrinogen-like precursor substance that is produced by the ____

A

Prostate; seminal vesicle

131
Q

When performing fertility testing, WHO recommends that _____ (how many) samples be collected not ____ (how many days or wks) apart with ___ (how many) abnormal samples considered significant

A

2 or 3
<7 days or >30 wks
2

132
Q

Failure of liquefaction to occur within ____ mins may be caused by a deficiency in ____

A

60 mins; prostatic enzymes

133
Q

Semen pH should be measured within ____ of ejac due to the loss of____ that occurs

A

1 hr

CO2

134
Q

Allow semen to settle on the slide for ____ (how long) before testing for sperm motility

A

1 min

135
Q

Use ____ deg angle when preparing smears for sperm morphology

A

45 deg angle

136
Q

Granulocytes can be differentiated from spermatogenic cells & lympho using ____

A

Peroxidase stain

137
Q

Motile sperm can be detected for up to ___ (how long) after intercourse, whereas nonmotile sperm can persist for ___ (how long)

A

24 hrs

3 days

138
Q

As the sperm die off, only the ___ (which part of sperm) remain and may be present for ___ (how long) after intercourse

A

Head

7 days

Analysis of Urine and Other Body Fluids (18 decks)

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