Chapter 33 - Alterations in Male and Female Reproductive Systems Flashcards
What is dysmenorrhea?
painful menstruation
Dysmenorrhea occurs from excess _________ secretion
prostaglandin
How do prostaglandins affect the myometrium?
stimulation and vasoconstriction
What is the myometrium?
smooth muscle cells of uterine wall superficial to endometrium
Prostaglandin induced vasoconstriction results in constriction of __________ tissue and nerve __________ which leads to pain
endometrial; hypersensitivity
What is the endometrium?
layer of tissue that lines uterus
Dysmenorrhea results in _________ and endometrial shedding
ischemia
Pain from dysmenorrhea is directly related to ______ and ______ of menstrual floq
length and amount
What is the treatment for dysmenorrhea?
NSAIDs
Primary amenorrhea involves the absence of menstruations by age ____ without the development of secondary characteristics by age ___
13; 15
Secondary amenorrhea involves the absence of menstruation for ___ cycles in women with previous cycles
3
Amenorrhea Compartment 1: disorder due to…
anatomical defects (absence of vagina and uterus)
Amenorrhea Compartment 2: disorders of…
ovary or genetic (ie. Turner’s syndrome)
Amenorrhea Compartment 3: disorders of the…
anterior pituitary gland that results in LH and FSH failure
Amenorrhea Compartment 4: disorder due to ____ that prevents release of ______ from the ________
CNS; GnRH; hypothalamus
______ is the leading cause of infertility in North America
PCOS
What 2 things diagnose PCOS?
-anovulatory menstrual cycles
-elevated androgen levels
Anovulatory
skipped ovulations
PCOS can be due to _______ or an _______-prone lifestyle
genetics; obesity
PCOS predisposes for _______ while _______ predisposes for PCOS
obesity; obesity
Why does obesity predispose for PCOS?
increased insulin resistance (excess insulin) and androgens
Hyper-insulinemia overstimulate ovarian _______ secretion
androgen
How do androgens contribute to PCOS?
increasing follicular growth
How does insulin contribute to PCOS?
by suppressing follicular apoptosis and allowing follicles to survive
PCOS involves ________ ovaries which contain fluid filled _____ (follicles) that surround eggs
enlarged; sacs
Genital tract infections can result from _________ or ___________ microorganisms
exogenous or endogenous
Exogenous microorganisms are often ________ transmitted
sexually
Endogenous microorganisms have ________ residence of…
normal; vagina, bowel, vulva
What is pelvic inflammatory disease (PID)?
an infection involving any organ or combination of organs of upper genital tract
Female Upper Genital Tract Organs
uterus, fallopian tubes, ovaries
What puts one at risk for PID?
-untreated STIs
-multiple sex partners
PID develops when pathogens ascent from cervix to _____ _____
fallopian tubes
What are the main STIs that cause PID?
gonorrhoea and chlamydia
Aerobic bacteria (_______) alter vaginal pH and decrease the integrity of the _______ blocking the cervical canal
gonorrhoea; mucus
What is used to treat PID?
broad spectrum antibiotics
What is salpingitis?
inflammation of the fallopian tubes
Infection changes the _________ epithelia of the upper reproductive treat
columnar
Inflammation = _____ and possible ______
edema; necrosis
What is the combined effect of gonorrhoea and chlamydia for salpingitis?
Gonorrhoea - secrete a toxin that damages mucosa
Chlamydia - replicates in damaged cells, burst cell membrane, leave scarring
What are the 3 consequences of PID?
-infertility
-tubal obstruction
-ectopic pregnancy
Ectopic Pregnancy
implantation of fertilized egg outside the uterus
Vaginitis
vaginal inflammation with increase in WBCs
Vaginosis
vaginal irritation without WBCs
What 3 things can cause vaginitis?
-normal flora overgrowth
-STIs
-low estrogen during menopause
Vaginitis is related to alterations in vaginal ____
pH
What is a normal vaginal pH?
4.0-4.5
What 2 factors contribute to vaginal pH?
-cervical secretions
-presence of normal flora that support acidic environment
A change in vaginal pH predisposes __________
infection
How is vaginitis diagnosed?
change in colour/amount of discharge
How is vaginitis treated?
-supporting acidic environment
-probiotics to proliferate normal vaginal flora
What is Lactobacillus crispatus?
a probiotic
What is cervicitis?
inflammation of the cervix
What 2 signs lead to cervicitis diagnosis?
-purulent (pus) discharge
-mucopurulent (mucus and pus) discharge
Mucopurulent cervicitis is a red and _______ infection
edematous
Cervicitis symptoms:
-mucopurulent discharge
-pelvic pain
-bleeding
Mucopurulent cervicitis is a symptom of _____
PID
Women under ____ should receive PID treatment while waiting for ______ examination
26; exudate
When do benign ovarian cysts occur?
in reproductive years around puberty and menopause
Benign ovarian cysts are related to…
hormonal imbalances
Benign ovarian cysts male up _____ of gynecological hospital admissions
1/3
How many follicles are stimulated during a normal menstrual cycle?
120
How many follicles reach ovulation in a normal menstrual cycle?
normally only one
Follicular cysts occur when the dominant follicle doesn’t __________ normally OR when non-dominant follicles do not ______
rupture; regress
Ovary cycts occur when ___ dominant follicle develops and completes the menstruation process
no
Corpus luteum cysts can develop from ________ cells left behind after ovulation
granulosa
What is endometriosis?
presence of functional endometrial tissue outside the uterus
Where can endometriosis affect?
ovaries, fallopian tubes, bladder
With endometriosis, the tissue responds to…
menstrual cycle hormonal fluctuations
Endometriosis causes high levels of ________
estrogen
Endometriosis causes cells to ______ ________ during development
switch fates
Endometriosis cells can develop new ______ ______ to support lesions
blood vessels (angiogenisis)
_______ cells play a role in the development of endometriosis lesions
stem
What is a serious complication of endometriosis?
ectopic pregnancy
Breast cancer is the _____ leading cause of death in women
2nd
1 in ____ have a chance of developing breast cancer
8
___ Canadian women will be diagnosed with breast cancer each day and ___ will die from breast cancer
75; 14
In 2022, _____ men will be diagnosed with breast cancer and ____ will likely die
240; 55
Breast Cancer Hypothesis 1/4: ovarian androgen (__________) excess
testosterone
Breast Cancer Hypothesis 2/4: Blood elevation in both _________ and ____________
estrogen and progesterone
Breast Cancer Hypothesis 3/4: “Estrogen-alone hypothesis”
relationship between levels of circulating estrogen and breast cancer in POSTMENOPAUSAL women
Breast Cancer Hypothesis 4/4: Local biosynthesis of estrogen in _______ tissue
breast
How is breast cancer diagnosed?
-clinical breast exam
-mammogram
-biopsy
Breast Cancer Risk Factors:
-gene mutation
-family history
-timing of menstruation and menopause
-nulliparous
-oral contraceptives
-obesity
Which gene mutations are associated with breast cancer? What do these genes normally do?
BRCA1 and BRCA2 - normally protect against cancer
Menstruation before age ___ or menopause after ___ pose risk for breast cancer
12; 55
Nulliparou
no children
_______ first pregnancy and removal of _______ and ______ gland are risks for breast cancer ***check
early; ovaries and pituitary gland
What is gynecomastia?
overdevelopment of breast tissue in males as a result of hormonal alterations
People with Klinefelter’s syndrome are at risk for…
Male breast cancer
What is Klinefelter’s syndrome?
males who have an extra X chromosome (XXY)
Breast cancer in males in linked to high ______ or low ________
estrogen; testosterone
Gynecomastia resolves in _____ months in younger males
4-6
Breast cancer in males older than 60 is linked to _______ and _______ mutations
BCRA1 and BCRA2
Gynecomastia in older men involves:
-nipple crusting and discharge
-enlarged axillary nodes
Axillary Nodes
lymph nodes in armpit that drain lymph from breast area
What is the treatment for gynecomastia in older males?
modified mastectomy with hormone therapy
What is urethritis?
inflammation of urethra commonly caused by STIs
What bacteria causes gonococcal urethritis?
Neisseria gonorrhoeae
Non-infectious urethritis is associated with ingestion of ______ alcohol or _______
wood; turpentine
What are the symptoms of urethritis?
-urethral tingling
-itching
-burning
-urine frequency and urgency
-clear mucous-like discharge
How is urethritis diagnosed?
-urine nucleic acid detection amplification test to detect N. gonorrhoeae and Chlamydia trachomatis
Phimosis
foreskin can’t be retracted
Paraphimosis
foreskin is retracted but can’t be moved forward to cover the gland
_________ eliminated the possibility of phimosis or paraphimosis
circumcision
What is priapism?
uncommon prolonged penile erection usually painful and not associated with sexual arousal
Priapism is a urological _________
emergency
What is the treatment for priapism?
needle aspiration of blood from dorsal glans
Dorsal glans
artery on top of the penis surface
What is varicocele?
abnormal dilation of testicular veins within the scrotum
Varicocele aka _______ of ______
bag of worms
90% of varicocele occur on the _____ side due to the structure of venous drainage
left
Varicocele occurs in ___ to ___% of men
10-15%
What is hydrocele?
excessive fluid between tunica vaginalis layers
Congenital hydrocele resolves spontaneously in the _____ year of life
first
What is spermatoceles?
benign epididymal cysts
Spermatocele cysts fill with milky fluid due to ______ involvement
sperm
Spermatoeceles cause _____
significant pain
What is cryptorchidism?
abnormality where testes don’t completely descend
Cryptorchidism leaves testes in _______ or inguinal canal
abdomen
What 3 things can cause cryptorchidism?
-short spermatic cord
-adhesions
-narrow inguinal canal
Cryptorchidism increases the risk of testicular cancer by ___ times
50
Cryptorchidism treatment:
-GnRH
-surgery
What is orchitis?
acute inflammation of the testes
What is the path of infection of orchitis?
urethra, vas deferens, epididymis, testes
What is the most common infection cause of orchitis?
mumps
What is epididymitis?
inflammation of epididymis
Who does epididymitis usually affect?
sexually active young males due to STIs (gonorrhoea or chlamydia)
What causes chemical epididymitis?
reflux of sterile urine into ejaculatory ducts
