Chapter 8 Flashcards
Kidney
Hilum Renal cortex Renal medulla Minor calyx Major calyx Renal pelvis Ureter
Renal medulla
Renal pyramid
Renal papilla
Renal column
Female anatomy
Ovaries Uterine tubes -Infundibula -Fimbriae Uterus -Uterine cavity -Cervix --Cervical canal Vagina Vulva Mons pubis Labia majora/minora Vestibule Clitoris Vaginal orifice External urethral orifice
Male anatomy
Seminal glands Prostate gland Bulbourethral glands Scrotum Testes Epididymis Ductus deferens Spermatic cords Prostatic urethra Intermediate urethra Spongy urethra External urethral orifice Penis Corpora cavernosa Corpus spongiosum Glans penis Prepuce
Branches of abdominal aorta
Celiac trunk Superior mesenteric artery Renal arteries Gonadal arteries Inferior mesenteric artery Common iliac arteries
Celiac trunk
Splenic artery
Common hepatic a.
L gastric a.
Common iliac arteries
Internal iliac arteries
External iliac arteries
Tributaries of the IVC:
Internal iliac veins External iliac veins Common iliac veins Renal veins Gonadal veins Hepatic veins
Hepatic portal system:
Splenic vein
Superior mesenteric vein
Hepatic portal vein
3 major dissections
1) completion of abdominal cavity organs (kidneys)
2) pelvic cavity (reproductive structures and vasculature)
3) vasculature and nerves (specifically posterior wall vasculature and the lumbar plexus)
3 key muscles on the posterior wall of abdominal cavity
Psoas major, iliacus ,and quadratus lumborum
one nerve (or 2) crossing the quadratus lumborum
iliohypogastric and ilioinguinal nerves
nerve crossing the iliacus muscle
lateral femoral cutaneous nerve
femoral nerve
largest nerve of the lumbar plexus
hysterectomy
uterus removed
Gonadal vessels
non gender reproductive vessels
waste from kindey
uric acid, hemoglobin breakdown, metabolites from hormones, pesticides, and food additives
kidneys help maintain our
acid/base balance in the body
acids in our body
sulfuric acid and phosphoric acid (the byproducts of amino acid metabolism)
blood pH is too basic, what would you suspect the kidneys need to absorb, or excrete?
see an increase in the excretion of bicarbonate
because bicarbonate concentrations would be greater
we should see a more basic urine
Kidneys can also regulate erythrocyte production
by secreting erythropoietin
Erythropoietin (EPO)
upon release acts on the bone marrow by stimulating red blood cell (RBC) production
What medical intervention can be done to helps mitigate these disastrous effects?
A type of dialysis, which uses a man-made filter that helps “clean” the blood by filtering it in place of the kidneys.
How can the kidneys can monitor blood volume?
This is carried out by a hormonal cascade called the renin-angiotensin-aldosterone system (RAAS). It starts when cells within the kidneys that act as mechanoreceptors detect a drop in either fluid volume or blood pressure
renin
enzyme from granular cells within the kidney, that releases to the response of a drop in blood volume
renin will then combine with angiotensinogen
which is continuously being released by the liver, to form angiotensin I (where it needs to be activated)
angiotensin-converting enzyme (ACE)
activates angiotensin I to angiotensin II
ACE can be released from
several different tissues, but the lungs are a prime example
Ace can metabolize other peptides, resulting in?
vasoconstriction
Angiotensin II
“primary effector” of the RAAS
Two things will happen to Angiotensin II:
1) acts on the adrenal gland to release the hormone aldosterone
2) can act directly on the vasculature to stimulate vasoconstriction.
Aldosterone
stimulates reabsorption of NaCl and H2O
—water follows sodium so an increase in blood volume will lead to increased arterial pressure.
Vasoconstriction
will reduce the amount of “space” in the lumen of blood vessels, and therefore also lead to an increase in arterial pressure
what helps regulate blood volume/blood pressure?
renin-angiotensin-aldosterone system (RAAS)
glomerulus
surrounded by a Bowman’s capsule, where filtration occurs; fluids and solutes are forced through the glomerulus passively
what marks the start of the tubule system of the kidney?
the glomerulus
PCT cells
principal cells and intercalated cells.
principle cells
involved with water and Na+ balance,
intercalated cells
help maintain acid/base balance
what makes up the nephron system of the kidney?
proximal convoluted tubules (PCT) and distal convoluted tubules (DCT)
3 hormones involved in kidney function
aldosterone, ADH (anti-diuretic hormone), and PTH
aldosterone primary function
released from the adrenal gland, it increases blood volume (thus pressure) by increasing Na+ reabsorption in the kidney tubules
ADH
is triggered by an imbalance in extracellular fluid osmolality (the ratio of water to solutes), from a state of dehydration
where is ADH released from?
from the posterior pituitary gland and inhibits diuresis, or urine output. It specifically acts on principal cells by upregulating aquaporins, which increase water permeability
PTH
released from the parathyroid glands to increase Ca2+ reabsorption, specifically by acting on the distal tubule cells in the kidney
where do excretions of the kidney moving through these tubules drain into
collecting duct system, which will eventually bring urine to the bladder via the urethra
Adrenal glands
“little hat”
-adrenal medulla and adrenal cortex
adrenal medulla
secretes catecholamines (epinephrine and norepinephrine)
adrenal cortex
secretes corticosteroids
Catecholamines
released in response to sympathetic stimulation, vasoconstriction
2 types of corticosteroids
mineralocorticoids and glucocorticoids
principal mineralocorticoid hormone
aldosterone, which accounts for about 90% of all mineralocorticoid activity, and affect electrolytes of the extracellular fluid (potassium and sodium)
glucocorticoids
result in increased glucose levels in the blood, can also effect both protein and fat metabolism
the major glucocorticoid hormone is that increases glucose
concentrations?
Cortisol, which accounts for approximately 95% of all glucocorticoid activity
The release of mineralcorticoids and glucocorticoids are
a long-term stress response that are stimulated by a hormonal cascade beginning in the hypothalamus.
when the hypothalamus detects stress, it will?
releases CRH (corticotropin releasing hormone), which then stimulates the anterior pituitary to release ACTH (adrenocorticotropic hormone). The target tissues of ACTH are located in the adrenal cortex, which then release mineralocorticoids and glucocorticoids
Spleen
“body’s largest filter of blood”, a lymphoid organ
spleen filters by
removing aged erythrocytes (red blood cells) as well as debris and other foreign matter, iron stores can also be found which will be used to make future hemoglobin
organ with antibacterial and
antifungal immune activity?
the spleen
tissues in the spleen can produce
antibodies
process of spermatogenesis
74 days
400 million sperm per day
in a young healthy male
seminiferous tubules
intertwining tubes within the testicle, join the epdidymis
germ cell ->
spermatid
where are sperm housed and stored
in the epididymis to achieve maturation prior to ejaculation
Once ejaculation has been initiated
the sperm travels through what is called an accessory duct system
accessory duct system
sperm travels going from the epididymis, through the ductus (or vas) deferens to the ejaculatory duct, and finally through the urethra to exit the penis
vasectomy
cutting the vas, sperm can no longer reach the ejaculatory duct and urethra from the epididymis
how is semen produced?
the seminal vesicles, prostate gland, and bulbo-urethral glands (or Cowper’s glands)
semen
is necessary to “house” the sperm and facilitate its travel within the female reproductive system
10%
of sperm in semen, 20-150 million sperm per mL
total ejaculate amount
2-5mL
The seminal vesicles join with the vas deferens to form the
ejaculatory duct and account for about 70% of the total volume of
semen
prostate gland
releasing a milky white colored fluid that activates sperm and makes up about 33% of the total semen volume
Cowper’s gland
produces a thick, clear mucus which drains the spongy urethra and also aids in lubrication of the glans penis, neutralizing and lubricating the urethra prior to ejaculation
semen pH
alkaline, 7.2-8.0 pH.
sperm does not thrive in
acidic conditions
prostaglandins
enzymes, as well as clotting factors in semen
Prostaglandin presence in the semen
helps to decrease the viscous nature of the cervical mucus as well as stimulates reverse peristalsis of the uterus to help sperm movement towards the
Fallopian tubes.
clotting factors
will help prevent semen “leakage” post-copulation and “stick” coagulated semen to the cervical walls
testosterone
regulates sperm production
testosterone stimulates
spermatogenesis, and drives libido as well as the maturation of sex organs
how is testosterone regulated?
by the HPG axis and the main hormones involved are GnRH (gonadotropic releasing hormone), LH (leutenizing hormone), and FSH (follicle stimulating hormone)
hypothalamus releases GnRH
stimulating the anterior pituitary to release FSH and LH.
In males, FSH stimulates
spermatogenesis indirectly by stimulating the release of a protein called, androgen binding protein (ABP), from Sertoli cells
androgen binding protein (ABP)
upregulates testosterone production by binding to testosterone and keeping it within the cells of the testicle.
the more localized testosterone is present within the testes,
the more spermatogenesis will occur
LH binds to cells (Leydig cells) that surround the seminiferous tubules
stimulating more testosterone production
testosterone can actually negative feedback on itself
once concentrations reach a certain threshold, these elevated testosterone levels can act on the hypothalamus to reduce the release of GnRH, thus inhibiting LH and FSH release.
or
It can also act
on the anterior pituitary to reduce the release of LH and FSH.
inhibin
released by Sertoli cells (cells within the seminiferous tubules) when it detects that sperm counts are high, it will then negatively feedback on the hypothalamus and anterior pituitary to reduce testosterone production
fertilization occurs in
the fallopian tubes, the ampulla region
Once a sperm and the oocyte have joined
an embryo moves inferiorly down the Fallopian tube and into the uterus where it will then implant into the uterine wall and begin development.
Menstruation
blood loss experienced by the female because of the shedding of the endometrium layer of the uterus
start of menstruation is the first day of the menstrual cycle
4-7 days
ovulation
hormones facilitate an oocyte to be developed and expelled from the ovary, around day 14
during ovulation
the endometrium, is thickening to prepare for embryo implantation
When no pregnancy occurs
the lining begins to weaken because of hormonal changes and is eventually sloughed off, resulting in menses and the cycle starts all over again
ovarian cycle
follicular phase and the luteal phase
follicular phase time
first half of the cycle, days 1-14
luteal phase time
second half, days 14-28.
dominant follicle
is chosen during the follicular phase and it begins to secrete a lot of estrogen
high levels of estrogen
result in a surge of FSH and LH
FSH is the primary driver behind follicular waves
is the hormone that determines the “dominant follicle”
LH plays a role during the follicular waves
its main job includes initiation of ovulation—rupture of the follicle to release the oocyte.
Follicular waves
waves of follicles, around 3-7, that build up towards the surface of the ovary and then digress and eventually become the dominant follicle
dominant follicle
“dominates” over the others to finally surface on the ovary and subsequently rupture, releasing an oocyte
luteal phase
corpus luteum, forms in place of where the follicle previously ruptured and it releases progesterone, which helps build up the endometrium
“the pregnancy hormone”
progesterone
In the early weeks of pregnancy
the release of progesterone from the CL helps maintain the pregnancy until the placenta itself takes over and produces more progesterone, usually after the 4th month of gestation
Corpus luteum
will degenerate into eventual disappearance to the point where there are no remaining signs of any rupture of the ovarian wall
progesterone concentrations are elevated in the luteal phase
estrogen concentrations are also at a slightly greater concentration largely due to its initial peak from the dominant follicle that carries through the luteal phase.
hormones supporting and building up the endometrium layer
estrogen and progesterone
LH hormone peaks during ovulation
because it is the primary hormone to initiate ovulation
when the ovarian wall ruptures where the dominant follicle has surfaced
an oocyte is released
Approximately 1-2% of all ovulations result in
more than 1 oocyte being expelled, increasing the chance of fraternal twins
Around the time of ovulation, the Fallopian tubes
bend towards the ovary and “drape” it while the fimbriae stiffen and surround the ovary, This helps to “catch” the oocyte
ectopic pregnancies
no continuous tissues connecting the ovary to the Fallopian tubes
What keeps the ovary and Fallopian tube in close proximity to each other?
ovarian ligament, round ligament, broad ligament
ovarian ligament
anchors the ovary to the body of the uterus
round ligament
which traverses through the inguinal canal, connects the uterine tubes to the labia majora
broad ligament
is a sheet of peritoneum that acts as a “mesentery” containing important vasculature to bring nutrient-rich blood to the uterus and ovaries.
peristalsis and beating cilia
help to move the oocyte towards sperm that have been awaiting its arrival in the ampulla
two layers of the uterine wall
the myometrium (a muscle layer), and the perimetrium (the outermost, serous layer)
uterine cycle
focuses on how thick the endometrium layer is
During the menstrual phase of the uterine cycle (days 1-5)
the endometrium layer would be thinnest since it is in the process of being sloughed off.
proliferative phase (days 5-14)
endometrium thicken as well as some vascularization
secretory phase (days 14-28)
endometrium is thickest and the vascularization is greatest in preparation for that possible embryo that could come “tumbling” down the Fallopian tube
