DIT repro Flashcards
Layers of penis:
Outer dermis Dartos fascia Deep Buck's Fascia Tunica albuginea then CORPUS CAVERNOSA or OR SPONGIOSA (latter is around urethra)
Nerve for boner?
Pelvic Nerve (parasympthatic)
NO makes more cGMP and sildenafil prevents breakdown
NE causes more Ca++ in the muscle and smooth muscle contraction and vasoconstriction and fight or flight so you don’t want blood to penis then)
Nerve for emission?
Hypogastric nerve
Nerve for ejaculation?
Pudendal nerve (visceral and somatic nerve)
LIgaments for uterus
C for Cervix and Cardinal ligament holding down Cervix
Broad uterus is BIG (everything else to pelvic wall) Uterus, ovary, fallopian tube, cut during hysterectomy)
Suspensory ligament of ovary suspends ovary to pelvic wall
Ovarian ligament is ovary to uterus
Round ligament of uterus is from gubernaculum
Which ligament holds ovarian vessels?
Uterine vessels?
Suspensory ligaemnt
Cardinal ligament
Venous drainage of Left vs right gonadal veins? clinical significance?
Left is to Renal vein to IVC (takes a right angle, so vericocele more common in left b/c 90 degree angle and blood leaves slower)
Right is to IVC directly
Adrenals do the same thing! Q bank damn!
Lymphatic drainage of ovaries/testes?
Howabout distal vag/vulva/scrotum?
Howabout uterus/proximal vagina?
Ovaries/testes to para aortic
Distal vagina/vulva/scrotum to inguinal nodes
Obturator, external iliac and hypogastric nodes
Mnemonic for inguinal hernias?
MDs dont LIe
Medially to inferior epigastric is Direct inguinal hernia (through hasselbach triangle)
Laterally to inferior epigastric artery is Indirect inguinal hernia (Processus vaginalis)
What does 5 alpha RIDEuctase important for in development?
External genitalia. If it is deficient, you have male internal genitalia, and ambiguous or perhaps female external… UNTIL PUBERTY!
What if sertoli cells aren’t making anti mullein factor?
You have female and male internal genitalia
Male external genitalia
Work on homologous gender structures on page 562
ok
What teste cells are affected by temp?
Sertoli.
What spermatogonial cell line cells can’t do meiosis 1?
you get a lot of primary spermatocytes. (makes sense b/c completion of M1 makes secondary spermatocyte, then completion M2 makes spermatid)
Cant do meiosis 2?
lots of secondary spermatocytes. makes sense
FSH action in male?
Sertoli supports for sperm
Also makes inhibin and androgen binding protein
LH action in male?
Testosterone production in Leydig
What is aromatase?
It converts testosterone and androgen to estrogens (especially big in obese, so fat can become adipose deficient)
Lipid affects of exogenous testosterone?
Higher LDL and lower HDL (opposite of what you want)
5 alpha reductase inhibitors? and use?
Finasteride is RIDEuctase inhibitor
used in BPH
male pattern baldness
What is an inhibitor of testosterone receptor? What is it used for?
Flutamide (girly b/c it is blocked)
Prostate carcionma
What is ketoconazole?
Inhibits desmolase (steroid synthesis) (no prenenolone is made from cholesterol)
PCOS to block hair growth and hirsutism
androgen insensitivity syndrome?
look like woman, but inside is male. Genetics is male. Testes often in labia majora (lumps there are often there in test)
High estrogen and LH b/c body not getting feedback
5 alpha reductase insufficiency?
Born with ambiguous or female genitalia, then as you hit puberty, testosterone goes up and you become male
Female pseudo hermaprhodite?
21 beta hydroxylase or 11 beta hydroxylase.
Look like male
Male pseudo hermaphrodite?
Androgen insensitivty syndrome
What is kallmann syndrome?
Low GnRH, so low FSH, LH, so low testosterone
Defect is X-linked KAL chain
Defective smell, amenorrhea? look into it!!!
What is epididymitis caused by? How diagnosed? How treat?
Tender
gonorrhea or chlamydia
Ceftriaxone IM and then doxy
If anal intercourse: enterobacter and do fluoroquine
How do you tell testicular torsion is from epididymitis?
support doesn’t relieve symptom
no cremaster reflex from the tickle
Treat with detorsion within six hours
Old man with tumor of testicle?
lymphoma metastasis
Buzzwords for tumors should be ok fi you got them
13:00 min of repro chapter 4
Schiller duval bodies
Yolk sac tumor
High alpha fetoprotein
Teratoma 50%
BUT REALLY Yolk sac tumor
High hCG
Choriocarcinoma (can be teratoma)
Fried Egg appearance
Seminoma (watery looking, makes sense seminoma)
Normal AFP but high hCG
Embryonal (bad prognosis)
Most common testicular tumor?
Seminoma (responds to radiation
Synciotrophoblasts
Choriocarcionma
Painful testicular tumor?
Embryonal
Most common tumor up to age 3!!! IMPORTANT TO KNOW
Yolk sac tumor!
Estrogen secreting tumor of testicle?
Sertoli tumor
Hydrocele vs spermatocele?
Tunica vaginalis lesions
Both are lesions in serous covering of testes that present as masses that CAN BE TRANSILLUMINATED.
Hydrocele: secondary to inclompete obliteration of processus vaginalis (common in neonates, don’t treat for some time)
Spermatocele is dilated epididymal duct
What is varicocele? Key description?
Dilated veins in pampiniform plexus. Cause of infertility “Bag of worms” MORE COMMON IN LEFT b/c testicular vein goes all the way to renal vein and 90 degree angle)
Reinke rods?
Leydig tumor
Also they are gold cuz you dig for gold
Sildenafil mechanism and use?
Inhibit cGMP phosphodiesterase so more cGMP and more relaxion in corpus callosum and hard
Raynaud
Primary pulmonary HTN
Symptom: blue green color vision (viagra is the blue pill and blue vision)
Life threatening with nitrates
What is Bowen Disease?
Gray crusty plaque on penile shaft and can progress to squamous cell carcinoma (rarely)
What is bowenoid papulosis?
multiple papular lesions of penis and affects younger people
DO NOT become invasive
Priapism is associated with what?
sickle cell and spinal cord
What is balanitis?
Inflammation of glans often from candida
DIABETICs (makes sense b/c candida)
and in uncircumcised
Acute prostatis younger than 35 age?
Older than 35? Tx?
Young: gonorrhea, chlamydia
Older than 35: klebsiella, serratia, enterobacter, proteus (UTI bugs)
Flouroquinolones, TMP SX for 4 weeks (UTI bugs)
BPH tx?
Nonselective alpha 1 blockers (azosins). Decrease smooth muscle tone in prostate. Dizziness, postural hypotension.
TAMSOLUSIN!!!! (SELECTIVE for prostate!) IMPORTANT (alpha 1AD)
5 alpha riductase (finasteride, dutasteride)
How do you remember estrogens?
1, 2, 3. Men, Women, Baby (order of importance ;) )
EstrONE: made in men and women in periphery by aromatase
EstraDIone: (2) so women and ovaries and strongest
EsTRIol: (3) in placenta so way up in preggers
Myometrial excitability affected by what hormones?
estrogen increases it
progesterone decreases it
What hormone increases body temp?
progesterone!
What is menorrhagia?
Metrorrhagia?
Menometrorrhagia?
Oligomenorrhea?
Polymenorrhea?
Memorrhagia: heavy periods
Metrorrhagia: frequent irregular (think like metro bus with lots of stops
Menometrorrhagia: heavy, frequent (combo)
More than 35 day
<21 days in cycle