Final Flashcards
Duct
Transport, store and mature sperm
Glands
Secrete most of semen volume, support but do not produce sperm
Spermatic Cord
Derived from anterolateral abdominal wall. Contains blood and nerve supply, accessory ducts
Penile raphe
Line down middle of penis, continues into scrotal and perineal raphe
Fibromuscular Sac
Smooth muscle layers within layers of scrotum
Cremaster
Continuation of internal oblique, surrounds testes. Skeletal muscle elevates testes when it is cold
Dartos
Smooth muscle within superficial fascia, contract to wrinkle and trap heat inside
Scrotum blood supply
Posterior and anterior scrotal arteries
Anterior scrotal artery
Femoral–> External pudenal–> anterior scrotal
Posterior scrotal artery
Internal iliac–> internal pudenal–> posterior scrotal
Testes
4x 2.5 cm, surrounded by 2 tunic layers
Tunica Vaginalis
Extension of parietal peritoneum, visceral and parietal layers with the cavity of tunica vaginalis in between
Tunica Albuginea
White fibrous capsule, seperate from peritoneum– contains lobules
Testes Lobules
250-300 lobules, each containing 1-4 seminiferous tubules
Order of sperm ducts
Seminiferous tubules Tubulus rectus Rete testis Efferent ductules Epididymis
3 layers of spermatic cord
Internal spermatic fascia
Cremasteric fascia
External spermatic fascia
Internal spermatic fascia
From transverse abdominal muscle
Cremasteric fascia
From connective tissue coverings of internal oblique
External spermatic fascia
From external oblique
7 constituents of spermatic cord
Testicular artery Pampiniform plexus Ductus deferens Artery of ductus Autonomic nerve fibers Sensory nerve fibers Lymphatics
Pampiniform plexus
Branched vessels make up testicular vein, surround artery for thermoregulation
Perineum
Muscular region for external genitalia and anal opening
Urogenital triangle
Pubic symphysis and ischial tuberosities
Anal triangle
Coccyx and ischial tuberosities
Levator ani
Pubococcygeus bound by iliococcygeus. Elevate anus during defecation
Male intermediate perineum
External urethral sphincter at urogenital diaphragm
Deep transverse perineal muscle covered by perineal membrane
2 perineal muscle
Bulbospongiosus
Ischiocavernosus
Bulbospongiosus
Constrict urethral canal and compress bulb of penis to assist with erection
Ischiocavernosus
Maintains erection by compressing outflow veins
Shaft of penis
Body and glans
Body of penis
Free portion without muscles, connective tissue surrounds erectile bodies
Glans
Enlarged end of corpus spongiosum forms head of penis
Prepuce (male)
Foreskin, corona is at the base of the neck
Suspensory ligament of penis
Deep fascia from pubic symphysis forms a sling that attaches at the root
Fundiform ligament
Extension from elastic fibers of linea alba
2 erectile bodies
Corpora cavernosa (2 top ones) Corpus spongiosum
Collagen fibers
White band that surrounds erectile bodies
What encloses the erectile bodies
Tunica albuginea
Enhancement phalloplasty
Release suppoting penis ligaments to increase length by 2.5 cm
Pericavernosal Graft
Adding tissue to corpora cavernosa to increase width by 30%
Allograft
Synthetic material (autograft is dermal fat)
2 parts of root of penis
Bulb: proximal extension of corpus spongiosum
Crura: Proximal seperation of corpus spongiosum
Internal pudenal artery
Branch of internal iliac. All the other penis blood vessels branch off this one
3 penis blood vessels
Dorsal arteries (either side of vein) Deep arteries (Within corpora cavernosa, for boner) Deep Dorsal vein (formed by venous plexus)
Epidydmis
Posterior surface of testes, continuous with efferent ductules and ductus deferens
How long does the epididymis store sperm
20 days
Duct of epididymis
Single, highly coiled duct where immature sperm gain motility
Ductus deferens
In spermatic cord, enters pelvic cavity through iguinal canal
Path of ductus defrens
Anterior to pubic bone, loops over ureter and descends along posterior bladder wall
Ampulla of ductus deferens
Most proximal, terminal portion
Ejaculatory Duct
Joining of ampulla and duct of seminal vesicles. Found entirely in prostate and ends at prostatic urethra
Urethra
Last duct. Comprised of prostatic, membranous and spongy parts
Membranous urethra
Surrounded by external urethral sphincter, with bulbourethral glands on either side
Spongy urethra
Within corpus spongiosum, recieves contents of bulbourethral glands
Urethral glands
Neutralizing mucous for acidic urine residue
Accessory glands
Secretions make up 95% of semen volume. Aid sperm in motility and provide nutrients
Seminal vesicles
Pair on posterior bladder wall. Make 60% of semen. Fructose and other sugars support sperm activity
Prostate gland
Middle, anterior, posterior and lateral lobes. Secrete prostatic fluid containing PSA
Prostate zones
Central zone susceptible to benign prostatic hyperplasia, peripheral zone susceptible to cancer
Prostate location
Anterior to rectum. Base associated with neck of bladder, apex at urogenital diaphragm
Prostatic fluid
Contains prostate specific antigen. Liquefying agent to aid sperm motility
What causes PSA increase
Infection
BPH
Cancer
Prostatitis
Inflammation of prostate (UTI). Most common reason for urologist visit
BPH incidence
50% at age 60
90% at age 70
BPH
Affects glandular tissue, can obstruct bladder neck and urethra
Effects of BPH
Cystitis from stagnant urine
Pyelonephritis of renal pelvis
Stone formation
Prostate cancer detection
PSA test
Digital rectal exam
Bulbourethral glands
Found in urogenital diaphragm, empty contents into spongy urethra. Mucoid substance neutralizes residue and lubricate penis. First to secrete during arousal
Where does spermatogenesis occur?
Walls of seminiferous tubules
Spermatogenesis steps
Diploid spermatogonia
Splits into another spermatognia + a primary spermatocyte
Meiosis 1: formation of 2 haploid secondary spermatocytes
Meiosis 2: Secondary sper. split again
Product: 4 haploid spermatids
Spermiogenesis
Streamline process to mature sperm. Form tail and mitochondria
Spermiogenesis steps
Golgi apparatus packages acrosomal enzymes
Position acrosome at head, centrioles at tail
Microtubules at centriole form flagellum
Mitochondria positioned around flagellum
Slough off excess cytoplasm for streamlining
Further maturation
Sperm head
Nucleus containing haploid DNA, acrosome
Semen
Transport medium, nutrients and chemicals to protect and activate sperm. Alkalinity neutralizes urine
Ejaculate volume
2.5 ml—> 50-130 million sperm per mL
Structures contributing to semen
Testes 5%
Seminal vesicles 45-80%
Prostate 15-35%
Bulbourethral 2-5%
Hypospermia
Less than 1.5 ml of semen. Can happen from frequent ejaculations
Hyperspermia
More than 5 ml of semen
Fertility
20 million sperm/mL
Erection
Parasympthathetic reflex stimulates bulbourethral glands. Corpora cavernosa expands and compresses drainage veins. Corpus spongiosum keeps urethra open
NO
Relaxes smooth muscle, arteriole dilation fills erectile bodies
GMP
Creates vasodialtion and erection
Erection steps
NO Active guanylate cyclase cGMP boner PDE5 (degrades cGMP)
Ejaculation
Sympathetic reflex. Ducts and accessory glands contract to empty contents into urethra. Bulbospongiosus muscle contracts rapidly
Internal urethral sphincter in ejaculation
Contracts to prevent expulsion of urine, and prevent reflux of semen into bladder
ED incidence
1/10 men
Viagara
Inhibits PDE5 so erection is maintained until ejaculation. 70% success rate
3 differences between the male and female systems
Gametes formed before birth
Ovulate one ovum at a time
Women have a reproductive period
Ovaries
Produce ova, secrete estrogen and progesterone
Location of ovaries
Upper pelvic cavity, posterolateral to uterus. Suspended by mesovarium
Follicles
Each contain an ovum. Rupture upon maturation to release oocyte
3 ovarian attachements
Broad ligament
Ovarian ligament
Suspensory ligament
Broad ligament
Part of parietal peritoneum
Mesosalpinx
Mesovarium
Mesometrium
Ovarian ligament
Anchored to uterus medially
Suspensory ligament (female)
From ovary to pelvic wall. Houses blood vessels, nerves and lymphatics
What artery do the testicular and ovarian arteries branch off of?
Abdominal aorta
Cortical region of ovary
Gametes and follicles develop here
Graafian Follicle
Mature, with antrum, about to be ovulated
Medullar region of ovary
Loose connective tissue and vascular supply
Uterine tubes
Infundibulum
Ampulla
Isthmus
Where does the egg meet the sperm 98% of the time
Ampulla
- Big site for ectopic pregnancies
4 uterine tube supports
Broad ligament
Uterosacral ligament: Posterior support
Lateral cervical: Distal uterus, superior vagina
Round ligament: Anterior support to body wall
Uterine tube blood supply
Uterine artery: branch off of internal iliac
Uterus gross anatomy
Fundus, body, isthmus
Internal os
Between uterine cavity an cervix
External os
Between cervical canal and vagina
Cervical cancer
From epithelial cells in cervix lining. 6th most common disease in women
Pap smear
Collection of tissue taken from external os
Perimetrium
Outer serous layer of uterus. Visceral peritoneum forms vesicouterine and rectouterine pouches
Myometrium
Longitudinal, circular and oblique layers of uterus . Respond to oxytocin and contract during labour
Endometrium
Inner mucosal lining of simple columnar epithelium. stratum functionalis and basalis
Stratum functionalis
Top layer of endometrium ready to recieve egg. Expands, vascularizes and sloughs off
Stratum basalis
Bottom layer of endometrium remains constant
Uterine blood vessels
Uterine artery–> Arcuate, radial, straight, spiral
Radial artery
Through myometrium towards stratum basalis
Straight artery
Supplies stratum basalis
Spiral artery
Grow with, and supply stratum functionalis
Skene’s gland
Female prostate in anterior wall of vagina
Lesser Vestibular gland
Anterior vagina around lower urethra
Mons pubis
Adipose tissue covers symphysis, provides cushioning during sex
Labia majora
Fold inferior to mons pubis. Homologous to scrotum development
Labia minora
Fold that encloses vestibule
Prepuce (female)
Two labia folds form a hood that covers clitoris
Clitoris
Projection of erectile tissue, equivalent of 2 corpus cavernosa bodies in males
Clitoris anatomy
Crus, angle, body, glans
Vaginal vestibule
Opening of vagina and urethra, enclosed by labia minor.
Vestibular glands
Lubricate orifice, first to secrete during arousal (equivalent of bulbourethral)
Deep perineum (female)
Urethra, vagina, rectum, levator ani muscles
Intermediate female perineum
External urethral sphincter, deep transverse perineal muscle, bulb: Erectile tissue surrounded by labia majora
Superficial female perineum
Urethra, vaginal orifice, ischiocavernosus (over crus), bulbospongiosus, superficial transverse perineal muscle
Mammary glands
Modified sebaceous sweat glands on ribs 2-6. Cover pectoralis major and serratus anterior
Axillary process
Small wing on breast heading to armpit
Sebum
Small dimples with glands below produce it. Like ear wax. Prevent dryness while nursing
Functional units of mammary glands
Secretory alveoli and ducts , stimulated to develop by prolactin produced in anterior pituitary
Mammary lobes
15-25 lobes seperated by adipose tissue, alveoli inside produce milk
Milk path
Lobe Lobule Alveoli Lactiferous ducts Lactiferous sinus Nipple
Mammary gland blood supply
Subclavian artery. Branches into internal and lateral thoracic arteries
Breast cancer incidence
1/8 women. 2nd leading cause of cancer detah
Ductal Carcinoma
From epithelial cells of lactiferous duct (90%)
Breast cancer detection
Self exam, mammography, ultrasound
How are breast masses identified by location
Upper/lower, inner/outer quadrants
Lymphatic drainage
Circulatory system drains extracellular fluid from accumulation site
Most common lymphatic draining sites
Axiallary and parasternal nodes
Where do the nodes drain
Right and thoracic lymphatic duct
Oogonium
Diploid stem cells divide into primary oocytes during fetal development. Remain diploid until end of meiosis 1
Oogenesis
Occurs during fetal period. Oogonium produces a haploid gamete
Egg Meiosis 1
Oogonia divide into 2 million primary oocytes
Eggs during childhood
Only 400,000 left as oocytes degenerate and remain inactive in ovary cortex until puberty
How many eggs are activated during menstruation
8-10
Polar bodies
In females, all resources go to one gamete, the rest become polar bodies and the DNA degenerates
Egg Meiosis 2
Primary oocyte splits into secondary oocyte + First polar body. SO and PB are ovulated. Meiosis 2 done when egg meets sperm
Fertilization
Secondary oocyte becomes an ovum + Second polar body. Meiosis 2 resumes
Zygote
Diploid cell formed from joining of ovum and nuclei of sperm
Ovarian cycle
Monthly events to mature an oocyte. Follicular and luteal phases
Follicular phase
FSH triggers follicle growth during days 1-14, and ovulation
FSH
Stimulated by hypothalamus, produced by anterior pituitary
Hormone produced in follicular phase
All cells produce estrogen, stimulates uterus
LH surge
Increase in lutenizing hormone once follicle matures (day 14). Triggers ovulation
Luteal phase time
Days 14-28
Corpus luteum
Graafian follicle remains in ovary after ovulation and becomes an endocrine organ. Produces progesterone and estrogen which forms a thick mucous plug
3 phases of uterine cycle
Menstrual
Proliferative
Secretory
Menstrual phase
(Day 1-5) Stratum functionalis detaches from uterine wall resulting in bleeding
Proliferative phase
Days 15-28: Estrogen from follicles stimulates basalis to seperate from functionalis
What does proliferative stage stimulate
Development of spiral ateries, endometrial veins and uterine glands
What hormone thins cervix mucous
Estrogen– so sperm can penetrate uterus
Secretory phase
Days 15-28: Corpus luteum produces progesterone. Spiral arteries develop and mucous thickens
When does corpus luteum degenerate
If fertilization does not occur. Progesterone decreases and spiral arteries die
Corpus Albicans
Scars on ovary surface from corpus luteum
Which phase matches luteal phase
Secretory
Pill
Mimics luteal/secretory phases by generating a constant level of progesterone and estrogen
What does the pill inhibit
Ovulation by suppressing FSH and LH
Sugar pill
Reduce progesterone to allow natural menstruation
Perimenopause
Reduced estrogen production because less eggs are available. Disrupted progesterone causes irregular ovulation and menstruation
Postmenopause
Little estrogen, no progesterone, no uterus lining
Order of development phases
Conceptus, pre embryo, embryo (3 weeks) , fetus (9 weeks)
Gestation period
From beginning of ovulation to birth. 14 days longer than pregnancy
How long is ovum viable after ovulation
12-24 hours. Sperm is viable up to 72
Capacitation
Final sperm maturation step. Increase motility of flagella, weaken acrosomal membranes
Acrosomal reaction
Sperm penetrate corona radiata at zona pellucida of egg. Its a glycoprotein so you need mulitple sperm to bust through
3 acrosomal enzymes
Hyaluronidase
Acrosin
Proteases
Infertility incidence
10-15% of population. 3% require intervention
Intrauterine insemination
First ART, for sterile male. Donated sperm deposited into vagina or cervix
IVF
Women induced to supraovulate, ova and sperm are collected and grown to 8-16 cell stage. Embryo transferred to uterus
Intracytoplasmic sperm injection
Sperm injected into egg, IVF
TESA
Testicular epididymal sperm aspiration. Sperm collected where they are more developed. Done for low sperm count or poor sperm health
Blastomere
Each cell in conceptus. Mitotic events create cleavage, splits into many smaller cells
Blastomere development stages
Blastomere
4 cell stage (2 days)
Morula (3 days, 32 more cells)
Blastocyst (4-6 days)
Blastocyst
Implants in uterine wall. Made of trophoblast and inner cell mass
Trophoblast
Single layer, forms placenta
Inner cell mass
Embroblast– Creates embryonic disc and embryo
Blastocele
Fluid filled cavity in blastocyst
When does implantation occur
7 days after ovulation
Window of implantation
Blastocyst floats in uterine cavity for 2-3 days, appropriate progesterone and estrogen levels prepare uterus
Uterine glands
Make a glycoprotein coat, blastocyst looks for right thickness
Implantation
Trophoblast attaches to endometrium, secretes enzymes and growth factors
Human chorionic gonadotropin
Secreted by trophoblast cells, maintains corpus luteum. First chemical signal sent by conceptus
When is there a spike of HCG
after ovulation
Early gastrula
First half of week 3, support membranes develop. Inner cell mass divides into epiblast and hypoblast
Amnion
Transparent, fluid filled sac from epiblast cells. Encapsulates embryo and provides supportive environment
Yolk Sac
From hypoblast, forms gut, blood vessels and primordial germ cells
Allantois
Outpocket from caudal end of yolk sac forms umbilical cord
Chorion
Outermost layer forms fetal portion of placenta
Decidua basalis
Moms portion of placenta
Decidua capsularis
Epithelium covering conceptus, not a part of placenta
Umbilical cord
Core of embryonic connective tissue, forms umbilical arteries and umbilical vein
Late gastrulation
2 layered disc becomes 3 layered embryo– ectoderm, mesoderm, endoderm. Cellular migration and rearrangement
Primitive streak
Groove on dorsal epiblast grows in direction of tail. Forms a longitudinal axis
Endoderm
Epiblast cells divide quickly and migrate to primitive streak. Replace hypoblast
Mesoderm
Epiblast cells wedge between endoderm and epiblast
Ectoderm
Cells remaining on dorsal surface when epiblast stops dividing
Ectoderm derivatives (4)
NS
Epidermis (skin, hair, nails, sweat glands
Cornea and lens
Epithelium of oral, nasal and anal cavities
Mesoderm derivatives
Muscle, cartilage, bone, connective tissue, blood, bone marrow, blood vessels, urogenital system
Endoderm
Epithelium of digestive and respiratory tracts, reproductive organs, liver and pancreas
Notochord
Beginning of nervous system formation from mesoderm. Stimulates ectoderm above to specialize
Ectoderm organogenesis
Neural plate with neural crest cells on either side. Edges of plate lift up to form neural groove and neural folds. Form neural tube
Mesoderm organogenesis
Notochord replaced by vertebral column. 40 pairs of somites present by week 4
3 Somites
Paired mesodermal blocks form vertebrae. Sclerotome, dermatome, myotome
Sclerotome
Closest to neural tube, migrate medially to form ribs and vertebrae
Dermatome
Form dermis of skin and dorsal body
Myotome
Form skeletal muscle and limb buds
Intermediate mesoderm
Form kidneys and gonads
2 parts of lateral mesoderm
Somatic mesoderm
Sphlanic mesoderm
Somatic mesoderm
Body– forms dermis of ventral body, parietal serosa and bone and ligaments of limbs
Sphlanic mesoderm
Organs– forms heart, blood vessels, connective tissue, smooth muscle and serosa of organs
Coelum
Singular cavity gets walled into different compartments during development
End of embryonic period
Bones ossify, muscles are contracting. Kidneys are developing and gonads have formed. Heart and liver bulge on ventral surface
When is the placenta complete and functional
Month 3
Baby side of placenta
Originates from trophoblast, becomes chorion
Mom side of placenta
Originates from stratum functionalis, becomes decidua basalis
Umbilical arteries
Two twisted up with umbilical vein. DEOXYGENATED
Umbilical vein
Carries oxygenated blood from placenta to fetus
Placenta previa
Forms adjacent or across internal os. Complicates expansion of uterus. Cant deliver by normal birth
Placenta previa incidence
0.5-0.8% most common placenta problm
Placenta abruptio
Premature seperation of placenta from uterine wall caused by bleeding into decidua basalis
Abruptio incidence
1% of pregnancies
Mild abruptio
10-20% minimal bleeding and normal FHR, careful monitoring
Moderate abruptio
20-50% loss of 1L of blood leads to fetal distress
Severe abruptio
Loss of more than 1.5L of blood leads to abnormal FHR and possible death
Age of viability
23 weeks
Fetal period
9-38 weeks
Amniocentesis
Obtain amniotic fluid containing fetal cells. Performed after 14 weeks gestation. Chemical analysis, kareotyping
AFP
Alpha feteoprotein– Abnormal levels found in amniotic fluid if there is a neural tube defect
How long does amniocentesis take
17 weeks– build enough fluid, collct sample, grow cell culture for 3 weeks then test
Chorionic villi sampling
Removal of small portion of placenta transcervically or trans abdominally
When is CVS done
10-12 weeks, results within days. Faster than amniocentesis but increased risk of spontaneous abortion
Labour stimulated by
Oxytocin from posterior pituitary
Prostaglandins produced by uterus
Dilation stage
Cervix dilates to 10cm and amniotic sac ruptures
Lactation preparation
Rising levels of estrogen and progesterone prepare breast
Lactation
Hypothalamus releases prolactin releasing hormone. Anterior pituitary releases prolactin to mature breast tissues
Milk production in 2-3 days
Colostrum
Initial fluid high in protein and antibodies
Let down reflex
Stimulated by suckling
Hypothalamus stimulates posterior pituitary to release oxytocin
Milk ejected from alveoli
Ductus venosus
Additional vessel from umbilical cord empties into inferior vena cava to bypass hepatic portal system
Foramen ovale
Hole in wall between right and left atria to by pass right ventricle. Bypass pulmonary system
Ductus arteriosus
From right ventricle to pulmonary trunk to aorta. Bypass pulmonary system
