HLTH male and female disorders, and STIs Flashcards
the scrotal sac
is continuous with the perineum and has a muscle layer and fascia
semen volume
2-5 mL, containing 100-200 million sperm
FSH role in males
initiates spermatogenesis
LH role in males
stimulates testosterone production by the interstitial cells
roles of testosterone
maturation of sperm, development of secondary sex characteristics, protein metabolism, and skeletal muscle development
epispadias
is a congenital defect in which there is an urethral opening on the dorsal surface of the penis, proximal to the glans; can lead to incontinence, infections, and exstrophy of the bladder
exstrophy of the bladder
is a failure of the abdominal wall to form across the midline and is associated with epispadias
hypospadias
is a congenital defect in which this is an urethral opening on the ventral surface of the penis and is more severe than epispadias; can lead to chordee (ventral curvature of the penis)
chordee
is a ventral curvature of the penis and is associated with hypospadias
peyronie’s disease
is a condition resulting from the development of fibrous scar tissue on the penis that may cause pain and/or a bend, interfering with sex and causing erectile dysfunction
causes of peyronie’s disease
is often due to injury, but can also be disorders of the CT or hereditary
cryptorchidism
occurs when one or both of the testes fail to descend into their normal position during the latter part of pregnancy; can be in the abdominal cavity or an abnormal position (called ectopic testis); in many cases spontaneous descent will happen during the first few years
causes of cryptorchidism
hormonal abnormalities, a short spermatic cord, or a small inguinal canal
complication of cryptorchidism
the seminiferous tubules degenerate and spermatogenesis is impaired, causing infertility; can also lead to testicular cancer
hydrocele
occurs when excessive fluid accumulates in potential space between the layers of the tunica vaginalis
causes of hydrocele
can be congenital when peritoneal fluid accumulates in the scrotum, when the processes of the tunica vaginalis remain open in an inguinal hernia, or can be from injury, infection, or a tumor
spermatocele
is a cyst containing fluid and sperm that develops between the testis and the epididymis outside of the tunica vaginalis; this may be related to an abnormality of the tubules
varicocele
is a dilated vein of the spermatic cord, usually on the left side and develops following puberty due to a lack of valves in the veins, causing backflow of blood and an increase in pressure; if serious, this can lead to infertility
torsion of the testis
occurs when the testis rotate on the spermatic cord, compressing the vessels, causing ischemia to develop and the testis swell
category 1 of prostatitis
acute bacterial
category 2 of prostatitis
chronic bacterial
category 3 of prostatitis
nonbacterial
category 4 of prostatitis
asymptomatic inflammatory
prostatitis
is an ascending infection and inflammation of the testis that has many causes (4 categories) and is associated with UTIs;
prostatodynia
means painful prostate
acute bacterial prostatitis apperance and urine characteristics
causes a tender, soft, and swollen gland, and urine often contains microorganisms
nonbacterial prostatitis apperance and urine characteristics
is confirmed by leukocytes in the urine and the prostate gland usually isn’t enlarged
chronic prostatitis apperance
prostate is slightly enlarged, irregular, and firm due to fibrosis tissue
acute bacterial prostatitis cause
usually is an ascending infection from the urethra from E coli
chronic bacterial prostatitis cause
recurrent infection from E coli
risk factors for developing bacterial prostatitis
UTIs, benign prostatic hypertrophy, STDs like gonorrhea, and sometimes through systemic circulation spread
signs of prostatitis
dysuria, frequency, urgency, lower back pain, fever, chills, and obstruction of urine flow; in nonbacterial, the systemic signs are less marked
balanitis
is a fungal infection of the glans penis that is transmitted during sex and common in uncircumcised men
balanitis causative organsim
candida albicans
signs of balanitis
vesicles that develop into patches, itching, and burning
epididymitis
is inflammation of the epididymis
orchitis
is inflammation of the testis
epididymo-orchitis
is inflammation of both the epididymis and the testis and is caused by both bacteria and viruses
causative agents of epididymo-orchitis
before sexual activity it often is E coli and during sexual activity it is often gonorrhea or chlamydia
benign prostatic hypertrophy
is hyperplasia of the prostate with formation of nodules around the urethra and is present in 50% of men 65+, leading to compression of the urethra
cause of benign prostatic hypertrophy
imbalance between estrogen and testosterone associated with aging
signs of benign prostatic hypertrophy
enlarged prostate, incomplete emptying (leads to frequency), reduced stream, frequent infections, and a distended bladder
most common type of prostate cancer
adenocarcinomas arising from tissue near the surface of the gland
metastasis of prostatic cancer
regional lymph nodes, urethra, and bone
causes of prostatic cancer
can be inherited from the HPC1 gene, increased insulin-like growth factor, high androgen levels, and recurrent prostatitis
signs of prostatic cancer
a hard nodule, often on the posterior surface of the gland and urethral obstruction causing hesitancy, a decreased stream, frequency, and bladder infections
two serum markers in prostate cancer
prostate-specific antigen and prostatic acid phosphatase (elevated when it has spread)
3 factors for confirmation of prostate cancer
elevated PSA, rectal exam, and biopsy
where does testicular cancer often arise from?
germ cells
testicular cancer
is most often malignant and occurs primarily in the 15-35 age group; mixed tumors are common
teratoma
means mixed testicular tumor containing different types of germ cells; it is often combined with an embryonal carcinoma
seminoma
is a type of testicular cancer arising from only one type of cell; the spread is less aggressive than mixed cell tumors
serum markers for testicular cancer
hCG and alpha-fetoprotein
spread of testicular cancer
follows a pattern in which it first spreads to the common iliac and paraaortic lymph nodes and then in the mediastinal and supraclavicular lymph nodes; then it spreads to brain, bone, liver, and lungs
cause of testicular cancer
is often genetic and inherited on chromosome 12, but also can be cryptorchidism, infection, or trauma related
signs of testicular cancer
hard, firm, unilateral mass, enlarged and heavy feeling testis, dull aching pain in the abdomen, hydrocele, epididymitis, and gynecomastia (enlarged breasts)
gynecomastia meaning
enlarged breasts in testicular cancer due to the tumor secreting hormones
where are non-motile sperm stored until ejaculation?
the ampulla of the vas deferens
what male disorders are distinguished by transillumination?
hydrocele
acquired hydrocele meaning
is from injury, trauma, or cancer
type of testicular cancer that spreads early on
choriocarcinoma
coitus meaning
intercourse
leukorrhea
is vaginal discharge that is produced by the skene’s and bartholin’s glands
lactobacillus role for female reproductive anatomy
it contributes to the acidic pH of the vagina during reproductive years
endocervical canal
is the passageway extending from the internal os (end of uterus) to the external os (at the vaginal end)
squamous-columnar junction
where the epithelium changes from stratified squamous to simple columnar and is at the endocervical canal; this is a common location for cervical cancer
menarche
refers to the first period
what is breast development stimulated by?
estrogen; estrogen and progesterone play a role in cyclic changes in the breast every month
acini
are the functional units of the breasts and consist of cells that secrete milk and those that move the milk through the ducts
what converts the follicle to the corpus luteum?
LH
signs of a marked retroversion of the uterus?
back pain, dysmenorrhea, and dyspareunia (painful intercourse)
uterine prolapse
is the descent of the uterus or cervix into the vagina and there are different degrees of this
first degree prolapse
is when the cervix drops down into the vagina
second degree prolapse
is when the cervix lies at the opening of the vagina and the uterus is in the vagina
third degree prolapse
is when the cervix and uterus hang out of the vaginal orifice
signs of prolapse
first and second degree are usually asymptomatic but third degree causes some mild discomfort and a feeling of heaviness
cystocele
is the protrusion of the urinary bladder into the anterior wall of the vagina; this causes incomplete emptying and predisposes to cystitis
rectocele
is the protrusion of the rectum into the posterior wall of the vagina; this can interfere with defecation
primary amenorrhea
refers to never getting one’s first period and can be due to turner syndrome, hypothalamus/pituitary disorders, or the absence of the uterus
secondary amenorrhea
is the cessation of one’s period when they have already gotten it; can be due to tumors, stress, sudden weight loss, eating disorders, participation in competitive sports, chemo, or anemia
NSAIDs and dysmenorrhea
inhibit prostaglandin synthesis thus relieve cramping and pain
secondary dysmenorrhea
results form disorders like endometriosis, uterine polyps, tumors, or PID
menorrhagia meaning
increased amount of flow
polymenorrhea meaning
short cycles of < 3 weeks
oligomenorrhea meaning
long cycles of >6 weeks
metrorrhagia meaning
bleeding between cycles
usual cause of menstrual abnormalities
is due to a lack of ovulation but can also be due to thyroid disorders or tumors
premenstrual dysphoric syndrome
refers to more severe PMS
endometriosis
refers to the presence of endometrial tissue outside of the uterus, on structures like the tubes, ovaries, and in some cases, the lungs; the ectopic tissue responds to cyclic changes (growing, shedding, and bleeding), in which blood is irritating to these tissues
cause of recurrent endometriosis
inflammation with each cycle eventually leads to the development of fibrous scar tissue, which can cause adhesions and obstructions
endometriosis and infertility
can develop due to the adhesions or obstructions that block the uterus, tubes, or ovaries
‘chocolate cyst’ meaning
occurs when endometrial tissue forms on the ovaries and contains a sac of old, brown blood
primary symptom of endometriosis
dysmenorrhea which becomes more severe each month
vaginitis
is an infection and inflammation of the vagina, often caused by changes in natural flora, but can also be yeast infection, protozoan infections, irritation due to feminine hygiene products, or atrophy due to menopause
cervicitis
is inflammation of the cervix, often associated with STDs
salpingitis
refers to inflammation of the tubes
oophoritis
refers to inflammation of the ovaries
mastitis
refers to inflammation of the mammary gland and is often caused by S aureus
primary causative organism of toxic shock
S aureus
candidiasis
aka yeast infection; this is not transmitted sexually and is caused by opportunistic flora
causative organism of candidiasis
C. albicans
causes of candidiasis
often follows antibiotic therapy, but also may occur when host resistance is decreased or when glycogen levels in the vaginal secretions decrease
candidiasis signs
red, swollen, and itchy mucus membranes with a white, thick, curd like discharge; dysuria and dyspareunia may also occur
pelvic inflammatory disease
is an infection of the female reproductive tract, particularly the tubes and ovaries
complications of PID
acute problems like peritonitis and pelvic abscess, and long term problems like infertility or ectopic pregnancies due to scar tissue and adhesions forming in this area
what does the PID infection begin as?
often is due to multiple pathogens and begins as vaginitis or cervicitis; the infection then ascends along the continuous mucus membrane
how does PID spread to the peritoneum
the tubes become obstructed due to inflammation and purulent exudate, causing the infection to spread through the fimbriae to the peritoneal cavity
common cause of death in PID
septic shock due to the infection spreading to the peritoneum
causative organism of PID
is usually caused by STDs like gonorrhea or chlamydia, and past infections of vaginitis or cervicitis increase the chances
signs of PID
lower abdominal pain that increases and is worse with walking, tenderness, purulent discharge, dysuria, and fever
leiomyoma
is a benign tumor that is hormone dependent and is located in the myometrium; it is common during reproductive years and often shrinks following menopause; these may also undergo necrosis and form cysts
intramural fibroids
develop in the uterine wall as polyps
submucosal fibroids
develop beneath the endometrium and may present as a polyp that protrudes into the uterine cavity
subserosal fibroids
develops under the serosa and may grow outward into the pelvic cavity
fibroid signs
often are asymptomatic but may cause abnormal bleeding like menorrhagia or cause pressure on surrounding structures and interfere with emptying
ovarian cysts
develop on ovaries usually underneath the serosa and usually disappear within 8-12 weeks without complications
complications of large ovarian cysts
can cause discomfort, urinary retention, or menstrual irregularities, and if it ruptures it can cause abnormal bleeding
stein–Leventhal syndrome
aka polycystic ovarian syndrome
polycystic ovarian syndrome
is ovaries containing cysts covered with a thick capsule, causing abnormal hormone levels and cessation of ovulation
cause of polycystic ovarian syndrome
is often due to a dysfunction in the hypothalamus-pituitary control system
hormone levels in polycystic ovarian syndrome
elevated androgen, estrogen, and LH and decreased FSH levels; usual FSH/LH fluctuations are missing
signs of polycystic ovarian syndrome
hiturism (abnormal hairiness), amenorrhea, and infertility
fibrocystic breast disease
includes a broad range of benign breast lesions that change during the menstrual cycle, mainly due to estrogen; 3 categories
how do the breasts change with fibrocystic breast disease throughout the cycle?
the CT is gradually replaced with dense fibrous tissue, fluid accumulates in cysts, and the epithelial cells in the ducts proliferate; the cysts enlarge over time and cause degeneration of normal tissue
nonproliferative lesions in fibrocystic breast disease
include microcysts and fibroadenomas that are singular, moveable masses and are not cancerous
proliferative lesions in fibrocystic breast disease
includes lesions, epithelial hypertrophy in the ducts, and typical cells, and is only cancerous if there is a genetic history
proliferative changes with atypical cells in fibrocystic breast disease
atypical cells can differentiate from benign tumors into malignant tumors
signs of fibrocystic breast disease
moveable cysts or nodules that change throughout the cycle
where do most malignant breast tumors develop?
the upper outer quadrant of the breast or the central portion and most are unilateral
where do most malignant breast tumors arise from?
the cells of the ductal epithelium
where does malignant breast cancer often spread to?
regional lymph nodes like the axillary nodes; then to the brain, bone, liver, and lungs
causes of breast cancer
often is genetic due to BRCA1 and BRCA2 genes; can also be high estrogen levels, no children, delayed first pregnancy, chest radiation, or fibrocystic disease with atypical cells
signs of breast cancer
single, small, hard, painless nodule that is moveable early on but later becomes fixed; other signs are dimpling of the skin, discharge from the nipple, and a change in breast contour
stages of developing cervical cancer
dysplasia of the epithelium that is mild, severe, then malignant; then carcinoma in situ which can last for ten years, followed by metastasize
stage 0 of cervical cancer
refers to carcinoma in situ
metastasis of cervical cancer
usually is localised, spreading to the the uterus, vagina, uterine wall, rectum, and ligaments; sometimes to lymph nodes but this is rare
causes of cervical cancer
herpes simplex 2 and HPV 16, 18, 31, 34, or 45; the viral antibodies are known to cause dysplasia
signs of cervical cancer
only develop after in situ and may be minor vaginal bleeding, watery discharge, anemia, and weight loss
early sign of uterus cancer
vaginal bleeding which for menopausal women is obvious
leiomyosarcomas
refers to uterine cancers that are derived from a CT or muscle
uterine cancer
is common in 40+ women and often spreads to the lungs before diagnosis
most common type of endometrium tumor
adenocarcinomas which arise from the glandular epithelium
causes of uterine cancer
high levels of estrogen, oral contraceptives, and infertility
ovarian cancer
is often a silent tumor and can be serous (most common), mucinous, and endometrioid tumors
signs of ovarian cancer
feeling of fullness, indigestion, frequent urination, back pain, and dyspareunia
cause of ovarian cancer
CA125 marker and talc (feminine hygiene product) combined with asbestos
male problems causing infertility
changes in sperm or semen, hormonal abnormalities, and obstruction in ducts
why are recurrent STDs common?
because immunity isn’t achieved after the first exposure
what STD is asymptomatic in women?
gonorrhea
leading cause of PID
chlamydia
most common STD
chlamydia
infective agent for chlamydia
C. trachomatis a gram-negative bacteria
lymphogranuloma venereum
refers to chlamydia infecting the lymph nodes in some cases
signs of chlamydia
dysuria, whitish discharge, itching, and swollen inguinal lymph nodes; in females it is not symptomatic until PID manifests
newborns and chlamydia
can be infected during birth, causing conjunctivitis or pneumonia
causative agent of gonorrhea
N. gonorrhoeae a gram-negative bacteria
most common inflammation sites in males due to gonorrhea
the urethra and the epididymis; can also cause pharyngitis, tonsillitis, or lymphadenopathy through orogenital contact
gonorrhea in females
often in asymptomatic but can cause a change in discharge to yellow/green; can also lead to PID
newborns and gonorrhea
may be infected with ophthalmia neonatorum
syphilis causative agent
treponema pallidum, an anaerobic spirochete
syphilis primary stage
includes the development of a chancre at the point of contact about 3 weeks after infection, which heal spontaneously; swollen lymph nodes may also be present
chancre
is a painless, firm, ulcerated nodule that develops at the point of contact following the first stage of syphilis infection
syphilis secondary stage
manifests as a widespread systemic rash and systemic signs; rash is maculopapular and develops often on mucous membranes such as the palate of the mouth
syphilis third stage
is the latent stage and is asymptomatic but the disease still remains and sometimes recurrence of lesions occurs
syphilis fourth stage
is called tertiary stage and doesn’t develop in all individuals but is the development of the gumma (an area of fibrosis and necrosis), which can cause damage to the oral mucosa, the bone, the liver, and the brain
when can the fetus be infected with syphilis?
after the fourth month, causing congenital issues in the bone, liver, teeth, and lungs
mycoplasma genitalium
colonizes the urethra and genitals and often does not cause symptoms
shigella flexneri
is transmitted via anal sex and can cause a GI tract infection and bacteremia, toxic megacolon, and reactive arthritis
why are viral STDs dangerous?
antiviral agents can decrease reproduction during the acute stage but they do not eradicate the entire infection
cause of genital herpes
HSV 2 or 1 (via orogenital sex)
genital herpes signs
painful vesicles that rupture, creating an ulcerated area and systemic signs of fever, swollen lymph nodes, and headache
herpes and newborns
can spread during vaginal delivery and frequently causes death of CNS damage
HPV virus
is a double stranded DNA virus
HPV lesions location
in men on the penis and in women on the cervix or vagina
trichomoniasis
is a protozoan infection caused by T. vaginalis and usually is asymptomatic in men and in women it flares up when natural flora shifts
signs of trichomoniasis
yellow, foul discharge, inflammation, and itching
what STD is decreasing in incidence?
gonorrhea
