Lecture 28 - Male Genital System Flashcards
Pathway of spermatogenesis to ejaculation: Spermatogenesis begins in _______ ______ –> continues in _____ testis at the hilum –> then in efferent ductules at head of ________ –> then in ___ ______ –> sperm move into paired ejaculatory ducts that join to form a single duct –> merges at distal end with Urethra.
Seminiferous tubules
Rete testis
Epididymis
Vas deferens
Hypospadias –> abnormal formation/location of the urethral meatus on the ______ side of the penis. ______ is the most common location (50% of cases), then _____ (30%), then posterior (20%).
Epispadias refers to the same issue but on the _____ side of the penis (much less common).
Ventral side
Anterior
Middle
Posterior
Dorsal
_______ is the causative agent for genital warts (Condyloma acuminatum).
Which serotypes are lowest risk? (they form external warts but have low cancer risk)
Which are high risk?
Keep in mind Condylomas are considered low-grade dysplasia.
HPV
6, 11, 42, 44
16, 18, 31, 33
The characteristeic cells of HPV infection are ______, which comes from the Greek for halo. Keep in mind these are much more abundant in ___-grade dysplasia (basically absent in ___-grade).
Why is this such a fitting term?
Koilocytes
This is a fitting term because there is a characteristic “halo” around the neuclei of koilocytes. Also, keep in mind the nucleus : cytoplasm ratio DOESN’T change much in koilocytes (normally it decreseases as normal/uninfected squamous cells mature).
Carcinoma in-situ of the penis is ALWAYS caused by _____. Serotype ____ is the most carcinogenic of the high risk types. All penile carcinomas in-situ have potential to progress to _______ ____ carcinoma.
HPV
16
Squamous cell carcinoma
Name this penile carcinoma in-situ and identify the demographic most affected.
Bowen’s disease
Most common in older patients
This is _____ ______, a penile carcinoma in-situ most common in _____ patients.
Bowenoid Papulosis
Young
This is termed _____ of _____ –> a single lesion on the glans at the meatus.
Erythroplasia of Queyrat
High grade dysplasia differs from low-grade in that high-grade shows very few (or none at all) ______ (cell type).
Koilocytes
_____ is protective against penile carcinoma. Why?
Circumcision
Excess foreskin provides a place for HPV to “hide” and multiply.
Over-production of ______ by squamous cells is a defining feature of squamous cell carcinoma. This can help distinguish it from other cancer types.
Keratin
Prostate cancer is a proliferation of ONLY the _____(inner or outer?) ______ cells.
Inner secratory
Benign Prostatic Hyperplasia (BPH) is clinically detectable (imaging or digital rectal exam) in ___% of patients with microscopic evidence of BPH. Symptoms can be seen in about ____% of patients with clincal evidence of BPH. What are the clinical symptoms?
In which zones of the prostate is BPH most common?
Keep in mind it is NOT a risk factor for ProstatE Cancer!
50%
50%
Slow flow and incomplete emptying (enlaged prostate squeezes the prstatic urethra.)
Transitional and Central
What characteristic feature does BPH show grossly and microscopically?
Nodules
Unlike BPH, prostate cancer typically occurs in the _____ zone of the prostate, which lends to the utility of _____ _____ exam for diagnosis. Unfortunately, prostate cancer detectable by this exam is localized only about ___-___% of the time. Prostate cancer detected by _____, on the other hand, is lcoalized about 90% of the time. However, it can be elevated by other things (only about 2/3 of the time the elevation is related to prostate cancer.)
Peripheral
Digital rectal exam (DRE)
50-60%
PSA (remember that PSA velocity - comparing current levels to previous to see rate of increase over time - is much better than using a single measurement for diagnosis.)