Male pathophysiology and Histology Flashcards
Week 12
Effects of elevated temperature
Testicular atrophy
Spermatogenic cells atrophy
Leydig cell hyperplasia = increased risk of testicular cancer
Only Sertoli cells in SE
Why is T not high with Leydig cell hyperplasia?
androgen resistance (defect in receptor)
low functioning Leydig cells (if hypogonadism)
neg feedback
What are the two phases of testicular decent?
Transabdominal
Inguinoscrotal
When does transabdominal and inguniscortal decent occur?
T- first 3-6 months
IS= last trimester (6 months –> birth)
Hormones involved in Transabodminal testicular descent
INSL3 = Gubernaculum thickening
testosterone = degenerates cranial suspensory ligament.
Hormone action of Inguinoscrotal testicular descent
testosterone = shortening and contraction of gubernaculum
What is Cryptiochidism
incomplete descent of one or both testes
why is there an increased risk of Cryptorchidism in premature babies?
as the IS phase occurs from 6 months –> birth, the reaction of gubernaculum is not likely to be complete
What are the two treatments of Crytorchidism?
HCG
Acts on Leydig cells
Provides local, concentrated T
Early Surgery
Early to minimize time testes is in the body do reduce leydig proliferation
How does Cyrptochormism lead to infertility?
Leydig cell hyperplasia and spermatogenic cell atrophy = decreased sperm count
What is Varicocele and how does it lead to infertility?
Enlarged spermatic cord veins
Infertility
Reduced blood flow = reduced heat exchange = increased temp = infertility
causes of primary hypogonadism
Testicular dysfunction
Klinefelter’s Syndrome
Pathophysiology of Klinefelter’s syndrome
decreased T from Leydig cells = decreased responsiveness to LH
decreased inhibin = increased FSH
fibrosis of SE tubules = infetility
treatment of Pri Hypogonadism
T supplementation
Hormonal profile of pri vs sec hypogonadism
Pri = HYPERgonadotropic
Sec= HYPOgonadotrophic
Causes of sec hypogonadism and treatment
Pituitary/ hypothalamus dysfunction
Tumor or Kallmann’s syndrome
treatment
hCG supplementation
causes of Hypergonasim
Androgen-secreting tumors
Adrenal adenomas
Leydig cell tumors
clinical features of Hypergonadism
Precocious puberty
Excessive muscle mass
Mood swings
Unusual body hair growth
Acne
Gynecomastia
Hormonal profile of Hypergonasims
Increased T
Decreased GnRH
Features of a normal SE tubule
colonised by sertoliu ells and spermatogenic cell
small clusters of leydig cells
Features of an atrophied SE tubule and what conditions would you see it in?
Collagen fibers
Missing cells
(Orchitis)
(Klinefelter’s Syndrome)
Features of SE tubule esposed to high temps and what conditions would you see it in?
Cells in center of tubule
Leydig cell hyperplasia
(cryptorchidism)
(Klinefelter’s syndrome)
features of Infant testis histology
Lower density of SE tubules
NO spermatogenic cells in tubules
Epididymis features (histology)
- pseudostratified cells with stereocilia
- lumen filled with spermatozoa and proteins
