Male Reproductive Pathology Flashcards
Structure of the testes
Compound tubular gland
Contained within tunica albuginea
Divided into lobules by septa
Each lobule contains 1-4 seminiferous tubules
Tunica albuginea
Thick Connective tissue coat of testes
2 steps of sperm development
Spermatogenesis
Spermiogenesis
Spermatogenesis
Undifferentiated spermatogonium develops into spermatid
Step 1
Spermiogenesis
Spermatid matures into a spermatozoan
Step 2
Where does Spermatogenesis occur
Germinal epithelium of seminiferous tubules
What divides the basal and adluminal compartments of the germinal epithelium of seminiferous tubules
Sertoli cells
What are the stem cells of Spermatogenesis
Spermatogonia
Where are spermatogonia and what do they do
Rest on seminiferous tubules basement membrane
Divide mitotically - make more spermatogonia and primary spermatocytes
What do primary spermatocytes do
Migrate to adluminal compartment
Enter meiosis to form secondary spermatocytes
Which stage of meiosis is prolonged in primary spermatocytes
Prophase - allows more exchange of genetic material between homologous chromosomes
Why are secondary spermatocytes rarely seen and how many pairs of chromatids do they have
Short period between first and second meiosis division
23 pairs
which meiotic division produced haploid spermatid
Second
Why is cytokinesis not complete in spermatid
Leaves cytoplasmic bridges for material exchange for synchronous maturation
Cellular changes in Spermiogenesis
Acrosome develops and overlies nucleus
Flagellum grows
Mitochondria arrange around flagellum
Majority of Cytoplasm cast off as residual body
(Flagellum faces lumen, head faces basal compartment)
What is the flagellum
Modified cilium that develops around the centrioles of the spermatid
What is the residual body and what happens to it
Cytoplasm cast of by spermatid during Spermiogenesis
Consumed by sertoli cells
Where are Sertoli cells
Germinal epithelium
Characteristics of Sertoli cells
Abundant cytoplasm
Oval nucleus
Dark nucleolus
Extend from basement membrane to lumen of seminiferous tubules
Sertoli cell function
Structural and chemical support to developing spermatogonia, spermatocytes, and spermatids
What substances do Sertoli cells produce and what do they do
Androgen binding protein - keeps testosterone level high, production stimulated by FSH
Inhibin - decr FSH production
Where are leydig cells
Connective tissue surrounding seminiferous tubules
What do leydig cells do
Produce testosterone
Which cells contain cytoplasmic crystals of reinke
Leydig cells
How are Sertoli cells connected
Junctional complexes of tight and adhesion junctions close to basement membrane
Features of seminiferous tubules pre puberty
mostly Sertoli cells
Occasional pri spermatocyte
Most of interstitial tissue between tubules are fibroblasts
Few leydig cells
Rete testes
Connects seminiferous tubules to ductus deferens
Function of microvilli in rete testes
Move spermatozoa along
Absorb excess material from seminal fluid
Type of epithelium in rete testes
Ciliated cuboidal
Epididymis
Muscular convoluted tubule that stores spermatozoa
Where do sperm become mobile
Epididymis
Epididymis and ductus deferens epithelium
Pseudostratified with non motile stereocilia
Ductus deferens
Muscular tubule that carries sperm downstream from epididymis
Is the muscular wall of the epididymis or ductus deferens thicker
Ductus deferens
How many muscular layers in the wall of the epididymis
3 - inner longitudinal, middle circular, outer longitudinal
Where do secretions from the seminal vesicles enter the ductus deferens
Ampulla
What is formed after the tubes from the seminal vesicles joins the ductus deferens
Ejaculatory duct
Seminal vesicle
Glandular sacs that produce a secretion that composes 80% of the seminal fluid
Histological Appearance of seminal vesicles
Honeycombed saccules
Thin highly branched folds of mucosa
Pseudostratified colomnar epithelium
Smooth muscle around saccules
Prostate
Walnut sized conglomeration of tubular acinar glands that surround the initial segment of the urethra
Purpose of the secretion from the prostate
Prevents semen coagulation - citric acid and proteolytic enzymes
Neutralise low pH in female repro tract - alkaline
What accumulates in the prostate with age
Prostatic concretions
Prostate epithelium
Columnar,
Numerous flattened basal cells visible
What surrounds the glands in the prostate
Stroma containing smooth muscle and connective tissue
3 columns of erectile tissue in the penis
2x corpus cavernosa
1x corpus spongiosum
Which column of erectile tissue in the penis contains the urethra
Corpus spongiosum
Epithelium in urethra
Transitional
Stratified squamous at opening
Atrophic testes
Shrinking and loss of function of testes
Atrophic testes histological characteristics
No cells of Spermatogenesis in seminiferous tubules
Sertoli and leydig cells still present
Thicker basement membrane
How is testosterone level affected by Atrophic testes
No effect or increase - testosterone still made normally by leydig cells, may decr as not being bound to androgen binding protein
Nodular hyperplasia of the prostate
Nodules form from hyperplasia of epithelial and stromal cells which can compress urethra and obstruct urine flow
What tissues are in nodular hyperplasia of the prostate
Glandular
Fibrous
Are benign or malignant glands larger in prostate adenocarcinomas
Benign
Adenocarcinoma of the prostate malignant gland histological characteristics
Lack basal cells
Nucleoli
Testicular torsion symptoms and signs
Unilateral scrotal pain
Nausea
Vomiting
Absent cremaster is reflex
Pathophysiology of testicular torsion
Venous compromise -> arterial occlusion -> ischaemia
Testicular torsion treatment
Detorsion
Orchidopexy
Orchiectomy
What type of cancer are 95% of testicular cancers
Germ cell tumours
2 types of testicular germ cell tumours
Seminomas
Non seminomas
Testicular cancer presentation
Unilateral palpable mass
Age 30-49
Where do testicular seminomas originate
Germinal epithelium of seminiferous tubules
Where do testicular non seminomas originate
Yolk sack
Embryonic cell
Choriocarcinoma
Teratoma
Are testicular seminomas or non seminomas more likely to metastasise
Non seminomas
Testicular cancer treatment
Radical orchiectomy
Surveillance
Radiation
Chemotherapy
Retroperitoneal lymph node dissection - residual post chemotherapy disease
Testicular seminomas histological characteristics
Cells with large vesicular nuclei, prominent nucleoli, and clear cytoplasm in seminiferous tubule
Most common type of yolk sack tumour
Microcystic yolk sac tumour
