Male Reproductive System Flashcards
Describe the rough structure of the Sertoli and Leydig cells in the testes
Leydig cells in interstitial comp
Separated by blood testicular barrier
Sertoli cells reach out to each other, form barrier between basal and mature spermatogonial cells
Mature spermatogonial cells in luminal comp
What are the functions of the 3 main cells in the testes
Sertoli
- support tubule nutritional support for sperm
- protection from immune attack
- inhibin, AMH, ABP, growth factor secretion
- excretion of absnomal sperm
Spermatogonial stem cell
-sperm production
Leydig
- testesterone production
- stimulates Sertoli function
What is the function of testosterone
Anabolic hormone
-increase bone and muscle
Primary, secondary sexual characteristics
Stimulates Sertoli and spermtogenesis
Describe the mechanism behind spermatogenesis
-when does this occur
Puberty onwards
Spermatogonial cells in mitosis => primary spermatocytes
Primary spermatocytes in meiosis => secondary spermatocytes
Loss of lips, cholestesterol => thinner
Mitochondria arranged in mid piece
Digestive enzymes in acrosome => head
Describe the HPT axis
FSH => Sertoli cells => inhibin
LH => leydig cells => testosterone
-ve feedback loop
What happens in sperm capacitance
When does this happen
4hrs after ejaculation => hyperactive
- cholesterol loss => thinner
- Ca increase => increased ATP and speed
What factors affect sperm production
-3 main factors
-Excess T => silences FSH, LH release
Sperm under increased oxidative stress => damaged
- Anabolic steroids
- Environment
- radiation
- air, food chain pollution
Describe the steps in the acrosome reaction and oocyte activation
Interaction with oocyte protein => hyaluronidase, across exposure => penetration
Diploidy restored, cortical granules released by egg to block polyspermic penetration
Resume meiosis, 2nd polar body released => fertilisation
What is Klinefelter syndrome
What is the pathophysiology behind it
What are the symptoms and signs
XXY/XXY mosaic
Tall decreased facial/body hair gynecomastia osteoporosis small testes feminine fat distribution
If XXY => no sperm
If XXY mosaic => some sperm prod
What is Kallman syndrome
What is the pathophysiology
How would you manage this
No GnRH => low FSH, LH => low spermatogenesis
FSH, LH injection
What is hyperprolactinaemia
What is the pathophysiology
How would you manage this
Increased PRL
Pituitary adenoma
Surgery
-transphenoid surgery
D2 agonist
- bromocriptine
- cabergoline
What is Androgen insensitivity syndrome
What is the pathophysiology
What are the symptoms and signs
No androgen receptors
Primary amenorrhea even though XY
Normal testosterone in male hormonal range
How might you manage prostate cancer
GnRH agonist (goserelin) => initial stimulatory effect but constant stimulation outmatches the bodies ability to produce LH and GnRH
GnRH antagonist (abarelix) => suppress LH production
Antiandrogens => block action of testosterone and DHT
5a reductase inh => prevent testosterone conversion to DHT
