Male Reproductive System - Test 2 Flashcards
What are the 4 major functions of the testes
male differentiation during fetal life
induction of secondary sex characteristics at puberty
sperm production
maintenance of the adult male phenotype and sex drive
What artery(ies) supply the testes?
testicular artery (primary from aorta)
cremasteric artery (inferior epigastric)
artery to the ductus deferens (internal iliac)
Where does testicular arterial blood drain into?
pampiniform plexus
What organs contribute to the components of ejaculation?
testicle (sperm)
prostate (PSA - breaks down semen to allow sperm to swim)
seminal vesicles
bulbourethral glands
What are the layers of the scrotum?
Scrotal skin
Dartos fascia
External spermatic fascia
Cremaster muscle
Internal spermatic fascia
Tunica vaginalis
Tunica albuginea
Describe the Hypothalamic-pituitary-gonadal axis
How is testosterone transported in serum?
SHBG and albumin (albumin > SHBG)
What hormone is responsible for BPH and baldness?
DHT
Do men produce estradiol?
yes! via aromatase
What stimulates Leydig cells? Sertoli cells? What do these cells make?
LH –> Leydg cells –> testoterone
FSH –> Sertoli cells –> spermatogenesis, ABH, inhibin B
What is clomiphene used for?
Clomiphene (clomid)
Partial Estrogen receptor agonist/antagonist
Prevents end products from creating the negative feedback resulting in more FSH and LH secretion –> increased testosterone
can be used to tx male infertility
What is anastrazole used for in men?
Anastrazole
Aromatase inhibitor
Prevents conversion of estradiol thereby inhibiting the negative feedback resulting in more FSH and LH secretion
can be used to tx male infertility
What is Klinefelter syndrome?
primary hypogonadism (hypergonadotropic hypogonadism)
dem balls don’t work
Increased FSH, LH, and estrogen
decreased testosterone
What is Kallman syndrome?
secondary testicular dysfucntion
hypogonadotropic hypogonadism
low FSH and LH
anosmia (can’t smell)
Define infertility
the inability to conceive after 12 months of regular, unprotected intercourse
When a patient comes to you complaining of low/no ejaculant, what do you want to determine?
evalutate for retrograde ejaculation into the bladder and for obstruction
Define azoospermia. What are the 2 types?
Azoospermia is the absence of sperm in the ejaculate
Non obstructive azoospermia (impaired spermatogenesis)
Obstructive azoospermia (impaired sperm transport)
What are the 3 types of subfertility?
Oligozoospermia (<15 million sperm/mL)
Asthenozoospermia (<40% motility)
Teratozoospermia (<4% morphologically normal sperm)
What does a Y-micro deletion in either the AZFa, AZFb, or AZFc gene on the p arm lead to?
azoospermia
In what condition do you see bilateral absence of the vas deferens?
Cystic fibrosis
What is a varicocele? How is it described? How is it treated?
dilated pampiniform plexus
described as a bag of worms
varicocelectomy
Define Intrauterine insemination (IUI)
Sperm is collected by masturbation, washed, concentrated, and instilled into the uterus
“turkey baster” method
Define IVF
Sperm is collected by masturbation, washed, concentrated, and mixed with eggs in vitro. Embryos grow in vitro through several cell cycles and then are transferred into the uterus
Define Intracytoplasmic sperm injection (ICSI)
Direct injection of sperm into egg
Name the tumor markers for testicular cancers
How is testicular cancer treated?
surgical removal via inguinal (add cisplatin f metastatic)
What Gleason grade is this?
Grade 1
notice the glands
What gleason grade is this?
gleason grade 5
no glands
What is the treatment for prostate cancer?
surveillance
radiation
surgery
chemical castration (leuprolide, abarelex, testosterone blocker [flutamide/bicalutamide])
What is a hydrocele? When do you treat?
Fluid collection in the tunica vaginalis layers
Only treat if symptomatic
What is a spermatocele? When do you treat?
Cyst of epididymis or rete testis
Only treat if symptomatic
What is testicular torsion? is it an emergency?
Twisting of the spermatic cord cutting off the testicles blood supply
Emergency! surgery to untwist the testicle
What is epididymitis caused by?
Chlamydia and N gonorrhoeae in men <35
E coli in men >35
What is the treatment for BPH?
medical: alpha antagonists (tamsulosin), 5-alpha reductase inhibitors (finasteride)
surgical: TURP
Where in the prostate does BPH occur? cancer?
transitional zone = BPH
peripheral zone = cancer
What type of testicular cancer is this?
smeinoma
fried egg appearance
