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ENR Biweekly 1 > McIntyre- surgical approach to male repro. disorders > Flashcards

McIntyre- surgical approach to male repro. disorders Flashcards

1
Q

______ can inhibit sperm motility

A

lubricants

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2
Q

patient’s progressive motility high or low

A

very low

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3
Q
A

varicocele

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4
Q

dilation of pampiniform plexus

A

varicocele

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5
Q

L or R side more common spot for varicocele

A

L side

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6
Q

exists to regulate temperature and wash down toxin metabolites from kidney and wash away oxidative stress and ROS

A

scrotum

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7
Q

top to bottom

A

top: skin
dartos
external spermatic fascia
cremaster muscle
internal spermatic fascia
tunica vaginalis

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8
Q
A

hydrocele

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9
Q

collection of fluid in tunica vaginalis

A

hydrocele

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10
Q

development the testis start in abdomen and migrate to scrotum (gubernaculum brings them down); if canal stays open, intra-abdominal fluid builds up (patent process vaginalis)

A

infantile hydrocele

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11
Q

why you never want to go below inguinal ligament

A

femoral a, n, v are there

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12
Q

testes drop through what during their descent

A

inguinal canal

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13
Q

a form of surgical sterilization by which the vas deferens is divided or damaged to the point it will no longer transport sperm

A

vasectomy

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14
Q

role of epididymis

A

sperm maturation and storage

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15
Q
A

vasectomy (isolate vas deferens)

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16
Q

Complete absence of sperm or presence of nonmotile sperm in semen after procedure means what

A

successful vasectomy

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17
Q

time of vasectomy to time of reversal; sperm backs up in epididymis

A

obstructive interval

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18
Q

steps of sperm transport

A

created in seminiferous tubules
stored in epididymis
move from epididymis to vas deferens
mix with fluids from seminal vesicles and prostate
travel through ejaculatory duct, prostate, and urethra and exit

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19
Q

diploid cells

A

spermatogonia and primary spermatocyte

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20
Q

haploid cells

A

secondary spermatocyte, spermatids, and sperm cells

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21
Q

____ to ____ after the 1st meiotic division

A

spermatogonia to primary spermatocyte

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22
Q

primary spermatocyte to ______ then to spermatid and sperm cells

A

secondary spermatocyte

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23
Q

____ region of epididymis is where sperm gains ability to fertilize

A

cauda (tail region)

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24
Q

______to inguinal ring obstruction to vas deferens is reversible

A

external

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25
Q

come together to form ejaculatory duct

A

vas deferense, seminal vesicles, and ampulla

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26
Q

useful surgical anatomy to identify what first

A

vas deferens

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27
Q

no sperm seen on semen analysis

A

Azoospermia

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28
Q

vas deferens absent in what main disease

A

CF

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29
Q

The vas is unable to form embryonically due to thickened secretions lack of canalization
Seminal vesicles are also atretic

A

CF

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30
Q

semen volume mainly from what

A

fluid from seminal vesicles

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31
Q

primordial bladder

A

cloaca

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32
Q

_____ descends over time

A

Vas (Wolffian duct)

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33
Q

“precum”; neutralizes the urethra; lubrication

A

bulbourethral glands

34
Q

watery discharge; contributes PSA

A

prostate

35
Q

(screening tool for prostate cancer) —-break down coagulum that comes out with ejaculate (so it can stick to cervix)

A

PSA

36
Q

Sperm formation is normal but they are unable to traverse the male genital tract.

A

Obstructive Azoospermia

37
Q

sperm retrieval in setting of OA

A

percutaneous approach to the epididymis

38
Q

men of reproductive age should never be above _____ for FSH

A

7.5

39
Q

LH and FSH abnormally high but testosterone normal; what does this mean

A

pituitary is abnormal

40
Q

brain is not seeing ______ signal back from testicles for negative feedback loop to work

A

inhibin

41
Q

example of primary hypogonadism/testicular failure where FSH and LH are elevated

A

Klinefelter’s (XXY)

42
Q

progressive scarring of testicles
disproportionate stature
infertility
hypogonadism

A

Klinefelter’s

43
Q

treatment options for non-obstructive azoospermia

A

IVF

44
Q

sperm retrieval rates for NOA patient

A

60%

45
Q

pregnancy rates for NOA patient

A

45%

46
Q

scrotal ultrasound shows what

A

a mass

47
Q

labs to order for testicular mass

A

hCG
LDH
AFP

48
Q

orchiectomy

A

remove testicle

49
Q

scrotum drains to what nodes

A

inguinal

50
Q

if you violate the scrotum while removing a testicle what can happen

A

expose lymphatics to cancer

51
Q

what else is seen here

A

hydronephrosis on L side

52
Q

elevated hCG most likely associated with what type of testicular cancer

A

Nonseminomatous germ cell tumor

53
Q

most common germ cell tumor

A

seminoma

54
Q

marker for Yolk Sac Tumor

A

AFP

55
Q

marker for choriocarcinoma

A

beta hCG

56
Q

treatment for seminoma w/ mets to retroperitoneum

A

chemo/radiation

57
Q

treatment for non-seminomatous germ cell tumor with mets to retroperitoneum

A

surgery/chemo

58
Q
A

R sided modified template

59
Q
A

L sided modified template

60
Q

why would you need to spare the nerves that innervate male reproductive tract

A

erection and ejaculation happen from sympathetics and parasympathetics

61
Q

Erection
Preganglionic neurons innervate the corpora cavernosa
IML at the S2-S4 level.
Exit through pelvic nerves
Pass through the hypogastric plexus

A

parasympathetic

62
Q

_____ artery comes off internal iliac artery

A

internal pudendal that supplies the penis

63
Q

______ artery becomes cavernous arteries

A

internal pudendal

64
Q

what pinches outflow of blood through veins that keeps blood into cavernous and maintains erection

A

Buck’s fascia

65
Q

what causes NO release in the erection pathway

A

parasympathetic stimulation

66
Q

NO stimulates ______ that upregulates cGMP

A

smooth muscle guanylyl cyclase

67
Q

_____ causes penile arteriolar vasodilation and relaxation of penile corporeal smooth muscle

A

cGMP

68
Q

terminates cGMP function

A

PDE5

69
Q

erectile dysfunction can be treated by inhibiting what

A

PDE5

70
Q

_____ inhibitors increase blood flow and muscle relaxation of penis

A

PDE5 inhibitors

71
Q

main 2 causes of ED

A

vascular and diabetes

72
Q

____ is a risk factor for cardiovascular disease in the future

A

ED

73
Q

first used for primary pulmonary HTN treatment and then ED

A

Viagra (Sildenafil)

74
Q

negative pressure pumped in to help erection

A

vacuum erection device

75
Q

topical prostaglandin E1 (intraurethral suppositories to do what)

A

erection

76
Q

inject prostaglandin E1 to vasodilate arteries is _____ mediated

A

cAMP

77
Q

_____ activates protein kinase G and causes decreased intracellular Ca2+ and decreased smooth muscle tone and vasodilation of penile arteries

A

cGMP

78
Q

____ activates protein kinase A and causes decrease in intracellular Ca2+ and decreased smooth muscle tone and vasodilation of penile arteries

A

cAMP

79
Q

another way to achieve erection if all other options dont work

A

penile implant (pump in scrotum)

80
Q

how long can penile implant last

A

7-10 years

ENR Biweekly 1 (11 decks)

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