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Reproduction Final > Patho of Male Reproduction > Flashcards

Patho of Male Reproduction Flashcards

1
Q

Define Testes

A

Generate male gametes and synthesize testosterone

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2
Q

Define Duct System

A

Receive, mature and transport male gametes

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3
Q

Define Accessory Gland

A

Secrete fluids that support sperm and generate the bulk of the semen

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4
Q

What are the accessory glands?

A

Prostate gland
Bulbourethral gland
Seminal vesicles

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5
Q

Where does spermatogenesis and spermiogenesis occur?

A

Seminiferous tubules of the testes

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6
Q

Define Spermiogenesis

A

Spermatids mature into spermatozoa with development of acrosome and flagella with loss of most cytoplasm

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7
Q

Define Spermatogensis

A

Process of forming haploid gametes

Mitosis, meiosis, spermiogenesis

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8
Q

Define spermatozoa

A

Fully differentiated and ready to be released

Have a head and tail

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9
Q

What does the head contain?

A

Acrosomal cap with proteolytic enzymes and hyaluronidase + the condensed nucleus

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10
Q

What does the tail contain & do?

A

Mostly mitochondria

Also known as Flagellum and enables movement

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11
Q

Semen is composed of?

A

Fluid and sperm from the vas deferens
Fluid from the seminal vesicles and prostate gland
Small amount of mucous secretions

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12
Q

How much sperm is produced per day from both testes

A

120 million

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13
Q

What is the average pH and average life span of sperm in female reproductive tract?

A

7.5

24-48 hours

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14
Q

Where does the bulk of semen made?

A

Seminal vesicles

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15
Q

How long can sperm be kept in the male reproductive tract?

A

They maintain viable for 1 month and metabolically inactivated

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16
Q

Testosterone is secreted by?

A

Leydig cells

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17
Q

What stimulates Leydig cells?

A

LH stimulates Leydig cells to produce testosterone

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18
Q

What is testosterone’s MOA?

A

Diffuses into cells

Converted to DHT by 5alpha-reductase

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19
Q

What happens after testosterone is converted to DHT?

A

It binds to the androgen receptor and that combination enters the nucleus and binds to the hormone response element of the DNA and induce gene transcription/protein synthesis

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20
Q

DHT is?

A

The active form and has a higher affinityf or the receptor than testosterone

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21
Q

Testosterone can also be converted to?

A

Estradiol via aromatase

22
Q

Why would guys need estrogen?

A

The sertoli cell us it to help with spermatogenesis

23
Q

What is the function of testosterone?

A

Secondary sex characteristics (body hair, baldness, lower of the voice, muscle development
It also increase bone growth and calcium retention, increased RBC and basal metabolism

24
Q

Define Hypothalamic-Pituitary Testicular Axis

A

Hypothalamus secretes GnRH which stimulates teh AP to secrete LH and FSH
LH stimulates teh leydig cells to secrete testosterone which can feedback to the AP
FSH stimulates sertoli cells to initiate spermatogenesis and inhibin feeds back to AP

25
Q

How does erection occur?

A

PS impulses generate in sacral spinal cord leading to erection
Hemodynamic changes
Arterial blood flow increases, fills sinusoids of corpora –> penile swelling and elongation

26
Q

How is excretion prolonged?

A

Decreased venous outflow from the corpora, due to compression of blood outflow

27
Q

I don’t get it, how does the outflow decrease?

A

The increase blood causes the veins to be pressed closed

28
Q

Parasympathetic stage of erection?

A

Impulses call dilatation of the arteries of the penis allowing blood to flow into the erectile tissue

29
Q

But how does it increase blood flow?

A

PS stimulation causes generation of NO which increases guanylate cyclase and increases the production of cGMP which decreases calcium and decrease SM contraction which causes vasodilation of the arteries and sinuses and increases the blood flow
Expansion of the cavernosum closes off the veins on the penis and trapping the blood inside

30
Q

Sympathetic impulses from the spinal cord go to the genitals to cause emission how?

A

Contraction of the vas deferens, prostate gland and seminal vesicles which cause propulsion of the sperm and semen into the urethra

31
Q

Sympathetic impulses from the spinal cord go to the genitals to cause ejaculation how?

A

Filing of the urethra with semen starts the stimulation of ejac
The rhythmic, wavelike increases in pressure in the genital ducts and urethra which causes propulsion of semen from the urethra to the exterior

32
Q

Define Resolution

A

Male sexual excitement disappears and erection ceases

33
Q

Causes of Erectile Dysfunction

A

Vascular problems (arteriosclerosis, hyperTN)
Peripheral neuropathies (DM)
Endocrine (hypogonadism, elevated prolactin)
Psych (depression and anxiety)
Drugs

34
Q

Which drugs can induce erectile dysfunction?

A 
Anti-cholinergic
Dopamine antagonists
Estrogens/anti-androgens
CNS depressants
Agents that decreases penile blood flow
35
Q

What is the physiology of treatment of erectile dysfunction?

A

cGMP causes vasodilation of erectile tissue causing erection
cGMP can be degraded by PDE5
Certain drugs competitively and reversibly inhibit PDE5

36
Q

Define Primary Hypogonadism

A

Decrease activity of testicles which leads to decrease in testosterone or other defect impaired male sexual function

37
Q

Define Secondary Hypogonadism

A

Improper GnRH signaling which means lack of LH and androgens
Lack of FSH which means lack of sertoli cells

38
Q

What is one other cause of hypogonadism?

A

Complete or incomplete androgen insensitivity (no receptors or lack of the enzyme)

39
Q

What causes primary hypogonadism?

A

Defects of gonad function or response

Testosterone and sperm counts are below normal and LH and FSH are above normal

40
Q

What causes secondary hypogonadism?

A

Hypothalamic or pituitary defects

Testosterone and sperm counts are below normal and LH and FSH are low or normal

41
Q

Define Andropause

A

Late-onset Hypogonadism
Low testosterone with normal LH
Earlier onset with: obesity, DM, CVD, COPD, frailty

42
Q

Testosterone Replacement Therapy

A

Rapid hepatic first pass metabolism

Common therapy: esters, alkylated androgens, transdermal patch or gel

43
Q

Testosterone Esters

A

More lipophilic, given IM

44
Q

Alkylated androgens

A

Slower hepatic metabolism (oral)

May cause hepatotoxicity

45
Q

Transdermal Patch or Gel

A

Avoid first pass metabolism by transdermal delivery of lipophilic testosterone

46
Q

What are adverse effects of testosterone?

A

Acne/oily skin, male pattern balding
Gynecomastia, reduced sperm production
More aggressive sexual behavior
Sodium retention!!! exacerbate HTN, CHF or edema
Predisposed to prostatic hyperplasia or cancer
Sleep apnea
Hepatotoxicity

47
Q

Define gynecomastia

A

Abnormal development of large mammary glands in males

Due to obesity, genetic, hormones, disease or drug induced

48
Q

What drugs can cause gynecomastia?

A 
Anabolic steroids, alcohol and drugs of abuse
Spironolactone
Androgen receptor antagonists
Chemo
Psychiatric meds
ACE_I
49
Q

Benign Hyperplasia

A

Cellular proliferation which causes gland enlargement
Urinary urgency, frequency, straining and dribbling could be seen
Finasterid: Enzyme inhibitor

50
Q

Prostate Cancer

A

Most common cause of death >75 yo

Treat with androgen receptor antagonists (Flutamide)

51
Q

Long term AAS use cause?

A

LH and FSH secretion suppresion and testosterone production and spermatogenesis is inhibited

52
Q

What are side effects of AAS

A

Suppression of HPT axis after stopping

Dysphoria could also be caused

Reproduction Final (6 decks)

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