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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
How does erection occur?
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
How is excretion prolonged?
Decreased venous outflow from the corpora, due to compression of blood outflow
27
I don't get it, how does the outflow decrease?
The increase blood causes the veins to be pressed closed
28
Parasympathetic stage of erection?
Impulses call dilatation of the arteries of the penis allowing blood to flow into the erectile tissue
29
But how does it increase blood flow?
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
Sympathetic impulses from the spinal cord go to the genitals to cause emission how?
Contraction of the vas deferens, prostate gland and seminal vesicles which cause propulsion of the sperm and semen into the urethra
31
Sympathetic impulses from the spinal cord go to the genitals to cause ejaculation how?
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
Define Resolution
Male sexual excitement disappears and erection ceases
33
Causes of Erectile Dysfunction
Vascular problems (arteriosclerosis, hyperTN) Peripheral neuropathies (DM) Endocrine (hypogonadism, elevated prolactin) Psych (depression and anxiety) Drugs
34
Which drugs can induce erectile dysfunction?
``` Anti-cholinergic Dopamine antagonists Estrogens/anti-androgens CNS depressants Agents that decreases penile blood flow ```
35
What is the physiology of treatment of erectile dysfunction?
cGMP causes vasodilation of erectile tissue causing erection cGMP can be degraded by PDE5 Certain drugs competitively and reversibly inhibit PDE5
36
Define Primary Hypogonadism
Decrease activity of testicles which leads to decrease in testosterone or other defect impaired male sexual function
37
Define Secondary Hypogonadism
Improper GnRH signaling which means lack of LH and androgens Lack of FSH which means lack of sertoli cells
38
What is one other cause of hypogonadism?
Complete or incomplete androgen insensitivity (no receptors or lack of the enzyme)
39
What causes primary hypogonadism?
Defects of gonad function or response | Testosterone and sperm counts are below normal and LH and FSH are above normal
40
What causes secondary hypogonadism?
Hypothalamic or pituitary defects | Testosterone and sperm counts are below normal and LH and FSH are low or normal
41
Define Andropause
Late-onset Hypogonadism Low testosterone with normal LH Earlier onset with: obesity, DM, CVD, COPD, frailty
42
Testosterone Replacement Therapy
Rapid hepatic first pass metabolism | Common therapy: esters, alkylated androgens, transdermal patch or gel
43
Testosterone Esters
More lipophilic, given IM
44
Alkylated androgens
Slower hepatic metabolism (oral) | May cause hepatotoxicity
45
Transdermal Patch or Gel
Avoid first pass metabolism by transdermal delivery of lipophilic testosterone
46
What are adverse effects of testosterone?
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
Define gynecomastia
Abnormal development of large mammary glands in males | Due to obesity, genetic, hormones, disease or drug induced
48
What drugs can cause gynecomastia?
``` Anabolic steroids, alcohol and drugs of abuse Spironolactone Androgen receptor antagonists Chemo Psychiatric meds ACE_I ```
49
Benign Hyperplasia
Cellular proliferation which causes gland enlargement Urinary urgency, frequency, straining and dribbling could be seen Finasterid: Enzyme inhibitor
50
Prostate Cancer
Most common cause of death >75 yo | Treat with androgen receptor antagonists (Flutamide)
51
Long term AAS use cause?
LH and FSH secretion suppresion and testosterone production and spermatogenesis is inhibited
52
What are side effects of AAS
Suppression of HPT axis after stopping | Dysphoria could also be caused

Reproduction Final (6 decks)

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