Pathophysiology: Chapter 24: Structure and Function of the Reproductive Systems

Question 1

The initial reproductive structures of the male and female embryos appear the same until
which week of gestation?
a. Third c. Twentieth
b. Eighth d. Thirtieth

Answer 1

ANS: B
Between 6 and 7 weeks’ gestation, the male embryo differentiates under the influence of
testes-determining factor (TDF). In the absence of testosterone, a loss of the wolffian
system occurs and the two gonads develop into ovaries at 6 to 8 weeks’ gestation.

Question 2

The absence of which major hormone is a determinant of sexual differentiation (wolffian

system) in utero?
a. Estrogen c. Growth hormone
b. Progesterone d. Testosterone

Answer 2

ANS: D
In the absence of testosterone, a loss of the wolffian system occurs and the two gonads
develop into ovaries at 6 to 8 weeks’ gestation. Between 6 and 7 weeks’ gestation, the
male embryo differentiates under the influence of TDF. The presence of estrogen is a
determinating factor. None of the other options function as a major determinant to sexual
differentiation in utero.

Question 3

Which gland produces the associated hormones that are found in high levels in a female
fetus?
a. Posterior pituitary excretes gonadotropin-releasing hormone (GnRH) and
luteinizing hormone (LH).
b. Hypothalamus excretes luteinizing hormone (LH) and gonadotropin-releasing
hormone (GnRH).
c. Anterior pituitaryfollicle-stimulating hormone (FSH) and luteinizing hormone
(LH).
d. Hypothalamus excretes gonadotropin-releasing hormone (GnRH) and
follicle-stimulating hormone (FSH).

Answer 3

ANS: C
In the female fetus, the anterior pituitary excretes high levels of two gonadotropins—FSH
and LH. The other sequences are not correct.

Question 4

Which hormone is linked to an increase in appetite during puberty?

a. Inhibin c. Activin
b. Leptin d. Follistatin

Answer 4

ANS: B
Sensitivity to leptin, which regulates appetite and energy metabolism, increases during
puberty; in theory, the adolescent consumes more calories to meet the caloric needs of the
pubertal growth spurt. The percent of body fat and leptin levels in girls continue to
increase, whereas muscle mass increases in boys. No apparent link exists between
increased appetite during puberty and any of the other options.

Question 5

The Skene glands are located on either side of which structure?

a. Introitus c. Clitoris
b. Urinary meatus d. Vestibule

Answer 5

ANS: B
The ducts of the Skene glands (also called the lesser vestibular or paraurethral glands) are
related only to the urinary meatus.

Question 6

What is the function of the mucus secreted by the Bartholin glands?
a. Enhancement of the motility of sperm
b. Lubrication of the urinary meatus and vestibule
c. Maintenance of an acid-base balance to discourage proliferation of pathogenic
bacteria
d. Enhancement of the size of the penis during intercourse

Answer 6

ANS: A
In response to sexual stimulation, the Bartholin glands secrete mucus that serves only to
lubricate the inner labial surfaces, as well as to enhance the viability and motility of sperm.

Question 7

Which change is a result of puberty and defends the vagina from infection?

a. The pH stabilizes between 7 and 8.
b. A thin squamous epithelial lining develops.
c. Vaginal pH becomes more acidic.
d. Estrogen levels are low.

Answer 7

ANS: C
At puberty, the pH becomes more acidic (4 to 5) and the squamous epithelial lining
thickens. These changes are maintained until menopause (cessation of menstruation), at
which time the pH rises again to more alkaline levels and the epithelium thins out.
Therefore protection from infection is greatest during the years when a woman is most
likely to be sexually active. Estrogen does not play a role in infection protection.

Question 8

What happens to the vagina’s lining at puberty?

a. It becomes thinner. c. It assumes a neutral pH.
b. It becomes thicker. d. It undergoes atrophy.

Answer 8

ANS: B
Before puberty, vaginal pH is approximately 7 (neutral) and the vaginal epithelium is thin.
At puberty, the pH becomes more acidic (4 to 5) and the squamous epithelial lining
thickens. Cell atrophy is not associated with puberty.

Question 9

Which structure is lined with columnar epithelial cells?

a. Perimetrium c. Myometrium
b. Endocervical canal d. Vagina

Answer 9

ANS: B
Of the available options, only the endocervical canal does not have an endometrial layer;
rather, the layer is lined with columnar epithelial cells.

Question 10

Where is the usual site of fertilization of an ovum?

a. Trumpet end of the fallopian tubes
b. Fimbriae of the fallopian tubes
c. Ampulla of the fallopian tubes
d. Os of the fallopian tubes

Answer 10

ANS: C
The ampulla, or distal third, of the fallopian tube is the usual site of fertilization (see
Figure 23-7).

Question 11

Where is the usual site of cervical dysplasia or cancer in situ?

a. Squamous epithelium of the cervix meets the cuboidal epithelium of the vagina.
b. Columnar epithelium of the cervix meets the squamous epithelium of the uterus.
c. Squamous epithelium of the cervix meets the columnar epithelium of the uterus.
d. Columnar epithelium of the cervix meets the squamous epithelium of the vagina.

Answer 11

ANS: D
The point at which the columnar epithelium of the cervix meets the squamous epithelium
of the vagina is called the transformation zone or the squamous-columnar junction. The
transformation zone is especially susceptible to the oncogenic human papillomavirus
(HPV), which leads to cervical dysplasia and, ultimately, cervical cancer; these are the
cells sampled during a Papanicolaou (Pap) test.

Question 12

Having ejected a mature ovum, the ovarian follicle develops into a(n):

a. Atretic follicle c. Corpus luteum
b. Thecal follicle d. Functional scar

Answer 12

ANS: C

Having ejected a mature ovum, the only resulting structure is the corpus luteum.

Question 13

The mucosal secretions of the cervix secrete which immunoglobulin?

a. IgA
b. IgE
c. IgG
d. IgM

Answer 13

ANS: A

Mucosal secretions from the cervix contain enzymes and antibodies—predominantly IgA.

Question 14

The equivalent to the female gonad is the male:

a. Epididymis c. Vas deferens
b. Spermatic cord d. Testes

Answer 14

ANS: D
Between 6 to 7 weeks’ gestation, the male embryo will differentiate under the influence of
TDF. TDF stimulates the male gonads to develop into the two testes. The ovaries, the
female gonads, are the primary female reproductive organs.

Question 15

A surge of which hormone causes the corpus luteum to produce progesterone?

a. Follicle stimulating hormone
b. Luteinizing hormone
c. Gonadotropin-releasing hormone
d. Estrogen

Answer 15

ANS: B
Luteinizing hormone from the anterior pituitary stimulates the corpus luteum to secrete
progesterone, the second major female sex hormone.

Question 16

What directly causes ovulation during the menstrual cycle?

a. Gradual decrease in estrogen levels
b. Sudden increase of LH
c. Sharp rise in progesterone levels
d. Gradual increase in estrogen levels

Answer 16

ANS: B
Menstrual cyclicity and regular ovulation are dependent on (1) the activity of the
gonadostat (GnRH pulse generator); (2) the pituitary secretion of gonadotropins; and (3)
estrogen (estradiol)–positive feedback for the preovulatory LH and FSH surges, oocyte
maturation, and corpus luteum formation.

Question 17

Which anatomic structure secretes follicle stimulating hormone (FSH) and luteinizing
hormone (LH)?
a. Hypothalamus c. Anterior pituitary
b. Ovaries d. Adrenal cortex

Answer 17

ANS: C

The anterior pituitary is the gland that secretes FSH and LH.

Question 18

During the time that ovulation occurs, which statement concerning basal body temperature
(BBT) is true?
a. BBT increases.
b. BBT decreases.
c. BBT fluctuates around 37° C (98° F).
d. BBT rises consistently above 37.8° C (100° F).

Answer 18

ANS: C

During the follicular phase of ovulation, the BBT fluctuates around 37° C (98° F).

Question 19

What structure in the male lies posterior to the urinary bladder?

a. Seminal vesicles c. Cowper glands
b. Prostate glands d. Parabladder glands

Answer 19

ANS: A
The seminal vesicles are a pair of glands, each measuring approximately 4 to 6 cm long,
which lie behind the urinary bladder and in front of the rectum. None of the other
structures lie in this location.

Question 20

When do penile erections begin?

a. Before birth c. Shortly before puberty
b. Shortly after birth d. After puberty

Answer 20

ANS: A
Erections begin in utero and continue throughout life, but ejaculation does not occur until
sperm production begins at puberty.

Question 21

Which statement is true regarding the major difference between male and female sex
hormone production?
a. Luteinizing hormone has no apparent action in a man.
b. In a man, sex hormone production is relatively constant.
c. Estradiol is not produced in a man.
d. In a man, gonadotropin-releasing hormone does not cause the release of follicle
stimulating hormone.

Answer 21

ANS: B
In men, sex hormone production is relatively constant with some diurnal variation. The
other options are not true statements.

Question 22

Where in the male body does spermatogenesis occur?

a. Epididymis c. Seminiferous tubules
b. Rete testes d. Vas deferens

Answer 22

ANS: C

Spermatogenesis takes place only in the seminiferous tubules of the testes

Question 23

Which immunoglobulin is contained in breast milk?

a. IgA c. IgG
b. IgE d. IgM

Answer 23

ANS: A
Not only does breast milk composition change over time to meet the changing digestive
capabilities and nutritional requirements of the infant, but it also contains immune cells,
specific immunoglobulins, especially IgA, and nonspecific antimicrobial factors, such as
lysozymes and lactoferrin, that protect the infant against infection, allergies, and asthma.

Question 24

Which hormone promotes the development of the lobular ducts in the breasts?

a. Progesterone c. Oxytocin
b. Prolactin d. Estrogen

Answer 24

ANS: D
Only estrogen promotes the increase in the size of the breasts by the formation of a mass
of tissue under the areola, which increases the size and pigmentation of the areola and
contributes to the development of the lobular ducts.

Question 25

What causes the vasomotor flushes (hot flashes) that are associated with declining ovarian
function with age?
a. Decreased estrogen levels      
b. Absence of estrogen
c. Increased estrogen levels    
d. Rapid changes in estrogen levels

Answer 25

ANS: D
A rapid change in estrogen levels (withdrawal or increase), rather than low estrogen levels,
induces hot flashes.

Question 26

When does the male body begin to produce sperm?

a. Before birth c. At puberty
b. Shortly after birth d. When erection is possible

Answer 26

ANS: C
Erections begin in utero and continue throughout life, but ejaculation does not occur until
sperm production begins at puberty.

Question 27

The human zygote has a total of how many chromosomes?

a. 23 c. 46
b. 25 d. 50

Answer 27

ANS: C
A 23-chromosome female gamete, the ovum, and a 23-chromosome male gamete, the
spermatozoon (sperm cell), unite to form a 46-chromosome zygote that is capable of
developing into a new individual.

Question 28

Which hormone promotes the development of testosterone in both males and females?

a. Progesterone c. Oxytocin
b. Prolactin d. Estrogen

Answer 28

ANS: B
Prolactin, a polypeptide synthesized and secreted from the pituitary, helps maintain
biosynthesis of testosterone.

Question 29

Which hormone stimulates gonads to produce both male and female hormones?

a. Gonadotropin-releasing hormone (GnRH)
b. Follicle-stimulating hormone (FSH)
c. Luteinizing hormone (LH)
d. Estrogen

Answer 29

ANS: C
Extrahypothalamic factors cause the hypothalamus to secrete GnRH, which stimulates the
anterior pituitary to secrete gonadotropins—FSH and LH. These hormones, in turn,
stimulate the gonads (ovaries or testes) to secrete female or male sex hormones.

Question 30

Which hormone relaxes the myometrium and prevents lactation until the fetus is born?

a. Gonadotropin-releasing hormone (GnRH)
b. Follicle-stimulating hormone (FSH)
c. Progesterone
d. Estrogen

Answer 30

ANS: C
Progesterone is sometimes called the hormone of pregnancy. Its effects in pregnancy
include (1) maintenance of the thickened endometrium; (2) relaxation of smooth muscle in
the myometrium, which prevents premature contractions and helps the uterus expand; (3)
thickening of the myometrium, which prepares it for the muscular work of labor; (4)
prevention of lactation until the fetus is born; and (5) prevention of additional maturation
of ova by way of suppressing FSH and LH, thereby stopping the menstrual cycle.

Question 31

A Sims-Huhner test is of particular interest to a patient experiencing which condition?

a. Infertility c. Venereal disease
b. Possible HIV infection d. Perimenopause

Answer 31

ANS: A
A Sims-Huhner test evaluates the ability of sperm to penetrate and maintain motility in
cervical mucus 2 to 4 hours after coitus approximately 1 day before ovulation. The
enzyme-linked immunosorbent assay (ELISA) detects the presence of antibodies to human
immunodeficiency virus (HIV). Venereal Disease Research Laboratory (VDRL) is a test
for nonspecific venereal diseases. Estradiol levels are associated with erratic or
intermittent menstruation.