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Spring 2014 > Physiology - Exam 3, Deck #1 - Reproduction > Flashcards

Physiology - Exam 3, Deck #1 - Reproduction Flashcards

1
Q

What are the Male Genital Organs?

A
  1. Testes
  2. Epididymis
  3. Vas deferens
  4. Urethra
  5. Penis
  6. Accessory glands
    — Seminal vesicles
    — Prostate gland
    — Cowpers = bulbourethral glands
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2
Q

What are the Testes?

A
  • 2 small, oval shaped glands situated in a pouch called the SCROTUM and suspended by the spermatic chords;
  • DO NOT develop in the scrotal sac
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3
Q

What is the Inguinal Canal?

A
  • Narrow canal connecting the peritoneal cavity with the scrotal sac;
  • Tests decend through canal at 7-9 months fetal life and enter the sac
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4
Q

What is Cryptochidism?

A
  • Condition in which the testes fail to descend into the scrotum ;
  • Male will NOT produce viable sperm
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5
Q

What causes Subsequent Inguinal Hernia Formation>

A

Incomplete closure of the inguinal canal at birth

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6
Q

How do the testes mature?

A
  • Grow little during the first 10 years of life;

- Puberty - 11-12th years and acquire adult proportions

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7
Q

What is the main structure of the Testes?

A
  • Outer fibrous coat = TUNICA ALBUGINEA;

- Inside glands = number of pyramid shaped LOBULES that face toward the surface

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8
Q

What makes up the weight of the Testes?

A

-90% = Seminiferous Tubules;
-10% = Interstitial cells of Leydig + other tissues
= Each lobule is made of of several seminiferous tubules with the interstitial cells of Leydig in between

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9
Q

What are Seminiferous Tubules?

A
  • More than 800 seminiferous tubules/testes;

- Tubules unite and form a plexus of canals called the RETE TESTIS

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10
Q

What is the Rete Testis?

A

A plexus of canals formed from the seminiferous tubules;

-Ends in the upper part of the testes in a series of called the VAS EFFERENS

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11
Q

What is the Vas Efferens?

A

The vas efferent penetrate the tunica albuginea (outer coat) and form a convoluted tubular mass lying ON TOP of the testis called the EPIDIDYMIS

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12
Q

What is the the Epididymis>

A

-Convoluted tubular mass lying on top of the testes that came form the vas efferent;

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13
Q

What is the flow from the Epididymis?

A

-Epididymis — Single Duct (vas deferens) — Urethara

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14
Q

What is the function of the Interstitial Cells of Leydig?

A

Site of the male sex hormone production = Testosterone

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15
Q

What is Spermatogenesis?

A

The process of sperm formation;

  • A type of meiosis that beings with the onset of puberty ;
  • Takes place in the germinal epithelium of seminiferous tubules
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16
Q

What are Sertoli Cells?

A

Nurse cell located in the germinal epithelium;

  • Sertoli cells are the target of FSH and function to causes changes in the spermatid to spermatozoa;
  • Provide nutrients, hormones, and enzymes that are needed for transforming the spermatids
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17
Q

Where is sperm carried on the chromosomes?

A
  • Half is carried on X chromosomes;

- Half is carried on Y chromosomes

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18
Q

What is Spermiation or Spermiogenesis?

A
  • When spermatids are first formed they possess the characteristics of epitheliod cells, but by attaching to SERTOLI CELLS, the excess cytoplasm is removed and spermatids become spermatozoa;
  • Each spermatid elongates into a spermatozoan
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19
Q

What makes up a Spermatazoan?

A
  1. Acrosome head;
  2. Midpiece;
  3. Tail
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20
Q

Where did the Acrosome head come from?

A
  • The acrosome head is formed from the golgi apparatus;

- Contains enzymes HYALURONIDASE and PROTEASES that play roles in entry of the sperm into the ovum

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21
Q

What are the stages of Spermatogenesis and Spermiogenesis?

A

START: Spermatogonia — Primary Spermatocytes;
1. Meiosis (first division) — Secondary Spermatocytes;
2. Meiosis (second division) — Spermatids = Testosterone required at Puberty;
3. Spermiogenesis = FSH required at puberty; Testosterone maintains after puberty
END: Spermatozoa

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22
Q

Where do sperm go once they are produced?

A

Sperm move from the seminiferous tubules, where they are NONMOTILE and can NOT fertilize an ovum;

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23
Q

What is Maturation of Sperm?

A
  • After 18 hours to 10 days, they develop the capability of motility even though some inhibiting factors still prevent motility until ejaculation;
  • Also develop the ability to fertilize an ovum
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24
Q

How do sperm enter the Ejaculatory Duct?

A

Sperm;

  1. Vas Efferens;
  2. Inguinal Canal;
  3. Over Pubic Arch;
  4. Posteriorly to the point where the vas deferens join the seminal vesicles and forms the EJACULATORY DUCT
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25
Q

How does the Vas Deferens meet the Ejaculatory Duct?

A

Vas deferens receives the duct of the seminal vesicles and enters the tissues of the PROSTATE GLAND as the Ejaculatory Duct

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26
Q

Where the the Ejaculatory Ducts go?

A

The right and left ejaculatory ducts open in the URETHRA within the prostate gland

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27
Q

Where is Spermatozoan stored?

A

A small quantity of sperm is stored in the EPIDIDYMIS, but most are stored in the VAS DEFERENS and in the AMPULLA of the vas deferens;

  • They can remain stored in a fertile state for up to several months;
  • With frequent sexual activity storage may be no longer than a few days
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28
Q

What are the Seminal Vesicles?

A

-Lobulated sacs located at the posterior surface of the bladder;

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29
Q

What fluid is secreted from the Seminal Vesicles?

A
  • Secrete a fluid that forms a part of the semen;
  • Fluid of the ejaculatory duct and forms 60% (range 45-80%) the bulk of semen;
  • Last fluid to be ejaculated and washes sperm out of the ejaculatory duct and urethra
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30
Q

What are components of the Seminal Vesicle FLUID?

A
  1. Fructose = energy source for spermatozoa;
  2. Phosphorylchoine = function unknown; legal test for presence of semen;
  3. Specific genes in the DNA of the spermatozoa;
  4. Prostaglandins = aid fertilization
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31
Q

How can a sperm donor be identified?

A

Through the use of nucleotide sequence analysis of RFLP analysis of specific genes in the DNA of spermatozoa

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32
Q

How do Prostaglandins aid fertilization?

A
  1. Reacting with cervical mucous to made it more receptive to sperm;
  2. Possible causing reverse peristaltic contractions int eh uterus and fallopian tubes to move sperm to the ovaries
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33
Q

What is the Prostate Gland?

A
  • Prostate gland is a muscular, glandular organ located below the bladder and anterior (in front) of the rectum;
  • Produces a secretion 15-30% of semen
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34
Q

What are the components of the Prostatic Secretion (fluid)?

A
  • Alkaline, somewhat milky, and contributes to the odor of semen;
  • 15-30% of semen volume;
  • Leaves the prostate gland and enters the URETHRA
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35
Q

Why is the Prostatic Secretion ALKALINE ?

A

Alkalinity (basic) neutralizes the ACIDIC environment of the male and female reproductive tracts so that the sperm won’t be inactivated

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36
Q

How the Prostate Gland change with age?

A
  1. Prostate gland tends to ENLARGE in older men and often constricts the urethra making it difficult to empty the bladder — Gland is often removed surgically;
  2. Prostate cancer occurs in older men
    * *Seminal vesicles and prostate gland are NOT essential for fertility, just enhance the probability
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37
Q

What is the test for Prostate Cancer?

A
  1. Includes a digital rectal exam for hard lumps and
  2. A blood born prostate specific protein antigen test which has the potential of detaching earlier stages of prostate cancer
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38
Q

What are the Bulbourethral (Cowper’s) Glands?

A

2 small yellow glands, about the size of peas lacerated in the bulb region at the base of the penis;
-These glands empty into the urethra from below

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39
Q

What is secreted from the Bulbourethral (Cowper’s) Glands?

A
  • Clear, mucoid fluid discharged during sexual stimulation;
  • Most of the secretion precess seminal emission;
  • Meant to lubricate the urethra and penis as well neutralizing the acidic condition of the urethra for sperm enter
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40
Q

What is the Penis?

A
  • The copulatory (sexual intercourse) organ of the male;

- Penis become erect during sex due to the Corpora Cavernosa and the Corpus Spongiosum (spongy, bloody sinuses)

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41
Q

What is the Glans Penis?

A
  • End of the penis;

- Covered by loose skin called FORESKIN or PREPUCE (removed by circumcism)

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42
Q

What is the Corpora Cavernosa

A
  • Spongy, bloody sinus involved in erection of the penis;

- Two longitudinal columns of the corpora cavernosa run the length of the penis on the dorsolateral aspect

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43
Q

What sit eh Corpus Spongiosum?

A
  • Spongy, bloody sinus involved in erection of the penis;

- A single column that runs mid-centrically on the penis

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44
Q

How is an erection achieved?

A

By parasympathetic nerve-induced VASODILATATION of the of arterioles that allow blood to flow into the corpora cavernosa and the corpus spongiosum of the penis

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45
Q

What is the Neurotransmitter that mediates an erection?

A

-Nitric Oxide = activates the enzyme guanylate cyclase which catalyzes a reaction that produces increase levels of cyclic monophosphate (cGMP)

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46
Q

What is the function of cGMP in causing an erection?

A
  • cGMP causes relaxation of the smooth muscle arterioles by closing Ca2+ channels and decreasing cytoplasmic Ca2+;
  • As the erectile tissue becomes engorged with blood and the penis becomes turgid, venous outflow of blood is partially occluded = causing erection
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47
Q

What is Erectile Dysfunction?

A

Failure to obtain or maintain an erection;
-The drug Viagra, Sildenafil Citrate works by selectively inhibiting the enzyme that destroys cGMP = Type 5 Phosphodiesterase;
— Erection is maintained longer due to longer activity of cGMP as it is not degraded

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48
Q

What is the volume of sperm released upon ejaculation?

A
  • Avg. 400 million sperm;
  • Avg. fluid volume in a seminal emission is 3.5mls;
  • Avg. sperm count = 120 million/ml (rage 35-200 million/ml)
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49
Q

What defines a below avg. fertility?

A

-A sperm count of below 60 million/ml

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50
Q

What defines infertility?

A

-A sperm count below 20 million/ml

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51
Q

How is Seminal Emission achieved?

A
  • Orgasm;
  • By stimulating the vas deferens, seminal vesicles, and prostate gland to pour their accumulated contents into the base of the urethra through the ejaculatory ducts;
  • A variety of sensation from ejaculation make up an orgasm;
  • Spermatozoa become motile upon ejection
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52
Q

How long are ejaculated sperm motile?

A
  • Some sperm can reach the upper uterine tubes in 5 minutes after entering the cervix near the uterus;
  • May maintain motility for 24-48 hours;
  • the Fertilizable life of the OVUM is only about 6-12 hours — female fertility is highly dependent on time of ovulation
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53
Q

What are the components of the Female Reproductive System?

A
  1. Ovaries -2
  2. Oviducts = fallopian tubes = 2
  3. Utereus
  4. Vagina
  5. External genitalia
  6. Mammary glands
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54
Q

What are the Ovaries?

A
  • Paired (2);
  • Lie on either side of the uterus and bellow the fallopian tubes;
  • Made up of a connective tissue framework, which supports the developing germ cell, muscle cells, blood cells, and nerves
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55
Q

What is within the Cortex of the germinal epithelium of the ovaries?

A

Contains numerous germ cells and follicles in various stages of development

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56
Q

Where does the ovum develop from?

A
  • The ovum develops from the OVARIAN FOLLICLE;

- Various stages of OOGENESIS are passed there, and developing ovum in one of the mature follicles is a Primary Oocyte

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57
Q

What hormones influence Follicle development in the ovary?

A
  • 2 hormones from the anterior pituitary;
    1. Follicle Stimulating Hormone (FSH);
    2. Luteinizing Hormone (LH)
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58
Q

What is Ovulation?

A
  • Occurs from puberty to menopause;
  • Mature follicles approach the surface of the ovary and rupture mature ova through the surface at regular monthly intervals;
  • Occurs about the middle of the 28 day menstrual cycle, but follicle cells persist and transform in the CORPUS LUTEUM
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59
Q

What takes place in the Corpus Luteum?

A
  • After ovulation, follicular cells enlarge and increase in numbers by increasing number of cell layers = a thick walled body produced in the corpus luteum;
  • Secretes 2 hormones between ovulation and menstruation = estrogen/progesterone
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60
Q

What is the role of Progesterone and Estrogen from the corpus luteum?

A
  • They sustain influence over the ENDOMETRIUM = the lining of the uterus;
  • Changes in the levels of these hormones depends on if pregnancy occurred or not
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61
Q

What are the Fallopian Tubes?

A
  • Tubes that conduct the ova from the ovaries to the uterus;
  • Lie in a horizontal plane above the ovaries and possess a funnel-like distal end;
  • NOT passive during ovulation by moves closer to the ovary to receive the ovum
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62
Q

What lines the Fallopian Tubes?

A
  1. A ciliated epithelium lines the tubes = Beating of the cilia move the ovum along towards the uterus;
  2. Smooth muscles in the tubular walls aid in propelling the ovum by peristalsis
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63
Q

What is the Uterus?

A

A thick-walled organ located in the upper pelvic region;

  • Receives the blastocyst and provides protection and nourishment to the developing embryo and fetus after implantation;
  • Will become slightly larger after first pregnancy;
  • Capable of great enlargement during pregnancy and can extend high into the abdominal cavity
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64
Q

What is the Endometrium?

A

Soft lining of the uterus

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65
Q

What is the Cervix?

A
  • The lower part of the uterus that is more cylindrical in shape;
  • Its external orifice opens into the vagina
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66
Q

What is the Vagina?

A
  • The canal leading from the vestibule of the external genitalia to there cervix of the uterus;
  • 7-9cm long;
  • Becomes part of the birth canal during childbirth (runs from the uterus through the cervix to the exterior)
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67
Q

What are the External Female Genitalia?

A
  1. Labia majora
  2. Labia minora
  3. Clitoris
  4. Vestibule
  5. Vestibular = Bartholin’s glands
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68
Q

What is the Labia Majora?

A

2 outer fleshy folds covered with pubic hair

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69
Q

What is the Labia Minora?

A
  • 2 membranous folds underneath and medial to the labia major;
  • Pink or red in color;
  • At their upper extremity they extend around the clitoris
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70
Q

What is the Clitoris?

A
  • Structure homologous to the penis;
  • 2.-2.5cm long, but largely embedded in tissue;
  • Only the tip (GLANS CLITORIS) protrudes and it it ordinarily covered with membranes - Erogenous Zone
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71
Q

What is the Vestibule?

A

The space bound by the labia minora and clitoris

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72
Q

What is the Vestibular Glands or Bartholin Glands?

A

Empty into the vestibular region;

-Their secretion is a lubricant during sexual activity

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73
Q

What are the Mammary Glands?

A
  • Modified skin glands in a woman’s breast;
  • Breast remain undeveloped until puberty, when the accumulation of fat adds to their size;
  • Glandular portion of the glands does not mature and become secretory until the TERMINATION of pregnancy
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74
Q

What hormones cause maturation of the mammary glands?

A
  1. Prolactin;
  2. Estrogen;
  3. Progesterone
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75
Q

What does Prolactin influence?

A

Stimulates and maintains LACTATION

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76
Q

What is Colostrum?

A
  • First secretion of the mammary glands that is a thin-yellowish substance;
  • Source of ANTIBODIES for babies = provides Passive Immunity
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77
Q

Days 1-4 Menstrual Cycle

A

-Mestruation (MENSES) = avg. blood loss is 35 mls.

78
Q

Day 5-13 Menstrual Cycle

A
  • Preovulatory Period = Proliferative Period;
  • Development of the ovarian follicle and growth of the endometrium;
  • Rise of estrogen = estradiol level
79
Q

Days 13-15 Menstrual Cycle

A
  • Rapid rise in blood LH concentration triggers ovulation;

- Ovulation - slight fall in estradiol level

80
Q

Days 15-26 Menstrual Cycle

A
  • Migration and breakdown of unfertilized ovum;
  • Development of Corpus Luteum;
  • High progesterone levels
81
Q

Days 27-28 Menstrual Cycle

A
  • Premenstrual Period;
  • Regression of the corpus luteum;
  • Progesterone levels fall;
  • Deterioration of endometrium
82
Q

What major changes take place during the menstrual cycle?

A
  1. Changes the the ENDOMETRIUM;
  2. Changes in the OVARY;
  3. Changes in HORMONE SECRETION
    - by the OVARY:
    — Estrogen = estriol
    — Progesterone
    - by the ANTERIOR PITUITARY:
    — Follicle stimulating hormone
    — Luteinizing hormone
83
Q

Endometrium Changes of Days 1-4 (Menstruation)

A

Endometrium deteriorates completely;

  • Soft mucous lining;
  • Removed during menstrual cycle
84
Q

Endometrium Changes of Days 5-13 (Proliferative/Estrogen Phase)

A
  • Controlled by Estrogen;
  • Epithelial cells on surface and deep layers of endometrium proliferate (thicken 3x);
  • Becomes glandular;
  • Present a soft, highly vascular bed at the time of ovulation (Day 14) for implantation of ovum if fertilized
85
Q

Endometrium Changes of Days 15-26 (Secretory/Progestational Phase)

A
  • ~14th day s of cycle, corpus luteum secretes progesterone with estrogen and results in…
    1. Endometrial glands secreting nutrient fluid that can be used by a fertilized ovum before implantation;
    2. Large quantities of fatty substances and glycogen deposited in deeper endometrial cells;
    3. Blood flow to endometrium increases
86
Q

Endometrium Changes of Days 27-28 (Premenstrual Flow)

A
  • At the end of the cycle when NO implantation has occurred, corpus luteum dies and production of estrogen and progesterone STOP;
  • Lack of the 2 hormones causes endometrial blood vessels to become spastic = blood supply stops, tissues die, and are lost in menstruation
87
Q

Ovary Changes of Days 1-4 (Menstruation)

A

Little happens in the ovary

88
Q

Ovary Changes of Days 5-12 (Preovulatory Period)

A
  • Graffian (ovary) follicle grows and ovum reaches maturity;

- Estrogen production of the Graffian follicle is highest at days 12-13

89
Q

Ovary Changes of Days 13-15 (Ovulation)

A
  • One sign of ovulation is a half a degree C increase in retail or oral temp;
  • Cervical mucous changes prior to ovulation;
  • Follicle RUPTURES releasing the ovum
90
Q

Ovary Changes of Days 15-25 (Breakdown of Ovum)

A
  • Migration and breakdown of UNFERTILIZED ovum;

- Corpus luteum becomes very active and reaches max output of both estrogen and progesterone by day 21-25

91
Q

Ovary Changes of Days 25-28 (Premenstrual Period)

A

-The corpus luteum REGRESSES and the output of estrogen and progesterone falls off rapidly between 26-28 reaching a low day 28

92
Q

Where are the female sex hormones produced?

A
  1. Ovary = estrogen and progesteron;

2. Adenopophysis (Anterior pituitary) = FSH and LH

93
Q

What is the role of FSH?

A

-Follicle stimulation hormone =

Influences the development of ovarian follicles (the pill)

94
Q

What is the role of LH?

A

-Lutenizing hormone = aids in stimulating ovulation and is concerned with the development of the corpus luteum

95
Q

How do FSH and Estrogen regulate the female sexual cycle?

A
  • Regulated by ALTERNATING secretion of FSH and estrogen;
    1. First part of the month = FSH causes ovary to secrete ESTROGEN and increased estrogen level later causes the ant. pit. to stop FSH;
    2. Estrogen level falls off just before menstruation;
    3. FSH is secreted again allowing the graffian follicle to mature
96
Q

What changes take place when pregnancy occurs?

A
  • Implantation of the blastocyst (embryo) in the endometrium effects the ovary and uterus in several ways =
    1. Chorionic villi embedded in the endometrium secrete human chorionic gonadotropin (HCG) which stimulates the corpus luteum to continue secreting estrogen and progesterone throughout pregnancy
97
Q

What the the role of estrogen/progesterone during pregnancy?

A
  • The ovaries supply of estrogen and progesterone is essential for the development of the embryo during the first 3 months of the gestation;
  • From the 3rd month on, placenta produces estrogen and progesterone to help develop the child
98
Q

What is an Ovariectomy?

A

Results in spontaneous abortion or miscarriage if occurs during the first 3 months of the gestation period

99
Q

Why is there no ovulation during pregnancy?

A

High levels of estrogen INHIBITS FSH release so there will be NO development of another graffin follicle

100
Q

How does the fetus develop?

A
  1. Ovum becomes fertilized soon after it enter upper end of the fallopian tubes;
  2. Zygote continues to develop for 3-5 days as it travels down the oviduct;
  3. Developing blastocyst remains in uterus for 205 more days before embedding into endometrium;
    * *Total elapsed time from fertilization to implantation = 5-10 days (avg. 7-8 days)
101
Q

How does the placenta develop?

A
  1. Outgrowth of the blastocysts = TROPHOBLASTIC Cells produce the chorionic villi;
  2. Small arteries of the endometrium break down and form follicles (blood spaces) and are connected with CHORIONIC VILLI
102
Q

What are the 4 extra-embryonic membranes produced?

A
  1. Chorion
  2. Amnion
  3. Allantosis
  4. Yolk Sac
103
Q

What is the Gestation Period?

A
  • 275-280 days = 38 weeks;

- 40 weeks from the last menstrual cycle

104
Q

What difference occur between male and female development?

A
  1. Genetic
  2. Gonadal
  3. Phenotypic (anatomical);
    * *For the first MONTH AND A HALF of gestation, all embryos can differentiate to male or female because developing reproductive tissues are identical and indifferent
105
Q

What is Genetic Sex?

A

Depends on the combination of sex chromosomes at the time of conception and in turn determines GONAL SEX

106
Q

What is Gonadal Sex?

A
  • Whether testes or ovaries develop;

- Presence of a Y chromosome determines gonadal differentiation

107
Q

When does Gonadal Specificity develop?

A

Gonadal specificity occurs during the 7th WEEK of intrauterine life;
-This is when the indifferent gonadal tissue of a genetic MALE begins to differentiate into testes under the influence of TESTIS DETERMINING FACTOR (TDF)

108
Q

What is Testis Determining Factor (TDF)?

A
  • Produced by the sex-determingin regions of the Y-chromosome (SRY) = the single gene for determining sex differentiation;
  • TDF triggers reactions that lead to physical male development
109
Q

How does SRY determine sexual difference?

A
  • Females LACK SRY and so do not produce TDF;
  • Their gonadal cells never signal for testicular formation, so the undifferentiated gonadal tissue starts developing during the 9th WEEK into ovaries instead
110
Q

What is Phenotypic Sex?

A

-The apparent anatomic sex of an individual depends on the genetics of their gonadal sex

111
Q

What is Sexual Differentiation?

A
  • Sexual differentiation refers to the embryonic development of EXTERNAL genitalia as either male or female;
  • Embryos has the the potential to develop either male or female reproductive tracts and external genitalia
112
Q

What causes MALE differentiation?

A

-Male-type reproductive systems are induced by ANDROGENS (testosterone), which re masculinizing hormones from the developing testes

113
Q

What causes FEMALE differentiation?

A

-The LACK of testicular hormones in female fetus results in female-type reproductive development

114
Q

When can the sexes easily be distinguished?

A

-By 10-12 weeks gestation can easily be distinguished by anatomical appearance of EXTERNAL GENITALIA

115
Q

What makes up UNDIFFERENTIATED external genitalia?

A
  1. Genital Tubercle,
  2. Paired urethral (urogenetal) folds surrounding a urethral groove;
  3. Lateral Genital swellings
116
Q

What comes form the Genital Tubercle?

A

Gives rise to the exquisitely sensitive erotic tissue =

  • Males = the GLANS PENIS (end of the penis)
  • Females = the GLANS CLITORIS
117
Q

What are the major differences of the Glans Penis and Glans Clitoris?

A
  1. Smaller size of the Clitoris;

2. Penetration of the Glans Penis by the urethral opening

118
Q

What is the Urethra?

A

Tube through which urine is transported from the bladder to the outside;
-Also serves in males as a passageway for the emission of semen

119
Q

What do the MALE urethral fold (urogenital folds) form?

A
  • they fuse around the urethral groove to form the PENIS;

- Penis encircles the urethra

120
Q

What do the FEMALE urethral fold (urogenital folds) form?

A

Urethral folds form the LABIA MINORA

121
Q

What do the MALE genital swellings form?

A

Genital swellings (labiscrotal folds) similarly fuse to form the scrotum and prepuce = a fold of skin that extends over the penis and covers the glans penis

122
Q

What do the FEMALE genital swellings form?

A

Genital swellings (labiscrotal folds) form the LABIA MAJORA

123
Q

How do the FEMALE urethral folds and genital swellings develop differently from males?

A

They DO NOT fuse at midline, but develop instead into the labia minor and labia major respectively;
-Urethral groove remains OPEN, providing access to the interior through the urethral opening and vaginal orifice

124
Q

What do the reproductive tracts develop from?

A
  • Males = Wollfian Ducts (mesonephric) ;
  • Females = Mullerian Ducts (paramesonephric)
  • *Both duct systems develops in ALL embryos — one will develop and one will degenerate depending on sexual differentiation
125
Q

What determines differentiation of the reproductive tracts?

A

Male or female reproductive tract development is determines by the presence or absence of 2 hormones of the fetal TESTES =

  1. Testosterone
  2. Mullerian-inhibiting factor
    * *hCG from the placenta stimulates early testicular secretion
126
Q

What is the role of Testosterone in male reproductive tract development?

A
  • Induces development of the Wolffian ducts into the MALE tract;
  • Testosterone is then converted to Dihydrotestosterone (DHT) and differentiates external genitalia into penis and scrotum
127
Q

What is the role of Mullerian-Inhibiting Factor in male reproductive tract development?

A

-Causes regression of the Mullerian Ducts

128
Q

Without Testosterone and Mullerian-Inhibitng Factor….

A
  • Wolffian ducts regress, and the Mullerian ducts develop into the female reproductive tract (oviducts and uterus);
  • External genitalia become clitoris and labia
129
Q

What causes female reproductive tract development?

A
  • Indifferent embryonic reproductive tissue passively developed into females structure unless acted on my masculinizing factors;
  • W/O male testicular hormones, females reproductive tract and genitalia develop no matter the genetic sex;
  • Ovaries do NOT need to be present for feminization
  • *Present the high female hormones of gestation from determine sex — all would be feminized
130
Q

What results when the testes fail to properly differentiate and secrete hormones?

A

-Development of an ANATOMICAL FEMALE, in a genetic male who is sterile

131
Q

What results from a deficiency in the enzyme that converts testosterone to DHT?

A
  • Develops a GENETIC MALE with testes and a male reproductive tract, but FEMALE external genitalia;
  • This happens because testosterone acts on the Wolffian ducts to develop the male reproductive tract, but DHT is responsible for the masculinization of the external genitalia
132
Q

What results from excess dehyroepiandrosterone from the anterior pituitary?

A

This weak androgen is normally secreted in insufficient amounts in females;
-Excess produces a GENETIC FEMALE with a MALE reproductive tract and genitalia

133
Q

Why is it important to diagnose sexual differentiation problems very early in life?

A
  • To avoid a traumatic gender identity crisis
  • So that a sex can be assigned and therefore reinforced;
  • Might require surgical and hormonal treatments so that psychosexual development can proceed as normal as possible;
  • Less dramatic cases of inappropriate sex differentiation occurs as sterility problems
134
Q

What determines chromosomal gender?

A
  • Determined by fertilizing SPERM.;
  • Each zygote inherits 23 chromosomes from the mother and 23 from the father = Produce 23 pairs of homologous chromosomes.;
  • 22 pairs = autosomal;
  • 23rd pair = sex;
  • Diploid cell undergoes meiotic division, its daughter cells receive only 1 chromosome from each homologous pair;
  • The gametes are HAPLOID.
135
Q

How does sexual differentiation begin?

A
  • 40 days after conception gonads of male/female are similar in appearance;
  • Cells that will give rise to spermatogonia and oogonia migrate from yolk sac to developing embryonic gonads
136
Q

How do the Testes form?

A
  1. Testis-determining factor (TDF) promotes the conversion to testes:;
  2. Seminiferous tubules appear within 43-50 days following conception and produce:
    — Germinal cells = sperm.
    — Nongerminal cells = Sertoli cells.
  3. Leydig cells = Appear about day 65.
137
Q

When do the Leydig cell start the production of testosterone?

A
  • Leydig cells secrete testosterone at the 8th week and peaks at 12-14th week;
  • Masculinizes embryonic structures.;
  • Testosterone then declines to very low levels until puberty.;
  • Testes descend into scrotum shortly before birth.
138
Q

How do the ovaries form?

A
  • Absence of Y chromosome and TDF, female develop ovaries.;

- Ovarian follicles DO NOT appear until 2nd trimester, about day 105.

139
Q

What is Hermaphroditism?

A
  • Disorder of embryonic sexual development;

- Both ovarian and testicular tissue is present in the body

140
Q

What is a Pseudohermaphrodite?

A
  • Disorder of embryonic sexual development;
  • Individual with either testes or ovaries but NOT BOTH;
  • Have accessory sex organs and external genitalia that are incompletely developed or inappropriate.;
  • Most common cause of female pseudohemaphroditism is CONGENITAL ADRENAL HYPERPLASIA.;
  • In the male, one cause is TESTICULAR FEMINIZING SYNDROME = Normal functioning testes, but lack receptors for testosterone.
141
Q

What brings the onset of puberty?

A
  • FSH and LH secretion is high in newborn, but falls to low levels in few weeks;
  • Gonadotropin remains low until puberty;
  • When FHS rises followed by LH, puberty has begun
142
Q

What is caused by the rise in Gonadotropin?

A
  1. Maturational changes in the brain that results in increased GnRH secretion by the hypothalamus;
  2. Decreased sensitivity of gonadotropin to negative feedback of sex steroid hormones at the time puberty is programmed
143
Q

What leads to increased GnRH secretion?

A
  • Maturation of the hypothalamus and other regions of the brain;
  • Children WITHOUT gonads show increased FSH at a normal time
144
Q

What happens in late puberty?

A
  • During late puberty, pulsatile secretion of LH and FSH increase during sleep and decreased during wakefulness;
  • Pulses of increase gonadotropin stimulate a rise in sex steroid secretion
145
Q

What sex steroid hormones increase at puberty?

A
  • Stimulates rise in testosterone (testes) and estradiol-17b (ovary);
  • Produce secondary sexual characteristics;
  • These changes come with a growth spurt, which begins younger for GIRS than in boys
146
Q

What determines the age of onset of puberty?

A
  • Age of onset related to the % of body fat and physical activity in the female;
  • Leptin secretion from adipocytes may be required for puberty
147
Q

How does physical activity affect female puberty?

A

Girls who are very physically active reach MENARCHE ( first menstrual cycle) at around age 15 — later than the average 12.6 yrs;

  • Seems to be due to the minimum % body fast for menstruation;
  • Possibly a mechanism of natural selection for the ability to complete a pregnancy and nurse a baby
148
Q

How does physical acidity affect women later in life?

A
  • Later lean and physically active women may have irregular cycle and AMENORRHEA (cessation of menstruation);
  • May also be related to % body fat;
  • Physical exercise may act to inhibit GnRH and gonadotropin secretion by endorphin transmission
149
Q

What is Parturition?

A

LABOR = the process by which a viable fetus is expelled from the uterus through the vagina to the outside

150
Q

How many babies born in the US are premature?

A

1 out of 8;
-Asymptomatic uterine infections, detected by the presence of microorganisms in the amniotic fluid = 1/3 to 1/2 premature births

151
Q

What controls the “pregnancy clock”?

A

Stress hormones that may be affected by diet, emotional stress, and genetic factors

152
Q

How does Inflammation affect labor?

A
  • Very big factor!;
  • Infections, allergic reactions, stretching of uterine muscles, and manufacture of a hormone from the fetal lung (SP-A) can initiate labor through inflammatory processes
153
Q

What initiates labor?

A
  • Shifts in the estrogen and progesterone;
  • Most of pregnancy = progesterone relaxes smooth muscles in the uterus and keep the cervix tight with collagen fibers;
  • *Blocking the B-Receptor for progesterone INDUCES LABOR
154
Q

Role of Progesterone in Labor

A
  • Most of pregnancy = progesterone relaxes smooth muscles in the uterus and keep the cervix tight with collagen fibers;
  • Progesterone BLOCKS the genetic factors that trigger labor;
  • When progesterone binds its receptor, complex then binds DNA and promotes gene transcription
155
Q

Role of Estrogen in Labor

A

Increasing estrogen excites the uterine muscle and prompt the fetal membranes on the cervix to produce PROSTAGLANDINS;
-Prostaglandins soften the cervix and enzymes digest collagen fibers

156
Q

What is Corticotropin-Releasing Hormone (CRH)?

A
  • Placental hormones that stimulates all events leading to labor;
  • Blood levels of CRH rise during pregnancy;
  • Levels t 4-5 months can be used to determine due date;
  • Early increase in CRH due to stress, genetics and dieting can lead to a premature birth
157
Q

What stimulate uterine contractions?

A
  1. Oxytocin;

2. Prostaglandins — cyclic fatty acids with paracine functions produced within the uterus = PGF2alpha and PGF2

158
Q

How does the FETAL adrenal cortex stimulate labor?

A
  • it supplies androgen dehydroepiandrosterone sulfate (DHEAS) to the placenta which becomes estriol;
  • Estriol stimulates..
    1. Production of oxytocin and prostaglandin receptors;
    2. Gap junctions between myometrial cells of uterus;
    3. Myometrium becomes more sensitive to oxytocin and prostaglandins with more receptors;
    4. Gap junctions coordinate uterine contractions
159
Q

What is an Abortion?

A

Miscarriage;

-Expulsion of the fetus before the stage of development when the fetus is abele to continue an extrauterine existence

160
Q

What is Premature?

A

Birth after a child is viable but before full term

161
Q

What 3 factors are involved in labor?

A
  1. Birth passages = birth canal, cervix, true pelvis, soft parts that line the pelvis and through the vagina;
  2. Fetus and membranes;
  3. Muscular contractions for delivery
162
Q

What is Fetal Universal Flexion?

A

Head and limbs flexed on trunk

163
Q

What is Fetal Presentation?

A
  1. Cephalic presentation = fetal head lowest in birth canal (96%);
  2. Transverse presentation = hard every, shoulder, etc;
  3. Breech presentation = butt or feet first (4%)
164
Q

What are the stages of labor?

A
  1. Dilation = Onset of labor to the complete dilation of cervix (8-24 hours in 1st pregnancy)
  2. Expulsion = cervical dilation to birth;
  3. Placental stage = birth — expulsion of placenta and membranes (10-45 minutes)
165
Q

Human Chorionic Gonadotropin during Pregnancy

A
  • Placental Hormone;
  • Begin weeks after onset of pregnancy and peaks ~8wks;
  • Similar to LH;
  • Maintain corpus lutem for the first 5.5wks;
  • May suppress immunological rejection of the embryo;
  • Exhibits TSH-like activity
166
Q

Estrogens during Pregnancy

A
  • Placental hormone;
  • Helps to maintain endometrium;
  • Suppresses gonadotropin secretion;
  • Stimulates mammary gland development;
  • Inhibits prolactin;
  • Promotes uterine sensitivity to oxytocin;
  • Stimulates mammary duct development
167
Q

Progesterone during Pregnancy

A
  • Placental Hormone;
  • Helps maintain endometrium;
  • Suppresses gonadotropin secretion;
  • Stimulates development of the alveolar tissue of the mammary glands
168
Q

Human Chorionic Somatomammatripin during Pregnancy

A
  • Placental hormone;
  • Similar to prolactin and growth hormone;
  • Promotes increased fat breakdown and fatty acid release form adipose and sparing glucose for the fetus (“diabetic-like” effects)
169
Q

What stress is the baby under during vaginal delivery?

A
  • Hypoxia and pressure on the baby’s head release stress hormones epinephrine and norepinephrine into the bloodstream;
  • Levels equal that of a woman giving birth or someone having a heart attack;
  • Surge of these cathecholamines prepare the baby for survival
170
Q

What adaptive advantages come from a vaginal delivery?

A
  • From surge of epinephrine and norepinephrine =
    1. Clear lungs of fluid, secreting surfactant and change physiology for normal breathing;
    2. Mobilize brown fat on babies back to nourish cells;
    3. Ensure a rich blood supply to heart and brain;
    4. Promote bonding between mother and child
171
Q

What are phase of Human Sexual Response?

A
  1. Excitation
  2. Plateau
  3. Orgasm
  4. Resolution
172
Q

Excitation Phase of Human Sexual Response

A
  • Myotonia and vasocongestion. ;
  • Engorgement of a sexual organ with blood.;
  • Erection of the nipples in both genders.
173
Q

Plateau Phase of Human Sexual Response

A
  • Clitoris becomes partially hidden.;

- Erected nipples become partially hidden by swelling of areolae

174
Q

Orgasm Phase of Human Sexual Response

A
  • Uterus and orgasmic platform of vagina contract.;

- Contractions accompanying ejaculation.

175
Q

Resolution Phase of Human Sexual Response

A
  • Body returns to preexcitation conditions.;

- Men enter refractory period.

176
Q

What is Male Sterilization?

A
  • Vasectomy;
  • Cauterizing or cutting the VAS DEFERENS;
  • Performed in a dr office;
  • Clinical success in reversing — 80-90%
177
Q

What is Female Sterilization?

A
  • Tubal Ligation;
  • Fallopian tubes are banded, cauterized, and cut;
  • Women who have surgery before age 28 have 5% chance of pregnancy;
  • Half done as outpatient;
  • Clinical success in reversing — 70%
178
Q

What are the Steroidal Contraceptives?

A
  • Oral
  • RU-486
  • Injections
  • Birth control patch
  • Vaginal ring
179
Q

How do Oral Contraceptives prevent pregnancy?

A
  • Used by more than 10 million in the US;
  • Alter normal hormonal rhythms of menstrual cycle;
  • Estrogen and progesterone doses prevent FSH and LH and inhibit ovum release;
  • Progesterone also immobilizes and kills sperm by thickening cervical mucous;
  • 30 different types of estrogen/progesterone pills and some minimills with only progesterone
180
Q

How does RU-486 prevent pregnancy?

A
  • Promotes abortion by blocking the actions of progesterone (required for endometrium to maintain pregnancy);
  • Competes with progesterone for cytoplasmic receptor proteins in the endometrium;
  • RU-486 binds receptors and thus progesterone cannot activate the nuclear genes ;
  • Result = endometrium breaks and loss of embryo
181
Q

What injection prevent pregnancy?

A
  1. Lunelle = monthly;
  2. Depo-provera = 4 times a year; active ingredient is is medroxyprogesterone acetate — synthetic similar to progesterone
182
Q

How do Birth Control Patches prevent pregnancy?

A
  • Patch contains PROGESTIN and ESTROGEN;
  • Replaces weekly for 3 weeks of each cycle;
  • More than 95% effective
183
Q

How do Vaginal Rings prevent pregnancy?

A
  • Contains ETONOGESTREL and ESTRADIOL that prevent ovulation;
  • Inserted and remains fro 3 weeks;
  • Removed at 4th week fro period to occur;
  • More than 98% effective
184
Q

How do Intrauterine Devices (IUDs) prevent pregnancy?

A
  • Inserted through the cervix into the uterus;
  • Prevent implantation of the blastocyst in the endometrium;
  • Used to be plastic, now copper-bearing is more effective;
  • Some release progesterone = Preogestasert-T (replaced yearly)
185
Q

What are the barrier methods of birth control?

A
  1. Condoms — also protect against STDs;
  2. Diaphragm — dome-shaped rubber device that covers the cervix;
  3. Sponge — polyurethatne sponge with spermicide nonoxynol-9; fits over cervix;
  4. Cervical cap — Fem cap/Lea’s shield; rubber and investigational device, NOT over the counter; works like a diaphragm but can remain for 3 days and no spermicide needed
186
Q

How do Spermicides prevent pregnancy?

A
  • All spermicides contain the active ingredient NONOXYNOL-9;
  • After insertion, a woman must wait 10-15 minutes for it to be effective;
  • Less than an hour later it is NOT effective;
  • Used by 3 million women as OTC contraception
187
Q

What are the fertility awareness methods?

A
  • Rhythm method = religious/cultural group — relies on knowing ovulation;
  • Methods of knowing ovulation =
    1. Cervical Mucus Method: LUNA methods — pH changes of cervical fluid;
    2. Temp. Method — body temp rises following ovulation;
    3. Estimation based on past ovulation dates
  • *Avoid sex 5 days prior and 2 days after ovulation — sperm and live 5 days in cervical mucus and ovum only 12 hrs after ovulation
188
Q

What is Abortion?

A

The induced terminate of pregnancy before 38 weeks gestation

189
Q

First Trimester Abortion

A
  • First 12.67 weeks;
    1. Menstrual abortion = evacuate uterine contents by a mild vacuum up to 6 wks after missed period;
    2. Dilatation and Curettage — standard surgical method;
    3. Vacuum aspiration — 6-12 wks after missed period; more complex apparatus
190
Q

Second Trimester Abortion

A
  • Second 12.67 weeks;
    1. Hypertonic injections = urea or glucose either intra or extraammniotically ; followed by labor in 24-48hrs and fetus expelled cleanly;
    2. Prostaglandins = potent IN VIVO stimulants; either in tra- or extraammionitacally
    3. Hysterectomy = remove part of the reproductive tract — ovaries, oviducts, and uterus; High mortality rate
191
Q

Third Trimester Abortion

A

Partial birth abortion

Spring 2014 (22 decks)

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