Repro Flashcards
Which mesodermal region do gonads arise?
intermediate
Non-functional
7-10 solid/tubular cell groups
In cervical area (head kidney)
Gone by the end of 4th week
pronephros
Interim functional
Appears at end of 4th week
10-26th somite level
mesoneophros
Permanent kidney
Developing by early 5th week
Functions by the 11th week
metanephros
How does mesonephric kidney form?
tubules come from mesonephric ridge and mesonephric (wolfian) duct. Aorta buds off glomerulus and the attaching tubules form the Bowan’s capsule
outgrowth of mesonephric duct near cloaca; forms ureter, renal pelvis, calices & collecting tubule
ureteric bud
forms nephrons and excretory system
metanephric blastema
What is molecular control of metanephric kidney?
WT1 allows mesenchyme to respond to BMP7 and FGF which come from collecting tubules. Wnt and Pax2 allow differentiation
Where do kidney arteries come from?
they start off common illiac and then come from abdominal aorta
What separates cloaca from bladder?
urogenital sinus
Horshoe kidney can impinge on?
superior mesenteric artery
When ureter doesn’t go through trigone and ends up entering organs like prostate gland, seminal vesicle, or vagina
ectopic ureter
When you have compensatory hypertrophy of one kidney or oligohydramnios (reduced amniotic fluid) due to bilateral absence
agenesis
Forms adrenal gland via NC, gonads via primordial germ
urogenital ridge
How does adrenal gland form?
there’s first a wave of epithelial cells that dive into intermediate mesoderm, then the NC follow, and finally a second wave of epithelial cells make mature cortex. NC innervated by SNS form medulla. During 2nd trimester the cortex grows and produces steroids to help maintain pregancy. After birth the cortex regresses a little.
How is indifferent sexual development?
germ cells appear in yolk sac by 4th wk, then they go through mitosis to form genital ridge ontop nephrenic ridge, then either mesonephric (wolffian) or paramesonephric ducts will come from cortex and cover the germ cells
If SRY is present, germ cells in gonadal cords become…
seminiferous cords
this becomes ductus deferens in males
mesonephric ducts
With lack or SRY…
Wnt4 expressed (ovarian determining factor) and cortex differentiates while medulla regresses, unlike in males. The cells in the cortex become the follicles
Upper vagina and up is derived from…while lower vagina is formed from…
paramesonephric/mullerian ducts and urogenital sinus
Incomplete fusion of urethral or labioscrotal folds
* Open urethra along ventral penis
hypospadias
Open urethra along dorsum of penis
* Failure of closure of the anterior abdominal wall
* Often associated with exstrophy of the bladder
epispadias
CT cord from testes to scrotum, before it’s full descent, this cord only extended to internal and external abs
gubernaculum
Caused by Indirect Congenital Hernia: Protrusion of intestine into connection between peritoneal cavity and scrotum. Can lead to Hydrocele: Irregular obliteration leading to formation of cysts along the spermatic cord
patent vaginalis
connects ovary to uterus via inguinal canal
round ligament
- Excessive androgens (androstenedione) produced from adrenal glands
- Spectrum of effects on size of clitoris/phallus, fusion of genital folds & narrowing/closure of vaginal opening
Congenital adrenal hyperplasia
When males have testes and anti mullerian factor but may have poorly developed vagina depending on severity
Androgen Insensitivity receptor
When males have anti mullerian factor and testosterone, but no male external genitalia, but at puberty can lead to surge that gives rise to genitalia
5 alpha reductase deficiency
Greater vs lesser pelvis
Obturator Internus
Attachments: obturater formamen and greater troch
Innervation: nerve to obturator internus (L5,S1)
Function: rotation and flexion
Piriformis
Attachment: anterior sacrum, greater troch
Innervation: Nerve to Piriformis (L5,S1,S2)
Function: lateral rotation of extended hip and abduction
pubococcygeus/Puborectalis
Attachments: Pubic bone to coccyx; Pubic bone to perineal body (behind the rectum)
Innervation: Inferior rectal branch of pudendal (S2-4) and S4 directly
Function: Support pelvic viscera; maintain angle between anus and rectum; vaginal sphincter; reinforce external anal sphincter
Iliococcygeus
Attachments: Tendinous arch of obturator internus; ischial spine; perineal body
Innervation: Inferior rectal branch of pudendal (S2-4) and S4 directly
Function: Support pelvic viscera
Coccygeous
Attachments: Ischial spine to coccyx
Innervation: S3-4
Function: Support pelvic viscera; pull coccyx forward during defecation.
What artery supplies that anal columns?
The superior rectal, this important because you need supply to support anal valves and anal mucus sinuses
Pectinate line above and below supplies
Above: Superior rectal artery, vein (inferior mesenteric vein/portal system)
Innervation: Autonomics
Below: Inferior rectal artery, vein (Pudendal vein/Internal iliac/IVC)
Innervation: Inferior anal and rectal nerves from pudendal nerve
How can portal hypertension cause rectal hemrroids?
above the pectinate line the flow of drainage is superior rectal vein, IMV, portal vein, and IVC. If a patient has liver cirrhosis this can cause back up.
Which parts of male and female genitalia are made of corpora cavenosa vs spongiosum?
Cavernosa in females: body of clit and the crus
Cavernosa in males: dorsal body of penis and crus of penis
Spongiosum in females: glans clit and bulb of vestibule
Spongiosum in males: ventral penis (contains urethra), glans penis, bulb of penis
Function: separates superficial pouch from Deep, Support vaginal canal and urethra
supply: Pudendal nerve branches and internal pudendal artery and vein branches are anterior to the membrane
perineal membrane
Deep perineal pouch contents in males
Part of urethra Preprostatic and membranous
Sphincter urethrae muscle (external)
Deep transverse perineal muscle
Bulbo-urethral gland
Neurovascular structures to dorsum of penis (Dorsal nerve of the penis)
deep perineal pouch contents in female
Urethra and vaginal canal
External urethral sphincter
Deep transverse perineal muscle
Internal pudendal artery and branches
Dorsal nerve of the clitoris
What are muscles of the superficial perineal pouch?
isciocavernous, Bulbospongiosus (bulb of vestibule, bulb of penis), and superficial transverse perineal. All innervated by pudenal
What are the fascial layers of the penis?
superficial dartos which goes around entire penis and scrotum, deep buck’s fascia which goes around dorsal and ventral penis, and tunica albigunea around cavernosa of the dorsal penis
Bartholins vs Skenes glands
Bartholins are on greater vestiuble and make mucus for sex. Skene’s are on lesser vestibule paraurethreal glands and secrete PSA, antimicrobials
Where are superficial and deep perineal fascias?
Superficial is continous with scarpa’s (membranous) campers (fatty), and this connects with dartos and thigh fascia. The deep fascia covers the bulbospongiosus, ischiocavernosis and superficial transverse muscles . Connects with the external oblique fascia and suspensory ligaments
Analagous structures
Gubernaculum: in males the inguinal canal and scrotum ligament and in females the round ligament/ovarian ligament
Genital tubercle: glans penis, corpus spongiosum, corpus cavernosum. In females the vestibules and clit
Urogenital sinus: urethras and glands for both
Urethral folds: penis shaft/urethra, and labia minora
Sacral Plexus nerves
L4-S4; gives off sciatic, superior/inferior gluteal, pudenal, nerve to piriformis, nerve to obturator, nerve to quad femoris, nerve to levator ani, femoral cutaneous
Coccygeal plexus
S4-C0
What is sympathetic portion of pelvis?
Superior hypogastric (L5), Inferior hypogastric (S2-4) do contraction of internal sphincters and smooth muscle during ejaculation. Inferior hypogastric also does regular parasympathetic functions (pelvic splanchnic >inferior hypogastric for urination)
Where is pelvic pain routes?
There is a line where afferent either take sypathetic or parasympathetic paths. If at dermatomes T10-L2 you take sympathetic and if at dermatomes S2-S4 you take parasympathetic
Refered pain of T10-L2 pelvic
umbilicus or anterior thigh
Reffered pain of S2-S4 pelvic
gluteal region
What are contents of greater sciatic foramen?
Piriformis Muscle, Super Gluteal A/N, Inferior Gluteal A/N, Sciatic N, Pudendal A/N, Nerve to Obturator Internus, Post. Cutaneous N. of Thigh, Nerve to Quadratus Femoris
What are contents of lesser sciatic foramen?
Pudendal A/N
Obturator Internus Muscle
Nerve to Obturator Internus
What arteries branch from anterior division of internal iliac?
Umbilical, Superior vesicular, Inferior vesicle/vaginal, Uterine, Middle rectal, Obturator, Internal pudendal, Inferior rectal, Inferior gluteal
What arteries branch from posterior division of internal iliac?
Iliolumbar
Lateral sacral
Superior gluteal
Uterine artery is found…
in the cardinal ligament, ureter also runs under this artery
ovarian artery is found…
in the suspensory ligament, this artery also anastomose with the uterine artery
Where does pudendal nerve travel and what are its branches?
the pudendal canal which is in obturator fascia, medial to obturator internus. Its branches are inferior rectal, superficial/deep perineal, and dorsal nerve of clit and penis
What are branches of internal pudendal artery?
in females: arteries of bulb of vestibule, deep/dorsal arteries of clit
in males: artery to bulb of penis, urethral artery, deep/dorsal penis artery
what are four weakest points of pelvis
pubic rami, acetabulum, SI joint, ala of illium
what are supplies below and above pectinate line?
Above: Blood supply =Superior rectal artery and vein
Innervation = Inferior hypogastric plexus
Lymphatic = Internal iliac lymph nodes
Below: Blood Supply =Inferior rectal artery and vein
Innervation =Inferior rectal nerves
Lymphatic = Superficial inguinal lymph nodes
also called Cowper’s Gland, either of two pea-shaped glands in the male, located beneath the prostate gland at the beginning of the internal portion of the penis; they add fluids to semen during the process of ejaculation
bulbourethral gland
What does broad ligament consist of?
A mesometrium that lines utereus, helps suspend, mesosalpinx encloses and suspends the fallopian tube within the pelvic cavity. The mesovarium is the posterior extension of the broad ligament, containing the ovary.
round ligament of female travels through…
deep inguinal ring
Uterine ligaments
Ovarian Ligament: From uterus to Ovary
Suspensory Ovarian Ligament: From Ovary to ilium CONTAINS OVARIAN (Gonadal) BLOOD SUPPLY
Uterosacral Ligament: Posterior uterus to sacrum
Cardinal Ligament: lateral cervix to ~ischial tuberosity CONTAINS UTERINE BLOOD SUPPLY
Pubocervical Ligament: Anterior cervix to pubic rami
Round Ligament of the Uterus: From lateral uterus, through deep inguinal ring, through inguinal canal, through superficial inguinal ring and terminating in labia majora.
Broad Ligament: Continuation of peritoneum covering and folding over pelvic contents, specifically the portion that covers the fundus & body of the uterus, the uterine tube & the ovarian/ suspensory ovarian ligament.
vesicular prolapse
cystocele
germinal epithelium
simple cuboidal
how does fsh affect follicular growth?
it initiates puberty, by growth of the oocyte
proliferation and changes in the follicular cells
proliferation and differentiation of the stromal
fibroblasts around the follicle and each month there’s one dominant follicle
What are layers of multilaminar primary follicle?
Granulosa cells= stratified follicular
gap junctions and basal lamina; secrete antrumx
Zona pellucida = glycoproteins
ZP1 to 4 – acrosomal activation
Filipodia (G) and microvilli (O)
gap junctions through ZP
How dp granulosa and theca interna combine endocrine function?
theca interna make androsteneedione and granulosa produce aromatase this allows production of estradiol which returns to theca vasculature
how long does it take primordial to become graffian
90 days
What is functions of FsH and LH in menstrual cycle?
Pituitary gland releases FSH which stimulates primordial follicles to grow. As concentrations increase, this causes proliferation, differentiation, and granulosa/theca secretion of progesterone/estrogen. LH causes PG release to cause uterine “broth” release and theca externa contraction. Progesterone, LH, FSH all weaken the cumulus oophorus causing egg to exit
When does oocyte do meiotic divisions?
completes first meiotic division right before ovulation to equally divide chromosomes. Secondary oocyte and first polar body enter oviduct where it does second meiotic division after fertilization and arrests in metaphase
theca lutein (interna) make…
progesterone and androstendione (estrogen)
granulosa lutein make…
aromatase to convert androstenedione into estradiol
what increases as corpus lutem becomes corpus albicans
fsh because estrogen from luteum was inhibiting fsh
Progesterone role in pregnancy:
thickening of endometrium, stimulate growth of breast tissue, strengthen cervical mucus plug, keeps the uterus from contracting
Epithelium of Uterine tube
Folded mucosa with Thick muscularis. Simple cloumnar non ciliated with peg cells. Cilia begin to grow from estrogen during follicular growth and loose during secretory phase
secretes glycoproteins for capacitation
peg cells
What causes process of menses?
Arcuate arteries of myometrium give off two types of branches, spiral in the functional endometrium and straight in basal. When Progesterone decreases in the menstrual phase, it decreases because corpus lutem regresses. Spiral arteries spasm and this causes ischemia. Also PGs increases causing functional layer to sloth off
Proliferative Phase
occurs with follicular development. Estrogens from theca interna of corpus luteum induces proliferation of basal glands. There’s straight glands with empty lumen. Spiral arteries lengthen and increase surface microvasculature
Secretory Phase
Corpus luteum secretes progesterone. Progesterone stimulates glandular epithelium to secrete glycogen/glycoproteins. Glands with secretions
in the dilated lumen. Progesterone inhibits myometrial contractions
Endometrial cells reflux and grow on the oviducts or ovaries. Estrogen and progesterone influence the monthly growth and degeneration of this ectopic tissue. Causes pelvic pain, produces inflammation, ovarian cysts, adhesions, and scar tissue
endometriosis
Noncancerous arising from uterine smooth muscle cells and fibroblasts. Made of Large amount of extracellular matrix surrounded by loose areolar connective tissue and compressed muscle fibers.
Increased menstrual bleeding, pelvic pressure/pain and sometimes infertility
Uterine Fibroids
how do cervical secretions change?
ovulation = watery because we want sperm to come, luteal phase = viscous due to progesterone because we need to prepare uterine lining before infiltration, and in pregnancy = “plug”
cervical glands proliferate
This stimulates the vaginal epithelia to accumulate glycogen
estrogen
Modified apocrine sweat gland with tubuloacinar cells
mammary glands (simple cuboidal) which are organized into lobules and connect to lactiferous duct (stratified)
What is flow of sperm?
Seminiferous tubules> tubuli recti> rete testis>efferent ducts>epididymis>vas deferens>ejaculatory duct>urethra
secrete MIS, protect germ cells via blood testis barrier (tight junctions), and are regulated by FSH
sertoli cells
What are growth stages of sperm?
type A sperm go to type B progenitors, they go through mitosis to become primary spermatocyte, they do first meiotic division to give secondary spermatocytes, and those go through second meiotic division to give off spermatid. Spermatids go through spermiogenesis which is them elongating, getting crazy flagella, form acrosome, and while producing residual bodies. Mature sperm = spermatozoa
epithelium of principal cells with stereocilia
efferent ducts
epithelium of pseudostratified columnar with stereocilia and circular muscle
epididymus
epithelium of pseudostratified columnar epithelium with cilia lamina propria, and 3 layers of smooth muscle (longitudinal, circular, longitudinal)
vas deferens
epithelium is folded mucousa from pseudostratified columnar to cuboidal
seminal vesicles
surrounded by a capsule, tubuloalveolar glands
epithelium varies depending on functional state (squamous to pseudostratified columnar), corpora amylacea in lumen of glands, fibromuscular stroma surrounds glands
prostate
site of benign prostatic hyperplasia
transition zone
main glands, site of prostate carcinoma
peripheral zone
Mucus secretion containing abundant sugars and sialic acid to lubricate and prepare urethra for passage of sperm
bulbourethral/ cowpers glands
What are different epitheliums of male urethra?
prostatic urethra (transitional epithelium), membranous urethra (pseudostratified to stratified columnar epithelium) between smooth and skeletal muscle sphincters, and penile urethra (pseudostratified to stratified columnar epithelium
Major female repro arteries
This hormone promotes division of spermatogonia
Growth hormone
formed from testosterone by Sertoli Cells upon FSH stimulation.
estrogen
formed from testosterone by Sertoli Cells upon FSH stimulation.
estrogen
where do sperm become motile
epididymus
what are contents of seminal vesicle semen?
Fructose
Citric Acid
Nutrients
Prostaglandins
Fibrinogen
to aid in nutrients and uterine motility
what are contents of prostate gland fluid?
Calcium
Citrate
Phosphate
Clotting Enzyme
Profibrinolysin
Makes alkaline environment for sperm
What is primary fast block of polyspermy?
Zona pellucida cortical granules are depolarized and there’s Ca2+ release to block new sperm
Path of male sexual sensation
glans penis>pudendal nerve> sacral plexus > sacral spinal cord >brain
