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