REPRO Flashcards
The Right testes and ovary drain into the Right Gonadal vein which goes to?
directly to ICV
the Left testes / ovary drain to Left gonadal vein then to?
LEFT RENAL VEIN
why are varicoceles more common on left?
bc the left gonadal vein is longer and has the make the 90 degree turn at the the Renal vein it has higher pressure.
is enlarged pampinoform plexus n
where does most of the blood supply to the pelvic region come from ?
whats the exception?
branch off the INTERNAL iliac arteries
and the exception
the .gonadal arteries off the aorta
where do the ovaries and testes
lymphatics drain to
para-aortic nodes
what lymphatics do the
body of uterues, cervix, superior bladder )
drain to
external iliacs
the prostate/ cervix / corpus cavernosum / proximal upper 2/3 vagina
lymphatic drain to
internal iliaic nodes
(hypogastric nodes)
distal vagina
vulva
scrotum*
distal anus
lymphatics tdrain into
Superficial inguinal nodes
where does the glans of the penis lymphatics drain to
deep inguinal nodes
what hernia
is more common in children.
due to failure of processsus vaginalis to close
which can also cause?
INDIRECT
can form hydrocele
what hernia occurs lateral tot epigastric vessels and goes into the inguinal ring into scrotum
indirect
what herniation goes through the inguinal (hesselbach traingle).
medial to inferior epigastric vessels
direct
what hernia is due to acquired weakness in transversalis fascia?
who gets this hernia
direct
common in older males
what makes up the hesselbachs triangle
inferior epigastric vessels (lateral)
inguinal ligment
lateral border of rectur abdominus (medial)
which hernia is more common in women?
femoral
what hernia
protrudes BELOW inguinal ligament
through the femoral canal below and lateral to pubic tubercle
femoral hernia
which hernia is more likely to present with
incarceration (irreducible hernia)
or strangulation ( contents of hernia undergo necrosis)
femoral hernia
what does the paramesonephric (Mullerian) duct form
fallopian tubes
uterus
UPPER portion of vagina.
(the lower part of vag is from the urogenital sinus)
what forms the lower vagina
urogenital sinus –> sinovaginal bulbs –> lower vag.
what does the mesonephric (Wolffian) duct
not form.
Seminal vesicles
Epididnmis
Ejaculatory duct
Ductus deferens
Prostate
it does not form the prostate
what can
leydig cell hypoplasia (leydig cell agenesis) cause?
no development of mesonephric duct.
bc cant respond to LH thus no testosterone thus no mesonephric duct thus no (SEED) structures
what does the paramesonephric mullerian duct form in a male.
what does the mesonephric wolffian duct form in a female
male - remnant is appendix testis
female: gartner duct
what do sertoli cells secrete
inhibiin B that inhibits FSH
androgen-binding protein –> maintain local levels of testosterone.
MIF
sertoli cells form tight junctions that forms blood testis barrier that functions to
isolate gametes from autoimmune attack
varicocele and cryptorchidism
both can cause increase in temp to teste what does this do
dec sperm production
dec inhibin B
what do leydig cells do?
secrete testosterone in presence of LH
FSH –> serotoli cells –> ?
LH –> leydig cells –> /
sperm production
\testosterone
dihydrostestosterone is responsible for development of?
it can treat
penis, scrotum protstate
its responsible for prostate growth
sebaceous gland activity
it can cause male pattern hair loss?
an OBESE pt can become testosterone deficient how?
bc of aromatase
testosterone –> estrogen
aromatase can be found in high concentrations in adipose tissue.
disorders of sex hormone
inc T
inc LH
defective androgen receptor
inc testosterone
dec LH
what the cause
testosteroe - secreting tumor,
exogenous steroids
primary hypogonadism
you will see what on labs
DEC TESTOSTERONE
INC LH
diagnosing diosrders of sex hormones
dec testosterone
DEC LH
What syndrome is associated with this?
HYPOGONADOTROPIC HYPOGONADISM
Kallmann syndrome
- low GnRH –> low LH and FSH
- due to defect of X-linked KAL chain
defect of olfactory bulb –> ANOSMIA (CANT SMELL!)
female w/ primary amenorrhea or delayed puberty that cant smell.
kallmann syndrome
=25 yo that has tried to have kids with his wife. on further questioning cant smell.
what is the diagnosis
hypopgonadotropic hypogonadism
genetically male but phenotypically female.
have lower part of vagina
NO uterus or ovaries
have testes (in labia majora)
inc testo, estrogen, LH
whats the cause
androgen receptor insensitivity
whats the cause?
early defect is ambiguous genitalia
at puberty he developed normal male genitalia.
NORMAL T, Estrogen LH
5a- reducatse def
cant convert testo –> DHT
malignant
painless,
homogenous testicular enlargement.
most common testicular tumor.
describe the histo ?
whats diagnosis?
large cells in lobules with watery cytoplasm and FRIED EGG appearance
Seminoma.
whats the main difference bw seminoma and embryonal carcinoma?
seminoma : NO hemorrhage or necrosis
painless
embryonal carcinoma: necrosis, hemorrhagic mass, painful
inc hCG!
What malignant testicular tumor has hemorrhagic mass w/ necrosis and painful.
describe the histo
embryonal carcinoma
glandular papillary morphology
2 yo presents with a testicular mass
you biopsy and see schiller Duval bodies, resembling primitive glomeruli
labs you find inc AFP.
diagnosis ?
yolk sac (endodermal sinus) tumor
know the histo
pt with a testicular lump. you do labs and see an inc hCG
you biopsy and get the histo in the exhibit.
you patient is complaining of gynecomastia, symptoms of hyperthroidism.
the tumor is a disorder of?
disorder of syncytiotrophoblast (increases hCG) and Cytotrophoblast.
diagnosis?
most common nongerm cell tumor
Tumor is Golden brown in color
histo: reinke crstals (eosinophilc cytoplasmic inclusion)
this tumor produces androgens or estrogens –> gynecomastia in men, precocious puberty in boys
leydig tumor.
you get increase testosterone secretion which undergoes peripheral conversion to estrogen –> gynecomastia
what is the most common testicular tumor of older men?
testicular lymphoma
not a primary cancer, arises from metastatic lympoma –> testes. (diffuse large B cell lymphoma)
pt didnt have pain, but had a ferver, night sweats, wt loss, 75 yo man. extranodal manifestations.
schiller duval bodies are most associated with what testicular tumor
yolk sac tumor
inc AFP are most associated with what testicular tumor
yolk sac
50% teratomas can have it
inc hCG? are most associated with what testicular tumor
choriocarcinoma
fried egg appearance
watery cytoplasm
are most associated with what testicular tumor
seminoma
normal AFP
inc hCG
embryonal
syncytiotrophoblast are most associated with what testicular tumor
choriocarcinoma
poor prognosis
painful tumor
painful tumor
most common up to age 3 is most associated with what testicular tumor
YOLK SAC tumor***
pt with BPH.
Describe what you would see on histo.
*hyperplasia of prostate stromal and glandular epithelial cells
in the lateral and medial lobes
during oogenesis
when is the primary oocyte arrested?
meiosis 1 is arrrested in prophase 1
for years until Ovulation
at puberty the oocyte finished meiosis one forming and cell devision occurs forming a haploid oocyte which goes into meiosis II and arrested in what phase??
metaphase II until fertilization
name all the effects of estrogen
(think growth)
growth of female reproductive organs
growth of breasts
stimulates endometrial proliferation
inhibits osteoclasts in bone
inc HDL, dec LDL
what are the functions of PROGESTRONE
inhibits proliferation but promotes secretory changes in endometrium
prepares breasts for milk production
thickens cervical mucus
inhibits uterine contractions
relaxes smooth muscle.
what produces thick cervical mucus that inhibits entry of sperm into uterus
progesterone
induces LH surge
Estrogen
what hormone relaxes uterine smooth muscle to prevent miss carriage
progesterone
what hormone stimulates endometrial proliferation
hince inc risk for endometrial cancer
estrogen
hCG has an Alpha subunit identical to
what other hormoens
FSH
LH9
TSH (presents with hyperthyroidiism)
hCG
what can Combined estrogen progestin cause besodes VTE, HTN, MI and stroke?
HEPATIC ADENOMA***