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ESA 4 - 2017 - Incomplete/Some errors > Repro 7 > Flashcards

Repro 7 Flashcards

1
Q

Where are sprematozoa produced?

A

Seminferous tubules of the testis

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2
Q

What is the original cell type that eventually differentiates to spermatozoa?

A

Spermatogonia

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3
Q

How many sperm cells are produced by the testes each day? How many of those become viable?

A

200-300 million

only 1/2 wil be viable

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4
Q

Describe the role of LH in spermatogenesis control

A

Acts on leydig cells to produce testosterone causing spermatogenesis

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5
Q

Describe the role of FSH in spermatogenesis control

A

Acts on androgen binding protein in Sertoli cells which form blood/testis barrier and increasing testosterone conc.

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6
Q

What is Oestrogen’s role in spermatogenesis?

A

Acts on Leydig cells to increase sperm viability

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7
Q

How does Inhibin control spermatogenesis?

A

-ve feedback loop. Inhibin from sertoli cells reduced FSH

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8
Q

What is spermiogenesis?

A

The differentiation of spermatids into spermatozoon

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9
Q

What is the function of the Acrosome?

A

Enables sperm to penetrate the ovum

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10
Q

Describe the midpiece of a spermatozoa

A

Mitochondira packed around contractile filaments

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11
Q

What structural change does testosterone induce in spermatozoa?

A

Stripping of organelles and cytoplasm

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12
Q

What is spermation?

A

Release of spermatozoa from sertoli cells into lumen of seminiferous tubules

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13
Q

How are spermatozoa transported to epididymis?

A

In testicular fluid (produced by sertoli cells) in peristaltic contraction

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14
Q

What happens to spermatozoa if not expelled?

A

Phagocytosed by epididymal epithelial cells

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15
Q

What are the four phases of coitus?

A

Excitement
Plateau
Orgasmic
Resolution

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16
Q

Breifly describe the male excitement phase of coitus

A

Limibc system stimulation
Sacral parasympathetic neurons activated
Arteriolar vasodilation in corpora cavernosa
Increased penile blood flow
Erection

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17
Q

Breifly describe the male plateau phase of coitus

A

Sacrospinous reflex
Ischiocavernosus contraction
Decreased arterial flow
Accessory secretion glands stimulated

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18
Q

What are the two stages of male orgasm?

A

Emission

Ejaculation

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19
Q

Breifly describe male emission

A

Smooth muscle contration; vas defrens, ampulla, seminal vesicle, prostate
Internal & external urethral sphincters contract
Semen pools in urethral bulb

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20
Q

Breifly describe male ejaculation

A 
Spinal reflex
Contraction of glands and ducts
IUS contracts 
Internal urethral filling stimulaes pudendal nerve
Expulsion
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21
Q

Breifly describe male resolution

A

Thoracolumbar sympathetic pathway activated
Smooth muscle contraction in corpora cavernosa
Flaccidity and resolution

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22
Q

Breifly describe the female excitement phase of coitus

A 
Sacral parasympathetic neurones fire
Vaginal lubrication
Clitoris engorges
Uterus elevates
INcrease muscle tone, heart rate, BP
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23
Q

Breifly describe the femal sexual plateau phase

A

Labia minor deepens
Clitoris withdraws under hood
Bartholin’s gland lubricates vestibule

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24
Q

Breifly descibe the female orgasm phase of coitus

A

Orgasmic platform contracts rhythmically 3-15 times
Uterus and anal sphincter contract
No refractory period

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25
Q

Breifly describe femal resolution

A

Clitoris descends as engorement subsides

General return to unaroused state

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26
Q

Breifly describe the changes in breasts during sexual response

A

Excitement - breast increase in size, nipple becomes erect
Plateau/Orgasm - continued increase in size, areola increases in size, sexual flush may appear
Resolution - return to unaroused state

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27
Q

What is the ‘G’ spot?

A

An area of erotic sensitivity located along the anterior wall of the vagina

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28
Q

List the possible impacts of ageing on the female sexual response cycle

A

Reduced desire
Reduced vaginal lubrication
Loss of elasticity of vaginal/urethral tissue
Reduced expansile ability of inner vagina during arousal
Number of orgasmic contractions may reduce

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29
Q

What is the most common sexual dysfunction

A

Desire i.e. little/no interest for age etc. - can be a result of abuse

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30
Q

List the causes of male impotence

Hint: 4

A

Psychological
Tears in fibrous tissue of corpora cavernosa
Vascular e.g. atherosclerosis
Drugs e.g. alcohol

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31
Q

How does viagra work?

A

Inhibition of cGMP breakdown in corpus cavernosum

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32
Q

Describe the normal composition of Semen

A

2-4ml per ejaculate
20-200x10^6 sperm per ml.
Lquefaction within 1hr

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33
Q

List the 7 possible morphologicl defects of sperm

A

Giant, micro, double headed, long head, rough head, abnormal middle piece

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34
Q

What are the bulbourethral glands?

A

AKA Cowper’s - secrete 5% semen volume, alkaline fluid to lubricate tip of penis and urethral lining

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35
Q

What do the seminal vesicles produce?

A

60% of semen, alkaline fluid to neutralise acidic environs, contains; fructose, prostaglandins and clotting factors

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36
Q

What is the Fructose in semen used for?

A

ATP production

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37
Q

What are the prostaglandins in semen used for?

A

To increase; sperm motility and female genital smooth muscle contraction

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38
Q

What does the prostate contribute to semen production?

A

25% of total volume, milky/slightly acidic fluid, contains; proteolytic enzymes, citric acid and phosphatase

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39
Q

Which seminal proteolytic enzymes are produced by the prostate?

A

PSA and pepsinogen

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40
Q

What function do the prostatic proteolytic enzymes serve in semen?

A

re-liquefaction by breakdown of clotting factors from seminal vesicles

41
Q

what is the citric acid in semen used for?

A

ATP production

42
Q

What function does Oxtytocin serve in the uterus?

A

Contraction

43
Q

Outline the process of oocyte maturation of the nucleus

A

Meiosis 1 -> nuclear membrane disappears -> 1st polar body separates-> meiosis II occurs -> arrested in metaphase II

44
Q

Outline the process of oocyte maturation of cytoplasm

A 
Mitochondria disperse 
ER accumulates in cortex
Protein and lipid synthesis creates coritcal granules
Lipid dorplets provide energy
Cytoskeleton forms
45
Q

How many sperm are needed for successful fertilization?

A

200-300 per ejaculate
300 reach site
299+ neededto disperse zona pellucida

46
Q

How long can sperm survive in female genital tract?

A

Up to 5 days

47
Q

How long does the oocyte survive?

A

6-24hrs, then phagocytosed

48
Q

How long, then, is the fertile period?

A

As early as 3 days prior to or on the day of ovulation

49
Q

How long does oocyte take to reach the body of the uterus?

A

3-4 days

50
Q

Where does fertilisation take place?

A

Fallopian tube

51
Q

What process do sperm cells need to undergo in order to penetrate oocyte?

A

Capacitation

52
Q

Describe capacitation

A

Further maturation of sperm in female reproductive tract; protein coat removed & acrosomal enzymes exposed + tail starts to whip

53
Q

What is the Acrosome reaction?

A

Activation of acrosomal enzymes, on binding to zona pellucida, to digest path through it

54
Q

Describe the regions of the oocyte plasma membrane. Which one does sperm bind and fuse to?

A

Region overlying metaphase chromosomes (devoid of microvilli)
Remainder (rich in micfrovilli), this is where sperm binds

55
Q

Describe the fast block to polyspermy

A

Electrical change in oocyte membrane as sodium channels open in wave starting fromsperm entry site

56
Q

Desribe the slow block to polyspermy

A

Ca2+ released from ER induces local exocytosis fo cortical granules in wave

57
Q

How do the cortical granules from the oocyte prevent polyspermy?

A

The proteases inside induce the zona reaction

58
Q

What is the zona reaction?

A

An alteration in the Zona pellucida structure. It hardens and sperm receptors are destroyed

59
Q

What is syngamy?

A

Union of male and female pronuclei forming diploid zygote (occurs after meiosis II)

60
Q

What is the importance of cleavage?

A

It increases the ratio of nucleus to cytoplasm

61
Q

Describe the actions of Oestrogen on the HPG axis before ovulation

A

Negative feedback on bot the pituitary and hypothalamus

62
Q

Describe the actions of oestrogen on the HPG axis at ovulation

A

Positive feedback on Pituitary and hypothalamus

63
Q

Descirbe the actions of Porgesterone on the HPG axis at lower doses

A

No inhibition of LH surge at ovulation (cervical mucus thickens)

64
Q

Describe the actions of progesterone on the HPG axis at moderate or high doses before ovulation

A

Enhances -ve feedback of oestrogen on the HPG axis before ovulation reducing LH and FSH secretion

65
Q

Describe the actions progesterone has on the HPG axis at omderate or high doses at ovulation

A

Inibits +ve feedback of oestrogen so no LH surge or ovulation

66
Q

What are the 6 normal methods of contraception?

A 
Natural
Barrier
Prevention of ovulation 
Inhibition of spermtransport
Inhibition of implantation 
Sterilisation
67
Q

Describe the natural method of contraception

A

Using fertility indicators to identify fertile and infertile periods e.g. cycle monitoring
OR lactational amenorrhoea period

68
Q

Describe the method of preventing ovulation

A

Combined pill
Porgesterone depot
Progesterone implant

69
Q

What are the secondary actions of the combined pill?

A

Reduces endometrial receptivity inhibiting implantation

Thickens cervical mucus to inhibit sperm entry

70
Q

List some disadvantages of the combined pill

A 
User dependent
Mood disturbances 
Breast tenderness
INcreased risk of MI 
Many contraindications
71
Q

List some disadvantages of the Progesterone Depot

A

LAtered or irregular bleeding
Delayed return of fertility for as much as one year after
Small loss of bone mineral density

72
Q

Describe how sperm transport is inhibited

A

Porgesterone only pill. lower dose so ovulation occurs but thickens cervical mucus

73
Q

What is the main advantage of the progestrone only pill?

A

Can be used when combined pill contraindicated

74
Q

What are the disadvantages of the progesterone only pill?

A

Menstrual problems common

Must be taken at same time each day (only 3 hour window)

75
Q

Describe inhibition of implantation

A

Coils: Inrauterine system (progesterone) or device (copper)

76
Q

What is teh mechanism of action of an IUS?

A

Slow release (low dose) progesterone reduces endometrial proliferation and prevents implantation for 3-5yrs

77
Q

What are the disadvantages of an IUS?

A

Unpleasant insertion
IUS displacement or expulsion may occur
~2/1000 risk of perforation

78
Q

What is the mechanism of action of and IUD?

A

Copper is toxic to ovum and sperm. Can last 5-10 years

79
Q

What are the advantages and disadvantages of IUDs

A

Can be used as emergency contraception up to 5 days after intercourse
But periods may be heavier or longer or more painful

80
Q

Describe male sterilisation

A

Vasectomy - Vas Deferens interuppted

81
Q

Describe female sterilisation

A

Fallopian tubes cut or blocked

82
Q

What are the advantages of sterilisation?

A

Permanent

No hormonal side effects

83
Q

How is infertility defined?

A

Failure of conception in a couple having regular, unprotected coitus for one year

84
Q

What is teh difference between primary and secondary infertility?

A 
Primary = no previous pregnancy
Secondary = previous pregnancy, successful or not
85
Q

How many people have difficulty conceiving?

A

~1/7 couples, approx. 3.5 million in UK

86
Q

Outline the aetiological profile of infertility

A

Male factors ~35%
Ovulatory disorder ~25%
Tubal damage ~20%
Uterine or peritoneal disease <10%

87
Q

List some male factors of infertility

A

Idiopathic oligospermia
Varicocele
Abnormal sperm production
Hypospadias

88
Q

What is varicocele?

A

Enlarged veins in scrotum similar to varicose vein that can cause low sperm count

89
Q

What is polycystic ovary syndrome?

A

Lots of cyst in ovaries, elevated androgen levels and resulting problems. Unknown pathophysiology but some genetic component

90
Q

What are the clinical features of POD?

A 
Hirsuitism (abnormal hair growth)
Acne
Obesity
Male-pattern baldness
Oligomenorrhoea
Psychological Sx
91
Q

What is oligomenorrhoea?

A

Infrequent menstrual periods

92
Q

List some uterine or peritoneal diseases

A 
Endometriosis
Asherman's syndrome
Uterine fibroids
Cervical stenosis
Cervical hostility
93
Q

What is endometriosis?

A

Presence of endometrial tissue in sites outside uterine cavity e.g. pelvic cavity

94
Q

What are the clinical features of endometriosis?

A

Dysmenorrhoea
Dyspareunia (painful intercourse)
Chronic pelvic pain

95
Q

When should a woman be referred for further investigations?

A

1yr without conceiving unknown cause

Not conceived after 6 cycles of AI unknown cause

96
Q

What are the common investigations of infertile women?

A 
Follicular phase LH and FSH (day 2)
Luteal phase progesterone (day 21 if regular)
Thyroid function test
Androgens, prolactin
Cervicsl smear
Pelvic USS
Tubal patency
97
Q

List some investigations of male infertility

A 
Sperm analysis (count, motility)
Antisperm antibodies
Androgens
USS
Karyotype
CF test
Testicular biopsy
98
Q

What is the usual pH range of semen?

A

7.2 - 7.8

ESA 4 - 2017 - Incomplete/Some errors (19 decks)

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