Repro Memorization Flashcards
1
Q
what are the 4 weak areas of the pelvis?
A
pubic rami, acetabulum, SI joints, and iliac ala
2
Q
where do obturator internus and piriformis attach?
A
greater trochanter so cause lateral rotation of thigh
3
Q
what is the tendinous arch of levator ani made up of?
A
obturator internus fascial thickening
4
Q
three muscles that make up levator ani and their orientation
A
iliococcygeus, pubococcygeus, and puborectalis from lateral to medial
5
Q
nerve supply and vein system above pectinate line
A
inferior hypogastric plexus (visceral) and superior rectal vein (portal system)
6
Q
nerve supply and vein system below pectinate line
A
inferior rectal nerves (somatic) and inferior rectal veins (systemic)
7
Q
key landmark for ureters
A
runs inferior to vas deferent/uterine artery
8
Q
internal urethral sphincter innervation
A
smooth muscle from inferior hypogastric plexus
9
Q
external urethral sphincter innervation
A
skeletal muscle from deep perineal branch of pudendal nerve
10
Q
what separates rectouterine and vesicouterine pouches?
A
broad ligament of the uterus
11
Q
contents of broad ligament of uterus
A
round ligament, uterine tube, proper ovarian ligament, ovary, uterus, ovarian vessels (suspensory ligament)
12
Q
Mesovarium location
A
connects ovary to mesosalpinx
13
Q
mesometrium location
A
connects uterine tube to uterus
14
Q
mesosalpinx location
A
connects uterine tube to uterus and ovary
15
Q
cardinal ligament function
A
supports cervix
16
Q
paracolpium
A
thick fascia from lateral vagina to tendinous arch
17
Q
normal uterus position
A
anteverted and anteflexed
18
Q
vert angle
A
cervix and vagina
19
Q
flex angle
A
uterine body and cervix
20
Q
where does inferior gluteal A. travel
A
through greater sciatic foramen but below piriformis
21
Q
sacral plexus contributions and locations
A
L4-S4; posterolateral walls of pelvic cavity anterior to piriformis
22
Q
pudendal nerve contributions and location
A
S2-S4; enters perineum through lesser foramen in the pudendal canal and innervates external genitalia and anal canal below pectinate line
23
Q
superior gluteal nerve contributions and location
A
L4-S1 exits through greater foramen above piriformis
24
Q
inferior gluteal nerve contributions and location
A
exits through greater foramen below the piriformis
25
coccygeal plexus contributions and location
S4-S5 on pelvic side of coccygeus muscle
26
superior hypogastric plexus
only sympathetic in front of L4 bifurcation, gives rise to ureteric, testicular, and common iliac plexuses
27
inferior hypogastric plexus
superior sacral sympathetic and pelvic splanchnic PS; gives rise to plexuses on pelvic viscera (rectum and internal anal sphincter)
28
gray rami communicantes
postganglionic sympathetic fibers from trunk to anterior rami
29
Pelvic splanchnic nerves
preganglionic PS fibers to inferior hypogastric plexus
30
Sacral splanchnic nerves
postganglionic sympathetic fibers to inferior hypogastric plexus
31
external pudendal artery supplies what?
scrotum and penis or labia majora and clitoris
32
Pudendal nerve contents (4)
preganglionic parasympathetic
somatic motor
somatic sensory
postganglionic parasympathetic
33
duct that opens into UG sinus
Wolffian or mesonephric duct
34
how does the paramesonpehric duct disappear in males?
SRY-SOX9-Anti mullerian hormone
| AMH regression in weeks 8-10
35
hypospadia
urethral opening lower on ventral side of penis
36
epispadia
urethral opening on dorsal side of penis; associated with exstrophy of bladder
37
superior gubernaculum gives rise to
round ligament of ovary
38
inferior gubernaculum gives rise to
round ligament of uterus
39
What is the seminal colliculus
enlarged area on the urethral crest (prostatic) where the two ejaculatory ducts open into
40
blood supply of prostate
inferior vesicle and middle rectal arteries
41
blood supply of seminal vesicles
superior and inferior vesicular arteries
42
what makes up seminiferous tubules?
Sertoli cells with interspersed germ cells; spermatogonia near periphery and spermatozoa near lumen of tubule
43
what cells synthesize and secrete T? (males)
leydig cells
44
how is T stored?
bound to ABP from Sertoli cells in the seminiferous tubules
45
action of 5alpha-reductase in peripheral tissues
conversion of T to dihydrotestosterone (DHT)
46
where are there high amounts of estrogens in males?
fluid of seminiferous tubules from the Sertoli cells (aromatase)
47
function of aromatase
T to estradiol
48
When does T production begin?
7-8 weeks gestation; Androgens diffuse to target cells and bind to ARs which are NRs
49
What does FSH cause
Sertoli cells to secrete ABP into lumen of seminiferous tubules
50
what happens in the epididymis?
maturation for a month, sperm become strongly motile, and decpacitation
51
what do seminal vesicles secrete?
fructose, prostaglandins, other nutients
52
function of prostaglandins
reacts with female cervical mucous to make it less thick and helps move sperm toward ovaries
53
Capacitation changes
washing away of inhibitory factors
loss of cholesterol making sperm head weaker
sperm more permeable to Ca which increases motility
54
What are stored in the acrosomal head of sperm?
hyaluronidase- depolymerizes Hyaluronic acid polymers that hold ovarian granulosa cells together
proteolytic enzymes digest proteins that adhere to ovum
55
Kallman's Syndrome
GnRH neurons fail to migrate to hypothalamus during embryonic development; delayed or absent puberty and an impaired sense of smell
56
Klinefelter's Syndrome
XXY; phenotypically male, low androgen production but increased gonadotropins; seminiferous tubules destroyed leading to infertility
57
When does Meiosis II resume in women?
only at fertilization
58
Mural Granulosa Cell function
steroidogenic and remain in ovary after ovulation to become the corpus luteum
59
periovulatory period
time from onset of LH surge to ovulation
60
what is released from the oocyte in response to LH?
GDF9; stimulates cumulus cells to secrete hyaluronic acid to cause expansion of oocyte complex making it easier for sperm to locate and penetrate
61
receptors present on Theca cells
LH
62
receptors present on granulosa cells
LH and FSH
63
what acts on cells of the corpus luteum after ovulation>
LH
64
source and function of inhibins
granulosa cells secrete inhibits in response to FSH (and LH after ovulation) which inhibit FSH production
65
what does the corpus luteum secrete?
progesterone, estradiol, and inhibins
66
function of 17B-HSD
estrone to estradiol
67
theca cell contribution to estradiol synthesis
desolate and 17-a hydroxylase
68
granulosa cell contribution to estradiol synthesis
aromatase
69
what stimulates proliferation and differentiation of the endometrium?
estrogen from developing follicles
70
net effect of OCPs
suppressed secretion of LH and FSH (act on hypothalamus and anterior pituitary); low LH levels prevent LH surge and ovulation
71
Polycystic Ovarian Syndrome
high LH, low FSH, high T; hyperandrogenism and increased DHEA; young obese females
72
Spermatid Phases
Golgi-makes acrosomal vesicle and poles
Cap- AV caps anterior half of nucleus
Acrosome- head in sertoli and flagella tail in lumen of ST
Maturation- cytoplasm removed and spermatid released
73
when is manchette formed?
acrosome phase of spermiogenesis
74
What secretes ABP and what does it bind?
Sertoli cells; T and DHT
75
what is the layers of myoid cells that create peristaltic waves to move spermatozoa through ST to duct called?
lamina popria; thickens with age leading to infertility due to small ST lumen
76
what binds 3 corpora of the penis together forming a capsule?
tunica albuginea
77
what does the deep artery of penis branch into?
helicine arteries
78
what do granulosa-lutein cells secrete and what receptors do they have
progesterone and estrogen with FSH and LH; express LH receptors
79
what to theca lutein cells produce
androstenedione and progesterone with LH stimulation
80
where is SRY gene expressed?
pre-sertoli somatic support cells
81
when does paramesonephric duct begin to degenerate in males?
week 9
82
what does DHT from fetal leydig cells contribute to formation of? (3) think more outside features
genital tubercle - penis
genital swellings - scrotum
urethral epithelium - prostate
83
embryonic layer for seminal vesicle
buds from mesonephric duct which is intermediate mesoderm (from genital ridge)
84
prostate and bulbourethral glands derived from
endodermal buds of UG sinus
85
WNT4 expression causes
FOXL2 which suppresses SOX9 (leydig and Sertoli cells)
86
what does the gubernaculum become?
scrotal ligament
| ovarian ligament or round ligament of the uterus
87
upper vagina and uterus derived from what germ layer
mesoderm
88
lower vagina (most of the entire vagina) derived from
endoderm
89
what two parts make the placenta a fetomaternal organ?
chorionic sac from fetus
| endometrium from mother
90
extraembryonic structures from blastocyst
CUCA; connecting stalk, umbilical vesicle, chorionic sac, amnion
91
layers and function of the decidua
functional layer of endometrium that separates after birth
basalis - deep to conceptus and maternal part of placenta
capsularis- superficial overlies conceptus
parietalis- rest of decidua
92
what is the blood supply to the embryo coming through during amnion development (primordial uteroplacental circulation)
lacunar networks
93
what germ layer lines trophoblast and covers amnion?
extraembryonic somatic mesoderm
94
what germ layer surrounds umbilical vesicle
extraembryonic splanchnic mesoderm
95
how are amnion and umbilical vesicle attached to the chorion
connecting stalk
96
what is the chorionic sac made up of?
Extraembryonic somatic mesoderm, cytotrophoblast, and syncytiotrophoblast
97
what is the fetal part of the placenta
villous chorion that projects into the intervillous space containing maternal blood
98
how does the chorionic villi (fetus) attach to decidua basalis (mother)
cytotrophoblastic shell on the external layer of trophoblast cells on maternal side
99
what marks the first stage of placental development
projections from primary chorionic villi
100
primary villi structure
cytotrophoblast core covered by syncytiotrophoblast
101
secondary villi structure
extraembryonic mesoderm invades primary villi
| mesoderm core-cytotrophoblasts-syncytiotrophoblasts
102
tertiary villi structure
extraembyronic mesoderm differentiates into capillary and blood cells
103
what makes up a fetal cotyledon
2 or more main stem villi and multiple branch villi
104
cause of preeclampsia
reduced development of chronic villous tree
105
syncytial knots
nuclei in syncytiotrophoblast aggregate to form multinucleate protrusions in the 3rd trimester
106
what enzymes do testis lack that prevents making glucocorticoids and mineralcorticoids
21 beta hydroxylase and 11 beta hydroxylase
107
what do testis have that lets them convert androstenedione to T
17 beta hydroxysteroid dehydrogenase
108
what cells in male make estrogens
Sertoli cells because they have aromatase
109
if testosterone present at 2nd embryonic month
penis and scrotum development; if not vagina and clitoris
110
what hormone is essential for spermiogenesis
FSH acts on sertolis to nurse and form sperm cells
111
main action of FSH in follicular phase of the ovarian cycle
selection of the dominant graffian follicle
112
what cells persist during follicular atresia and why?
thecal cells (retain their LH receptors) to repopulate the cellular stroma of the ovary
113
what causes the surge in LH?
rapid rise in ovarian estradiol secretion
114
how does BBT change throughout menstrual cycle
BBT goes down with higher estrogen early in the cycle; rises after ovulation with higher progesterone
115
what stimulates proliferation and differentiation of endometrium
estrogen
116
endometriosis
tissue that grows normally inside uterus grows outside of it; painful; lots of bleeding
117
turner syndrome
elevated serum FSH and primary hypogonadism
118
what is the functional unit of the placenta
chorionic villi
119
how does the fetus excrete waste byproducts
amniotic fluid
120
what does hCG come from and do?
syncytiotrophoblasts; binds LH with high affinity to stimulate CL to not undergo luteolysis
121
what does hPL come from and do?
syncytiotrophoblasts; coordinates conversion of glucose to fatty acids and ketones; ANTAGONISTIC TO MATERNAL INSULIN; similar to prolactin
122
Progesterone actions during pregnancy
reduces uterine motility and prevents uterine contractions; released primarily into maternal compartment so blood levels in mother rise
123
estrogen actions during pregnancy
increases uteroplacental blood flow, LDL receptor expression, and prostaglandin/oxytocin receptors for birth
124
where is placental cholesterol derived from?
mother
125
where are placental enzymes derived from?
fetal adrenal gland and liver
126
why does the fetus lack the ability to produce estrogen?
no 3 beta hydroxysteroid DH or aromatase
127
what does the fetus do to steroid intermediates?
conjugates sulfates to reduce their activity, then uses sulfates to allow placenta to complete the steroidogenesis
128
what system mediates increase in maternal blood volume
RAAS; rapid increase during 2nd and 3 trimester
129
why does MAP decrease during pregnancy despite increase in blood volume
vasodilating effects of progesterone and estrogen
130
what causes increased alveolar ventilation during pregnancy?
progesterone
131
parturition stage 0
uterine tranquility
132
parturition stage 1
uterine awakening and initiation of birth extending until complete cervical dilation
133
parturition stage 2
active labor until delivery
134
parturition stage 3
delivery of fetus until expulsion of placenta and end of all contractions
135
when are prostaglandin and oxytocin receptors increased as well as enzymes to breakdown matrix and cervix?
stage 1
136
what 3 factors induce contractions during stage 2?
increased prostaglandins, myometrial cell connectivity, and myometrial response to PGs and Oxytocin
137
what does progesterone do during parturition?
relaxes myometrium need to antagonize to induce labor
138
what does an increase in estrogen receptors after desensitization to progesterone during parturition cause?
increase responsiveness to oxytocin and prostaglandins; forms gap junctions
139
prostaglandin function
stimulates myometrial contractions; PGF2alpha is key and potentiates oxytocin
140
what makes PGF2alpha
decimal production
141
what is the primary stimulus for release of oxytocin called? what does it do
Ferguson reflex; distention of cervix causes oxytocin release which then causes PGF production in bursts
142
relaxin origin and function
CL, placenta, and decidua; keeps uterus quiescent and may help soften/dilate the cervix
143
what does placenta made CRH do
promotes myometrial contractions; stimulates fetal ACTH secretion increasing cortisol and estrogen
144
what is considered a preterm labor
before 37th week
145
what is the fundamental secretory unit of the breast
series of secretory lobules that empty into ductules; ductules combine to duct which widens at ampulla
