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Endo/Repro > Repro Memorization > Flashcards

Repro Memorization Flashcards

1
Q

what are the 4 weak areas of the pelvis?

A

pubic rami, acetabulum, SI joints, and iliac ala

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2
Q

where do obturator internus and piriformis attach?

A

greater trochanter so cause lateral rotation of thigh

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3
Q

what is the tendinous arch of levator ani made up of?

A

obturator internus fascial thickening

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4
Q

three muscles that make up levator ani and their orientation

A

iliococcygeus, pubococcygeus, and puborectalis from lateral to medial

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5
Q

nerve supply and vein system above pectinate line

A

inferior hypogastric plexus (visceral) and superior rectal vein (portal system)

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6
Q

nerve supply and vein system below pectinate line

A

inferior rectal nerves (somatic) and inferior rectal veins (systemic)

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7
Q

key landmark for ureters

A

runs inferior to vas deferent/uterine artery

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8
Q

internal urethral sphincter innervation

A

smooth muscle from inferior hypogastric plexus

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9
Q

external urethral sphincter innervation

A

skeletal muscle from deep perineal branch of pudendal nerve

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10
Q

what separates rectouterine and vesicouterine pouches?

A

broad ligament of the uterus

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11
Q

contents of broad ligament of uterus

A

round ligament, uterine tube, proper ovarian ligament, ovary, uterus, ovarian vessels (suspensory ligament)

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12
Q

Mesovarium location

A

connects ovary to mesosalpinx

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13
Q

mesometrium location

A

connects uterine tube to uterus

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14
Q

mesosalpinx location

A

connects uterine tube to uterus and ovary

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15
Q

cardinal ligament function

A

supports cervix

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16
Q

paracolpium

A

thick fascia from lateral vagina to tendinous arch

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17
Q

normal uterus position

A

anteverted and anteflexed

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18
Q

vert angle

A

cervix and vagina

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19
Q

flex angle

A

uterine body and cervix

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20
Q

where does inferior gluteal A. travel

A

through greater sciatic foramen but below piriformis

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21
Q

sacral plexus contributions and locations

A

L4-S4; posterolateral walls of pelvic cavity anterior to piriformis

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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

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23
Q

superior gluteal nerve contributions and location

A

L4-S1 exits through greater foramen above piriformis

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24
Q

inferior gluteal nerve contributions and location

A

exits through greater foramen below the piriformis

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25
Q

coccygeal plexus contributions and location

A

S4-S5 on pelvic side of coccygeus muscle

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26
Q

superior hypogastric plexus

A

only sympathetic in front of L4 bifurcation, gives rise to ureteric, testicular, and common iliac plexuses

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27
Q

inferior hypogastric plexus

A

superior sacral sympathetic and pelvic splanchnic PS; gives rise to plexuses on pelvic viscera (rectum and internal anal sphincter)

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28
Q

gray rami communicantes

A

postganglionic sympathetic fibers from trunk to anterior rami

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29
Q

Pelvic splanchnic nerves

A

preganglionic PS fibers to inferior hypogastric plexus

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30
Q

Sacral splanchnic nerves

A

postganglionic sympathetic fibers to inferior hypogastric plexus

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31
Q

external pudendal artery supplies what?

A

scrotum and penis or labia majora and clitoris

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32
Q

Pudendal nerve contents (4)

A

preganglionic parasympathetic
somatic motor
somatic sensory
postganglionic parasympathetic

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33
Q

duct that opens into UG sinus

A

Wolffian or mesonephric duct

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34
Q

how does the paramesonpehric duct disappear in males?

A

SRY-SOX9-Anti mullerian hormone

AMH regression in weeks 8-10

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35
Q

hypospadia

A

urethral opening lower on ventral side of penis

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36
Q

epispadia

A

urethral opening on dorsal side of penis; associated with exstrophy of bladder

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37
Q

superior gubernaculum gives rise to

A

round ligament of ovary

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38
Q

inferior gubernaculum gives rise to

A

round ligament of uterus

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39
Q

What is the seminal colliculus

A

enlarged area on the urethral crest (prostatic) where the two ejaculatory ducts open into

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40
Q

blood supply of prostate

A

inferior vesicle and middle rectal arteries

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41
Q

blood supply of seminal vesicles

A

superior and inferior vesicular arteries

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42
Q

what makes up seminiferous tubules?

A

Sertoli cells with interspersed germ cells; spermatogonia near periphery and spermatozoa near lumen of tubule

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43
Q

what cells synthesize and secrete T? (males)

A

leydig cells

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44
Q

how is T stored?

A

bound to ABP from Sertoli cells in the seminiferous tubules

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45
Q

action of 5alpha-reductase in peripheral tissues

A

conversion of T to dihydrotestosterone (DHT)

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46
Q

where are there high amounts of estrogens in males?

A

fluid of seminiferous tubules from the Sertoli cells (aromatase)

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47
Q

function of aromatase

A

T to estradiol

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48
Q

When does T production begin?

A

7-8 weeks gestation; Androgens diffuse to target cells and bind to ARs which are NRs

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49
Q

What does FSH cause

A

Sertoli cells to secrete ABP into lumen of seminiferous tubules

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50
Q

what happens in the epididymis?

A

maturation for a month, sperm become strongly motile, and decpacitation

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51
Q

what do seminal vesicles secrete?

A

fructose, prostaglandins, other nutients

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52
Q

function of prostaglandins

A

reacts with female cervical mucous to make it less thick and helps move sperm toward ovaries

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53
Q

Capacitation changes

A

washing away of inhibitory factors
loss of cholesterol making sperm head weaker
sperm more permeable to Ca which increases motility

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54
Q

What are stored in the acrosomal head of sperm?

A

hyaluronidase- depolymerizes Hyaluronic acid polymers that hold ovarian granulosa cells together

proteolytic enzymes digest proteins that adhere to ovum

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55
Q

Kallman’s Syndrome

A

GnRH neurons fail to migrate to hypothalamus during embryonic development; delayed or absent puberty and an impaired sense of smell

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56
Q

Klinefelter’s Syndrome

A

XXY; phenotypically male, low androgen production but increased gonadotropins; seminiferous tubules destroyed leading to infertility

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57
Q

When does Meiosis II resume in women?

A

only at fertilization

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58
Q

Mural Granulosa Cell function

A

steroidogenic and remain in ovary after ovulation to become the corpus luteum

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59
Q

periovulatory period

A

time from onset of LH surge to ovulation

60
Q

what is released from the oocyte in response to LH?

A

GDF9; stimulates cumulus cells to secrete hyaluronic acid to cause expansion of oocyte complex making it easier for sperm to locate and penetrate

61
Q

receptors present on Theca cells

A

LH

62
Q

receptors present on granulosa cells

A

LH and FSH

63
Q

what acts on cells of the corpus luteum after ovulation>

A

LH

64
Q

source and function of inhibins

A

granulosa cells secrete inhibits in response to FSH (and LH after ovulation) which inhibit FSH production

65
Q

what does the corpus luteum secrete?

A

progesterone, estradiol, and inhibins

66
Q

function of 17B-HSD

A

estrone to estradiol

67
Q

theca cell contribution to estradiol synthesis

A

desolate and 17-a hydroxylase

68
Q

granulosa cell contribution to estradiol synthesis

A

aromatase

69
Q

what stimulates proliferation and differentiation of the endometrium?

A

estrogen from developing follicles

70
Q

net effect of OCPs

A

suppressed secretion of LH and FSH (act on hypothalamus and anterior pituitary); low LH levels prevent LH surge and ovulation

71
Q

Polycystic Ovarian Syndrome

A

high LH, low FSH, high T; hyperandrogenism and increased DHEA; young obese females

72
Q

Spermatid Phases

A

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
Q

when is manchette formed?

A

acrosome phase of spermiogenesis

74
Q

What secretes ABP and what does it bind?

A

Sertoli cells; T and DHT

75
Q

what is the layers of myoid cells that create peristaltic waves to move spermatozoa through ST to duct called?

A

lamina popria; thickens with age leading to infertility due to small ST lumen

76
Q

what binds 3 corpora of the penis together forming a capsule?

A

tunica albuginea

77
Q

what does the deep artery of penis branch into?

A

helicine arteries

78
Q

what do granulosa-lutein cells secrete and what receptors do they have

A

progesterone and estrogen with FSH and LH; express LH receptors

79
Q

what to theca lutein cells produce

A

androstenedione and progesterone with LH stimulation

80
Q

where is SRY gene expressed?

A

pre-sertoli somatic support cells

81
Q

when does paramesonephric duct begin to degenerate in males?

A

week 9

82
Q

what does DHT from fetal leydig cells contribute to formation of? (3) think more outside features

A

genital tubercle - penis
genital swellings - scrotum
urethral epithelium - prostate

83
Q

embryonic layer for seminal vesicle

A

buds from mesonephric duct which is intermediate mesoderm (from genital ridge)

84
Q

prostate and bulbourethral glands derived from

A

endodermal buds of UG sinus

85
Q

WNT4 expression causes

A

FOXL2 which suppresses SOX9 (leydig and Sertoli cells)

86
Q

what does the gubernaculum become?

A

scrotal ligament

ovarian ligament or round ligament of the uterus

87
Q

upper vagina and uterus derived from what germ layer

A

mesoderm

88
Q

lower vagina (most of the entire vagina) derived from

A

endoderm

89
Q

what two parts make the placenta a fetomaternal organ?

A

chorionic sac from fetus

endometrium from mother

90
Q

extraembryonic structures from blastocyst

A

CUCA; connecting stalk, umbilical vesicle, chorionic sac, amnion

91
Q

layers and function of the decidua

A

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
Q

what is the blood supply to the embryo coming through during amnion development (primordial uteroplacental circulation)

A

lacunar networks

93
Q

what germ layer lines trophoblast and covers amnion?

A

extraembryonic somatic mesoderm

94
Q

what germ layer surrounds umbilical vesicle

A

extraembryonic splanchnic mesoderm

95
Q

how are amnion and umbilical vesicle attached to the chorion

A

connecting stalk

96
Q

what is the chorionic sac made up of?

A

Extraembryonic somatic mesoderm, cytotrophoblast, and syncytiotrophoblast

97
Q

what is the fetal part of the placenta

A

villous chorion that projects into the intervillous space containing maternal blood

98
Q

how does the chorionic villi (fetus) attach to decidua basalis (mother)

A

cytotrophoblastic shell on the external layer of trophoblast cells on maternal side

99
Q

what marks the first stage of placental development

A

projections from primary chorionic villi

100
Q

primary villi structure

A

cytotrophoblast core covered by syncytiotrophoblast

101
Q

secondary villi structure

A

extraembryonic mesoderm invades primary villi

mesoderm core-cytotrophoblasts-syncytiotrophoblasts

102
Q

tertiary villi structure

A

extraembyronic mesoderm differentiates into capillary and blood cells

103
Q

what makes up a fetal cotyledon

A

2 or more main stem villi and multiple branch villi

104
Q

cause of preeclampsia

A

reduced development of chronic villous tree

105
Q

syncytial knots

A

nuclei in syncytiotrophoblast aggregate to form multinucleate protrusions in the 3rd trimester

106
Q

what enzymes do testis lack that prevents making glucocorticoids and mineralcorticoids

A

21 beta hydroxylase and 11 beta hydroxylase

107
Q

what do testis have that lets them convert androstenedione to T

A

17 beta hydroxysteroid dehydrogenase

108
Q

what cells in male make estrogens

A

Sertoli cells because they have aromatase

109
Q

if testosterone present at 2nd embryonic month

A

penis and scrotum development; if not vagina and clitoris

110
Q

what hormone is essential for spermiogenesis

A

FSH acts on sertolis to nurse and form sperm cells

111
Q

main action of FSH in follicular phase of the ovarian cycle

A

selection of the dominant graffian follicle

112
Q

what cells persist during follicular atresia and why?

A

thecal cells (retain their LH receptors) to repopulate the cellular stroma of the ovary

113
Q

what causes the surge in LH?

A

rapid rise in ovarian estradiol secretion

114
Q

how does BBT change throughout menstrual cycle

A

BBT goes down with higher estrogen early in the cycle; rises after ovulation with higher progesterone

115
Q

what stimulates proliferation and differentiation of endometrium

A

estrogen

116
Q

endometriosis

A

tissue that grows normally inside uterus grows outside of it; painful; lots of bleeding

117
Q

turner syndrome

A

elevated serum FSH and primary hypogonadism

118
Q

what is the functional unit of the placenta

A

chorionic villi

119
Q

how does the fetus excrete waste byproducts

A

amniotic fluid

120
Q

what does hCG come from and do?

A

syncytiotrophoblasts; binds LH with high affinity to stimulate CL to not undergo luteolysis

121
Q

what does hPL come from and do?

A

syncytiotrophoblasts; coordinates conversion of glucose to fatty acids and ketones; ANTAGONISTIC TO MATERNAL INSULIN; similar to prolactin

122
Q

Progesterone actions during pregnancy

A

reduces uterine motility and prevents uterine contractions; released primarily into maternal compartment so blood levels in mother rise

123
Q

estrogen actions during pregnancy

A

increases uteroplacental blood flow, LDL receptor expression, and prostaglandin/oxytocin receptors for birth

124
Q

where is placental cholesterol derived from?

A

mother

125
Q

where are placental enzymes derived from?

A

fetal adrenal gland and liver

126
Q

why does the fetus lack the ability to produce estrogen?

A

no 3 beta hydroxysteroid DH or aromatase

127
Q

what does the fetus do to steroid intermediates?

A

conjugates sulfates to reduce their activity, then uses sulfates to allow placenta to complete the steroidogenesis

128
Q

what system mediates increase in maternal blood volume

A

RAAS; rapid increase during 2nd and 3 trimester

129
Q

why does MAP decrease during pregnancy despite increase in blood volume

A

vasodilating effects of progesterone and estrogen

130
Q

what causes increased alveolar ventilation during pregnancy?

A

progesterone

131
Q

parturition stage 0

A

uterine tranquility

132
Q

parturition stage 1

A

uterine awakening and initiation of birth extending until complete cervical dilation

133
Q

parturition stage 2

A

active labor until delivery

134
Q

parturition stage 3

A

delivery of fetus until expulsion of placenta and end of all contractions

135
Q

when are prostaglandin and oxytocin receptors increased as well as enzymes to breakdown matrix and cervix?

A

stage 1

136
Q

what 3 factors induce contractions during stage 2?

A

increased prostaglandins, myometrial cell connectivity, and myometrial response to PGs and Oxytocin

137
Q

what does progesterone do during parturition?

A

relaxes myometrium need to antagonize to induce labor

138
Q

what does an increase in estrogen receptors after desensitization to progesterone during parturition cause?

A

increase responsiveness to oxytocin and prostaglandins; forms gap junctions

139
Q

prostaglandin function

A

stimulates myometrial contractions; PGF2alpha is key and potentiates oxytocin

140
Q

what makes PGF2alpha

A

decimal production

141
Q

what is the primary stimulus for release of oxytocin called? what does it do

A

Ferguson reflex; distention of cervix causes oxytocin release which then causes PGF production in bursts

142
Q

relaxin origin and function

A

CL, placenta, and decidua; keeps uterus quiescent and may help soften/dilate the cervix

143
Q

what does placenta made CRH do

A

promotes myometrial contractions; stimulates fetal ACTH secretion increasing cortisol and estrogen

144
Q

what is considered a preterm labor

A

before 37th week

145
Q

what is the fundamental secretory unit of the breast

A

series of secretory lobules that empty into ductules; ductules combine to duct which widens at ampulla

Endo/Repro (2 decks)

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