Repro Session 1 Flashcards
What compromises the male internal genitalia?
Testes, epididymis, vas deferens, urethra, seminal vesicles, prostate gland and bulbourethral glands
What comprises the female internal genitalia?
Ovaries, Fallopian tubes, uterus, cervix and vagina
What comprises the male external genitalia?
Penis and scrotum
What comprises the female external genitalia?
Vagina, vestibule, labia minora and majora and clitoris
What are the male secondary sexual characteristics?
Larger body size, body composition and fat distribution, facial hair, male pattern baldness, CNS effects and smell
What are the female secondary sexual characteristics?
Smaller body size, SC fat distribution, breast and hair development, CNS effect
How does the development of both male and female reproductive tracts broadly start?
At an indifferent stage with a gonad and duct system
When do structural and functional development of the reproductive tracts occur?
Structural in utero
Functional after birth in childhood, adolescence and puberty
What is the urogenital ridge?
Region of intermediate mesoderm that gives rise to the embryonic kidney and indifferent gonad
Where do the cells of the primitive gonad originate from?
Stroma/parenchyma from intermediate mesoderm supported by primordial germ cells from yolk sac
How do primordial germ cells end up in the indifferent gonad?
Arise in yolk sac in week 3 and migrate into the retroperitoneum along the dorsal mesentery
Why are retroperitoneal germ cell tumours seen in the gonads?
Indifferent gonads develop in the retroperitoneum
How is the indifferent gonad developed in the genetic male?
Male gamete carries Y chromosome –> XY conceptus –> primordial germ cells carry Y –> expression of SRY genes on Y leads to male transcription factors
How does the indifferent gonad develop in the genetic female?
Male gamete carrying X chromosome –> XX conceptus –> no SRY gene zone and therefore development of female
How does the medullary cord differ in the male and female?
Develops in male, regresses in female
How do the cortical cords differ in the male and female?
No cortical cords in male, they develop in the female
Why does the ovary not have a tunica albuginea?
Oocytes have to migrate outside gonad
What does the fate of the mesonephric and paramesonephric ducts depend on?
Whether there is an ovary or testis present
Where do the mesonephric and paramesonephric ducts end?
Cloaca
What is the alternative name for the mesonephric duct?
Wolffian duct
What combines with the mesonephric duct to form the embryonic kidney to give a primitive renal function?
Mesonephric tubules
Where is the mesonephric duct positioned?
Close to the primitive gonad and making contact with the cloaca caudally
What prevents regression of the Wolffian duct?
Male sex hormones from Leydig cells
What is the paramesonephric/Mullerian duct?
Invaginations of the urogenital ridge that enlarge and pull peritoneum into the midline to form the uterus
What allows development of the paramesonephric duct?
Absence of Mullerian inhibiting substance form Sertoli cells
Where do the paramesonephric ducts have openings?
Caudally at the cloaca and cranial into the abdominal cavity
Why can the paramesonephric duct open into the abdominal cavity?
Lack draining function
How do the external genitalia appear at 7 weeks?
Indifferent: genital tubercle, genital folds surrounding opening of urogenital sinus and genital swellings
What is the result of presence of dihydrotestosterone on external genitalia?
Genital tubercle elongation, fusion of genital folds on ventral surface, fusion of genital swellings
What does fusion of the genital folds and swellings form respectively?
Spongy urethra and scrotum
What is the result of lack of testis derived androgen on the external genitalia?
Genial tubercle doesn’t elongate, genital folds do not fuse, genital swellings do not fuse and the urethra opens into the vestibule
What are the fates of the components of the indifferent gonad in the absence of testis derived androgens?
Genital tubercle –> clitoris
Genital folds –> labia minora
Genital swellings –> labia majorum
Describe the descent of the testis.
Appear retroperiotneally high up on posterior abdominal wall
–> processus vaginalis creates path for testes to be guided by the gubernaculum anterior to the pubic symphysis
What is the processus vaginalis?
Outpouching of peritoneum
What is the round ligament of the uterus?
Adult remnant of gubernaculum that attaches the ovary inferiorly to the labio-scrotal folds
Why is the round ligament of the uterus seen in the inguinal canal?
Tethered to labio-scrotal folds
Why does the ovary not move any more inferiorly that the pelvis?
It is tethered by ligaments
What does gestation depend on?
Placental support within female reproductive tract
What are hermaphrodites?
Individuals that have both ovarian and testicular tissue
If a hermaphrodite has the genotype 46, XX what do they usually have?
Uterus
Are hermaphrodites typically male or female in terms of genital development?
Either
Describe the hormone derangement in congenital adrenal hyperplasia.
Low steroid hormone production by the adrenals and hence high ACTH production
Which two processes can be affected in congenital adrenal hyperplasia?
21-hydroxylation or more rarely 17-alpha-hydroxylation
How might females affected by congenital adrenal hyperplasia present?
Parietal masculinisation with large clitoris, virilisation with male appearance, female internal and external genitalia but failure of secondary sexual characteristics
What is inhibited in males affected by congenital adrenal hyperplasia?
Virilisation
What happens in androgen insensitivity syndrome?
Males that have a Y chromosome and testis but lack of receptors to/response to dihydrotestosterone –> no male genitalia but paramesonephric duct is suppressed
How may an individual affected by complete androgen insensitivity syndrome present?
Short/poorly developed vagina, testes in inguinal or labial regions but no spermatogenesis
What does complete androgen insensitivity syndrome increase the risk of?
Testicular tumours
Describe the spectrum of effects seen in mild/partial androgen insensitivity syndromes.
Mild–> virilisation
Partial –> ambiguous genitalia
Tested are usually undescended
What happens in 5-alpha-reductase deficiency?
Testosterone is not converted to dihydrotestosterone therefore causing ambiguous genitalia in males with hypospadias/clitoromegaly
Describe Klinefelter syndrome.
47, XXY causing decreased fertility, small testes, decreed testosterone +/- gynaecomastia
Describe Swyer syndrome (XY female gonadal dysgenesis).
Point mutations/deletion of SRY gene so pts appear to be female but do not menstruate or develop secondary sexual characteristics