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SUGER > Reproduction > Flashcards

Reproduction Flashcards

1
Q

A 47 year old woman is seen in a ‘well woman’ clinic at her General Practitioner’s surgery. She reports that she has not had a menstrual period for three months and has no other symptoms. A pregnancy test is negative. Which is the primary physiological change that results in the menopause?

A

Reduced production of oestradiol (estradiol) and inhibin B by the ovary

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2
Q

After embryo implantation the luteal phase supports the early days of the pregnancy through production of a hormone. Which hormone is produced?

A

Progesterone

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3
Q

The Type B spermatogonium migrates through the blood-testis barrier. Into which of the following does Type B spermatogonium develop?

A

Primary spermatocytes

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4
Q

Spermatids transform into spermatozoa. Which of the following is the term for this process?

A

Spermiogenesis

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5
Q

Gametogenesis

A

Process by which gametes are produced in the reproductive organs (gonads) of an organism

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6
Q

Oogenesis

A

Begins in fetal life
Significant milestones at puberty
Ceases at menopause

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7
Q

Phases of menstrual cycle

A

Follicular phase = days 1-13/14
Ovulation = days 13/14
Literal phase = days 14-28

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8
Q

What days are the follicular phase of the menstrual cycle

A

1-13/14

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9
Q

What days are the ovulation phase of the menstrual cycle

A

13/14

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10
Q

What days are the luteal phase of the menstrual cycle

A

14-28

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11
Q

Primordial follicle

A

1 oocyte surrounded by granulosa cells

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12
Q

What does the primordial follicle secrete

A

Oestrogen
Progesterone
Inhibin

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13
Q

Primary follicle

A

Oocyte grows and separates from granulosa cells by the Zona pellucida
Contains glycoproteins
Used for binding sperm

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14
Q

Preantral follicle

A

Granulosa cells differentiate into theca cells
2 cells function together for oestrogen synthesis

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15
Q

Early antral follicle

A

Primary oocyte is full sized
Antrum forms
Filled with fluid secreted from granulosa cells
Progresses from the birth of the child to when that follicle enters the menstrual cycle years later

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16
Q

Another name for mature follicle

A

Graafian follicle

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17
Q

Mature follicle

A

After day 7 of the cycle
At the beginning of the cycle 10-15 preantral/early antral follicles develop and grow
After day 7 one follicle is dominant

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18
Q

What happens to the non-dominant follicles

A

Undergo atresia (cell death)

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19
Q

Dominant follicle

A

Increases in size as does its antrum from the increased fluid secretion
Oocyte emerges from meiosis arrest due to LH surge
Completes its secondary oocyte- this increases in size and balloons out of the ovary = ovulation
Enzymatic digestion ruptures the follicle and the oocyte is carried away by the antral fluid

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20
Q

What does the dominant follicle depend on

A

Conditions and oestrogen production

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21
Q

Stages of follicular phase and ovulation

A

Primordial follicle
Primary follicle
Preantral follicle
Early antral follicle
Graafian follicle
Ruptured follicle —> ovulation
Corpus luteum
Degenerating corpus luteum
Corpus albicans

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22
Q

What do granulosa cells differentiate into

A

Theca cells

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23
Q

What contains primary oocyte

A

Primordial follicle

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24
Q

Luteal phase

A

After discharge the follicle collapses
Granulosa cells increase in size—> becomes the corpus luteum
Granulosa cells secrete oestrogen / progesterone and inhibin

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25
Q

What hormones do granulosa cells secrete

A

Oestrogen
Progesterone
Inhibin

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26
Q

If egg is not fertilised

A

After 10 days
The corpus luteum undergoes apoptosis triggering menstruation
Once it has collapsed it is called the corpus albicans - marks end of luteal ohase

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27
Q

What marks the end of the luteal phase

A

Collapsation of corpus luteum into corpus albicans

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28
Q

How long is it before the corpus luteum undergoes apoptosis if not fertilised

A

10 days

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29
Q

Uterine changes: menstrual phase days?

A

1-5

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30
Q

Uterine changes: menstrual phase

A

Withdrawal of progesterone leads to endometrial degeneration- trigger for menstrual flow

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31
Q

What causes the endometrial degeneration

A

Withdrawal of progesterone

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32
Q

Uterine changes: proliferative phase days?

A

5-14

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33
Q

Uterine changes: proliferative phase

A

Oestrogen from granulosa cells and theca cells causes the endometrium to thicken
Stimulates the myometrium
Also stimulates progesterone receptor generation in the endometrium

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34
Q

What does thickening of the endometrium stimulate

A

Myometrium
Progesterone receptor generation in the endometrium

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35
Q

Where is the site of fertilisation

A

Ampulla of fallopian tube

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36
Q

What hormone causes the endometrium to thicken

A

Oestrogen

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37
Q

Uterine changes: secretory phase days?

A

15-28

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38
Q

Uterine changes: secretory phase

A

Progesterone binds with its receptors in the endometrium
Endometrium secreted glycogen from glandular epithelium (also glycoproteins and mucopolysaccharides)
Provides a hospitable environment which is nourishing to sperm and oocyte
Progesterone overrides oestrogen to prevent myometrium contraction and prostaglandin secretion

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39
Q

At what stage does the follicle arrest at birth

A

Primordial follicle

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40
Q

What triggers further development of follicle from primordial arrest

A

FSH and LH secretion at sexual maturity

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41
Q

What do glandular epithelium cells in endometrium secrete

A

Glycogen (and glycoproteins and mucopolysaccharides)

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42
Q

What prevents myometrium contraction and prostaglandin secretion

A

Progesterone overrides oestrogen

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43
Q

During fetal life what happens to oocyte

A

Mitosis

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44
Q

At puberty what happens to primary oocyte

A

Meiosis I

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45
Q

When does meiosis II occur

A

After fertilisation

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46
Q

When does meiosis I occur

A

At puberty

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47
Q

Meiosis of primary oocyte produces

A

Secondary oocyte and polar body

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48
Q

Meiosis of secondary oocyte produces

A

Ovum and second polar body

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49
Q

What type of mucus is secreted when high oestrogen

A

Abundant clear and watery mucus
- good for sperm movement and implantation

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50
Q

What type of mucus is produced when there is progesterone and oestrogen

A

Thick and sticky
- stops bacteria entering and offer protection to the implanted egg

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51
Q

What hormones peak at ovulation

A

LH
FSH
oestrogen

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52
Q

Zona pellucida

A

Glycoprotein layer surrounding oocyte

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53
Q

Changes to uterus at days 1-5

A

Menstrual flow
Shedding of endometrium and small amount of blood

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54
Q

Where are LH and FSH produced

A

Pituitary gland

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55
Q

Changes to breasts at days 1-5

A

Reduction in swelling
Feeling of fullness
Sensitivity
Tenderness

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56
Q

When is it the most appropriate time for a woman to do a breast self-examination

A

Day 5 of menstrual cycle

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57
Q

Changes to uterus at days 6-7

A

Menstrual flow ceases
Repair of uterus begins with day 6 regrowth of endometrium

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58
Q

Changes to brain at days 6-7

A

GnRH from hypothalamus stimulates secretion of FSH and LH by pituitary

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59
Q

What stimulates secretion of FHS and LH

A

GnRH

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60
Q

Where is GnRH released from

A

Hypothalamus

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61
Q

Changes to ovary at days 6-7

A

FSH stimulates development of follicle and secretion of oestrogen

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62
Q

Changes to breasts at days 6-7

A

By day 7 breasts reach their minimum size

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63
Q

Changes to uterus at days 8-12

A

Growth in endometrium is stimulated by oestrogens

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64
Q

Changes to ovary at days 8-12

A

Increase in oestrogen secretion

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65
Q

Changes to brain at days 8-12

A

Decline in FSH and LH secretion due to negative feedback of oestrogen

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66
Q

Changes to brain at days 13-14

A

Surge in levels of FSH and LH secretion as a result of positive feedback of oestrogens

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67
Q

Changes to ovary at days 13-14

A

LH surge on day 14 causes ovulation

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68
Q

Which hormone surge causes ovulation

A

LH

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69
Q

Changes to brain at days 15-24

A

Decline in level of FSH and LH caused by return to negative feedback of oestrogen and progesterone

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70
Q

Changes to uterus at days 15-24

A

Progesterone produces changes making uterus ready to accept a fertilised ovum

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71
Q

Changes to ovary at days 15-24

A

Corpus luteum secretes increasing amounts of progesterone and oestrogen

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72
Q

Changes to ovary at days 25-28

A

Degeneration of corpus luteum and decline in progesterone and oestrogen

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73
Q

Changes to uterus at days 15-24

A

Because of lower progesterone levels, degenerative changes start taking place in endometrium— menstrual flow

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74
Q

Changes to breasts at days 15-24

A

Increasing feelings of fullness and swelling
Sensitive to touch

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75
Q

When are the breasts their minimum size

A

Day 7

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76
Q

2 hormones produced by ovaries

A

Oestrogen
Progesterone

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77
Q

Where is oestrogen produced in follicular phase

A

Granulosa cells

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78
Q

Where is oestrogen produced in luteal phase

A

Corpus luteum

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79
Q

Where is progesterone produced in follicular phase

A

Granulosa and theca cells- in small amounts

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80
Q

Where is progesterone produced in luteal phase

A

Corpus luteum in large amounts

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81
Q

Why is there are increase in FSH in the early part of the follicular phase

A

Due to the follicle developing from pre/early antral into a mature follicle

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82
Q

Levels of FSH in menstrual cycle

A

Increase in early part of follicular phase
Slow decrease throughout menstrual cycle
Increases on day 10/11

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83
Q

Why is there a slow decrease of FSH throughout the menstrual cycle

A

One follicle becoming dominant and the others dying
- as becomes dominant there is more oestrogen leading to a decrease in FSH

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84
Q

What leads to an increase in GnRH

A

Removal of oestrogen and progesterone

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85
Q

At what day is there an increase in FSH

A

10/11

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86
Q

Effect of FSH on theca cells

A

LH receptors develop

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87
Q

Why is the decrease in FSH greater than LH

A

Due to presence of Inhibin which actively inhibits the release of FSH

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88
Q

Function of Inhibin

A

Decreases FSH

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89
Q

When do inhibin levels peak

A

Ovulation

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90
Q

When do inhibin levels decrease

A

As the corpus luteum degenerwtes

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91
Q

Levels of LH during menstrual cycle

A

Constant for most of follicular phase
LH surge about 18 hours before ovulation
Decrease after ovulation

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92
Q

When does LH levels surge

A

18 hours before ovilagion

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93
Q

What generates the LH surge

A

High oestrogen levels from the maturing follicle
Acts in hypothalamus and anterior pituitary to increase sensitivity to GnRH (positive feedback)

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94
Q

Function of LH surge

A

Allows oocyte to complete meiosis I

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95
Q

Why is there a decrease in LH after ovulation

A

Production of progesterone - negative feedback on hypothalamus and anterior pituitary

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96
Q

Effect of LH in theca cells

A

Produce androgens

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97
Q

Androgens

A

Converted to produce oestrogen and antral fluid by granulosa cells

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98
Q

What maintains the corpus luteum

A

Low LH

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99
Q

Completion of meiosis I results in

A

Ovulation

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100
Q

What do granulosa cells produce

A

Oestrogen and inhibin

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101
Q

Negative feedback of oestrogen and progesterone

A

Decrease GnRH and so decrease FSH and LH after ovulation for 14 days

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102
Q

What does the corpus luteum secrete

A

Oestrogen
Progesterone
Inhibin

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103
Q

Withdrawal of what hormone causes menstrual bleeding

A

Progesterone

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104
Q

What maintains the corpus luteum in pregnancy

A

hCG

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105
Q

Location of spermatogenesis

A

Occurs entirely in testes

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106
Q

Meiotic divisions in spermatogenesis

A

Equal division of cells

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107
Q

Germ line epithelium in 1

A

Involved in gamete production

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108
Q

Number of gametes produced in spermatogenesis

A

4

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109
Q

Size of gametes produced in spermatogenesis

A

Sperm smaller than spermatocytes

110
Q

Duration of spermatogenesis

A

Uninterrupted process

111
Q

Onset of spermatogenesis

A

Begins at puberty

112
Q

Release of spermatogenesis

A

Continous

113
Q

End of spermatogenesis

A

Lifelong but reduces with age

114
Q

Location of oogenesis

A

Occurs mostly in ovaries

115
Q

Meiotic divisions in oogenesis

A

Unequal divisions of cytoplasm

116
Q

Germ line epithelium in oogenesis

A

Not involved in gamete production

117
Q

Number of gametes produced in oogenesis

A

One (plus 2-3 polar bodies)

118
Q

Size of gametes in oogenesis

A

Ova larger than oocytes

119
Q

Duration of oogenesis

A

In arrested stages

120
Q

Onset of oogenesis

A

Begins in fetus (pre-natal)

121
Q

Release of oogenesis

A

Monthly from puberty- menstrual cycle

122
Q

End of oogenesis

A

Terminates with menopause

123
Q

When is meiosis completed in oogenesis

A

After fertilisation

124
Q

When is oogenesis first arrested

A

Prophase of meiosis I- maturation begins during menstrual cycle

125
Q

When is oogenesis secondarily arrested

A

Metaphase of meiosis II until ovulation

126
Q

Semen

A

Fluid and soerm

127
Q

Normal sperm count

A

50-120 million/ml

128
Q

Amount of semen expelled during orgasm

A

2-5ml

129
Q

What percentage of semen secretions come from bulbourethral

A

10%

130
Q

What percentage of semen secretions come from prostate

A

30%

131
Q

What percentage of semen secretions come from seminal vesicles

A

60%

132
Q

Where does semen come from

A

Bulbourethra
Prostate
Seminal vesicles

133
Q

Functions of semen secretions

A

Buffers- protect against acidic environment
Chemicals to increase motility - fructose
Prostaglandins - stimulate female peristaltic contractions

134
Q

What stimulates female peristaltic contractions

A

Prostaglandins

135
Q

What does the bulbourethral gland release

A

Lubricating mucoid secretions

136
Q

What do prostate and seminal vesicle secretions contain

A

Digestive enzymes
Fructose
Zinc
Citric acid
Prostaglandins

137
Q

What increases motility of sperm

A

Fructose

138
Q

Route of sperm

A

Seminiferous tubules
Rete testis
Efferent ducts
Epididymis
Vas deferens
Ejaculatory duct
Urethra
Penile urethra

139
Q

Blood-testis barrier

A

Seminiferous tubule bound by a basement membrane
Sertoli cells extend from basement membrane into lumen
Joined by tight junctions
Unbroken ring inside seminiferous tubule

140
Q

2 components of ring inside seminiferous tubule

A

Basal
Central

141
Q

What forms the blood-testis barrier

A

Sertoli cells

142
Q

Function of blood-testis barrier

A

Prevents movement of chemicals
Ensures proper conditions for development and differentiation

143
Q

Length of sperm without fail

A

60 um

144
Q

Length of sperm with tail

A

120 um

145
Q

Head cap-acrosome of sperm

A

Contains special enzymes to penetrate wall of ovum

146
Q

Parts of sperm

A

Head cap-acrosome
Head
Neck
Body
Tail

147
Q

Body of sperm

A

Contains mitochondria for enegry

148
Q

Length of spermatogenesis process

A

64 days

149
Q

Where are spermatozoa produced

A

Testis

150
Q

Spermatogonia

A

Undifferentiated sperm cells

151
Q

What do spermatogonia divide into and when

A

Divide mitotically at puberty into 2 types

152
Q

Type A spermatogonia

A

Remain outside the blood-testis barrier and produce more daughter cells

153
Q

Type B spermatogonia

A

In basal compartment and are primary spermatocytes

154
Q

What type of spermatogonia are the primary spermatocytes

A

Type B

155
Q

Spermiogenesis

A

Occurs when the spermatic develop by growing tails and discarding the cytoplasm
Become spermatozoa

156
Q

What causes release of sperm into lumen

A

Invaginations in Sertoli cells and when these retraction they release sperm

157
Q

Sperm production

A

300-600 sperm per second per gram of testis

158
Q

Structure of spermatozoa

A

Pear-shaped head
Haploid
Tip of nucleus covered with acrosome
Tail- flagellum

159
Q

Feedback of spermatogenesis of HOG axis

A

Direct inhibition/ negative feedback on hypothalamus
Reduced receptor sensitivity to specific LH/FSH response to reduce hormone

160
Q

How does testosterone inhibit LH secretion

A

Acts on hypothalamus to decrease amplitude of GnRH burst, resulting in decreased secretion
Acts directly in anterior pituitary to decrease LH response to GnRH

161
Q

What do Sertoli cells produce

A

Inhibin

162
Q

What do leydig cells produce

A

Testosterone

163
Q

What does testosterone do

A

Stimulate Sertoli cells
Inhibitors LH secretion

164
Q

What does inhibin do in males

A

Inhibit FSH production

165
Q

FSH function in males

A

Stimulate Sertoli cells to carry out spermatogenesis

166
Q

Development of spermatozoa

A

Spermatogonium
Spermatogonia type A/B
Commitment —> primary spermatocytes
Secondary spermatocytes
Spermatids
Spermatozoa
Activation mobile

167
Q

At what stage of spermatogenesis does meiosis occur

A

Primary spermatocytes—-> secondary spermatocytes—> spermatids

168
Q

When is sex determined

A

At fertilisation

169
Q

How does Y chromosome cause a male

A

Contains SRY gene which leads to development of testis

170
Q

If no SRY gene present

A

Ovary development

171
Q

If SRY gene present

A

Testis development

172
Q

Barr body

A

Non-functional X in female gonads condenses to form chromatin

173
Q

What are genital organs formed from

A

Intermediate mesoderm from the genital ridge

174
Q

At what week of embryology do the primordial gonads differentiate

A

Week 6

175
Q

Double genital duct system

A

Wolffian ducts
Mullerian ducts

176
Q

Where do germ cells for sperm and ova come from

A

Yolk sac of hindgut

177
Q

In males which duct system stays

A

Wolffian duct (Mullerian regresses)

178
Q

What do Sertoli cells produce in males

A

Mullerian inhibitory factor

179
Q

What induces production of MIF

A

SRY gene

180
Q

Testosterone and Wolffian ducts

A

Converts into epididymis, vas deferens, ejaculatory duct and seminal vesicle

181
Q

What does Mullerian inhibitory factor lead to

A

Testis determining factor which influences formation of male gonads

182
Q

What is found deep in the medulla of the testis

A

Cord of testis

183
Q

Rete testis

A

At hilum of testis there are multiple tubes

184
Q

Tunica albuginea

A

Dense connective tissue under the epithelial in testis

185
Q

Function of DHT (from testosterone )

A

Development of penis, scrotum and prostate

186
Q

What causes the testes to descend into the scrotum

A

Testosterone

187
Q

Which duct is present in females

A

Mullerian duct

188
Q

What does the Müllerian duct form

A

Fallopian tubes
Uterus
Upper 2/3 vagina

189
Q

What forms the lower 1/3 vagina and external genitalia

A

Urogenital sinus

190
Q

Week 7 of female development

A

2nd generation cords penetrate underlying mesenchyme

191
Q

Month 3 of female development

A

Cords split into isolated clusters with surround oogonium and follicular cells

192
Q

What does oestrogen help to form in female development

A

Uterine tubes
Uterus
Cervix
Vagina
Labia minora and majora
Clitoris

193
Q

Size of testes

A

4cm long and 2.5 cm diameter
Oval organ

194
Q

Tunica vaginalis

A

Sac-like extension of peritoneum covering testes anteriorlu

195
Q

Pendulous pouch

A

Holds the testes

196
Q

Why is testicular thermoregulation necessary

A

Sperm not produced at core body temperature

197
Q

How is testicular thermogenesis carried out

A

Heat exchange of pampiniform plexus

198
Q

At what temperature is sperm produced

A

35

199
Q

Median septum

A

Divided pendulous pouch of testes

200
Q

What changes transform spermatids into spermatozoa

A

Discarding excess cytoplasm and growing tails

201
Q

How is the sperm tail divided

A

Midpiece
Principal piece
Endpiece

202
Q

Midpiece of tail

A

Contains mitochondria around axoneme of the flagellum

203
Q

Principal piece of tail

A

Axoneme surrounded by fibres

204
Q

Endpiece of tail

A

Axoneme only
very narrow tip of flagellum

205
Q

Length of ejaculatory duct

A

2cm

206
Q

Location of leydig cells

A

Clusters of cell between the seminiferous tubules

207
Q

Function of Sertoli cells

A

Promote sperm cell development

208
Q

What do seminiferous tubules drain into

A

Rete testis

209
Q

Where does meiosis occur in males

A

Seminiferous tubules

210
Q

Meiosis I in males forms

A

2 secondary spermatocytes

211
Q

Meiosis II in males forms

A

4 spermatids

212
Q

What forms the blood-testis barrier

A

Tight junctions between Sertoli cells
Basement membrane

213
Q

Efferent ductules of spermatic ducts

A

12 small ciliated ducts collecting sperm from the Rete testis and transporting it to the epididymis

214
Q

Structure of epididymis

A

6cm long coiled duct adhering to posterior testis
Head , body and tail

215
Q

Function of epididymis

A

Site of sperm maturation and storage

216
Q

How long are sperm fertile for

A

40-60 days

217
Q

Vas deferens

A

Muscular tube passing up from scrotum through inguinal canal to posterior surface of bkadder
45cm long
Widens into a terminal ampulla

218
Q

Ejaculatory duct

A

2cm duct formed from vas deferens and seminal vesicle
Passes through prostate to empty into urethra

219
Q

Amount of semen expelled during orgasm

A

2-5 ml

220
Q

What sperm count is associated with infertility

A

<25 million/ml

221
Q

Composition of semen

A

60% seminal vesicle fluid
30% prostatic
10% sperm
Trace of bulbourethral fluid

222
Q

Other components of semen

A

Fructose (energy for sperm motility)
Fibrinogen
Clotting enzymes
Fibrinolysin
Prostaglandins
Spermine

223
Q

Function of clotting enzymes in semen

A

Convert fibrinogen to fibrin causing semen to clot

224
Q

Function of fibrinolysin in semen

A

Liquefied semen within 30 mins

225
Q

Function of prostaglandins in semen

A

Stimulate female peristaltic contractions

226
Q

Function of spermine in semen

A

Base stabilising sperm pH at 7.2-7.6

227
Q

What is sex determined by

A

The type of sperm fertilising the egg I.e. 50% XY and 50% XX

228
Q

What is the name of the peptide hormone which play a major role in both ovulation and the activity of the interstitial cells of the testis?

A

Luteinising hormone LH

229
Q

Which peptide hormone formed in the hypothalamus is necessary for normal spermatogenesis?

A

Gonadotropin-releasing hormone (GnRH)

230
Q

Anovulation

A

anovulatory cycle is a menstrual cycle in which ovulation, or the release of an egg from the ovaries, does not occur. Anovulation is often due to hormonal imbalances that can be the result of using hormonal birth control, being underweight or overweight, exercising excessively, or experiencing significant stress.

231
Q

Which one of the following statements is correct? Sperm capacitation is a process that___

A

Prepares spermatozoa in vivo for fertilisation

232
Q

What are Sertoli cells

A

Phagocytes

233
Q

Which cells contain Reinke’s crystalloids

A

Leydig cells

234
Q

Where do Sertoli cells lie

A

Against basement membrane of seminiferous tubules

235
Q

What stimulates leydig cells to secrete testosterone

A

Luteinising hormone LH

236
Q

What type of mitochondria are found in spermatozoa

A

Spiral mitochondria

237
Q

How much does the normal adult testis weigh

A

15-19 g

238
Q

The rete testis lies between which two structures?

A

Straight tubule and epididymis

239
Q

What are the prostate’s secretions rich in

A

Acid phosphatase

240
Q

Where is lipofuscin found

A

Seminal vesicles epithelium

241
Q

Does the prostate have a well-defined or poorly defined capsule

A

Poorly defined

242
Q

How many primordial follicles are present in the ovary at birth?

A

400000

243
Q

Proliferative endometrium is characterised by the presence of:

A

Stromal mitotic figures

244
Q

Proliferative endometrium

A

glands are straight, do not have secretions, are not vacuolated and there are mitoses in stromal and glandular epithelial cells

245
Q

Early secretory phase endometrium

A

prominent subnuclear glycogen vacuoles and the lack of secretions

246
Q

Which of the following is lined by stratified squamous keratinising epithelium with hairs?
A.Clitoris
B.Hymen
C.Labia majora
D.Labia minora
E.Vagina

A

Labia majora

247
Q

Development of female gonads

A

The gonads begin as genital rigid (a pair of longitudinal ridges derived from intermediate mesoderm and overlying epithelium). In the 4th week , germ cells begin to migrate from the endoderm lining of the yolk sac to the genital ridges via the dorsal mesentery of the hindgut: reaching the genital ridges in the 6th week. Simultaneously the epithelium of the genital ridges proliferates and penetrates the intermediate mesoderm to form the primitive sex cords.
Due to the lack of the SRY gene, the primitive sex cords degenerate. The epithelium of the gonad continues to proliferate, producing cortical cords, which in the third month, break up into clusters, surrounding each oogonium with a layer of epithelial follicular cells, forming a primordial follicle.
The gonads arise in the upper lumbar region and are tethered to the labia by the gubernaculum. The ovaries migrate caudally and the gubernaculum becomes the ovarian ligament and round ligament of the uterus.

248
Q

Development of female internal genitalia

A

In the first weeks of urogenital development, all embryos have 2 pairs of ducts, both ending at the cloaca, called the Mesonephric (Wolffisn) ducts and paramesonephric (Mullerian) ducts. In the female, there are no leydig cells to produce testosterone. In the absence of testosterone, the Wolffian ducts degenerate, leaving behind a vestigial remnant called the Gartner’s duct. Also, the absence of anti-Mullerian hormone allows for the development of the Müllerian ducts. They have 3 parts:
1. Cranial- becomes the fallopian tubes
2. Horizontal- becomes the fallopian tubes
3. Caudal- fuse to form the uterus, cervix and upper 1/3 of the vagina
The lower 2/3 of vagina is formed by sinovaginal bulbs derived from the pelvic part of the urogenital sinus

249
Q

Development of female external genitalia

A

Development begins in the third week when mesenchymal cells from the primitive streak migrate to the cloacal membrane to form a pair of cloacal folds. Cranially, these folds fuse to form the genital tubercle. Caudally, they divide into the urethral folds and anal folds. Genital swellings develop either side of the urethral folds.
Oestrogen causes the genital tubercle to elongate slightly to form the clitoris. The urethral folds and genital swellings do not fuse, forming the labia minora and majora. The urogenital groove remains open, forming the vestibule into which the urethra and vagina open.

250
Q

Effect of pituitary hormones on ovaries

A

Gonadotropin releasing hormone (GnRH) from the hypothalamus stimulates luteinising hormone and follicular stimulating hormone release from the anterior pituitary gland. FSH binds to granulosa cells to stimulate follicle growth, permit the conversion of androgens (from theca cells) to oestrogens and stimulate inhibin secretion. LH acts on theca cells to stimulate oestrogen production and secretion of androgens. The LH surge in the middle of the menstrual cycle stimulates ovulation and it maintains the corpus luteum for 10 days following ovulation.

251
Q

Effect of ovarian hormones in endometrium, cervix and vagina

A

Proliferative Phase:
• Following menses, the proliferative phase runs alongside the follicular phase, preparing the reproductive tract for fertilisation and implantation. Oestrogen initiates fallopian tube formation, thickening of the endometrium, increased growth and motility of the myometrium and production of a thin alkaline cervical mucus (to facilitate sperm transport).
Secretory Phase:
• The secretory phase runs alongside the luteal phase. Progesterone stimulates further thickening of the endometrium into a glandular secretory form, thickening of the myometrium, reduction of motility of the myometrium, thick acidic cervical mucus production (a hostile environment to prevent polyspermy), changes in mammary tissue and other metabolic changes.
Menses:
• Menses marks the beginning of a new menstrual cycle. It occurs in the absence of fertilisation once the corpus luteum has broken down and the internal lining of the uterus is shed. Menstrual bleeding usually lasts between 2-7 days with 10-80ml blood loss.

252
Q

Phases of coitus

A

Excitement
Plateau
Orgasmic
Resolution

253
Q

Excitement phase in males

A

Sacral parasympathetic neurons
• arteriolar vasodilation in corpora cavernosa increasing penile blood flow
• Penile filling (latency)
• Penile tumenscence (erection)

254
Q

Excitement phase in females

A

Sacral parasympathetic neurons
• vasocongestion
• Vaginal lubrication
• Clitoris engorges with blood, uterus elevates
• Increased muscle tone, heart rate and bp
• inner 2/3 of vagina lengthens and expands

255
Q

Plateau phase in males

A

Sacrospinous reflex
• contraction of ischiocavernosa- venous engorgement and decreased arterial inflow
• Testes become engorged and elevated
• Stimulates secretions from accessory glands
• Lubricates distal urethra and neutralises acidic urine in urethra

256
Q

Plateau phase in females

A

Sacrospinous reflex
• labia minora deepens in colour
• Clitoris withdraws under hood
• Bartholin’s glands secrete to lubricate vestibule
• Uterus fully elevates

257
Q

Orgasmic phase in males

A

Emission = thoracolumbar sympathetic reflex
• contraction of smooth muscles in ductus deferens, ampulla, seminal vesicle and prostate
• Semen pooled in urethral bulb
Ejaculation = spinal reflex with cortical control (L1, L2 sympathetic)
• contraction of glands, ducts and urethral sphincter
• Filling of internal urethra stimulates pudendal nerve- contraction of genital organs, ischiocavernosa and bulbocavernosa

258
Q

Orgasmic phase in females

A

Spinal reflex with cortical control (L1,L2 sympathetic)
• orgasmic platform (in lower 1/3 of vagina) contracts rhythmically 3-15 times
• Uterus and anal sphincter contract

259
Q

Resolution phase in males

A

Thoracolumbar sympathetic pathway
• arteriolar vasoconstriction
• Increased venous return
Refractory period

260
Q

Resolution phase in females

A

Thoracolumbar sympathetic pathway
• clitoris descends and engorgement subsides
• Labia return to unaroused colour and size
• Uterus descends
• Vagina shortens and narrows
• No refractory period unlike in males

261
Q

Polycystic ovary syndrome is a common hormonal disorder.

Which of these symptoms is not associated with Polycystic Ovary Syndrome
A. Depression
B. Galactorrhoea
C. Hirsutism
D. Obesity
E. Oligomenorrhoea

A

B - galactorrhoea

262
Q

A 55-year-old woman presents with vaginal dryness as part of her menopausal symptoms.

Which of these terms best describes the epithelium of the vagina?

A

Non-keratinised stratified squamous epithelium

263
Q

22 year old woman underwent menarche at the age of 12. She last had a period 14 months ago. She is not pregnant and has never been pregnant before.

Which phrase best describes her current condition?

A

Secondary amenorrhoea

264
Q

Oligomenorrhoea

A

abnormally infrequent menstruation (intervals of greater than 35 days)

265
Q

Primary amenorrhoea

A

failure to establish menstruation by the time of expected menarche (e.g. by age 15 with normal secondary sexual characteristics)

266
Q

Secondary amenorrhoea

A

cessation of menstruation in a woman with previously normal menses

267
Q

Menorrhagia

A

regular excessive menstrual blood loss that interferes with a woman’s physical, social emotional well being

268
Q

Secondary infertility

A

inability to become pregnant or carry a baby to term after previously giving birth to a baby

269
Q

Rudge and Hannah have been trying for many years to have a baby however upon examination they have found Rudge is infertile due to low sperm production. Where is the main site for spermatogenesis

A

Seminiferous tubules

270
Q

Which one of the following statements isn’t true about LH

A

Granulosa cells secrete inhibin which mainly inhibits LH (FSH)

SUGER (17 decks)

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