Reproductive Flashcards
gene mutation causing holoprosencephaly
sonic hedgehog
gene necessary for proper organization along dorsal ventral axis
wnt-7 gene
stimulates mitosis of underlying mesoderm providing for limb lengthening
FGF gene
appendages in wrong locations
hox (transcriptional factors)
when does hcG secretion begin
day 6 (day of implantation of blastocyst) blastocyst "sticks" at day 6
how many layer disk at 2 weeks
2 layers
when does gastrulation occur (formation of 3 layers)
week 3
when is embryo susceptible to teratogens
formation of neural tube (embryonic period) between weeks 3-8
what week does heart beat and limbs begin to form
4
4 chamber heart
4 limbs
when to fetal movements start
weeks 8 (GAIT AT WEEK 8)
when can you tell male/femal genitalia
week 10
TENitalia
origin of adenohypophisis
surface ectoderm (rathke pouch)
origin melanocytes
neural crest
origin retina and lens of eye
lens of eye - surface ectoderm
retina - neural tube
mesodermal defects result in what
VACTERL vertebral anal atresia cardiac defects TE fistula renal agenesis limb defects
origin nucleus pulposus
notochord
origin chromaffin cells of adrenal medulla and parafollicular c cells of thyroid
neural crest
amniotic band syndrome is what type of error
disruption (breakdown of previously normal tissue)
agenesis vs aplasia
agenesis - no organ NO PRIMORDIAL TISSUE
aplasia - no organ, primordial tissue present
apalasia vs hypoplasia
aplasia - absent organ
hypoplasia - incomplete organ
deformation vs malformaiotn
deformation - extrinsic, post embryonic period
malformation - intrinsic, during embyonic period 3-8
teratogen tetracycline
discolored teeth, inhibited bone growth
TEETHracyclines
why are trimehoprim, methotrexate, and antiepileptic drugs contraindicated in pregnancy
they inhibit FOLATE = neural tube defects
lithium teratogen
ebstein anomaly (apical dispalcement for tricuspid valve)
which anticoag is good an bad for pregnancy
warfarin bad “wage war on baby”
heparin good”heppy baby”, does cross placenta
lack or excess iodine can do what to fetus
congential goiter or hypothyroidism (cretinism)
maternal diabetes increases risk for what in fetus
hypoglycemia, macosomia, neural tube defects, caudal regression syndrome congenital heart defects
why are mothers told to avoid fish in pregnancy
avoid methymercury poisoning which causing neurotoxicity ot baby
leading cuase of intellectual disability in US
fetal alcohol syndrome
smooth philtrum, thin vermillion border, small palpebral fissures, limb dislocation
fetal alcohol syndrome
MOA of fetal alcohol syndrome in causing its effects on baby
failure of cell migration
dizygotic twins
2 eggs fertalized by 2 separate sperm (2 zygotes), 2 separate amniotic sacs, 2 separate placentas
identical ttwins
1 fertilzed egg that splits early in pregnancy
mono twins split at 0-4 days
dichorionic diamniotic
mono twins split between 4-8 days
monochorionic diamniatic (most identical twins) (chorion is shared FIRST)
mono twins pslit 8-12 days
monochorionic monoamniotic (rare)
monotwins split past 12 days
conjointed twins
two layers for fetal placenta
cytotrophoblast (inner) and synctiotorphoblast (outer)
purpose of cytotroph and synctiotropho
cyto - Cyto makes Cells inside
synctiotropho - Synthesizes hormones outside
which layer of fetal placenta least suseptible to attack by maternal immune system
synctio (lacks MHC 1 expression)
which vessels return deoxygenated blood form fetal internal iliac arteries to placenta
umbilical arteries (2 of them)
which vessel supplies oxygenated blood form placenta to fetus
umblical vein (1 of them)
what can give you single umbilical artery
assocaited with congeintal and chromosomal anomalies
umbilical arteries derived from what
allantois
urachus is a duct between what two strutures; when does it develop
fetal blader and umbilicus (week 3)
patent urachus
total failure of urachus to obliterate (urine discharge from umbliicus)
fluid filled cavity lined with uroepithelium between umbliicus and bladder
urachal cysts (can lead to infeciton or adenocarcinoma)
when does vitelline duct obliterate
week 7
partial closure of vitelline duct; true diverticulum; ectopic gastric/pancreatic tisseu causing melan, hematochezia, abd pain
meckel
what happens if vitelline duct fails to close completely
fitula - meconium dischage from umbilicus
artery of 2nd aortic arch
stapedial artery and hyoid artery (Second arch - Stapedial) S’s
arteyr of 4th arch
left - aortic arch
right - proximal part of subclavin artery
4th arch - 4 limbs (systemic circulation)
artery of 3rd arch
Common Carotid artery and proximal internal Carotid artery
3rd arch - 3’rd letter of alphabet CCC
artery of 6th arch
pulmonary arteries proximal (left) and ductus ductus arteriosis
pulmonary and pulmonary to systemic shunt (ductus arteriosis
artery of 1st arch
maxillary artery (branch of external carotid) 1st arch is MAXIMAL
brachial cleft, arch, pouch derived from…
CAP covers outside to inside
Cleft aka grooves - ectoderm
Arch - mesoderm + neural crest
Pouch - endoderm
1st branchial cleft becomes…
external auditory meatus
branchial clefts 2-4 get obliterated when 2nd arch mesenchyme proliferaets…what happens when there is a persistent cerivcal sinus
branchial cleft cyst in lateral neck
location of branchial cleft cysts
anterior to SCM muscle, immobile during swalloing
how to remember branchial arch nerves
First chew, then sile, then swallow stylishliy, or simply swallow and then speak
1 - V2 V3 chew
2 - VII smile
3 - IX innervates stylopharyngeus (swallow stylishly)
4 - superior laryngeal CN X (simply swallow)
6 - recurrent laryngeal CN X (or speak)
which arches foorm posterior 1/3rd of tongue
3 and 4
origin of maxillary process (maxilla and zygomatic bone)
1st arch
origin of mandibular process
1st arch
meckel cartilage
origin of malleus and incus
1st arch
orign of greatern horn of hyoid
3rd arch
origin of lesserhorn of hyoid
2nd arch
origin of arytnoids, crricoid cartilage
4-6th arch
origin thyroid cartilage
4-6th arch
origin of cricoyhyroid
6TH ARCH (all other intrinsic larynx muscles) are from 4th arch
origin of platysma
platySma
2nd arch
origin of stapediu
2nd arch (Stapedius)
origi of muscles of mastication
1st arch (teMporalis, Masseter, lateral and Medial pterygoids, Mylohyoid
micorgnathia, glossoptosis, cleft palate, airway obstruction
pierre robin sequence
abnormality of 1st and 2nd arch
neural crest dysfunction, mandibular hypoplasia, facial abnormlaities
treacher collins syndrome (1st and 2nd arch)
orign stylopharyngeus
3rd arch
how to remember branchial POUCH derivaties
Ear, tonsils,( bottom-to) top 1st - ear 2 - tonsils 3rd dorsal inferior parathyrids 3rd ventral to= thyroid 4th top - superior parathyroids
all thyroid portions except for parafollicular C cells are devid from…
endoderm (parafollicular C cells from neural crest)
diegeorge syndrome bad eevelopment of which pouches
3rd and 4th
digeorge cardiac abnormality
truncus arteriosus
tetraology of fallot
vsd
failure of formation of 2nd palate leads to
cleft palate (palatine shelves)
failure fusion of primary palate leads to..
cleft lip
how do testes develop
SRY gene on Y chromosome produces testis determing factor (TDF)
purpose of sertoli and leydig cells in development
sertoli - secrete mullerian inhibiting facto (MIF), that supprresses development of paramesonephric ducts (female)
leydig - secretes androgens that stimulate mesonephric (male, wolffian ducts)
Leydig Leads to male (intiernal and external)
Sertoli Shuts down female (internal)
what does paramesonephric duct develop into
Mullerian duct devleops into femal internal structures
fallopian tubes, uterus, upper portion of vagina (lower portion from urogenitcal sinus)
female wiht fully developed 2ndary seual characterisitscs wiht pirmary amenorrhea
mullerian agenesis (mayer rokitansky kuster hauser) secondary characteristics are present because ovaries are functioning
mesonephric duct devlepps into….
SEED
seminal vesicles, epididymis, ejactulary duct, ductus deferens
remnant of mesonephric duct in females
gartner duct
how to develop seminal vesicles, epididymis, ejac duct, ductus deferens, with fallpian tubes, uterus, upper portinon of vagina but still have penis and scrotum
lack of sertoli cells or MIF
male internal genitalia but ambiguous external genitalia until puberty
5a reductase deficiency
usually converts testosterone into DHT to develop penis until puberty makes more testosterone
iincomplete resportion of septum of mullerian ducts
septate uterus (assocaited with decreased fertility and early miscarriage)
how to treat setpat uterus
septoplasty
bicornuate uterus
incomplete fusion o fmullerian ducts (increased risk of complicated pregnancy, early pregnayc loss, prematurity)
complete failure of fusion of mullerian ducts
uterus didelphys
double uterus double cervix double vagina
uterus didelphys
origin of bulbourethra glands, prostate gland
urogentical sinus
origin of vestibular bulbs and glans cliturs
genital tubercle
origin of glans and corpus cavernosum/spongiosum
genitcal tubercule
origin of labia minora and penile urethra
urogenital folds
origin scrotum and labia MAJORA
labioscortal swelling
what causes hypospadias
failure of urethra folds to fuse
cause of epispadias
faulty positioning of genital tubercle
extrosophy of bladder
epispadias
what penile abnormality is assocaited with inguinal hernia and cryptorchidism
hypospadias
testes anchor to scrotum remnant of what
gubernaculum
ovarian ligament and round ligament of uterus remnant of
gubernaculum
origin of tunica vaginalis
processes vaginalus (evagination of peritonuem)
lymph drainage glans penis
deep inguinal nodes
lymph drainiage scrotum
superficial inguinal node
lymph drainage body of uterus
external iliac
lymph drainage ovary/testes
para aortic
lmyph drainiage prostate
internal iliac nodes
lymph drainage proximal vagina and distal vagina
proximal - internal iliac
distal - superficial inguinal
lymph drainage cervix and body of uterus
external iliac
pymh superior bladder
external iliac
which structure is drained by both external and internal iliac nodes
cervix
lymph drainage corpus cavernosum
internal iliac
components of broad ligametn
mesosalpinx, mesometrium, mesovarium
which ligament contains ovarian vessels
suspesnory ligament of ovary (infundibulopelivc ligament)
during oophorectomy and we try to ligate ovarian vessels what structure is at risk of inury
ureter
which structure contains uterine vessels
cardinal ligament
which ligament connects cervix to side wall of pelivs
cardinal ligament
which ligament connects ovaries to lateral pelvic wall
infundibulopeliv ligament
which ligament is a derivative of gubernaculum
round ligament (travels through round inguinal canal) and ovarian ligament
which ligament latches ti lateral uterus
ovarian ligament
transformation zone is transition between
outside- nonkeratinized stratified squamous
inside - simple columnar epithelium
actual zone is squamocolumnar
which strucutre has simple columnar epithelium with long tubular glands in proliferative phase and coiled glands in secretory phase
uterus
which structure has simple cuboidal epithelium
ovary outer surface
pathway of sperm during ejaculation
SEVEN UP seminiferous tubules epididymus vas deferens ejaculatory ducts nothing urethra penis
pelvic fracture, urine leak into retro=pubic space
posterior urethra injury
perineal straddle injury with urine leakin gin deep fascia of buck or into perineal space
anterior urethra injury
innervation erection ejeaculation process
erection - parasymp (PELVIC NERVE)
emission - sympathtic (hypogastric nerve)
ejaculation - viseral and Somatic nerve (pudendal nerve)
Point Squeeeze Shoot
parasym
symphatietic
somatic
anti erectile and pro erectile substances
Nor epi - Ca - smooth muscle contraciton - vasoconstrict = anti erectile
No - CGMP - smooth uscle relaxation - vasodilation = proerectile
MOA PDE5 inhibitors
decreas breakdown of cGMP = more erection
which cells maintain germ cell pool and produce primary spermatocytes
spermatogonia (germ cells)
How do sertoli cells inhibit FSH
inhibin B
whwhat akes up the blood testis barrier
tight junction between adjacent sertoli ceels
which cells secreate androgen bining protein
sertoli cells (maintains local levels of testosterone)
where are leaydig cells located
interstitium
how does increased temperature affect sperm production and inhibin B
decrease sperm production an dinhibin B
leydig secrete testosterone in presence of what hormone
LH
potency of estrogens and location
estradiol (in ovary) > (estrone in adipose tissue > estriol in placenta
how is estrogen produced
LH acts on theca cell -> increases cAMP -> cholesterol converted to androstenedione bY DESMOLASE -> androstenedion moves to granulosa cell where it is converted to esterone via AROMATASE and then estrogen….upregulated by FSH psotively regulating via cAMP
increased progesterone is indicative of….
ovulation
how does progesterone effect estrogen, and gonadotropins
decreases estrogen receptor and inhibits LH and FSH (preparetion for preganncy)
when do 1 oocytes begin meosis I
featl life and complete meosis 1(diploid( just prior to ovulation puberty)
meosis 1 is arrested in PROHPASE 1 (haploid) for years until ovulation (primary oocyte)
when is meosis 2 arrestee
metaphose II until fertilization (secondary oocytes)
what does LH, estrogen, GnRH look during ovulation
Increased estrogen induces LH Surge, and Increased GnRH receptors
mid cycle ovulatory pain can have peritoneal irritation from follicular swelling or fallopian tube contractions can mimic appendicitis
Mittelschmerz
at low concentrations, estrogen does what to LH
inhibit..
at high enogh coencentraiton it will sitmulate LH secretion leading to LH surge
FSH is secreted in response to high or low estrogen
low…
so when estrogen climbs FSH will go down
what 3 hormones does corpus luteum prodce
estrogen inhibin (inhibits FSH, we don't need more follicles after ovulation) progresterone (inhibits GnRH releaes, stimulates endometrial growth)
when does progresterone start to go down in luteal phase
when corpus luteum degenerates (no fertilization)
betaHCG is produced by placenta until
week (8-10) in ordder to maintain corpus leteum until it can secrete its own estriol and progesterone
how does protaglandins influence uterus
increaes uterine contractions
oxytocin does…
stimulates prostaglandins (uterine contracts) and induces conractions
what does pregnancy do to HR an RR
increase both to increase perfusion to fetus as well as to eliminate more CO2
how does pregnancy affect preload and afterload
incresaed plasma volume (can see dilutional anemia)
will increase preload and decrease afterload
pregnancy is hypercoagualbe true or false
true (in order to rpevent massive blood loss during pregnancy
how does estrogen influence oxytocin receptors
increaes them through pregnancy
how does human placental lacctogen influnce insulin
increases insulin abut induces resistance contirbutes to gestational diabetes
how is GFR affected in pregnancy
incerased (more urination) and more renal blood flow
GI adverse affect of pregnancy
reflux, constipation,
