Reproductive Flashcards
- Occurs in young men usually between 20-40 years of age
- Is highly curable
- 90% of newly diagnosed respond to treatment
Testicular Cancer
- Characterized by tumor cell markers (hCG, LDH and AFP).
- Most testicular tumors are germ cell tumors that arise from the spermatozoa (seminoma) or other germline tissue (non-seminoma).
- Seminomas tend to retain the features of the spermatozoa, whereas the non-seminomas contain multiple cell types and are less differentiated than seminomas.
- Non-germinal cell tumors arise from seminiferous epithelium.
- Carries the highest mortality rate of all genital cancers combined
Ovarian Cancer
- often not diagnosed until advanced stage (“silent killer”)
- increases with age and related to length of time a woman’s ovarian cycle has not been suppressed by pregnancy, lactation, or oral contraception
Genital warts can cause _____
Cervical Cancer
Formation of organs (organogenesis) and trilaminar embryo (gastrulation) (2-8 weeks)
Embryonic period
Mass of dialted and tortuous varicose veins in the spermatic cord
Varicocele
- Between 20-40% of men diagnosed with infertility have this
- occurs in 10-15% of males, usually between ages 13-18
Regulates hormonal control of spermatogenesis through feedback inhibition of LH and GnRH
Testosterone
_____ tissue found in ectopic sites outside the uterus
- Causes pain, bleeding, and possible infertility
- Can block gamete transport in fallopian tubes
Endometriosis
Abnormal twisting of spermatic cord due to rotation of testis or the mesorchium (fold in area between testis and epididymis)
Causes strangulation and if untreated infarction of the testis
Testicular Torsion
Main cause is infection of human papillomavirus (HPV)
Cervical cancer
- over 100 types HPV
- screening with pap test has greatly reduced incidence
- Vaccine available
- Formation of sperm
- occurs across the seminiferous tubules formed by Sertoli and Leydig cells
- involves mitosis and meiosis to develop haploid gametes
Spermatogenesis
- Common endocrine disorder affecting 5-10% of women of reproductive age
- Characterized by high androgen levels associated with acne, hirsutism, and insulin resistance leading to hyperinsulinemia
- Conditions that are often associated, such as obesity, T2DM, hyperlipidemia
- Anovulation, amenorrhea, infertility
Polycystic Ovary Syndrome (PCOS)
- Diagnosis involves clinical presentation combined with a number of tests for hormone levels, in particular androgens (male hormones) including testosterone, with free testosterone levels elevated in ~60% of PCOS patients.
- Treatment is guided by patient goals but include lowering of insulin, restoration of fertility, treatment of hirsutism or acne, and restoration of normal menstruation to prevent endometrial hyperplasia and endometrial cancer.
- PCOS is a complex, heterogeneous disorder of uncertain etiology, but evidence suggests a genetic component to the disorder, perhaps in an autosomal dominant manner with high penetrance but variable expression.
Chlamydia can cause _____
sterility
Painful menstruation often caused by increased prostaglandins (stimulate smooth muscle contraction, often under progeserone control)
Dysmenorrhea
Testosterone release is governed by feedback loop involving the ______ and _____
hypothalamus and anterior pituitary
- negative feedback
- hypothalamus releases GnRH
- GnRH stimulates anterior pituitary to release LH and FSH
- LH stimulates Leydig cells to produce testosterone
Process of Parturition
Labor initiated by mechanisms not completely understood but thought to involve fetal signals (oxytocin)
- Placenta releases prostaglandins
- maternal release of oxytocin from posterior pituitary
- oxytocin and prostaglandins stimulate smooth muscle contraction
- after delivery of the infant, placenta is delivered
Approximately day 14 of Ovarian Cycle, hormones involved
Ovulation; estrogen
- LH surge causes release of egg
- Follicle bursts open causing ovulation
- Secretes progesterone, estrogens, human placental lactogen, human chorionic thyrotropin, and relaxin
- Maintains hormones for the duration of pregnancy
- Prevents the mixing of maternal and embryonic blood
Placenta
formed and functional by 3rd month
Syphillis causes _____
Skin rash, fever, joint pain, anemia or neurological disorder
Complete formation of all major systems and external features (8 weeks- birth)
Fetal development
Process of Lactation
- Prolactin and estrogen develop breast tissue during pregnancy
- As estrogen levels decrease at birth, prolactin stimulates milk
- Nutrient rich colostrum is secreted along with milk
- oxytocin stimulates milk letdown by contracting smooth muscle cells that are part of the alveoli in mammary tissue
Gonorrhea causes _____ and _____
Pelvic inflammatory disease (PID) and sterility
Cessation of menstruation caused by low fat stores, as in athletes
Secondary Amenorrhea
Name for gonads where sperm production takes place
Testes
Cleavage reactions and implantation of blastocyst (0-2 weeks)
Preembryonic development
Process of Implantation
- Bastocyst reaches uterus on day 6
- Trphoblast adheres to endometrium and releases digestive enzymes
- hCG is secreted by trophoblast and maintains corpus luteum until placenta develops (around 3rd month)
Days 1-5 of Uterine cycle
Menstruation
- shedding of functional layer of endometrium
Days 6-14 of Uterine Cycle
Proliferative phase
- estrogen levels increasing
- regeneration of endometrium
- synthesis of progesterone
- Inflammation of the prostate due to bacterial infection or other cause
- Most common cause of recurrent UTI’s in men
Prostatitis
List the Primary Germ Layers and what they include
-
Ectoderm
- skin, epidermis, and nervous system
-
Mesoderm
- everything else (bone, muscle)
-
Endoderm
- epithelial linings of digestive, respiratory, and urogenital systems and glands
Testosterone is a steroid hormone that is important for:
- Sperm development (spermatogenesis)
-
Development of male characteristics
- secondary sex characteristics & growth
-
Stimulates erythopoiesis
- males generally have higher hematocrit than females
- acts on vocal cords (males deeper voice than females)
- Behavioral charcteristics (sex drive)
- Various symptoms; onset 7-14 days before menses; subsides with menses.
- 70-90% of women experience PMS at some point in their childbearing years
- Causes unclear; stress can exacerbate not cause PMS.
- S/S: vary and range in changes in behavior/personality; physical—breast or abdominal tenderness/swelling; headache; heart palpitations; dizziness; diarrhea or constipation; skin problems (acne, rashes).
- Tx: antidepressant (SSRI); prostaglandin inhibitor; NSAIDs.
Premenstrual Syndrome (PMS)
- Premenstrual Dysphoric Disorder (PMDD): severe form of PMS with cyclical occurrence of psychatric symptoms (anger, irritability, internal tension); characterized by severe monthly mood swings and physical signs that interfere with everyday life.
Days 15-28 of Uterine Cycle
Secretory phase
- estrogen and progesterone involved
- secretions released from endometrium
- inhibition of new follicle development
Days 1-14 of ovarian cycle and hormones involved
Follicular phase; estrogen
- The developing follicle produces estrogen
- Estrogen decreases FSH release
- Only the strongest follicles survive the drop in FSH
Relaxes and increases flexibility of pelvic ligaments and pubic symphysis
Relaxin
Failure to become pregnancy after one year of unprotected intercourse
Infertility
- Causes of infertility fall about equally between causes involving only the male partner, causes involving the female partner, or causes involving both partners.
- Male causes of infertility include impaired production or function of sperm, low sperm concentration, or impaired delivery of sperm.
- Female causes include fallopian tube damage or blockage, endometriosis, ovulation disorders, hyperprolactinemia, polycystic ovary syndrome (PCOS), early menopause (premature ovarian failure) uterine fibroids, or pelvic adhesions.
Prepares breast tissue for lactation
Human placental lactogen (hPL)
Process of Fertilization
- Oocyte released from ovary (viable for 24 hours)
- Capacitation: flagellum and membranes of postejaculatory sperm made more permeable (viable for 48-72 hours)
-
Acrosomal reaction: contents of acrosome released
- occurs BEFORE fertilization
-
Block to polyspermy: enzymes released to prevent additional sperm from binding
- occurs AFTER fertilization
- Completion of meiosis II (oocyte)
- Fusion of pronuclei of ovum and spermatozoa
- Zygote formed
Works with estrogen to inhibit muscle contraction of uterus
Progesterone
Name of female gonads and what they do
Ovaries ; release gametes (ova) under influence of estrogen and progesterone
- A congential disorder where one or both testes fail to descend into the scrotum
- Needs immediate treatment
- Can lead to infertility
Cryptorchidism
- Occurs in 30% of premature male neonates
- 3% of those born at term
- In 80% of affected infants the testes descend spontaneously during the first year
- Highly successful surgical treatment available
Is one of the most common gynecologic cancers
- Is strongly associated with excessive estrogen stimulation and endometrial hyperplasia
- Usually presents as bleeding
Endometrial (Uterine) Cancer
Process of Hormonal Changes
- Estrogen and progesterone remain high
- GnRH (LH and FSH) is inhibited by negative feedback loops
- high estrogen and progesterone combination suppresses LH and FSH
- hCG is released by blastocyst and stimulates hormone secretion by the corpus luteum
- hCG decline after 12 weeks results in the degeneration of the corpus luteum
Often adenocarcinoma in the posterior lobe of the prostate gland, incidences increase rapidly after age 50
Prostate cancer
- Collection of fluid between the visceral and parietal layers of the tunica vaginalis of the testicle or along the spermatic cord
- Is the most common cause of scrotal swelling
Hydrocele
Acute inflammatory response to upper reporductive tract (uterus, fallopian tubes, ovaries)
Pelvic Inflammatory Disease (PID)
- Can cause infertility, ectopic pregnancy, abscess formation, and chronic pain
- Treatment: antibiotics for infection
Prostrate enlargement that can lead to urethral compression and cause urinary obstruction
Benign prostatic hyperplasia (BPH)
Estrogen promotes _____ and _____
- Oogenesis and follicle development
- Stimulates growth
- bone, breast tissue, fat deposition, widening/lengthening of pelvis
Days 15-28 of Ovarian Cycle, hormones involved
Luteal phase; estrogen and progesterone
- Follicle cells become corpus luteum, making progesterone
- Corpus luteum remains for 10 days unless fertlization occurs
increases maternal metabolism during pregnancy
human chorionic thyrotropin (hCT)
Where is oxytocin released from?
Posterior pituitary
