Reproductive - Anatomy

Question 1

Gonadal drainage

• Venous drainage
  
  • Left ovary/testis
  • Right ovary/testis
• Lymphatic drainage
  
  • Ovaries/testes
  • Distal vagina/vulva/scrotum
  • Proximal vagina/uterus
• Left vs. right flow

Answer 1

• Venous drainage
  
  • Left ovary/testis Ž–> left gonadal vein Ž–> left renal vein –>Ž IVC.
  • Right ovary/testis –>Ž right gonadal vein Ž–> IVC.
  • Left gonadal vein takes the Longest way
• Lymphatic drainage
  
  • Ovaries/testes Ž–> para-aortic lymph nodes.
  • Distal vagina/vulva/scrotum –>Ž superficial inguinal nodes.
  • Proximal vagina/uterus Ž–> obturator, external iliac and hypogastric nodes.
• Left vs. right flow
  
  • Because the left spermatic vein enters the left renal vein at a 90° angle, flow is less continuous on the left than on the right. Ž
  • –> left venous pressure > right venous pressure
  • –>Ž varicocele more common on the left.

Question 2

Female reproductive anatomy (563)

Answer 2

Question 3

Infundibulopelvic ligament (suspensory ligament of the ovaries) (563)

• Connects…
• Structures contained
• Notes

Answer 3

• Connects…
  
  • Ovaries to lateral pelvic wall
• Structures contained
  
  • Ovarian vessels
• Notes
  
  • Ligate vessels during oophorectomy to avoid bleeding.
  • Ureter courses retroperitoneally, close to gonadal vessels.
  • At risk of injury during ligation of ovarian vessels.

Question 4

Cardinal ligament (not labeled) (563)

• Connects…
• Structures contained
• Notes

Answer 4

• Connects…
  
  • Cervix to side wall of pelvis
• Structures contained
  
  • Uterine vessels
• Notes
  
  • Ureter at risk of injury during ligation of uterine vessels in hysterectomy.

Question 5

Round ligament of the uterus (563)

• Connects…
• Notes

Answer 5

• Connects…
  
  • Uterine fundus to labia majora
• Notes
  
  • Derivative of gubernaculum.
  • Travels through round inguinal canal
    
    • Above the artery of Sampson.

Question 6

Broad ligament (563)

• Connects…
• Structures contained
• Notes

Answer 6

• Connects…
  
  • Uterus, fallopian tubes, and ovaries to pelvic side wall
• Structures contained
  
  • Ovaries, fallopian tubes, and round ligaments of uterus
• Notes
  
  • Mesosalpinx, mesometrium, and mesovarium are the components of the broad ligament.

Question 7

Ovarian ligament (563)

• Connects…
• Notes

Answer 7

• Connects…
  
  • Medial pole of ovary to lateral uterus
• Notes
  
  • A derivative of the gubernaculum.
  • Ovarian Ligament Latches to Lateral uterus.

Question 8

Female reproductive epithelial histology

• Vagina
• Ectocervix
• Endocervix
• Transformation zone

Answer 8

• Vagina
  
  • Stratified squamous epithelium, nonkeratinized
• Ectocervix
  
  • Stratified squamous epithelium, nonkeratinized
• Endocervix
  
  • Simple columnar epithelium
• Transformation zone
  
  • Squamocolumnar junction (most common area for cervical cancer)

Question 9

Female reproductive epithelial histology

• Uterus
• Fallopian tube
• Ovary, outer surface

Answer 9

• Uterus
  
  • Simple columnar epithelium with long tubular glands
• Fallopian tube
  
  • Simple columnar epithelium, many ciliated cells, a few secretory (peg) cells
• Ovary, outer surface
  
  • Simple cuboidal epithelium (germinal epithelium covering surface of ovary)

Question 10

Female sexual response cycle

Answer 10

• Most commonly described as phase of excitement (uterus elevates, vaginal lubrication), plateau (expansion of inner vagina), orgasm (contraction of uterus), and resolution
• Mediated by autonomic nervous system.
• Also causes tachycardia and skin flushing.

Question 11

Male reproductive anatomy:
Pathway of sperm during ejaculation (564)

Answer 11

• SEVEN UP:
• Seminiferous tubules
• Epididymis
• Vas deferens
• Ejaculatory ducts
• (Nothing)
• Urethra
• Penis

Question 12

Autonomic innervation of the male sexual response

• Erection
• Emission
• Ejaculation
• Sildenafil and vardenafil

Answer 12

• Erection
  
  • Parasympathetic nervous system (pelvic nerve):
    
    • ƒƒNO Ž–> increased cGMP Ž–>Ž smooth muscle relaxation ŽŽ–> vasodilation Ž–>Ž proerectile.
    • ƒƒNorepinephrine Ž–>Ž increased [Ca2+]_in ŽŽ–> smooth muscle contraction Ž–>Ž vasoconstriction Ž–>Ž antierectile.
• Emission
  
  • Sympathetic nervous system (hypogastric nerve).
• Point and Shoot.
• Ejaculation
  
  • Visceral and somatic nerves (pudendal nerve).
• Sildenafil and vardenafil inhibit cGMP breakdown.

Question 13

Spermatogonia (566)

• Type of cells
• Function(s)
• Location

Answer 13

• Type of cells
  
  • Germ cells
• Function(s)
  
  • Maintain germ pool and produce 1° spermatocytes
• Location
  
  • Line seminiferous tubules [A]

Question 14

Sertoli cells

• Type of cells
• Function(s)
• Location

Answer 14

• Type of cells
  
  • Non–germ cells
• Functions
  
  • Secrete inhibin Ž–> inhibit FSH
  • Secrete androgen-binding protein Ž–> maintain local levels of testosterone
    
    • Convert testosterone and androstenedione to estrogen via aromatase
  • Tight junctions between adjacent Sertoli cells form blood-testis barrier –>Ž isolate gametes from autoimmune attack
    
    • Sertoli cells Support Sperm Synthesis
  • Support and nourish developing spermatozoa
  • Regulate spermatogenesis
  • Produce MIF
  • Temperature sensitive
    
    • Decrease sperm production and decrease inhibin with increased temperature
    • Increased temperature seen in varicocele, cryptorchidism
• Location
  
  • Line seminiferous tubules

Question 15

Leydig cells

• Type of cells
• Functions
• Location

Answer 15

• Type of cells
  
  • Endocrine cells
• Functions
  
  • Secrete testosterone in the presence of LH
    
    • Testosterone production unaffected by temperature
  • Also contain aromatase
• Location
  
  • Interstitium of seminiferous tubules