Reproductive- Physiology

Question 1

Why is varicocele most common on left testis

Answer 1

Because the left spermatic vein enters the left renal vein at a 90° angle, flow is less laminar on left than on right Ž left venous pressure > right venous pressure Ž varicocele more common on the left.

Question 2

Sertoli cells function

Answer 2

Secrete inhibin B Ž inhibit FSH.
Secrete androgen-binding protein
Produce MIF.
Tight junctions
Support and nourish developing spermatozoa.
Regulate spermatogenesis

Question 3

Leydig cells function

Answer 3

Secrete testosterone in the presence of LH; testosterone production unaffected by temperature.

Question 4

Estrogen

- source

Answer 4

Ovary (17β-estradiol), placenta (estriol), adipose tissue (estrone via aromatization).

Potency: estradiol > estrone > estriol

Question 5

Estrogen

- Function

Answer 5

• Development of genitalia and breast
• Growth of follicle, endometrial proliferation
• feedback inhibition of FSH and LH, then LH surge
• stimulation of prolactin secretion.
• Increase transport proteins, SHBG; high HDL; low LDL.

Question 6

Progesterone

- Source

Answer 6

Corpus luteum, placenta, adrenal cortex, testes

Question 7

Progesterone

- Function

Answer 7

• Stimulation of endometrial glandular secretions and spiral artery development.
• Maintenance of pregnancy
• Decrease myometrial excitability
• Inhibition of gonadotropins (LH, FSH).

Question 8

Oogenesis

Answer 8

1° oocytes begin meiosis I during fetal life and complete meiosis I just prior to ovulation (arrested in prophase).

Meiosis II is arrested in metaphase II until fertilization (2° oocytes)

If fertilization does not occur within 1 day, the 2° oocyte degenerates

Question 9

Ovulation

Answer 9

High estrogen, high GnRH receptors on anterior pituitary. Estrogen surge then stimulates LH release Ž ovulation (rupture of follicle).

increase temperature (progesterone induced).

Question 10

Mittelschmerz

Answer 10

transient mid-cycle ovulatory pain (“Middle hurts”); classically associated with peritoneal irritation

Question 11

Menstrual cycle

Answer 11

pag. 613

Question 12

Abnormal uterine bleeding

• Structural causes
• Non-structural causes

Answer 12

(PALM): Polyp, Adenomyosis, Leiomyoma, or Malignancy/ hyperplasia

(COEIN): Coagulopathy, Ovulatory, Endometrial, Iatrogenic, Not yet classified

Question 13

Pregnancy

• Fertilization
• Implantation
• Syncytiotrophoblast

Answer 13

Fertilization occurs in upper end of fallopian tube (the ampulla). Occurs within 1 day of ovulation.

Implantation within the wall of the uterus occurs 6 days

Syncytiotrophoblasts secrete hCG, which is detectable in blood 1 week after conception and on home test in urine 2 weeks after conception

Question 14

Calcutation of

• Gestational age
• Embryonic age

Answer 14

calculated from date of last menstrual period.

calculated from date of conception (gestational age minus 2 weeks)

Question 15

Physiologic adaptations in pregnancy:

Answer 15

Increase HR
Anemia
Hypercoagulability
Hyperventilation

Question 16

Human chorionic gonadotropin}

- Function

Answer 16

Maintains corpus luteum (and thus progesterone) for first 8–10 weeks. After, placenta synthesizes its own estriol and progesterone

Question 17

hCG is High in

hCG is Low in

Answer 17

multiple gestations, hydatidiform moles, choriocarcinomas, and Down syndrome;

in ectopic/failing pregnancy, Edwards syndrome, and Patau syndrome.

Question 18

Human placental lactogen (chorionic somatomammotropin.)

- Function

Answer 18

Stimulates insulin production, overall increase insulin resistence.

Maternal hypoglycemia from insulin resistance leads to lipolysis. Gestational diabetes can occur if maternal pancreatic function cannot overcome the insulin resistance.

Question 19

Apgar

Answer 19

Appearance, Pulse, Grimace, Activity, and Respiration

Apgar scores < 7 require further evaluation.

10 poin scale

Question 20

Infant/child development

Answer 20

Pag 616

Question 21

Low birth weight

Answer 21

Defined as < 2500 g. Caused by prematurity or intrauterine growth restriction (IUGR)

Question 22

Menopause

Answer 22

Diagnosed by amenorrhea for 12 months. Usually preceded by 4–5 years of abnormal menstrual cycles.

Menopause before age 40 suggests 1° ovarian insufficiency (premature ovarian failure).

Question 23

Androgens

Answer 23

Testosterone, dihydrotestosterone (DHT), androstenedione

Testosterone is converted to DHT by 5α-reductase, which is inhibited by finasteride.

In the male, androgens are converted to estrogen
by cytochrome P-450 aromatase

Question 24

Testosterone

- Function

Answer 24

ƒƒDifferentiation of epididymis, vas deferens, seminal vesicles.
ƒƒGrowth spurt: penis, seminal vesicles, sperm, muscle, RBCs.
ƒƒDeepening of voice.
ƒƒ Closing of epiphyseal plates.
ƒƒ Libido.

Question 25

dihydrotestosterone (DHT)

- Functionn

Answer 25

ƒƒ Early—differentiation of penis, scrotum, prostate.

ƒƒ Late—prostate growth, balding, sebaceous gland activity.

Question 26

Spermatogenesis

Answer 26

begins at puberty with spermatogonia. Full development takes 2 months. Occurs in seminiferous tubules.

Produces spermatids that undergo spermiogenesis (loss of cytoplasmic contents, gain of acrosomal cap) to form mature spermatozoon.

Question 27

Tanner stages of sexual development

Answer 27

Pag 619