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Mech. 2 > Reproductive syst. > Flashcards

Reproductive syst. Flashcards

1
Q

Male reproductive tract-important structures

A

Seminal vesicles and prostate gland=support sperm
-prostate is below bladder
Prostate urethra proximal to ejaculatory duct
Urethra=sperm travels through
Testis houses sperm/spermatogenous
-sperm goes through epidermis–>vas(ductus) deferens to eject. duct
Prostate(bladder issues)and testis(Affecting fertility)=dangerous dis.

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2
Q

Female reproductive tract-important structures

A

Ovary(ovum/oogenesis)–>uterin fallopian tube (oviduct) –>uterus/uturim–>vagina –>external genital=vulva
Ovulation=2wks after last period
-implantation is 2 wks after fertilization
-prego.=4wks after ovulation

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3
Q

Infertility

A

Cnt conceive w/in 1 yr of attempting to conceive
The number of incidence has not incre. over the years
Screen and tx(med/therapy)
-assisted reproductive tech(ART) only tx 3% of cases

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4
Q

Infertilely-female cn be fertile even thought gametes are produce?

A

No, females cn be infertile w/ gamete production

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5
Q

Infertility-female and ovary

A 
Impacts ova production and decre. fertility 
-oocytes are affected
Causes
-endocrine
  :hypothalamus/pit. dis. 
  :gonadotropin production insuff.
-ovarian dis.=polycystic ovarian synd. 
  :caused by gonadotropin insuff./direct ovarian damage (damage oocyte)
-other causes 
  :chemo/pelvic irradiation
  :destroy developing oocytes
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6
Q

Infertility-female and tubal/uterine

A

Tubal=oviducts receives structural damage
-prevent ova movement/fertilization process
-fertilization=sperm cnt travel in tube which cnt fertilize
Uterine
-Damage prevent implantation or maintenance of prego.
-damage uterine wall

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7
Q

Infertility-male types

A

Pretesticular
Testicular
Post-testicular

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8
Q

Infertility-female and tubule/uterine Thyroid dis. causes

A

Decre. T3/4=incre. thyrotropin releasing hormone

  • cause PRL secretion
  • PRL cn decre. GnRH
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9
Q

Infertility-female and tubule/uterine-Androgen excess causes

A

Affects oocyte develop
Anovulation and amenorrhea
Genetic, environment cause

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10
Q

Infertility-female and tubule/uterine- Hyperprolactinemia

A

Both inhibit dopamine from inhibiting PRL secretions
Drugs change PRL secretion
Direct pit. damage

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11
Q

Infertility-female and tubule/uterine causes

A 
Infection
Pelvic/abdo. surgeries 
-cn cause scarring adhesion 
Toxin exposure=endometrium damage 
Thyroid dis. 
Androgen excess
Hyperprolactinemia(both dnt dopamine to inhib. PRL secretion)
Dopamin is effected by fertility 
-change gonadotropin release
-direct effect on follicles 
-have dopa Recep.
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12
Q

Infertility-female and tubule/uterine infection causes

A

Infection

  • from inflamation, scars and adhesion(or implantation difficulty)
  • block transport(stenosis)/implantation
  • ectopic prego. possible
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13
Q

Infertility-female types (basic)

A

Ovulatory
Tubule
Uterine

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14
Q

Infertility-male and pretesticular

A

Causes
-endocrine disorder=hormone promoting spermatogen.
:hypothal.-pit def. –>affect horm. prod.–>decre. testosterone/spermatogen.
-drug inhib. horm. effects
:anabolic steroids initiating inhib. neg. feedback loop=decre. LH/FSH level
Factors affecting spermatogenesis
-hormones and med.
-systemic dis.
-environment/lifesyle factors
-dietary def.
-toxins

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15
Q

Infertility-male and testicular affects what?

A

Direct effect on testicular function

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16
Q

Infertility-male testicular causes(basic)

A 
Direct effect on testicular function 
-variocele 
-scortal temp.
Trauma 
Testicular torsion 
Infection 
Genetic dis. 
Cryptorchidism 
Toxin
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17
Q

Sexually Transmitted Dis.-Chlamydia (chlamydia trachomatis)

A

Obligate intracell bact.
Lymphophathia Venerea=type of chlamydia
-AKA lymphogranuloma venereum
-infect specific sterotypes (L-type)
:Chlaym. causautive agent
-Chonic
:Initial small lesion
:Lesion growth=incre. lymph. node swelling
*goes to GIT lymph node
*cn rupture if not tx=cause fibrosis/stricture in Lower urogential tract structures and lymph node
-other genital chlamydia apperance ~gonorrhea =need microbio analysis

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18
Q

Infertility-male w/ direct effect on testicular function, testicular damage

A

Direct effect testicular function (develop. issue)
-Variocele=abnomral dialted scrotal vn.
:MC cause of decre. male infertility
:vn=valvular issues which causes backflow
*b/c gravity/pull
*incre. blood in scrotal tissue w/in
-tunica vaginalis layers
-Incre. scortal temp.
:caused by (affect sperm tissue)
*varicocele
*tight clothing b/c scrotum close to body
*seasonal temp. change
*fever
Testicular damage
-trauma
:early intervention=reversible
:damage=atrophy
:Compartmentalization to sep. sperm from rest of body is brkdwn
*antisperm antBD is form
*sep. help keeps sperm alive
-Testicular torsion of spermatic cord
:disrupted blood flow
:brkdwn tissue
:2 circumstances
*neonatal=in utero/shortly after birth(not anatomic defect)
*adult but mainly adolescence
-sudden onset of testicular pain
-no apparent inj./cause
-linked to bilat. anatomic dfect that incre. mobility
:A vascular disorder=twisting of spermatic cord decre./ inhib. venous drain
*thickened vn’s wall=pampiniform plexus
*remain patent
:infarction b/c decre. venous draining
:full recovery if fixed in 6hrs.

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19
Q

Infertility-male and other testicular causes

A

Genetic dis. impacting sperm
-klinefelter synd.=chromo abnorm. (XXY)
:lydig cell malfunction
:decre. serum testosteron
:incre. FSH
-microdeletion on Y chromo.
Cryptorchidism =complete/partial failure of testes descend during fetal develop.
-developing disorder
-normally w/in body during embryogen. and descend during fetal develop.
-incre. temp=decre. function
-microscopic structrual changes @ 2yrs. old
:inhib. germ cell develop=inhib. spermatogonia, 1ry/2dry spermatocyte, spermatids
:lost spermatogoniatissue
:hyalinzation and thick BsM
Toxin
-diff. cells r more senstivie
-cig. smoke=incre. erectile dysfunction and sperm DNA formation
-radiation/chemo affect sperm dividing cells

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20
Q

infertility-male and factors affecting spermatogenesis

A 
Hormones/med. 
Syst. dis. 
Environment/lifestyle factors 
Dietary def. 
Toxin 
Testicular temp
Ionizing of red./alkylating agents
develop disorder. 
Local infections
21
Q

Infertility-male and post testicular causes

A

Ductal obstruction
-effect vas deferens and epididymis
-Surgical (trauma, vestectomy-cut vas def.)
-congenital (cystic fibrosis (mucus blockage)
Ejaculatory issues (near prostate)
-cyst cn block eject duct
-duct obstruction (cong./acq.)
-anejaculation (spinal cord injuries)
Infection=STD, E.coli
-b/c urinary tract abnorm. b/c sperm travel through urethra to exit body
-

22
Q

infertility-male and post testicular factors affecting spermatogenesis

A

Developmental disorders

Local infections

23
Q

Dis. assoc. w/ prego.-ectopic prego.

A

Embryo implantation anywhere but uterus
Location
-90% in uterine tube
-w/in vagina wall
-scar tissue
-cervical
-abdo.
-ovary
-fimbrae of uterine tube
-uterine tube
Predisposing condition=pelvic inflamm. dis. that results dis. in chronic salpingitis
-damaged structures nearby tube
Incre. in patients w/ peritubal scarring/adhesions caused by appendicitis endometriosis, surgery
MC cause=tubal hematoma
Fertilized ovum cn form an placenta and amniotic sac
-embryo–>fetus and implantation
-incre. growth=rupture tube
:massive fatal intraperitoneal hemorrhage
Cn undergo regression/resorption (@ timess mom dnt know) Or spontaneous ejection into abdo. cavity (tubal abortion)
- not an emergency but others are and need abortion

24
Q

Sexually Transmitted Dis.-specific infect.

A

Bacterial (gram neg.)
-Gonorrhea(N. gonorrhoeae)
-Chancroid(haemophilus ducreyi)
-Granuloma inguinal (K. granulomatis)
-Syphilis (spirochete: treponema pallidum)
Bacterial (obligate intracell.)=Chlamydia (chlamydia trachomatis)
Viral=genital herpes(HSV2 infection)

25
Sexually Transmitted Dis.-bacterial gram neg.
Neisseria Gonorrhoeae -Effecting male=urethritis -Effecting female=often Asymp., pelvic inflammatory dis. and infertility -infected mom delivers newborn w/ conjunctivitis -->blind -Other ~ gram neg. bact. :Haemophilus ducreyi=chancroid (skin lesion) :Klebsiella granulomatis=granuloma inguinale Syphilis=treponema pallidum (spirochete) -cn cross placenta=congenital syphilis
26
Sexually Transmitted Dis.-herpes simplex virus infection
``` Both HSV-1(oral) and HSV-2(genital herpes) infect mucosa Infect/latent in N. -activated by stress(skin lesion/cold sores), trauma, UV radiation, hormonal change Also cause -corneal lesion(blindness) -Encephalitis -Bronchopneumonia -Esophagitis -hepatitis ```
27
Female reproductive disorders
Disruption of mensuration
28
Menstrual disorders
``` Amenorrhea=no menstrual bleeding Dysmenorrhea -irreg. menstrual symp. -excessive pain Menorrhagia=excessive bleeding Metrorrhagia=Irregular/protracted bleeding ```
29
Menstrual disorder-Amenorrhea
``` Normal-prego(no secretory), menopause Uterine disorder -scarring after infect=wall not thickening properly :no solough off as horm. decre. Ovarian disorder -Gonadal failure :multiple cause :no ovarian horm.=no wall thcik -Endocrine disorder=insuf. gonadotropin secretion ```
30
Endometriosis
Define=endometrium located outside uteur Affected other parts of reproductive tracts=infertility -damage tract Causes intestinal disorder when affecting intestines Pathogenesis not well understood S/S=dymenorrhea, pelvic pain, infertility -infertility=depend on where endometrial tissue as cuased
31
Dis. assoc. w/ prego.-pre. prego./during prego./after prego.
Pre prego.=Ectopic Prego. During prego.=eclampsia/preeclampsia After prego.=Matitis
32
Dis. assoc. w/ eclampsia/pre. eclampsia
``` Systemic syndrome of prego. -Wide spread maternal endoth. dysfunction -S/S :Pre=HTN, edema, proteinuria *maternal HTN no proteinuria :Eclam.= pre and convulsions :hypercog., acute renal failure and palm. edema :HELLP synd. ```
33
Dis. assoc. w/eclampsia/pre. eclampsia= abnormal placental vasculature
During implantation and placental develop. -spiral arteries of secretory phase to endometrium r modified to provide blood to placenta :fetal cell invade decidual plate and destroy the excess sm. muscle :vessels change from small lumen --> high R to lrg lumen (low R) *incre. BF and incre. support to placenta and developing fetus No remodel=no fetal cells invasion/not destroy sm. muscle -no in pre-eclampsia -results in placental ischemia and maternal HTN :may develop atherosis =lipid deposits in decidual vs. intima :Hemorrhages is visible in liver, brain, heart and ant. pit. :kid. has excess fibrin in glomeruli(affect function and proteinuria) and thrmobi cortex assoc. w/ bilat. cortical necrosis *damage filtration memb.
34
Dis. assoc. w/ Mastitis
Acute bact. infection of breast -w/in 1st mo. of breast feeding -during breast feeding :cracks/fissures develop in nipples=bact. gain access bact. (S. Aureus/strep.cocci) S/S=fever, painful swelling and edema Tissue changes=erythema(icre. RBC), abcesses (S. Aureus) or cellulitis (Strep) that inflam. CT tissue Starts in ducts but may spread to entire breast Tx w/ antiBT and milk expression (flow own duct and throw away milk b/c bact=give baby formula Severe=surgical drainage if other tx not wrk (b/c bact cn travel/sepsis)
35
female reproductive-normal hormones
Normal hormone control -GnRH(hypothal.)-->pit. to release FSH and LH to act on ovaries :FSH=follicle develop and +estrogen :LH=follicle maturation and +progesterone -ovary hormones act on uterus :estrogen produce by follicle B4 ovulation =+ prolif. phase *thicken endometrium form for implantation/period :Porduce by copus luteum=+secretory phase *secretory phase=no endometrial thick but thinning of gland/arteries for implantation *corpus luteum=remnet following ovluation
36
Prostate gland
Prostate gland products-->urethra -slightly alkaline fluid -contain enzymes maintain seminal fluid as liq. :move sperm in female tract
37
Prostate dis.
Surrounds urethra=inflammation or hypertrophy impact urethral function and dysuria S/S=difficult urinating(starting vol, incomplete voiding, pain) -b/c prostate location
38
Male reproductive disorder-prostatis clinical
Clinical synd. - found in biopsy w/ acute/chronic inflam.(depend on cell present) - histo: chronic=inflam. VS. Acute small abcess, lrg abcess necrosis, diffuse edema, congestion suppuration
39
Male reproductive disorder-prostatis causative agents
Bacterial Abacterial Granulomatous
40
Male reproductive disorder-Acute prostatis bacterial
Acute -causative agents~ cystitis/bladder inflam. -access prostate=urinary reflux(bladder/urethra b/c bact. access to prostate), surgery, lymphatis/blood from distant (lymphoematogenesis spread) -S/S=fever and chills(bact.), dysuria -Exam=enlarged/tender prostate :bulgy -DX=urine culture/Sx and exam -tx=antBT is difficult b/c hard to penetrate prostate
41
Male reproductive disorder-prostatis Abacterial
MC today Chronic bact. but bact cultures r inhib. prostatic secretions has leukocytosis =not have urinary bact. infect.
42
Male reproductive disorder-prostatis granulomatous
``` Specific agent ID (bact.) VS. nonspecific NOT ID(abact.) Caused by cancer tx Fungal w//in immunocomp. host Nonspecific=rupture duct/acini -inflam. rxn from duct/secretion rxn ```
43
Male reproductive disorder-Benign prostate hypertrophy (zones)
Around vas deferen 3 zones -Peripheral zone (PZ) :main glands w/ long ducts :1ry location for inflammation/cancer(more firm) -Transition zone (TZ) :mucosal glands empty directly-->urethra *urethra function comp. :commonly location for hypertrophy(BPH)
44
Male reproductive disorder-Benign prostate hypertrophy and Pathogenesis
Testoosteron-->dehydrotestosteron(DHT) -by 5 alpha reductase in prostatic stroma B/c incre. DHT=excessive cell grwoth Tx w/ reductase inhib. slows growth and relieves symp. -other TX=destroy tissue :minimally invasive :surgical
45
Male reproductive disorder-Benign prostate hypertrophy and pathology
Compression of urethra lumen by hyperplastic glands Two layers of cells in glands -inner columnar -outer basal flattend
46
Male reproductive disorder-Benign prostate hypertrophy (BPH) clinical
``` Only clinically in 10% of patients S/S -histancy -urgency -nocturia -poor urinary stream Chronic obstruction=incre. risk of UTI Acute obstruction=damage bladder or kidney ```
47
Dis. assoc. w/ eclampsia/pre. eclampsia and pathogen
Pathogen.=not well understood but linked 3 specific changes -abnormal placental vasculature -Endoth. dysfunction(imbalance of anti/angiogenic factors) :defective vascular develop. iin placenta 2ndry to hypoxia -Coag. abnorm. :reduced endoth. production of antithrombotic factos
48
Male reproductive disorder-Chronic prostatis bacterial
``` ~causative agents as acute Asymp. and not need to follow acute(cn just be chronic) S/S -low back pain -dysuria -perineal/suprapubic discomfort :b/c prostate inflam. Caused by recurrent urinary tract infect DX=leukocytosis in prostatic secretion -+ bact. culture (not in acute) ```

Mech. 2 (8 decks)

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