Reproductive System Flashcards
vas deferens
Ducts that conveys sperm from he testicle to the urethra
Seminal vesicles
The seminal vesicles (also known as the vesicular or seminal glands) are a pair of glands found in the male pelvis, which function to produce many of the constituent ingredients of semen. They ultimately provide around 70% of the total volume of semen
bulbourethral gland
In response to sexual stimulation, the bulbourethral glands secrete an alkaline mucus-like fluid. This fluid neutralizes the acidity of the urine residue in the urethra, helps to neutralize the acidity of the vagina, and provides some lubrication for the tip of the penis during intercourse
What is 5 alpha-reductase?
The enzyme that converts testosterone into Dihydrotestosterone
What is the function of dihydrotestosterone?
DHT is biologically important for sexual differentiation of the male genitalia during embryogenesis, maturation of the penis and scrotum at puberty, growth of facial, body, and pubic hair, and development and maintenance of the prostate gland and seminal vesicles.
What does LH (leutinizing hormone) do in males?
Make the Leydig cell pump out testosterone
For men, luteinizing hormone stimulates the production of testosterone from Leydig cells in the testes. Testosterone, in turn, stimulates sperm production and helps accentuate male characteristics — like a deep voice or growth of facial hair.
remember
A negative feedback system occurs in the male with rising levels of testosterone acting on the hypothalamus and anterior pituitary to inhibit the release of GnRH, FSH, and LH. The Sertoli cells produce the hormone inhibin, which is released into the blood when the sperm count is too high.
What does inhibin do?
High levels of inhibin reduce the release of LH and FSH
What is the function of epididymis?
Store and matures sperm
The epididymis is a long, coiled tube that rests on the backside of each testicle. It carries and stores sperm cells that are created in the testes. It’s also the job of the epididymis to bring the sperm to maturity — the sperm that emerge from the testes are immature and incapable of fertilization.
Epidimytitis and orchitis
Associated with UTI and prostatitis, GC, or Chlamydia in men under 35
E. coli pseundomas in men over 35
mumps 1 week after onset
Varicocele
Scrotal varicosity, abnormal dilation and tortuosity of pampiniform plexus of veins
99% left-sided
A varicocele (VAR-ih-koe-seel) is an enlargement of the veins within the loose bag of skin that holds your testicles (scrotum). A varicocele is similar to a varicose vein you might see in your leg. Varicoceles are a common cause of low sperm production and decreased sperm quality, which can cause infertility.
Hydrocele
accumulation of serous fluid in the scrotum
occurs developmentally in the descent of testis or second to inflammations, painless, enlarged fluctuant scrotum
Hematocele/torsion
blood in scrotal sac due to trauma or sx spontaneously in atherosclerosis, DM, scurvy
Seminomas
Most common tumor with cryptorchidism
best prognosis of testicular tumors
metastasis to lymphatics
some have incrased HCG
Bacterial Prostatitis
e.coli and other gram-negative rods, staph, GC
dysuria, fever, tender, boggy prostate, painful
chronic prostatitis > mb asymptomatic or low back pain, dysuria, positive culture in expressed secretions, tx difficult
Chronic abacterial prostitis
Mostly common chlamydia, ureaplasma, no history of recurrent UTI
15 WBC per HPF, cultures negative
Benign prostatic hyperplasia/Nodular hyperplasia
discrete nodules in periurethral area middle and lateral lobes, partial or complete obstruction
TUP sx, dihydrotestosterone causes hyperplasia
Carcinoma of Prostate
Most common cancer of men, usually posterior lobe
hematogenous spread is mainly to lumbar spine, femur, pelvis, thoracic spine, ribs; local invasion, blacks higher incidence
Acute cervicitis
GC, Chlamydia, trichonomas,
Cervical motion tenderness + mucopurulent discharge
Chronic cervicitis
Vaginal bacterial overgrowth causing irritation of cervix, transformational zone
Cervical intraepithelial neoplasia
Mostly benign dysplasia in transformational zone
We try to stop dysplasia before they get anaplastic
Cervical cancer
DPV 16, 18, 31, 33..
Exposure replayed spread:
Early age first intercourse
Mutual sexual partners
Cervical squamous cell carcinoma
90% of cervical cancer Peak at age 40-60 Stage I-IV spread and prognosis: Stage I 80% 5 yr survival Stage IV has a 10-15% 5 yr survival Most are asymptomatic Bleeding post intercourse can be a common sign
Acute endometritis
Bacterial infection group A strep, staph follwoing delivery or miscarriage
Chronic Endometritis
PID, IUD, TB, Chamydia
Endometriosis
endometrial cells outside the uterus
May fall anywhere
Ovary and adnexa are most common
often painful disorder in which tissue similar to the tissue that normally lines the inside of your uterus — the endometrium — grows outside your uterus. Endometriosis most commonly involves your ovaries, fallopian tubes and the tissue lining your pelvis.
Endometrial Polyps
May be estrogen receptive or Tamoxifen induced.
Not considered precancerous
Causes menorrhagia
Leiomyoma/fibroid
Most common tumor in women Estrogen dependent Fibroid myometrium Asymptomatic or symptomatic: - Compressive Sn/Sx - Bleeding - Urinary frequency - Infertility
Leio = smooth Myo = muscle oma = tumor
How is the uterus anchored to the sacral bone?
By the uterosacral ligaments
Parts of the uterus
Ovaries, ovarian ligament, fimbriae infundibulum, ampulla, isthmus, fundus, cervix, body, round ligaments (anteriorly), cardinal ligaments (laterally), mesometrium (part of the broad ligament)
Uterine adenocarcinoma
Most common invasive cancer of the female tract More common than the leiomyoma Age 55-65 DM Hypertension Nulliparous
Oophoritis
inflammation of the ovaries; uncommon`
Follicular cysts
Common, physiologic, may cause pelvic pain
follicular cyst occurs when the follicle of the ovary doesn’t rupture or release its egg. Instead, it grows until it becomes a cyst.
Cysted formed during the first 2 weeks
Luteal cyst
Corpus luteal (CL) cysts are a type of functional ovarian cyst that results when a corpus luteum fails to regress following the release of an ovum
Fails to regress
Normal, may rupture into the peritoneum and cause inflammation
Cyst formed during the second 2 weeks
PCO/ Stein-Leventhal Syndrome
Polycystic ovary syndrome
Poly = many
Cystic = cysts
Dysfunction of the hypothalamic-pituitary-ovarian axis
Too much release of LH causing the theca cells to produces excess amounts of androstenedione. It flows into the blood. Then it gets converted into estrone by aromatase in fats. This causes negative feedback to the anterior pituitary.
You have an ovarian system that is not moving androgen to estrogen; androgen excess.
How is the normal menstrual cycle divided?
Follicular phase - before ovulation
Luteal phase - after ovulation
What happens during the follicular phase?
The hypothalamus release Gonadaltropic releasing hormone. This hormone gets into the anterior pituitary and makes it secrete other hormones, called gonadotropins such as LH and FSH.
Where do the FSH and LH travel to once they are released from the anterior pituitary?
To the follicles in the ovaries
What are follicles?
follicles are small clusters of theca and granulosa cells. They protect the developing egg (oocyte)
Theca cells have receptors for the LHs. Lh makes theca cells release androstenedione.
Granulosa cells have receptors for the FSH. These make the granulosa cells release aromatase which converts androstenedione into 17 B estradiol
With the rise in 17 B estradiol, negative feedback occurs telling the hypothalamus to release less FSH
Remember
the first 2 weeks are follicular and the second 2 weeks are luteal.
1st 2 weeks, estrogen dominant.
2nd two weeks, progesterone predominant
Tumor of ovaries
80% are benign cysts Malignant disease increases after 40 years Risk: - BRCA and other genetic makers Nulliparous
May be more fatal due to
- Usually asymptomatic; Dx at high grade/stage
May have GI symptoms
Skenes ducts
found close to the urethra.
believed to secrete a substance to lubricate the urethra opening.
Bartholin’s glands
helps lubricate the vagina
located on each side of the entrance to the vagina
vulva dystrophy
Vulvar dystrophy is a condition that is caused by an abnormal growth of skin on the vulva
Lichen Sclerosus
after menopause, skin parchment-like, vaginal mucosa thinned, dryness, discomfort
LH
induces ovulation
Metabolism - (ovarian) sex steroids
Cholesterol - pregnenolone - 17 alpha hydroxypregnenolone - either dehydroepiandrosterone or androstenedione
What converts androstenedione into testosterone?
aromatase
Remember
Aromatase is the enzyme that creates estrogens from androgens
Menopause
40-55 yrs
52 is average in US
No menses for 12 or more months
Breast benign conditions
Congenital nipple inversion
Galactocele (cyst in lactiferous duct or lobule)
Acute mastitis
Bacterial infection of the lactating breast
Staph
Fever
Mammary duct ectasia
dilation of lactiferous ducts usually multiparous women 50-60 yrs, mb abnormal abnormal mammogram
mammary duct ectasia
benign (non-cancerous) breast condition that occurs when a milk duct in the breast widens and its walls thicken. This can cause the duct to become blocked and lead to fluid build-up
Carcinoma
in ductal and glandular tissue Number 1 female cancer Family hx: mutation of BRCA 1 Estrogen: Early menarche / late menopause Nulliparous
What does nulliparous mean?
Term used to describe women who can no longer give birth to a child
Paget’s disease of the breast
Palpable mass in the breast
Starts in the milk ducts of the nipple
How many stages are there between fertilization and implantation?
4 stages 1 - fertilization to zygote formation 2 - 2 cell stage through morula 2-3 3 - free blastocyst 4-5 4. Blastocyst attaches day 5-6
What is the primary site of fertilization?
The ampulla
Where does implantation usually occur?
More in the posterior wall than anterior wall
More in the Superior uterus
Ectopic implantation
Medical emergency
This happens when a fertilized egg implants in a structure that can’t support its growth. An ectopic pregnancy often happens in the fallopian tube
Ectoderm
CNS PNS Sensory epithelia of eye, ear, and nose Epidermis and appendages Mammary glands Posterior pituitary Adrenal medulla
Mesoderm
Connective tissue, cartilage, bone Muscle Heart Blood, lymph vessels, and cells Kidneys, ovaries, testes, genital ducts Serous membranes Spleen Adrenal cortex
Endoderm
Gastric and respiratory epithelium
Parenchyma of tonsils, thyroid, parathyroid, liver, thymus, pancreas
Epithelial lining of bladder, most of urethra, tympanic cavity, tympanic antrum, auditory tube
anterior pituitary
What does the ligamentum teres connect?
The liver to the umbilicus
Ligamentum arteriosum
Connecting the proximal left pulmonary artery and the undersurface of the junction of the aortic arch and descending aorta, at the aortic isthmus
Foramen ovale
Dentation in the wall which separates the two atrium
Lactation and suckling reflex
Both posterior and anterior pituitary plays part in this process.
Posterior will release oxytocin which allows for milk ejection.
Anterior pituitary releases prolactin which induces milk production in the breast
Lactation and suckling reflex
Both posterior and anterior pituitary plays part in this process.
Suckling will send signals to the hypothalamus.
Posterior will release oxytocin which allows for milk ejection.
Anterior pituitary releases prolactin which induces milk production in the breast
Reminder
hCG levels increase during the first weeks of pregnancy (12-14 weeks)
Corpus luteum causes progesterone and ovary estrogen to come out
After these are run out, we have the placenta producing oestradiol
Nucleotide
sugar with a base (nucleoside) and phosphate
DNA
Deoxyribose
Adenine, Thymine, Guanine, Cytosine
Two strands in a double helix
RNA
Adenine, URACIL, Guanine, Cytosine
Single strand
What are the purines?
Adenine and Guanine
AG
What are the pyrimidines?
Uracil, thymine, and cytosine
UTC
Nucleosides
Finish with -ine
Nucleotides
Finish with -ate
What is purine biosynthesis dependent on?
100% folic acid-dependent for its methylation step
Folic acid is a complete cofactor for
50% folic acid-dependent
Transcription
Formation of mRNA from DNA
mRNA carries instruction from the nucleus to the cytoplasm
RNA polymerase polymerizes nucleotides on the DNA template to form an RNA copy
Promoters signal RNA polymerase when to start
Polymerase I
makes rRNA
Polymerase II
makes mRNA
Polymerase III
makes tRNA
mnemonic
1, 2, 3
r, m, t
Cell division
Replication
Apoptosis
controlled death of cells
Mitosis
nuclear division
occurs in somatic / body cells
Meiosis
produces gametes
occurs in reproductive cells
What are the divisions of mitosis?
Interphase (Go, G1, S, G2), Prophase, metaphase, anaphase, and telophase
