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Anatomy and Physiology > Reproductive System > Flashcards

Reproductive System Flashcards

1
Q

what do genetically male gonads secrete that causes sexual differentiation?

A

AMH (anti-mullerian hormone)

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2
Q

what does AMH do?

A

it binds to the receptor on the Mullerian duct causing the duct to atrophy

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3
Q

what stimulates the Wolffian ducts and the development of male genitalia?

A

testosterone made by leydig cells of the testis

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4
Q

where do testes form?

A

abdomen and descend by birth through inguinal canal

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5
Q

do genetically female gonads secrete AMH?

A

no AMH, mullerian ducts remain and Wolffian ducts regress, develop genetically female genitalia

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6
Q

what are the three layers of the uterus?

A

perimetrium, myometrium, endometrium

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7
Q

what does the suspensory ligament do?

A

anchors the ovary to the pelvic wall and contains ovarian artery and vein

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8
Q

what encloses the ovaries, fallopian tubes and uterus?

A

mesentery

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9
Q

what limits side to side movement of the ovary?

A

broad ligament

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10
Q

what is the mesentery attached to?

A

attaches to the sides and floor of the pelvic cavity and subdivides the peritoneal cavity

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11
Q

what is the ovary stabilized by?

A

mesovarium, ovarian ligament, suspensory ligament

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12
Q

what covers the female ovaries?

A

visceral peritoneum called germinal epithelium

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13
Q

what are the three main functions of the female ovaries?

A
  1. production of immature gametes (oocytes)
  2. secretion of XX sex hormones (estrogen and progestins)
  3. secretion of inhibin, involved in feedback control of pituitary FSH
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14
Q

in females, what is the state of primary oocytes until puberty?

A

suspended development until pubery

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15
Q

during puberty, what stimulates and triggers the start of the ovarian cycle?

A

FSH

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16
Q

what does the female ovary release each month?

A

a secondary oocyte

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17
Q

what stimulates the production of estrogen?

A

FSH

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18
Q

what two cells are responsible for the production of estrogen in the ovary?

A

theca and granulosa cells

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19
Q

how is estrogen made in theca and granulosa cells?

A

production starts in theca cells when androstenedione is made from cholesterol. Androstenedione crosses from thecal cells into granulosa cells where it is converted into estrone or estradiol

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20
Q

where are theca and granulose cells found?

A

corpus luteum

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21
Q

what stimulates the production of progesterone?

A

LH

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22
Q

what does progesterone do?

A

it makes endometrial layer receptive for embryo

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23
Q

what is progesterone made by?

A

corpus luteum

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24
Q

what happens to the corpus luteum if there is no pregnancy?

A

degenerates and becomes corpus albicans, cyclical shedding of the enodmetrial layer

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25
Q

what is menopause?

A

the termination of uterine cycles

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26
Q

when and from what does the corpus luteum develop?

A

develops from a follicle after ovulation

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27
Q

what does the corpus luteum make?

A

progesterone, estradiol/estrogen, inhibin, relaxin

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28
Q

what is the function of the fallopian tubes?

A

transport oocyte from ovary to uterus, takes 3-4 days, site of fertilization

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29
Q

what are the three segments of the fallopian tube?

A

infundibulum, ampulla, isthmus

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30
Q

what is the infundibulum?

A

an expanded funnel near ovary

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31
Q

what are the projections of the infundibulum that extend into pelvic cavity?

A

fimbriae

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32
Q

what are fimbriae lined with?

A

cilia that beat toward the middle segment

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33
Q

what is the ampulla?

A

middle segment of smooth muscle layers that become thicker approaching the uterus

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34
Q

what is the isthmus?

A

short segment between ampulla and uterine wall

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35
Q

what moves the oocyte to the uterus?

A

ciliary and peristaltic contrations

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36
Q

where does fertilization usually occur in the fallopian tube?

A

near boundary between ampulla and isthmus

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37
Q

when must the secondary oocyte meet spermatozoa for fertilization to occur?

A

first 12-24 hours

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38
Q

what cell’s secretions provide nutrient-rich environment in the fallopian tube?

A

peg cells

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39
Q

what do peg cells secrete?

A

lipids and glycogen

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40
Q

what is an ectopic pregnancy?

A

out of place pregnancy where the fertilized egg implants outside the uterus

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41
Q

where does the egg settle in most ectopic pregnancies?

A

fallopian tubes

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42
Q

what is the leading cause of maternal deaths in the 1st trimester?

A

ruptured ectopic pregnancy

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43
Q

who is at risk for ectopic pregnancies?

A
  • PID (STI increases risk)
  • previous ectopic pregnancy
  • fallopian tube surgery
  • infertility problems
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44
Q

what is the cause of ectopic pregnancies?

A
  • the fertilized egg is unable to travel quickly enough to the uterus
  • infection of inflammation of the tube
  • PID is a common cause of blockage caused by gonorrhea or chlamydia
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45
Q

what is the function of the uterus?

A
  1. mechanical protection
  2. nutritional support
  3. waste removal
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46
Q

what are the three parts of the uterus?

A

fundus, body, isthmus

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47
Q

what epithelial type is the vagina?

A

non-keratinized, stratified squamous

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48
Q

what are the folds of the epithelium called?

A

rugae

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49
Q

what are the distinct characteristics of the vaginal lamina propria?

A

thick and elastic

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50
Q

true or false, the vaginal lamina propria contains small blood vessels, nerves and lymph nodes?

A

true

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51
Q

how is the vaginal mucosa arranged?

A

circular and longitudinal bundles of smooth muscle fibers

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52
Q

what is the vaginal mucosa surrounded by?

A

elastic muscular layer

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53
Q

what is a double uterus called?

A

uterine didephys

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54
Q

what is the function of the scrotum?

A

encloses testes

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55
Q

what are the two main functions of the testes?

A
  1. secrete sex hormones (androgens)
  2. produce gametes (spermatozoa)
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56
Q

what divides the testis into lobules?

A

septa

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57
Q

what are the tightly coiled tubules called?

A

seminiferous tubules

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58
Q

what is the function of seminiferous tubules?

A

produce sperm

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59
Q

what do seminiferous tubules connect to?

A

rete testis

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60
Q

what connections rete testis to epididymis?

A

efferent ductules

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61
Q

what temperature does sperm need to develop?

A

~2 degrees lower than body temp

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62
Q

what are the three type of cells in the testes?

A
  1. germ cells
  2. Sertoli cells (nurse cells)
  3. leydig cells (interstitial cells)
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63
Q

what do germ cells produce?

A

produce spermatogonia

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64
Q

what do Sertoli cells produce?

A

synthesize AMH, inhibin, androgen binding globulin, transferrin

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65
Q

what do leydig cells produce?

A

synthesize testosterone

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66
Q

what maintains the blood-testis barrier?

A

sertoli (nurse) cells

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67
Q

what secretes inhibin? and what is it’s function?

A

sertoli cells. downregulates FSH synthesis

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68
Q

what is the function of androgen-binding protein?

A

keeps testosterone high

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69
Q

what is the function of the blood-testis barrier?

A

separates seminiferous tubules from circulation

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70
Q

what does the outer basal compartment of the BTB contain?

A

spermatogonia

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71
Q

what does the inner luminal compartment of the BTB contain?

A

meiosis and spermiogenesis occur

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72
Q

what is spermatogenesis?

A

process of sperm formation

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73
Q

what are the stages of sperm starting at spermatogonium?

A

spermatogonium, primary spermatocyte, secondary spermatocyte, spermatid, sperm

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74
Q

what is spermiogenesis?

A

last step of spermatogenesis, spermatids develop into sperm

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75
Q

what hormone targets the nurse cells (sertoli cells) of the seminiferous tubules?

A

FSH

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76
Q

what targets the interstitial cells of the testes?

A

LH

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77
Q

what is the main function of testosterone?

A

maintains libido, secondary sexual characteristics and maintenance of the accessory glands and organs of the male reproductive system

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78
Q

what happens to spermatogonia (stem cells)?

A

divide by mitosis. one remains as spermatogonium, second differentiates into primary spermatocyte

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79
Q

what happens to the primary spermatocyte (2n)?

A

begins meiosis and form secondary spermatocytes

80
Q

what happens to secondary spermatocytes (1n)?

A

differentiate into spermatids (immature gametes)

81
Q

what happens to spermatids (1n)?

A

differentiate into spermatozoa

82
Q

what happens to spermatozoa?

A

lose contact with wall of seminiferous tubule and enter fluid in lumen

83
Q

when does sperm become highly specialized?

A

spermiogenesis = spermatids become mature spermatozoa

84
Q

what are spermatids attached to?

A

cytoplasm of sertoli cells

85
Q

what happens at spermiation?

A

spermatozoon loses attachment to sertoli cell and enters the lumen of seminiferous tubules

86
Q

what are the 4 parts of the spermatozoon?

A
  1. head
  2. neck
  3. middle piece
  4. tail
87
Q

what is the function of the head of the sperm?

A

contains nucleus and chromosomes. Also acrosome, enzyme essential to fertilization

88
Q

what is the function of the neck of the sperm?

A

connects head to middle piece

89
Q

what is the function of the middle piece of the sperm?

A

contains mitochondria which provides ATP to move tail

90
Q

what is the function of the tail of the sperm?

A

flagellum that is a whiplike organelle that moves cell from one place to another

91
Q

true or false, mature spermatozoon has no ER, Golgi, lysosomes, peroxisomes, inclusions, no glycogen or energy reserves?

A

true

92
Q

true or false, spermatozoa from the testes are physically mature but CANNOT fertilize an oocyte?

A

true

93
Q

what is the pathway of sperm?

A

testis, epididymis, ductus (vas) deferens, ejaculatory duct, urethra

94
Q

function of the epididymis?

A

monitors and adjusts fluid produced by seminiferous tubules, protects and stores spermatozoa, facilitates functional maturation but immobile

95
Q

what is the function of the vas deferens?

A

lined by ciliated epithelium and has peristaltic contractions that move sperm from storage sites into the urethra

96
Q

what are the three accessory organs of the male reproductive system?

A
  1. seminal vesicles
  2. prostate gland
  3. bulbo-urethra gland
97
Q

what is the function of the seminal vesicles?

A

produce about 60% of semen volume

98
Q

what is the function of the prostate gland?

A

produces prostatic fluid (slightly acidic) which is around 20-30% volume of semen. contains seminal plasmin, a protein with antibiotic properties

99
Q

what is the function of the bulbo-urethral glands?

A

secrete thick, alkaline mucus that helps neutralize urinary acids in urethra and also lubricates the glans

100
Q

what is found in seminal fluid?

A

fructose, prostaglandins, fibrinogen

101
Q

what is the function of fructose in seminal fluid?

A

easily metabolized by spermatozoa

102
Q

what is the function of prostaglandins in seminal fluid?

A

stimulate smooth muscle contractions

103
Q

what is the function of fibrinogen in seminal fluid?

A

forms temporary clot in vagina

104
Q

why is seminal fluid slightly alkaline?

A

to neutralize acids in prostate gland and vagina

105
Q

what is capacitation?

A

changes in sperm that occur in order to fertilize the ovum

106
Q

sperm becomes motile when?

A

mixed with secretions of seminal glands

107
Q

sperm becomes capable of fertilization when?

A

exposed to female reproductive tract. may also involve CFTR

108
Q

zoospermia

A

live sperm in the ejaculate

109
Q

azoospermia

A

absence of sperm in the ejaculate

110
Q

teratospermia

A

presence of sperm but abnormal morphology

111
Q

astenozoospermia

A

reduced sperm motility

112
Q

oligozoospermia

A

low sperm count

113
Q

oligosthenospermia

A

both reduced sperm motility and low sperm count

114
Q

Congenital bilateral absence of the Vas Deferens

A
  • bilateral agenesis of the vas deferens & atrophy of seminal vesicles and large portion of epididymis
  • common in those with CF
  • can have sperm surgically extracted
115
Q

Benign Prostate Hyperplasia

A
  • hypertrophy of prostate gland that restricts passage of urine through the urethra
  • bladder may hypertrophy to help move urine and contract even when not full leading to frequent urination
  • UTI if urine remains in bladder
116
Q

Erectile Dysfunction

A
  • inability to maintain erection
  • requires an intact vascular, neural, endocrine, mental and intracellular signaling system
117
Q

how is ED treated?

A

drugs that protect cAMP by inhibiting phosphodiesterase type 5 degradation in the corpus cavernosum. increase cAMP, increase smooth muscle relaxation, more blood flow to penis. include viagra and cialis

118
Q

true or false, humans are born with a lifetime supply of eggs

A

true

119
Q

true or false, in females, oocytes lay dormant until puberty?

A

true

120
Q

what is ovulation?

A

monthly selection of a follicle

121
Q

what is the function of the uterus?

A

site of implantation and placentation

122
Q

what is menstruation?

A

hormone responsive shedding of the endometrium

123
Q

what is the ovarian cycle?

A

monthly series of events associated with the maturation and release of an oocyte

124
Q

over how long does the ovarian cycle occur?

A

~28 days

125
Q

what are the three phases of the ovarian cycle?

A
  1. follicular phase
  2. ovulation
  3. luteal phase
126
Q

what stimulates the growth of follicles and estrogen production during the follicular phase?

A

FSH and LH

127
Q

what do estrogen levels do to levels of FSH and LH?

A

negative feedback loop, inhibiting the release of FSH and LH

128
Q

what is the overall state of estrogen during the follicular phase?

A

slow increase

129
Q

what is selected for preferential growth?

A

dominance of a tertiary follicle

130
Q

what happens to the follicle during mid cycle?

A

dominant follicle produces increasing amounts of estrogen

131
Q

what is the overall state of estrogen during the ovulation/mid cycle phase?

A

increasing amounts until estrogen levels peak

132
Q

what do the high estrogen levels do?

A

postiive feedback on hypothalamus and pituitary which triggers and LH surge

133
Q

what is the overall state of LH during ovulation phase?

A

LH surge

134
Q

what does the LH surge stimulate?

A

ovulation: release of oocyte from follicle into abdominopelvic cavity

135
Q

what happens to the follicle cells that remain in ovary?

A

undergo luteinization forming a corpus luteum

136
Q

what does the corpus luteum do during the luteal phase?

A

produces significant levels of progesterone and estrogen

137
Q

what do CL hormones do?

A

exert negative feedback on hypothalamus and pituitary to inhibit LH and FSH

138
Q

after how long does the CL die if there is no conception?

A

14 days

139
Q

what is the uterine menstrual cycle?

A

cyclic changes in the endometrium in response to ovarian hormones

140
Q

what are the three phases of the menstrual cycle?

A
  1. menstrual phase (1-5)
  2. proliferative phase (preovulatory 6-14)
  3. secretory phase (post ovulation 15-28)
141
Q

what is menses?

A

shedding of the endometrium resulting in vaginal bleeding

142
Q

what happens when fertilization does not occur?

A
  1. CL degenerates
  2. progesterone and estrogen levels plummet
  3. endometrial arteries kink and spasm
  4. endometrial cells begin to die
  5. endometrial layer (stratum functionalis) sloughs off
143
Q

when does the menstrual cycle reinitiate?

A

day 1 of menses

144
Q

what is amenorrhea?

A

absence of menstrual periods

145
Q

what are physiological amenorrhea?

A

pre-puberty, pregnancy, lactation, menopause

146
Q

what is primary amenorrhea?

A

failure of menses to occur with puberty

147
Q

what is secondary amenorrhea?

A

cessation of menses in previously menstruating females

148
Q

what is the major cause of anovulation?

A

obesity

149
Q

how does obesity affect the hypothalamic pituitary ovarian axis?

A
  • discordant GnRH secretion patterns
  • altered pituitary response to gonadotropins
  • disrupted ovarian steroidogenesis
150
Q

what is obesity a state of?

A

functional hyperandrogenism

151
Q

how does obesity cause anovulation?

A

obesity increases insulin resistance which results in compensatory hyperinsulinemia. This causes the liver to secreted reduced SHBG which leads to increased androgen activity and impaired follicle development

152
Q

true or false, clinical guidelines do support fertility therapy in obese individuals?

A

false, success is poor, high complications

153
Q

what is an unintended pregnancy?

A

defined as either an unwanted or mistimed child

154
Q

what % of pregnancies are unwanted and what is the leading cause of unwanted pregnancies?

A

45%. inconsistent or incorrect use of contraception

155
Q

what are the two types of hormonal contraception?

A
  1. combined hormonal preparations
  2. progestin-only preparations
156
Q

what is combined hormonal preparations?

A
  • both synthetic estrogen and progesterone
  • exposure to estrogen and progestin for 3 weeks followed by 1 week of no hormones
  • hormones impait folliculogenesis and inhibit ovulation
  • induces endometrial development
  • removal of exposure induces menses
157
Q

what is progestin only preparations?

A
  • contraindications for estrogen
  • progestin only pull or injection
  • exposure impacts reproductive tract and folliculogenesis
  • thicken cervical mucus to block sperm
  • impart endometrial development
158
Q

LARC?

A
  • longer acting reversible contraception
  • 12y
  • intra-uterine device or subcutaneous implants
159
Q

what does hormonal IUD release?

A

progestin into uterus (up to 7 years)

160
Q

what does copper IUD do?

A

provides mechanical barrier (up to 12 years) that blocks sperm from reaching and fertilizing egg. prevents implantation but does NOT inhibit ovulation

161
Q

what do hormonal implants do?

A

flexible matchstick implant that secretes progestin (3 years)

162
Q

what are two forms of emergency contraception?

A
  1. IUD
  2. Morning after pills
163
Q

how do emergency IUDs work?

A

insertion up to 5 days after unprotected sex. up to 99% success rate.

164
Q

how do morning after pills work?

A

take up to 5 days. 75-90% reduction of pregnancy chances. better if 3 days.

165
Q

what is levonorgestrel?

A
  • plan B
  • synthetic progestin
  • blocks LH surge and delays ovulation
  • <155 pounds
166
Q

what is ulipristal acetate?

A
  • progesterone receptor modulator
  • blocks LH surge and ovulation
  • > 155 pounds
167
Q

what is trichomoniasis caused by?

A

a parasite

168
Q

what are three STIs caused by bacteria?

A

syphilis, gonorrhea, chlamydia

169
Q

what is trichomoniasis cured by?

A

antibiotic

170
Q

what is the most common STI in the US?

A

Genital HPV infection

171
Q

what can easily stop senital HPV infection?

A

vaccine

172
Q

true or false, genital warts is NOT a common symptom of HPV infection?

A

false

173
Q

what STI has become increasingly resistant to antibiotics?

A

gonorrhea

174
Q

how is chlamydia cured?

A

easily cure by antibiotics

175
Q

if HIV is untreated what can it lead to?

A

acquired immunodeficiency syndrome (AIDS)

176
Q

what is the most common vaginal infection?

A

bacterial vaginosis

177
Q

what is the most common “notifiable condition” reported to the CDC?

A

chlamydia

178
Q

why are STI rates higher among college students?

A

alcohol consumption imparts judgement

179
Q

what STIs are not curable?

A

herpes, hepatitis B, HIV/AIDS, and HPV

180
Q

what STIs are curable?

A

syphilis, gonorrhea, chlamydia, and trichomoniasis

181
Q

what are some common symptoms of an STI?

A
  • painful urination, unusual discharge, skin changes (bumps, sores, etc), genital itching or pain, pelvic discomfort or pain, testicular pain
182
Q

what two STDs have symptoms that are indistinguishable?

A

gonorrhea and chlamydia

183
Q

is there a vaccine for gonorrhea?

A

meningitis vaccine provides protection against gonococcal infections

184
Q

what sample is most often tested for gonorrhea using what test?

A

urethral gonorrhea tested in urine by nucleic acid amplification tests

185
Q

why might is be so hard to treat STIs like gonorrhea?

A

pharyngeal gonorrhea infections due to oral sex

186
Q

what percentage of women and men are asymptomatic?

A

75% of women and 50% of infected men

187
Q

why is STI preferred over STD?

A

because many with STI/STD don’t have symptoms

188
Q

how does chlamydia get into the peritoneal cavity?

A

travels up vagina, through cervix, out of fallopian tube into peritoneum

189
Q

what can occur if STI gets into peritoneal cavity?

A

pelvic inflammatory disorder (PID) can increase risk of infertility

190
Q

what percentage of women with chlamydia develop PID?

A

10-15%

191
Q

true or false, the damage caused by chlamydia is always reversible?

A

false, each episode of PID doubles the risk of permanent tubal damage

192
Q

what long term damage can trachomatis infections cause?

A

damage the fallopian tubes and lead to blockage of the fallopian tubes and fibrotic scarring

193
Q

what about female anatomy increases a women’s risk of STD?

A

lining of vagina is thinner and easier to penetrate than skin of penis, vagina is moist, fallopian tubes open to peritoneal cavity which can spread into the abdominal cavity

194
Q

where in the body does chlamydia reside?

A

intracellular, mucosal epithelial cells of the vagina, urethra, fallopian tubes, anus and rarely the throat

195
Q

what specific epithelial cell type does chlamydia typically infect?

A

ciliated simple columanr cells at mucosal sites

196
Q

what is the lifecycle of chlamydia?

A

enters the body in elemntary bodies
interacts with glycogen
replicates
reorganize back to EBs
lysis or extrusion spreads to other cells/people

197
Q

what unique problem can occur due to chlamydial infections?

A

neonatal conjunctivitis from perinatal transmission
trachoma (blindness)

Anatomy and Physiology (7 decks)

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