Reproductive System Flashcards
1
Q
what do genetically male gonads secrete that causes sexual differentiation?
A
AMH (anti-mullerian hormone)
2
Q
what does AMH do?
A
it binds to the receptor on the Mullerian duct causing the duct to atrophy
3
Q
what stimulates the Wolffian ducts and the development of male genitalia?
A
testosterone made by leydig cells of the testis
4
Q
where do testes form?
A
abdomen and descend by birth through inguinal canal
5
Q
do genetically female gonads secrete AMH?
A
no AMH, mullerian ducts remain and Wolffian ducts regress, develop genetically female genitalia
6
Q
what are the three layers of the uterus?
A
perimetrium, myometrium, endometrium
7
Q
what does the suspensory ligament do?
A
anchors the ovary to the pelvic wall and contains ovarian artery and vein
8
Q
what encloses the ovaries, fallopian tubes and uterus?
A
mesentery
9
Q
what limits side to side movement of the ovary?
A
broad ligament
10
Q
what is the mesentery attached to?
A
attaches to the sides and floor of the pelvic cavity and subdivides the peritoneal cavity
11
Q
what is the ovary stabilized by?
A
mesovarium, ovarian ligament, suspensory ligament
12
Q
what covers the female ovaries?
A
visceral peritoneum called germinal epithelium
13
Q
what are the three main functions of the female ovaries?
A
- production of immature gametes (oocytes)
- secretion of XX sex hormones (estrogen and progestins)
- secretion of inhibin, involved in feedback control of pituitary FSH
14
Q
in females, what is the state of primary oocytes until puberty?
A
suspended development until pubery
15
Q
during puberty, what stimulates and triggers the start of the ovarian cycle?
A
FSH
16
Q
what does the female ovary release each month?
A
a secondary oocyte
17
Q
what stimulates the production of estrogen?
A
FSH
18
Q
what two cells are responsible for the production of estrogen in the ovary?
A
theca and granulosa cells
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
20
Q
where are theca and granulose cells found?
A
corpus luteum
21
Q
what stimulates the production of progesterone?
A
LH
22
Q
what does progesterone do?
A
it makes endometrial layer receptive for embryo
23
Q
what is progesterone made by?
A
corpus luteum
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
25
what is menopause?
the termination of uterine cycles
26
when and from what does the corpus luteum develop?
develops from a follicle after ovulation
27
what does the corpus luteum make?
progesterone, estradiol/estrogen, inhibin, relaxin
28
what is the function of the fallopian tubes?
transport oocyte from ovary to uterus, takes 3-4 days, site of fertilization
29
what are the three segments of the fallopian tube?
infundibulum, ampulla, isthmus
30
what is the infundibulum?
an expanded funnel near ovary
31
what are the projections of the infundibulum that extend into pelvic cavity?
fimbriae
32
what are fimbriae lined with?
cilia that beat toward the middle segment
33
what is the ampulla?
middle segment of smooth muscle layers that become thicker approaching the uterus
34
what is the isthmus?
short segment between ampulla and uterine wall
35
what moves the oocyte to the uterus?
ciliary and peristaltic contrations
36
where does fertilization usually occur in the fallopian tube?
near boundary between ampulla and isthmus
37
when must the secondary oocyte meet spermatozoa for fertilization to occur?
first 12-24 hours
38
what cell's secretions provide nutrient-rich environment in the fallopian tube?
peg cells
39
what do peg cells secrete?
lipids and glycogen
40
what is an ectopic pregnancy?
out of place pregnancy where the fertilized egg implants outside the uterus
41
where does the egg settle in most ectopic pregnancies?
fallopian tubes
42
what is the leading cause of maternal deaths in the 1st trimester?
ruptured ectopic pregnancy
43
who is at risk for ectopic pregnancies?
- PID (STI increases risk)
- previous ectopic pregnancy
- fallopian tube surgery
- infertility problems
44
what is the cause of ectopic pregnancies?
- 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
45
what is the function of the uterus?
1. mechanical protection
2. nutritional support
3. waste removal
46
what are the three parts of the uterus?
fundus, body, isthmus
47
what epithelial type is the vagina?
non-keratinized, stratified squamous
48
what are the folds of the epithelium called?
rugae
49
what are the distinct characteristics of the vaginal lamina propria?
thick and elastic
50
true or false, the vaginal lamina propria contains small blood vessels, nerves and lymph nodes?
true
51
how is the vaginal mucosa arranged?
circular and longitudinal bundles of smooth muscle fibers
52
what is the vaginal mucosa surrounded by?
elastic muscular layer
53
what is a double uterus called?
uterine didephys
54
what is the function of the scrotum?
encloses testes
55
what are the two main functions of the testes?
1. secrete sex hormones (androgens)
2. produce gametes (spermatozoa)
56
what divides the testis into lobules?
septa
57
what are the tightly coiled tubules called?
seminiferous tubules
58
what is the function of seminiferous tubules?
produce sperm
59
what do seminiferous tubules connect to?
rete testis
60
what connections rete testis to epididymis?
efferent ductules
61
what temperature does sperm need to develop?
~2 degrees lower than body temp
62
what are the three type of cells in the testes?
1. germ cells
2. Sertoli cells (nurse cells)
3. leydig cells (interstitial cells)
63
what do germ cells produce?
produce spermatogonia
64
what do Sertoli cells produce?
synthesize AMH, inhibin, androgen binding globulin, transferrin
65
what do leydig cells produce?
synthesize testosterone
66
what maintains the blood-testis barrier?
sertoli (nurse) cells
67
what secretes inhibin? and what is it's function?
sertoli cells. downregulates FSH synthesis
68
what is the function of androgen-binding protein?
keeps testosterone high
69
what is the function of the blood-testis barrier?
separates seminiferous tubules from circulation
70
what does the outer basal compartment of the BTB contain?
spermatogonia
71
what does the inner luminal compartment of the BTB contain?
meiosis and spermiogenesis occur
72
what is spermatogenesis?
process of sperm formation
73
what are the stages of sperm starting at spermatogonium?
spermatogonium, primary spermatocyte, secondary spermatocyte, spermatid, sperm
74
what is spermiogenesis?
last step of spermatogenesis, spermatids develop into sperm
75
what hormone targets the nurse cells (sertoli cells) of the seminiferous tubules?
FSH
76
what targets the interstitial cells of the testes?
LH
77
what is the main function of testosterone?
maintains libido, secondary sexual characteristics and maintenance of the accessory glands and organs of the male reproductive system
78
what happens to spermatogonia (stem cells)?
divide by mitosis. one remains as spermatogonium, second differentiates into primary spermatocyte
79
what happens to the primary spermatocyte (2n)?
begins meiosis and form secondary spermatocytes
80
what happens to secondary spermatocytes (1n)?
differentiate into spermatids (immature gametes)
81
what happens to spermatids (1n)?
differentiate into spermatozoa
82
what happens to spermatozoa?
lose contact with wall of seminiferous tubule and enter fluid in lumen
83
when does sperm become highly specialized?
spermiogenesis = spermatids become mature spermatozoa
84
what are spermatids attached to?
cytoplasm of sertoli cells
85
what happens at spermiation?
spermatozoon loses attachment to sertoli cell and enters the lumen of seminiferous tubules
86
what are the 4 parts of the spermatozoon?
1. head
2. neck
3. middle piece
4. tail
87
what is the function of the head of the sperm?
contains nucleus and chromosomes. Also acrosome, enzyme essential to fertilization
88
what is the function of the neck of the sperm?
connects head to middle piece
89
what is the function of the middle piece of the sperm?
contains mitochondria which provides ATP to move tail
90
what is the function of the tail of the sperm?
flagellum that is a whiplike organelle that moves cell from one place to another
91
true or false, mature spermatozoon has no ER, Golgi, lysosomes, peroxisomes, inclusions, no glycogen or energy reserves?
true
92
true or false, spermatozoa from the testes are physically mature but CANNOT fertilize an oocyte?
true
93
what is the pathway of sperm?
testis, epididymis, ductus (vas) deferens, ejaculatory duct, urethra
94
function of the epididymis?
monitors and adjusts fluid produced by seminiferous tubules, protects and stores spermatozoa, facilitates functional maturation but immobile
95
what is the function of the vas deferens?
lined by ciliated epithelium and has peristaltic contractions that move sperm from storage sites into the urethra
96
what are the three accessory organs of the male reproductive system?
1. seminal vesicles
2. prostate gland
3. bulbo-urethra gland
97
what is the function of the seminal vesicles?
produce about 60% of semen volume
98
what is the function of the prostate gland?
produces prostatic fluid (slightly acidic) which is around 20-30% volume of semen. contains seminal plasmin, a protein with antibiotic properties
99
what is the function of the bulbo-urethral glands?
secrete thick, alkaline mucus that helps neutralize urinary acids in urethra and also lubricates the glans
100
what is found in seminal fluid?
fructose, prostaglandins, fibrinogen
101
what is the function of fructose in seminal fluid?
easily metabolized by spermatozoa
102
what is the function of prostaglandins in seminal fluid?
stimulate smooth muscle contractions
103
what is the function of fibrinogen in seminal fluid?
forms temporary clot in vagina
104
why is seminal fluid slightly alkaline?
to neutralize acids in prostate gland and vagina
105
what is capacitation?
changes in sperm that occur in order to fertilize the ovum
106
sperm becomes motile when?
mixed with secretions of seminal glands
107
sperm becomes capable of fertilization when?
exposed to female reproductive tract. may also involve CFTR
108
zoospermia
live sperm in the ejaculate
109
azoospermia
absence of sperm in the ejaculate
110
teratospermia
presence of sperm but abnormal morphology
111
astenozoospermia
reduced sperm motility
112
oligozoospermia
low sperm count
113
oligosthenospermia
both reduced sperm motility and low sperm count
114
Congenital bilateral absence of the Vas Deferens
- 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
Benign Prostate Hyperplasia
- 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
Erectile Dysfunction
- inability to maintain erection
- requires an intact vascular, neural, endocrine, mental and intracellular signaling system
117
how is ED treated?
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
true or false, humans are born with a lifetime supply of eggs
true
119
true or false, in females, oocytes lay dormant until puberty?
true
120
what is ovulation?
monthly selection of a follicle
121
what is the function of the uterus?
site of implantation and placentation
122
what is menstruation?
hormone responsive shedding of the endometrium
123
what is the ovarian cycle?
monthly series of events associated with the maturation and release of an oocyte
124
over how long does the ovarian cycle occur?
~28 days
125
what are the three phases of the ovarian cycle?
1. follicular phase
2. ovulation
3. luteal phase
126
what stimulates the growth of follicles and estrogen production during the follicular phase?
FSH and LH
127
what do estrogen levels do to levels of FSH and LH?
negative feedback loop, inhibiting the release of FSH and LH
128
what is the overall state of estrogen during the follicular phase?
slow increase
129
what is selected for preferential growth?
dominance of a tertiary follicle
130
what happens to the follicle during mid cycle?
dominant follicle produces increasing amounts of estrogen
131
what is the overall state of estrogen during the ovulation/mid cycle phase?
increasing amounts until estrogen levels peak
132
what do the high estrogen levels do?
postiive feedback on hypothalamus and pituitary which triggers and LH surge
133
what is the overall state of LH during ovulation phase?
LH surge
134
what does the LH surge stimulate?
ovulation: release of oocyte from follicle into abdominopelvic cavity
135
what happens to the follicle cells that remain in ovary?
undergo luteinization forming a corpus luteum
136
what does the corpus luteum do during the luteal phase?
produces significant levels of progesterone and estrogen
137
what do CL hormones do?
exert negative feedback on hypothalamus and pituitary to inhibit LH and FSH
138
after how long does the CL die if there is no conception?
14 days
139
what is the uterine menstrual cycle?
cyclic changes in the endometrium in response to ovarian hormones
140
what are the three phases of the menstrual cycle?
1. menstrual phase (1-5)
2. proliferative phase (preovulatory 6-14)
3. secretory phase (post ovulation 15-28)
141
what is menses?
shedding of the endometrium resulting in vaginal bleeding
142
what happens when fertilization does not occur?
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
when does the menstrual cycle reinitiate?
day 1 of menses
144
what is amenorrhea?
absence of menstrual periods
145
what are physiological amenorrhea?
pre-puberty, pregnancy, lactation, menopause
146
what is primary amenorrhea?
failure of menses to occur with puberty
147
what is secondary amenorrhea?
cessation of menses in previously menstruating females
148
what is the major cause of anovulation?
obesity
149
how does obesity affect the hypothalamic pituitary ovarian axis?
- discordant GnRH secretion patterns
- altered pituitary response to gonadotropins
- disrupted ovarian steroidogenesis
150
what is obesity a state of?
functional hyperandrogenism
151
how does obesity cause anovulation?
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
true or false, clinical guidelines do support fertility therapy in obese individuals?
false, success is poor, high complications
153
what is an unintended pregnancy?
defined as either an unwanted or mistimed child
154
what % of pregnancies are unwanted and what is the leading cause of unwanted pregnancies?
45%. inconsistent or incorrect use of contraception
155
what are the two types of hormonal contraception?
1. combined hormonal preparations
2. progestin-only preparations
156
what is combined hormonal preparations?
- 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
what is progestin only preparations?
- contraindications for estrogen
- progestin only pull or injection
- exposure impacts reproductive tract and folliculogenesis
- thicken cervical mucus to block sperm
- impart endometrial development
158
LARC?
- longer acting reversible contraception
- 12y
- intra-uterine device or subcutaneous implants
159
what does hormonal IUD release?
progestin into uterus (up to 7 years)
160
what does copper IUD do?
provides mechanical barrier (up to 12 years) that blocks sperm from reaching and fertilizing egg. prevents implantation but does NOT inhibit ovulation
161
what do hormonal implants do?
flexible matchstick implant that secretes progestin (3 years)
162
what are two forms of emergency contraception?
1. IUD
2. Morning after pills
163
how do emergency IUDs work?
insertion up to 5 days after unprotected sex. up to 99% success rate.
164
how do morning after pills work?
take up to 5 days. 75-90% reduction of pregnancy chances. better if 3 days.
165
what is levonorgestrel?
- plan B
- synthetic progestin
- blocks LH surge and delays ovulation
- <155 pounds
166
what is ulipristal acetate?
- progesterone receptor modulator
- blocks LH surge and ovulation
- >155 pounds
167
what is trichomoniasis caused by?
a parasite
168
what are three STIs caused by bacteria?
syphilis, gonorrhea, chlamydia
169
what is trichomoniasis cured by?
antibiotic
170
what is the most common STI in the US?
Genital HPV infection
171
what can easily stop senital HPV infection?
vaccine
172
true or false, genital warts is NOT a common symptom of HPV infection?
false
173
what STI has become increasingly resistant to antibiotics?
gonorrhea
174
how is chlamydia cured?
easily cure by antibiotics
175
if HIV is untreated what can it lead to?
acquired immunodeficiency syndrome (AIDS)
176
what is the most common vaginal infection?
bacterial vaginosis
177
what is the most common "notifiable condition" reported to the CDC?
chlamydia
178
why are STI rates higher among college students?
alcohol consumption imparts judgement
179
what STIs are not curable?
herpes, hepatitis B, HIV/AIDS, and HPV
180
what STIs are curable?
syphilis, gonorrhea, chlamydia, and trichomoniasis
181
what are some common symptoms of an STI?
- painful urination, unusual discharge, skin changes (bumps, sores, etc), genital itching or pain, pelvic discomfort or pain, testicular pain
182
what two STDs have symptoms that are indistinguishable?
gonorrhea and chlamydia
183
is there a vaccine for gonorrhea?
meningitis vaccine provides protection against gonococcal infections
184
what sample is most often tested for gonorrhea using what test?
urethral gonorrhea tested in urine by nucleic acid amplification tests
185
why might is be so hard to treat STIs like gonorrhea?
pharyngeal gonorrhea infections due to oral sex
186
what percentage of women and men are asymptomatic?
75% of women and 50% of infected men
187
why is STI preferred over STD?
because many with STI/STD don't have symptoms
188
how does chlamydia get into the peritoneal cavity?
travels up vagina, through cervix, out of fallopian tube into peritoneum
189
what can occur if STI gets into peritoneal cavity?
pelvic inflammatory disorder (PID) can increase risk of infertility
190
what percentage of women with chlamydia develop PID?
10-15%
191
true or false, the damage caused by chlamydia is always reversible?
false, each episode of PID doubles the risk of permanent tubal damage
192
what long term damage can trachomatis infections cause?
damage the fallopian tubes and lead to blockage of the fallopian tubes and fibrotic scarring
193
what about female anatomy increases a women's risk of STD?
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
where in the body does chlamydia reside?
intracellular, mucosal epithelial cells of the vagina, urethra, fallopian tubes, anus and rarely the throat
195
what specific epithelial cell type does chlamydia typically infect?
ciliated simple columanr cells at mucosal sites
196
what is the lifecycle of chlamydia?
enters the body in elemntary bodies
interacts with glycogen
replicates
reorganize back to EBs
lysis or extrusion spreads to other cells/people
197
what unique problem can occur due to chlamydial infections?
neonatal conjunctivitis from perinatal transmission
trachoma (blindness)
