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SF4 Exam 3 General Flashcards

1
Q

Ejaculatory Duct

A

Formed by joining of Ductus Deferens and duct of Seminal Vesicle. Pierces posterior surface of Prostate Gland through Prostatic Utricle, becoming Prostatic Gland

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2
Q

Secreted by Leydig Cells

A
  1. Testosterone

2. Insulin-like 3 (INSL3)

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3
Q

Parasympathetic Innervation to Rectum

A

Pelvic Splanchnic Nerves (via Inferior Hypogastric Plexus)

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4
Q

Trigone

A

Smooth area on inner surface of Posterior Wall of Bladder. (The rest of it is loose and folded for expansion)

Shaped like a triangle pointing down

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5
Q

Time of Dominant Follicle Selection

A

Early Follicular Phase. Attains dominance and matures in Mid-Late Follicular Phase

10-14 days before Ovulation

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6
Q

Reactions Blocking Polyspermy

A

Fast Block:

Oocyte membrane depolarizes after fusing with Spermatozoa. Ca2+ wave causes electron-dense granules beneath oocyte to fuse with plasma membrane

Cortical Reaction:
Exocytosis of granule contents induced hardening of Zona Pellucida

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7
Q

Inferior Gluteal Artery Passes Between Which Two Nerves

A

Posteriorly between Anterior Rami S1/S2 and S2/S3

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8
Q

17α-hydroxylase

A

Converts Pregnenolone and Progesterone into Androgens

Not present in Granulosa Cell, reason why it needs Thecal Cell to produce Estrogen

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9
Q

Vagina: Arterial Supply

A

Vaginal Artery and Vaginal Branch of Uterine Artery

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10
Q

Actions of Progesterone on Female Reproductive Tract During Pregnancy

A
  1. Stimulates Production/Storage of Nutrient to Sustain Embryo (Secretory Phase / Prior to functional Placenta)
  2. Prepares Endometrium for Implantation
  3. Inhibits Uterine Contractions (Sustains pregnancy)
  4. Induces Viscous Mucus Production by Cervix
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11
Q

Adaptation During Pregnancy: Serum Na

A

Decreased

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12
Q

Syncytiotrophoblast Estradiol and Estrone Synthesis

A
  1. Fetal Zone of Adrenal Cortex releases DHEA-S
  2. Sulfate removed by Sulfatase in Syncytiotrophoblast
  3. Enzyme converts DHEA to Testosterone and Androstenedione
  4. T/Andro then converted to Estradiol and Estrone by Aromatase
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13
Q

Adaptation During Pregnancy: Hematocrit

A

Decreases. However, RBC count increased.

Prolactin and hPL enhance effect of Erythropoietin

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14
Q

Testis Cords

A

Primitive Sex Cords penetrating deep into Gonadal Medulla. Formed by Sertoli Cells aggregating around PGCs

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15
Q

Tactile Stimulus Pathway Initiating Erection

A
  • Afferent Tactile: Pudendal Nerve
  • Reflex Integration: S2-S4
  • Efferent: Parasympathetics in Cavernous Nerve
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16
Q

Lactational Amenorrhea

A

Ovulatory cycle will resume if no breastfeeding for 8-10 weeks

Mechanisms:

  1. PRL inhibits release of GnRH (feedback loop)
  2. Afferent neural pathway to GnRH neurons in Hypothalamus
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17
Q

Structures Derived from the Labioscrotal Swelling

A
  • Labia Majora (Female)

* Scrotum (Male)

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18
Q

Neurons Mediating Emission

A

L1-L2 Sympathetic Neurons

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19
Q

Cell Types in Corpus Luteum

A
  1. Granulosa-Lutein Cells

2. Thecal-Lutein Cells

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20
Q

How long does the Embryo stay in the Uterine Tube

A

First three days of pregnancy. Mostly in the Ampulla.

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21
Q

Muscles of the Bladder

A
  1. Detrusor Muscles

2. Internal Urethral Sphincter (MALE)

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22
Q

Involution

A

Name for the atrophy of the Corpus Luteum into the Corpus Albicans

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23
Q

Fate of Indifferent Gonad Cortex

A
  • Differentiates in Ovary

* Regresses in Testis

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24
Q

Process of Releasing the Oocyte at the Stigma

A
  1. Proteolytic enzymes are released by Thecal and Granuosa cells in response to LH
  2. Extracellular Matrix proteins in Thecal Layer broken down
  3. Surface of Ovary at Stima broken down
  4. Antral fluid, Oocyte, and Cumulus Cells released
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25
Q

Common Site of Rupture of Spongy Urethra

A

Bulb of Penis after leaving Urogenital Diaphragm

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26
Q

Result of DHT Absence on External Genitalia Differentiation

A

Female or Ambiguous. Possibly male with micropenis with Hypospadias

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27
Q

Separates Pubic Bone and Bladder

A

Retropubic Space of Retzius

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28
Q

Afferent Aspect of Ejactulation

A

Filling of Urethra elicits signals sent to the sacral spinal cord via the Pudendal Nerve

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29
Q

Parts of the Posterior Wall of the Prostatic Urethra

A
  1. Urethral Crest
  2. Prostatic Sinus
  3. Seminal Colliculus
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30
Q

Bony Landmark Found Between Greater and Lesser Sciatic Notches

A

Ischial Spine

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31
Q

Site of Entry of Caudal Injection / Epidural

A

Sacral Hiatus (Inferior opening to sacral canal)

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32
Q

Sleep-Associated LH Surge

A

First detectable change in Prepubertal period as puberty approaches. Diurnal LH release.

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33
Q

Sulfatase

A

Expressed by Syncytiotrophoblast to remove the Sulfate Group on DHEA-S (Fetal Adrenal) and 16α-OH DHEA (fetal liver)

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34
Q

Perineal Body

A

Small mass of connective tissue located between Anorectal Junction and Urogenital Gap in Pelvic Diaphragm

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35
Q

Primary Hormonal Influence in Proliferative Phase (Menstrual Cycle)

A

Estrogen

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36
Q

Epithelium Endometrium

A

Columnar Epithelium with Glands

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37
Q

Anal Columns

A

Upper Half of Anal Canal

Vertical folds of mucous membrane containing Superior Rectal Vessels.

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38
Q

Transurethral Resection

A

Surgical enlargement of Prostatic Urethra done in patients with BPH.

Can result in damage to the Internal Urethral Sphincter of Bladder and cause reflex of semen into bladder.

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39
Q

Obturator Internus Muscle: Origin

A
  1. Obturator Membrane

2. Ischium/Pubis

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40
Q

Sacrospinous Ligament: Attachments

A
  1. Sacrum

2. Ischial Spine (Not Iliac)

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41
Q

Internal Os

A

Opening between Uterine Cavity and Cervix

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42
Q

External Urethral Sphincter: Innervation

A

Perineal Branch of Pudendal Nerve

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43
Q

HPG Axis: Early Follicular Phase

A
  1. FSH rises at end of Luteal Phase of previous cycle due to decline in negative inhibition
  2. FSH increasing at start of Follicular Phase
  3. LH constant
  4. FSH promotes Granulosa Cell proliferation
  5. FSH and LH stimulate Estradiol Synthesis
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44
Q

Spinal Roots of Sacral Plexus

A
  1. Lumbrosacral Trunk L4-L5

2. Anterior Rami S1-S4

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45
Q

Epithelium of Primordial Follicles

A

Squamous

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46
Q

Levator Ani: Insertions

A
  1. Coccyx
  2. Anococcygeal Body
  3. Perineal Body
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47
Q

LH Receptors on these Ovary Cells induce Androgen Biosynthesis

A
  1. Thecal Cells

2. Interstitial Cells

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48
Q

Receptors on Male Accessory Organs

A

α1-adrenergic receptors

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49
Q

Regions of the Epididymis

A
  1. Head
  2. Body
  3. Tail
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50
Q

Stimulates Hepatic Angiotensinogen Synthesis

A

Estrogen (pregnancy)

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51
Q

Obturator Internus Muscle: Course

A

Leaves True Pelvis via Lesser Sciatic Foramen

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52
Q

Structures Derived from Urethral Folds

A
  • Labia Minora (Female)

* Ventral Folds of Penis (Male)

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53
Q

Upper Half of Anal Canal: Arterial Supply

A

Superior Rectal Artery

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54
Q

Parts of the Uterus

A
  1. Fundus
  2. Body
  3. Cervix
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55
Q

Converts DHEA-S to 16α-OH DHEA-S

A

Fetal Liver enzymes

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56
Q

Widest and Most Dilatable Part of Urethra

A

Prostatic Urethra

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57
Q

Innervated by Superior Gluteal Nerve

A

Gluteal Muscles

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58
Q

Prior to Week 8, Genital Ducts in Both Sexes

A
  1. Wolffian (Mesonephric) Ducts

2. Mullerian (Paramesonephric) Ducts

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59
Q

Adaptation During Pregnancy: Pancreas

A

Hypertrophy and Hyperplasia of Beta Cells.

Increased insulin resistance in 2nd half of pregnancy (hPL and Cortisol)

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60
Q

Nerve innervation of Accessory Organs During Emission

A

Hypogastric Nerve (carrying L1-L2 sympathetics)

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61
Q

Mechanism of NO

A
  1. Binds to soluble Guanylyl Cyclase in Cytoplasm

2. cGMP rise leads to smooth muscle relaxation and vasodilation

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62
Q

Estrone

A

E1

Much weaker than Estradiol. Formed by peripheral conversion of Estradiol and Androstenedione

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63
Q

Anococcygeal Body

A

Fibrous raphe connecting Anal Canal and Coccyx

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64
Q

Follicular Cell with limited cholesterol Supply

A

Granulosa Cells

Not close to vasculature. Separated by Basal Lamina during Follicular Phase. Secrete more Progesterone in Luteal Phase when Corpus Luteum vascularized

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65
Q

Change to Granulosa Cells when going from Primary to Mature Preantral Follicle

A

Begins to express FSH and Estrogen Receptors

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66
Q

Prostate Specific Antigen (PSA)

A

Breaks down clotting factors in semen (Fibrinogen from Seminal Vesicles)

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67
Q

Structures Attached to the Perineal Body (6)

A
  1. External Anal Sphincter
  2. Superior/Inferior Layers of Urogenital Diaphragm
  3. Superficial Transverse Perineal Muscle
  4. Deep Transverse Perineal Muscle
  5. Superficial Perineal Fascia
  6. Bulbospongiosus Muscle
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68
Q

Neurogenic Bladder

A

Dilated/flaccid bladder caused by spinal cord injury at S2-S4

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69
Q

Phagocytize Cytoplasm Released During Spermiogenesis

A

Sertoli Cells

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70
Q

Cumulus Cells

A

Granulosa cell type. Surround and maintain gap junctions with the Oocyte. Released with the Oocyte during ovulation

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71
Q

Navicular Fossa

A

Dilated part of Penile Urethra in Glans Penis

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72
Q

Required for External Genitalia Differentiation in Males

A

Dihydrotestosterone (DHT)

Derived from Testosterone, converted by 5α-reductase

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73
Q

Progesterone Role in Secretory Phase

A
  1. Inhibits Epithelial Cell Proliferation
  2. Promote Differentiation of Endometrium
  3. Enhance Secretory Capacity
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74
Q

Detrusor Muscles: Innervation

A

Pelvic Splanchnic Nerves (Parasympathetic Fibers)

Inhibited by Sympathetics of T12-L2 (Hypogastric Nerves)

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75
Q

Cumulus Expansion

A

Hyaluronic Acid is secreted by the Cumulus Cells in response to LH stimulation.

Expands Extracellular Matrix and enlarges Cumulus-Oocyte complex. Enlargement facilitates Oocyte capture by the Fallopian Tubes

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76
Q

Change to Granulosa Cells Upon Being Selected as Dominant Follicle

A

FSH induces expression of LH Receptors. Allows it to respond to the LH surge.

Estradiol enhances the effect of FSH on LH receptor induction.

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77
Q

Pubic Arch

A

Angle between Inferior Rami and Bodies of Pubic Bones on both sides

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78
Q

Mediolateral Episiotomy

A

Surgical cutting of Vagina and Posterior Wall of Vulva (lateral to Perineal Body)

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79
Q

Receptor Binding AMH

A

TWO Serine-Threonine Kinase Receptors (R I and R II)

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80
Q

Bladder: Arterial Supply

A

Superior and Inferior Arteries

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81
Q

Oxytocin Effects on Uterine Contraction

A
  1. Uterus Oxytocin Resistant (first 2 Trimesters)
  2. Does NOT initiate labor
  3. Distention of Cervix increases Oxytocin (pos. feedback)
  4. Uterine sensitivity increases before/during contraction due to increase in receptors
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82
Q

Adaptation During Pregnancy: Lung Function Values

RV, FRC, TLC, VC, TV

A
  1. Residual Volume: Decreases
  2. Functional Residual Capacity: Decreases
  3. Total Lung Capacity: Decreases (slight)
  4. Vital Capacity: Unchanged
  5. Tidal Volume: Increases
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83
Q

Digests Extracellular Matrix and Basement Membrane in Menstrual Phase

A

Matrix Metalloproteinases

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84
Q

Source of Anti-Mullerian Hormone

A

Sertoli Cells

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85
Q

Decidual Reaction

A

Continues process started by Progesterone during Luteal Phase, transforming Endometrial Stromal Cells into enlarged cells forming an Epithelioid-like Compact Layer. Reaction spreads throughout Endometrium

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86
Q

Changes to Spermatozoa Membrane During Capacitation

A

Uterine Wall and Fallopian tube secretion destabilize plasma membrane near head.

Increased Ca2+ permeability

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87
Q

Artery of Bulb (of Penis)

A

Supplies erectile tissue of Bulb and Corpus Spongiosum

Anastomosis with Dorsal Artery of the Penis at Glans Penis

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88
Q

Action(s) of Bulbospongiosus Muscle

A
  1. Aids in emptying urethra

2. Contributes to erection by compressing blood engorged bulb of penis

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89
Q

Induces Expression of Aromatase

A

FSH

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90
Q

Secreted by the Testes

A
  1. Testosterone (by far major secretion)
  2. Estrogens
  3. Weak Androgens (Androstenedione and DHEA)
  4. Various Biosynthetic Intermediates
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91
Q

Cyclooxygenase-2 (COX-2)

A

Catalyzes formation of Prostaglandins, derived from Arachidonic Acid metabolism

Expression by Granulosa Cells (Preovulatory Follicle) induced by LH

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92
Q

Adaptation During Pregnancy: Afterload

A

Decreases

Aorta more distensible (Estrogen/Progesterone), decrease in Peripheral Resistance

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93
Q

Interaction between R I and R II

A

AMH binds to R II, which is constitutively phosphorylated. Binding causes R II to recruit R I and phosphorylate it. R I kinase activity activated

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94
Q

Acrosomal Reaction

A

Triggered by Spermatozoa head proteins binding to ZP3 receptor on Zona Pellucida. The rise in intracellular Ca induces release of Hydrolytic Enzymes to digest through Zona Pellucida

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95
Q

Blood Supply to Penis are Branches off…

A

Internal Pudendal Artery

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96
Q

Stimulates Fetal Leydig Cell Testosterone Production

A

Chorionic Gonadotropin (hCG)

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97
Q

Negative Feedback of Ovarian Hormones

A
  1. Estradiol on Ant. Pit / Hypothalamus
  2. Progesterone on Ant. Pit / Hypothalamus
  3. Inhibin A/B on Ant. Pit only
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98
Q

Iliococcygeus

A

Part of Levator Ani

  • Originates on Tendinous Arch and Ischial Spine
  • Inserts on Coccyx and Anococcygeal Body
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99
Q

Reason for Decreased Venous Efflux During Erection

A

Compression of Subtunical Venous Plexus against wall of Tunica Albuginea

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100
Q

Medial Umbilical Ligament

A

Obliterated Distal part of Umbilical Artery

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101
Q

Dorsal Artery of the Penis

A

Supplies skin of the penis and fascial sheath surrounding erectile tissue.

Anastomoses with Artery of Bulbs of Penis at Glans Penis.

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102
Q

Sensory Innervation to the Clitoris

A

Dorsal Nerve of Clitoris (Branch of Pudendal Nerve)

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103
Q

Midpiece (Mature Spermatozoa)

A

Packed with mitochondria for energy

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104
Q

External Os

A

Opening between Cervix and Vagina

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105
Q

Supplies Proximal Part of Rectum

A

Superior Rectal Artery

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106
Q

Fornix of Vagina

A

Part of Vaginal Lumen surrounding Cervix. Four Parts:

  1. Anterior
  2. Two Lateral
  3. Posterior
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107
Q

Muscle Surrounding Anorectal Junction

A

Puborectalis Muscle (Levator Ani)

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108
Q

Requirements for Ovary Differentiation

A
  1. Invasion of Cortex by PGCs
  2. Reactivation of Inactivated X Chromosome
  3. Absence of SRY Gene
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109
Q

Smad3

A

AMH Pathway

Cytoplasmic protein phosphorylated by R I. Nuclear Localization Signal unmasked when activated.

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110
Q

5α-Reductase

A

Converts Testosterone to DHT. Present in DHT-sensitive target tissue

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111
Q

Chorinonic Somatomammotropin (hCS) / Placental Lactogen (hPL)

A

Same structural family as GH/PRL. Secreted into the blood both by the mother and fetus. Functions to maintain glucose flow to fetus

  1. Stimulates Lipolysis (Mother)
  2. Antagonizes Insulin (Mother)
  3. Required for Breast Development
  4. Enhances Erythropoietin Effect (Mother)
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112
Q

Hysterosalpingography

A

Radiography of Uterus and Uterine tube following radiopaque injection. Determine patency (passability) of Uterine Tube

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113
Q

Ectopic Tubal Pregnancy

A

Ovum is fertilized but cannot pass down the tube. Uterine Tube will later rupture due to the placenta and result in life-threatening hemorrhage into Peritoneal Cavity

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114
Q

Cavernous Endothelial Cells

A

Release Nitric Oxide in addition to the efferent parasympathetics during erection

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115
Q

Nabothian Cyst

A

Pus-filled cyst, filled with mucus from a blocked cervical gland in the Cervix.

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116
Q

Promotes Descent of Testes Through Inguinal Canal into Scrotum

A

Testosterone

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117
Q

Epithelium of Efferent Ductules

A

“Scalloped” Look

Alternating:

  1. Nonciliated Cuboidal Epithelium
  2. Ciliated Simple Columnar Epithelium
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118
Q

Characterize Growth of Dominant Follicle

A
  1. Graunlosa Cell Proliferation (Cumulus Oophorus)
  2. Oocyte pushes to one side of follicle
  3. Expansion of Antrum
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119
Q

Posterior Half of Perineum

A

Anal Triangle

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120
Q

Most Potent Postpartum Stimulus of Prolactin

A

Suckling

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121
Q

Location of Urogenital Diaphragm

A

Inferior to Pelvic Diaphragm in Perineum

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122
Q

Indicates present of a dominant follicle

A

Dramatic increase in circulating Estradiol

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123
Q

Anterior Lobe (Prostate)

A

Anterior to Prostatic Urethra

Little glandular tissue/significance

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124
Q

Secreted by Seminal Vesicles

A
  1. Prostaglandins (Uterine Contraction)
  2. Fructose
  3. Fibrinogen (Helps clot semen together)
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125
Q

Oxytocinase

A

Enzyme resulting in Uterus’ resistance to Oxytocin in the first two Trimesters

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126
Q

Syncytiotrophoblast Estriol Synthesis

A
  1. DHEA-S from Fetal Adrenal Cortex Converted to 16α-OH DHEA-S in Fetal Liver
  2. Placental Sulfatase removes Sulfate
  3. 16α-OH DHEA converted to 16-hydroxyandrostenedione
  4. Then to Estriol by Placental Enzymes
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127
Q

Posterior Lobe (Prostate)

A

Inferior to Ejaculatory Duct and Posterior to Prostatic Urethra

Common site for Carcinoma

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128
Q

Adaptation During Pregnancy: Baroreceptor Reflex

A

Lower set point

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129
Q

Site of Milk Storage

A

Lactiferous Sinus

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130
Q

Structures Derived from Genital Tubercle

A
  • Clitoris (Female)

* Glans Penis (Male)

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131
Q

FSH Receptor Intracellular Mechanism

A

cAMP Signaling Pathway

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132
Q

Destination of Ovarian Vein Drainage

A
  • Right: Inferior Vena Cava

* Left: Left Renal Vein

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133
Q

Actions of FSH on Sertoli Cell

A
  1. Promotes Proliferation/Differentiation of the Cell (Immature Testes)
  2. Maintains Function in Mature Testes
  3. Induction of Proliferation, Development, and Anti-Apoptotic Effects on Spermatogonia
  4. Promotes Synthesis/Release of ABP
  5. Stimulates Inhibin Release
  6. Upregulate Aromatase
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134
Q

Suspensory Ligament of the Ovary

A

Part of Broad Ligament of the Uterus

Suspends ovary from lateral pelvis walls. Contains Neurovascular supply to ovary

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135
Q

Decidua

A

Name for Endometrium post-implantation

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136
Q

HSD 2

A

Protein expressed by Placenta, protecting Fetus from Maternal Cortisol

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137
Q

Source of hCG in Pregnancy

A

Syncytiotrophoblast

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138
Q

True Pelvis: Superior and Inferior Boundaries

A
  1. Superior – Pelvic Inlet

2. Inferior – Pelvic Outlet

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139
Q

Location of Portal-Caval Anastomoses in Anal Canal

A

Anal Columns

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140
Q

Spinal Roots of Pudendal Nerve

A

S2-S4

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141
Q

Placental Variant of Human Growth Hormone (hGH-V)

A

Secreted by Syncytiotrophoblast in two isoforms

Dominant form of GH in maternal secretion (pituiatry GH under negative feedback of IGF-1)

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142
Q

Actions of the Bulbospongosis Muscles (Female)

A
  1. Constricts Vaginal Orifice
  2. Aids in Expression of Greater Vestibular Glands
  3. Contributes to Erection of the Clit
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143
Q

HPG Axis Feedback Regulation

A
  1. Testosterone

Inhibits Hypothalamic Pulse Generator (GnRH frequency). Lowers ratio of LH to FSH.

  1. Inhibin

Secreted by Sertoli Cells. Inhibits ONLY FSH release

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144
Q

HPG Axis: Late Follicular Phase

A
  1. Increase in Estradiol from increase in Granulosa Cells in Dominant Follicle and FSH/LH stimulation
  2. Positive feedback effect on Pit/Hypothalamus leads to LH surge/ovulation
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145
Q

Adaptation During Pregnancy: Resting Heart Rate

A

Increases by 10-20 bpm

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146
Q

Muscle in Greater Sciatic Foramen

A

Piriformis Muscle

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147
Q

ZP1, ZP2, and ZP3

A

Extracellular proteins secreted by Oocyte which embed into the Zona Pellucida, providing species specific binding sites for sperm

Binding of Spermatozoa to ZP3 triggers the Acrosomal Reaction

Added in the process of forming a Mature Preantral Follicle

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148
Q

Fourchette

A

Point where Labia Minora unites posteriorly (also called Frenulum of Labia Minora)

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149
Q

Layers of the Uterus (Superficial to Deep)

A
  1. Endometrium
  2. Myometrium
  3. Perimetrium
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150
Q

Stigma

A

Poorly vascularized bulge on Ovary surface due to pressure of follicle against it

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151
Q

Broad Ligament of the Uterus

A

Two-layered reflection of Peritoneum from Uterus, extending laterally to the Pelvic Wall

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152
Q

Seminiferous Tubule Compartments

A

Formed by Tight Junctions between Sertoli Cells

  1. Basal Compartment
  2. Adluminal Compartment
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153
Q

Vagina: Venous Draiange

A

Vaginal Venous Plexus

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154
Q

Detrusor Muscles

A

Three-layered smooth muscular coat of Bladder

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155
Q

Fetal Zone of Adrenal Cortex During Pregnancy

A

Major Source of DHEA for Synctiotrophoblast Estriol secretion.

Released as DHEA-S

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156
Q

Breast Development: Pregnancy (Requirements for Development)

A

Development Requires:

  1. Prolactin
  2. hPL
  3. Estrogens
  4. Progesterone

Permissive:

  1. GH
  2. IGF-1
  3. Insulin
  4. Cortisol
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157
Q

Genes Induced by CREB

A

CREB induces transcription of the following Steroidogenic genes in the LH Pathway:

  1. StAR
  2. P450scc (Cholesterol to Pregnenolone)
  3. 17α-Hydroxylase
  4. Proteins/Enzymes involved in Cholesterol Synthesis/Uptake
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158
Q

Action of SOX9

A

Regulates expression of genes that promote Sertoli Cell Differentiation

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159
Q

Upper Half of Anal Canal: Venous Drainage

A

Superior Rectal Vein

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160
Q

Posterior Division Branches (Internal Iliac Artery)

A
  1. Iliolumbar Artery
  2. Lateral Sacral Artery
  3. Superior Gluteal Artery
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161
Q

Termination of the Bulb of Vestibule

A

Glans of Clitoris

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162
Q

Obturator Fascia

A

Thick regional expression of Endopelvic Fascia covering Obturator Internus

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163
Q

Inhibits Lactation During Pregnancy

A

Progesterone

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164
Q

Adaptation During Pregnancy: Plasma Osmolality

A

Decreased

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165
Q

Anterior Division Branches (Internal Iliac Artery)

A
  1. Obturator Artery
  2. Umbilical Artery
  3. Inferior Vesical Artery (Male)
  4. Middle Rectal Artery
  5. Vaginal Artery (Female)
  6. Uterine Artery (Female)
  7. Inferior Gluteal Artery (Terminal)
  8. Internal Pudendal Artery (Terminal)
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166
Q

Source of Cholesterol for Granulosa-Lutein Cells

A

Obtain cholesterol from circulating LDL/HDL.

  1. LH induces breakdown of Basal Lamina (Vascularized)
  2. LH induces expression of LDL/HDL receptors
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167
Q

Obstetric Conjugate

A

True Conjugate.

Thickest Part of Pubic Symphysis to Sacral Promontory

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168
Q

Contained in Basal Compartment of Seminiferous Tubule

A
  1. Spermatogonia

2. Early Stage Primary Spermatocytes

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169
Q

Structures of Upper Half of Anal Canal

A
  1. Anal Columns
  2. Anal Valves
  3. Anal Sinuses
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170
Q

Glycosuria in Pregnant Women

A

Caused by an increase in filtered Glucose (see: GFR) and diminished ability to reabsorb

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171
Q

Contents of Superficial Perineal Pouch

A
  1. Root of External Genitalia
  2. Superficial Transverse Perineal Muscle
  3. Bulbospongosus Muscle
  4. Ischiocavernosus Muscle
  5. Greater Vestibular Glands (FEMALE)
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172
Q

Mural Cells

A

Granulosa cell type. Develop in close contact with Thecal Layer and are actively engaged in steroidogenesis.

Retained after ovulation and differentiate into the Corpus Luteum

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173
Q

RSPO1

A

Gene which directly activates the WNT4 / Beta-Catenin Pathway. Promote ovarian differentiation and represses development of Testis.

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174
Q

Upper Half of Anal Canal: Innervation

A

Hypogastric Plexus of Autonomic System

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175
Q

Ovarian Cycle Day Breakdown

A
  1. Follicular Phase (1-13)
  2. Ovulation (14)
  3. Luteal Phase (15-28)
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176
Q

Muscles of the Pelvic Diaphragm

A
  1. Levator Ani (Anterior 3/4)

2. Coccygeus (Posterior 1/4)

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177
Q

Overview of AMH-Receptor Mechanism

A
  1. R I and R II receptor dimer
  2. R I phosphorylates Smad3
  3. Smad3 + Smad4 move to nucleus
  4. Promotes Apoptotic Genes
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178
Q

Colles’ Fascia

A

Also called generically the Superficial Perineal Fascia (Anal Triangle part). Continuation of Scarpa’s Fascia from Anterior Abdominal Wall

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179
Q

Round Ligament of the Ovary

A

Ligament from Uterus to Ovary

Remnant of proximal part of Gubernaculum, attached to lateral side of Uterus inferior to the Uteirne Tube

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180
Q

Innervation of Bladder

A
  1. Sacral Nerves (S2-S4) via Pelvic Splanchnic Nerves

2. T11-L2

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181
Q

True Pelvis: Lateral Walls

A
  1. Pelvic Bones
  2. Obturator Internus Muscle
  3. Sacrospinous Ligaments
  4. Sacrotubeorus Ligaments
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182
Q

Contains the Proximal Part of Spongy Urethra

A

Bulb of Penis

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183
Q

Levator Ani: Origins

A
  1. Anterior – Body of Pubis
  2. Middle – Tendinous Arch
  3. Posterior – Ischial Spine
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184
Q

Adaptation During Pregnancy: Diastolic Volume (Preload)

A

Increases

Due to Estrogen and Progesterone increasing Compliance

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185
Q

Supplied by Arteries to Bulb of the Vestibule

A

Bulb and related parts of the Vagina

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186
Q

Used to treat erectile dysfunction

A

cGMP-Specific Phosphodiesterase Inhibitors

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187
Q

Histological Appearance of Prostate Gland

A

Has Prostatic Concretions (hardened/calcified protein)

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188
Q

Contents of Deep Perineal Pouch

A
  1. Deep Transverse Perineal Muscle
  2. External Urethral Sphincter
  3. Membranous Urethra (Male)
  4. Bulbourethral Glands (Male)
  5. Urethra and Vagina (Female)
  6. Internal Pudendal Artery, Veins, and Branches
  7. Pudendal Nerve and Branches
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189
Q

Course of Genital Ducts

A

From Gonad to Urogenital Sinus

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190
Q

Components of Linea Terminalis: Posterior to Anterio

A
  1. Arcuate Line (Ilium)
  2. Pecten Pubis
  3. Pubic Crest
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191
Q

Sperm Passage through Cervix

A

Moves through the Interstitial spaces created by Mucin molecules proliferate and accumulate water in response to mid-cycle estrogen peak

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192
Q

Myometrium

A

Middle layer of the Uterus

Thick muscular layer expelling the fetus during birth

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193
Q

Act as friction ridges during intercourse and allow for distention during childbirth

A

Vaginal Rugae

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194
Q

Marked by Lower Corner of Trigone

A

Internal Orifice of Urethra

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195
Q

Superficial Dorsal Vein of Penis

A

Drains blood from and fascia of penis into Superficial External Pudendal Vein

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196
Q

Ischioanal Fossa

A

Fat-filled space surrounding External Anal Sphincter in Anal Triangle of Perineum

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197
Q

Contained in Adluminal Compartment of Seminiferous Tubule

A
  1. Late Stage Primary Spermatocytes
  2. Secondary Spermatocytes
  3. Spermatids
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198
Q

Prostaglandin F2α

A
  1. Promotes Degradation During Luteolysis

2. Released by Endometrium to promote vasospasms in Menstrual Phase

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199
Q

Sacral Plexus Nerves Which Exit Greater Sciatic Foramen (4) [And Relation of Exit to Piriformis]

A
  1. Superior Gluteal Nerve (above)
  2. Inferior Gluteal Nerve (below)
  3. Sciatic Nerve (below)
  4. Posterior Cutaneous Nerve of Thigh (below)
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200
Q

Structures Differentiating from the Mullerian Ducts

A
  1. Fallopian Tubes
  2. Uterus
  3. Cervix
  4. Upper 1/3 of Vagina
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201
Q

Uterovaginal Primordium

A

Fusion of the Mullerian Ducts and the Caudal End

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202
Q

Bladder: Venous Drainage

A

Vesical Venous Plexus (Drains to Superior/Inferior Vesical Veins then Internal Iliac Veins)

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203
Q

Follicular Cell without Aromatase Activity

A

Thecal Cell

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204
Q

Major Estrogen in Post-Menopausal Women

A

Estrone

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205
Q

Cystitis

A

Bladder infection

Common in females due to short urethra

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206
Q

Gonocyte

A

Prespermatogonia

Differentiated PGCs within Testis Cords which have entered Mitotic Arrest at Weeks 10-12. Resume proliferation after birth (don’t enter Meiosis until puberty)

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207
Q

Danger from Artery during Hysterectomy

A

Uterine artery crosses anterior to the Ureter, very close. Ureter can be damaged.

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208
Q

Clinical Manifestations of Declining Estrogen in Menopause

A
  1. Uterine Atrophy
  2. Dryness of the Vagina
  3. Loss of Bone Mass
  4. Rise in Circulating Gonadotropins
  5. Hot Flashes
209
Q

HPG Axis: Childhood (after neonatal)

A

Under CNS inhibition, quiet during childhood. Girls somewhat higher FSH

210
Q

Marked by Upper Corners of Trigone

A

Opening of Ureters

211
Q

Principal Steroid Hormones Secreted by Ovaries

A
  1. Estradiol
  2. Progesterone
  3. Androstenedione
212
Q

Equivalent of Bulbourethral Glands in Females

A

Greater Vestibular Glands (Bartholin’s Glands)

213
Q

Hormones Secreted During Pregnancy (6)

A
  1. Chorionic Gonadotropin (hCG)
  2. Progesterone
  3. Estrogens
  4. Chorionic Somatomammotropin (hCS) aka Placental Lactogen (hPL)
  5. Placental Variant of Human Growth Hormone (hGH-V)
  6. Relaxin
214
Q

Obturator Internus Muscle: Insertion

A

Greater Trochanter of Femur

215
Q

hCG Structure

A
  • α subunit: identical to other Ant. Pit. glycoproteins
  • β subunit similar to LH

Uses LH receptors but has longer half-life (glycosylated)

216
Q

LH Receptor Pathway: Phosphorylated by PKA

A

CREB (Transcription Factor)

217
Q

Rectovesical Septum

A

Fused to Inferior End of Peritoneum, lying between base of bladder and rectum.

Anterior to rectum (palpable during rectal exam)

218
Q

Adaptation During Pregnancy: Plasma Volume

A

Increases due to Estrogen stimulation of Renin

219
Q

Fetoplacental Unit

A

Collaboration between Placenta and Fetus to Produce Estrogen (Estriol)

  1. Synctiotrophoblast can synthesize Progesterone and has Aromatase
  2. Fetal Zone of Adrenal Cortex source of Androgens
220
Q

Meiosis Arrest in Secondary Oocyte

A

Arrested at Metaphase II by Cytostatic factor until feritilzation

221
Q

Orchitis

A

Inflammation of the Testes. Seminiferous Tubule destruction may occur. Usually secondary to Mumps

Leydig Cells NOT affected

222
Q

Supine Hypotensive Syndrome

A

Cardiac output higher when mother in Lateral Recumbent Position as opposed to Supine (Third Trimester). Weight of Uterus compresses IVC when Supine

223
Q

Adaptation During Pregnancy: Blood Viscosity

A

Lowered due to:

  1. Decrease in Oncotic Pressure (Albumin conc. drop)
  2. Decreased Hematocrit
224
Q

Efferent Aspect of Ejaculation

A

Trigger rhythmic contractions of Striated Musculature of Perineum, especially the Bulbocavernosus Muscle

225
Q

Continuations of Colles’ Fascia

A
  • Scrotum – Dartos Fascia

* Penis – Superficial Penile Fascia

226
Q

Secretion of Inhibin A vs Inhibin B (Female)

A
  • Inhibin A: Granulosa-Lutein Cells of Corpus Luteum in Response to LH
  • Inhibin B: Graunlosa Cell in Response to FSH
227
Q

Composition of Indifferent Gonad

A
  1. External Cortex (Thickened Epithelium)

2. Internal Medulla (Prim. Sex Cords and Mesen. Tissue)

228
Q

Corona Radiata

A

Crown of Granulosa Cells between Oocyte and Antrum

229
Q

Adaptation During Pregnancy: Urinary Protein Secretion

A

Increases due to increase in GFR and permeability of Glomerular Basement Membrane.

Decrease in Serum:

  1. Creatinine
  2. Urea
  3. Uric Acid
230
Q

Genital / Gonadal Ridge

A

Thickened area formed from Epithelial and Mesenchymal cell proliferation in Week 5. Found along ventromedial surface of Mesopehros

231
Q

HPG Axis: Prepubertal Period

A
  • Gradual Disinhibition of GnRH Pulse Generator

* See: Sleep-Associated LH Surge (Dirunal)

232
Q

Epithelium of Epididymis

A

Pseudostratified Epithelium surrounded by Smooth Muscle

233
Q

Ischiocavernosus Muscle

A

Located in Superficial Perineal Pouch. Covers Crura of Penis/Clitoris

234
Q

Cell Types Differentiated from Trophoblasts

A
  1. Cytotrophoblasts

2. Syncytiotrophoblasts

235
Q

Coccygeus: Origin

A

Ischial Spine

236
Q

Alternate Branching of Obturator Artery

A
  • Normal – Anterior Division of Internal Iliac

* Alternative – Inferior Epigastric Artery

237
Q

Progesterone Peak Stage

A

Mid-Luteal Phase of Ovarian Cycle

238
Q

Right and Left Lateral Lobes (Prostate)

A

Separated by Prostatic Urethra. May become enlarged (BPH) and compress urethra

239
Q

Histological Appearance of Corpus Albicans

240
Q

Precursor of the Seminiferous Tubules

A

Testis Cords

Solid structures until puberty. They then will develop a lumen and mature into functional tubules.

241
Q

Blood Supply to Female Copulatory Organs

A
  1. Arteries to Bulb of the Vestibule
  2. Deep Arteries of the Clitoris
  3. Dorsal Arteries of the Clitoris
242
Q

HPG Axis: Luteal Phase

A
  1. LH promotes development/secretions in Corpus Luteum
  2. Hormone production declines with Luteolysis
  3. FSH rises as Corpus Luteum fails (decreased neg. feedback)
243
Q

Mechanism of Tonic Inhibition of Prolactin

A

Dopamine action on Lactotrope in Anterior Pituitary. G(i) protein

  • α Subunit – inhibits Adenylyl Cyclase
  • βγ Subunits – Activate K+ channel (Hyperpolarize)
244
Q

Innervated by Posterior Cutaneous Nerve of Thigh

A

Back of Thigh

245
Q

Prostate Gland: Venous Drainage

A

Prostatic Venous Plexus (valveless), drains into Internal Iliac Vein

246
Q

Reason for Prolactin Rise During Pregnancy

A

Estrogen promotes:

  1. Lactotrope Hypertrophy/Hyperplasia
  2. Prolactin Synthesis
247
Q

Histological Appearance of Seminal Vesicles

A

Elaborate mucosal foldings, filling most of the lumen

248
Q

Major Hormonal Influence on Proliferative Phase of Menstrual Cycle

249
Q

Actions of LH on Preovulatory Follicle

A
  1. Induces release of Inflammatory Cytokines and Metalloproteinases (breakdown Ovary wall)
  2. Induces Expression of COX-2 in Granulosa Cells
  3. Triggers Ovulation w/in 36 hrs
  4. Stimulates Progesterone and Receptor Synthesis
  5. Promotes Cumulus Expansion / Detachment of Oocyte Cumulus Complex
  6. Promotes Reorganization of Mural Cells into Corpus Luteum
  7. Promotes Resumption of Meiosis I
250
Q

Corresponding Endometrial Cycle Phase(s) of Luteal Phase

A

Secretory Phase

251
Q

Ducts in Breast Lobules

A
  1. Alveolar Duct

2. Lactiferous Duct

252
Q

Adaptation During Pregnancy: Thyroid

A
  1. Enlarged during 1st Trimester (hCG)
  2. Iodide uptake increased (due to higher renal clearance)
  3. T4 and T3 increase (estrogen-induced TBG synthesis)
253
Q

Smad4

A

AMH Pathway

Forms complex with activated Smad3 and moves into nucleus to upregulate Apoptotic genes

254
Q

Seminal Colliculus

A

Rounded emininence on Urethral Crest on the Posterior Wall of the Prostatic Urethra.

Slit-like orifice leads to small Vestigal Prostatic Utricle. Opening for Ejaculatory duct next to orifice to utricle

255
Q

Released by Cavernous Nerve During Erection

A
  1. Nitric Oxide (NO)

2. Vasoactive Intestinal Peptide (VIP)

256
Q

Diagonal Conjugate

A

Approximation of Obstetric Conjugate. Attained during digital exam

Inferior Border of Pubic Symphysis to Sacral Promontory.

257
Q

HPG Axis: Puberty

A
  • Gonadotropins elevation persistent throughout day

* HPG axis increasingly active (Adult regulation pattern established)

258
Q

Urogenital Hiatus / Gap

A

Allows for passage of Urethra (both) and Vagina (females) through Pelvic Diaphragm

259
Q

Lower Half of Anal Canal: Innervation

A

Inferior Rectal Nerve (branch of Pudendal Nerve)

Somatic sensory responding to pain, touch, and temperature

260
Q

Mesosalpinx

A

Part of Broad Ligament of the Uterus located inferior to the Uterine Tube

261
Q

Location of the Bulbourethral Glands

A

Below prostate, lateral to Membranous Urethra

262
Q

Morula

A

Ball of cells from mitotic division of fertilized Zygote as it enters the Uterus. Remains unattached for another three days and subsists on uterine secretions

Develops into a Blasocyst

263
Q

Phases of the Endometrial Cycle

A
  1. Proliferative
  2. Secretory
  3. Menstrual
264
Q

PRL Receptor Type

A

Tyrosine Kinase-Associated Receptor (JAK/STAT Pathway)

265
Q

Peritoneal Coverings of Rectum:

A
  • Superior 1/3: Anterior and Lateral Surface Covered
  • Middle 1/3: Anterior Only
  • Lower 1/3: none
266
Q

Delays Capacitation

A

Binding of Sperm to the Uterine Tube epithelium. Extends the life of the sperm and prevents too many for reaching the egg

267
Q

Piriformis Muscle: Insertion

A

Greater Trochanter of Femur

268
Q

Mechanism of Blastocyst Escaping Zona Pellucida in Order to Implant

A

Trophoblast cell secrete proteases to digest Zona Pellucida, allowing embryo to escape

269
Q

Sacral Plexus Nerves Which Exit Greater Sciatic Foramen and Re-Enter Through Lesser Sciatic Foramen

A
  1. Pudendal Nerve

2. Nerve to Obturator Internus and Superior Gemellus Muscles

270
Q

Part of Endometrium NOT Shed During Menstruation

A

Stratum Basalis – Lower 1/3

271
Q

Completion of Second Meiotic Division of Oocyte

A

Triggered by Ca2+ signal. Oocyte develops into Female Pronucleus, Spermatozoa into Male Pronucleus

Fuse to form Diploid Zygote.

272
Q

Lower Half of Anal Canal: Arterial Supply

A

Inferior Rectal Artery (Branch of Internal Pudendal Artery)

273
Q

Anal Valves

A

Upper Half of Anal Canal

Semilunar epithelial folds joining inferior ends of Anal Columns

274
Q

Parts of the Broad Ligament of the Uterus

A
  1. Mesometrium
  2. Mesovarium
  3. Mesosalpinx
  4. Suspensory Ligament of Ovary
275
Q

Arteries Supplying Penis

A

Branches of Internal Pudendal Artery

  1. Artery of Bulb
  2. Deep Arteries of the Penis
  3. Dorsal Artery of the Penis
276
Q

Klinefelter Syndrome

A

Extra X chromosomes in Male, 80% of time 47, XXY

  • Small, firm testes
  • Hyalinized Seminiferous Tubules
  • Germ Cell Degeneration
277
Q

Innervated by Inferior Gluteal Nerve

A

Gluteal Muscles

278
Q

Ligaments of Cervix of Uterus

A

Condensations of Endopelvic Fascia on Superior Surface of Pelvic Diaphragm. Hold the cervix in place to maintain anteflexed/anteverted position of Uterus and prevent prolapse.

Stretching during childbirth could contribute to Prolapse

279
Q

Milk Ejection

A

Promoted by Oxytocin acting on Myoepithelial Cells surrounding Alveoli.

Principal stimulus of reflex is suckling

  • Psychic Stimuli: Crying of Infant
  • Repression: Fear, Anger, Stress, Pain
280
Q

Follicular Cell with constant cholesterol supply

A

Thecal Cells

Close to blood vessels so they have constant LDL Cholesterol

281
Q

Internal Hemorrhoids

A

Varicosities of tributaries of Superior Rectal Veins in Anal Columns, covered by mucous membrane. Less painful than external hemorrhoids

282
Q

Course of Ductus Deferens

A
  1. Enters Pelvis crossing over External Iliac Artery
  2. Crosses over Ureter at posterolateral angle of Bladder
  3. Descends to posterior surface of Bladder
283
Q

Deep Penile Fascia

A

Buck’s Fascia

Deep to Superficial Dorsal Vein of Penis. Encloses deep dorsal arteries/vein of Penis and Corpora of penis

284
Q

Structure becoming Body of Clitoris Anteriorly

A

Crura of Clitoris

285
Q

Obturator Canal

A

Remaining space in Obturator Foramen after being covered by Obturator Membrane

286
Q

Causes of Secondary Hypogonadism (Male)

A
  1. Hypopituitarism

2. Kallman Syndrome

287
Q

Cryptorchidism

A

One or both testes fail to descend. 3% of males

288
Q

Nourish Embryo After Initial Implantation in Endometrium

A

Uterine Glands

289
Q

Location of the Ovary

A

Found in the Ovarian Fossa on the lateral wall of the Pelvis. Bound superiorly by External Iliac Vessels and inferiorly by Internal Iliac Vessels and Ureter

290
Q

Primary Regulator of Thecal Cell Activty

291
Q

Induces Vasospasms and Uterine Contractions in Menstrual Phase

A

Prostaglandin F2α

292
Q

Syndrome of Persistent Mullerian Ducts

A

Normal genotypic/phenotypic male either:

  1. Cannot Synthesize AMH
  2. Receptor Defective
  • Mullerian Duct derivatives persist in Inguinal Hernia
  • Testes fail to descend
  • Structures underdeveloped
293
Q

Role of FSH in Selection of Dominant Follicle

A
  1. Stimulates Granulosa Cell Proliferation and Estradiol Synthesis
  2. Estradiol and Inhibin Negative Feedback deprives non-dominant follicles of FSH. Dominant has store in Antrum
  3. Dominant Follicles also has more FSH Receptors than others
  4. Induces Expression of LH Receptors in Granulosa Cell
294
Q

Two Ways to have Iatrogenically Induced Sterility

A
  1. Disruption to Sympathetics to Ductus Deferens, Prostate, and Seminal Vesicles as a result of surgery in Pelvis (does not affect erection)
  2. Surgical enlargement of Prostatic Urethra (Transurethral Resection)
295
Q

Causes of Lactation Cessation

A

1) Absence of Suckling -> no PRL
2) Absence of Suckling -> no Oxytocin
3) Milk Accumulation in Alveoli (pressure on epithelial cells)

296
Q

Suspensory Ligament of Penis

A

Supports body of penis. Arises from Symphysis Pubis and inserts into fascia surrounding penis

297
Q

Ovarian Arteries: Origin and Course

A
  • Arise from Aorta at L2
  • Descend on Posterior Abdominal wall to Pelvic Brim
  • Cross over External Iliac Vessels to enter Suspensory Ligament of Ovary
  • Enters the Mesovarium to supply the Ovary and sends medial branches to Uterine Tube
298
Q

Undifferentiated Primordial Structures Which Becomes External Genitalia

A
  1. Genital Tubercle
  2. Genital Fold
  3. Labioscrotal Swelling
299
Q

Lamina Propria

A

Found beneath the basement membrane in the Uterine Tube

300
Q

Estradiol’s Role in Proliferative Phase of Menstrual Cycle

A
  1. Increases thickness of Endometrium
  2. Induces growth of Uterine Glands
  3. Promotes Development/Elongation of Spiral Arteries
  4. Prepares Uterus for Progesterone-induced Endometrial Differentiation (Increases Progesterone Receptors)
301
Q

Original of Vaginal Artery

A

Arises from initial part of Uterine Artery

302
Q

Contents of the Broad Ligament of the Uterus

Note: not the anatomical parts

A
  1. Uterine Tube
  2. Round Ligament of the Uterus
  3. Round Ligament of the Ovary
  4. Uterine Artery/Vein
  5. Terminal Branches of Ovarian Artery/Vein
303
Q

Causes of Luteolysis

A
  1. Decline in LH (Estrogen/Progesterone Feedback)
  2. Prostaglandin F2α
  3. “Various Paracrine Factors”
304
Q

Hypospadias

A

Birth defect where urethral opening is on the underside of the penis rather than the tip. Associated with Androgen absence during differentiation and Micropenis

305
Q

Estradiol Secretion by Sertoli Cells

A

Aromatization of Androgens. Stimulated by FSH (increases Aromatase expression)

306
Q

Sensory Innervation to the Penis

A

Dorsal Nerve of the Penis (Branch of Pudendal Nerve)

307
Q

Anal Sinuses

A

Upper Half of Anal Canal

Recess superior to Anal Valve and between Anal Columns

308
Q

Coccygeus: Insertion

A

Sacrum and Coccyx

309
Q

Bulbospongiosus Muscle

A

Located in Superficial Perineal Pouch. Covers Bulb of Penis or Bulb of Vestibule (Female)

310
Q

Stimulates Proteolytic Enzymes Secretion by Thecal and Granulosa Cells

A

LH (release of the Oocyte during ovulation)

311
Q

External Hemorrhoids

A

Varicosities of tributaries of Inferior Rectal Veins covered by skin. Most painful (somatic sensory)

312
Q

Gives off Prostatic Branch (Artery)

A

Inferior Vesical Artery

313
Q

Menstrual Cycle Day Breakdown

A
  1. Menses (1-4)
  2. Proliferative Phase (5-14)
  3. Secretory Phase (15-26)
  4. Premenstrual Phase (27-28)
314
Q

AMH (Female)

A

Involve in Intraovarian Signaling. Mature Prenantral Follicle secretes it to restrain development of other Follicles

315
Q

Piriformis Muscle: Origin

316
Q

Arteries Passing in Between Piriformis and Coccygeus Muscles in Greater Sciatic Foramen

A

Inferior Gluteal and Internal Pudendal Arteries

317
Q

Formed from Single Layer of Pregranulosa Cells Around Primary Oocyte

A

Primordial Follicle

318
Q

Corresponding Endometrial Cycle Phase(s) of Follicular Phase

A

Menstrual and Proliferative Phases

319
Q

Rectovaginal Septum

A

Separates vagina from rectum. Fused to inferior end of Peritoneum. Limits spread of infection or cancer

320
Q

Sex Steroids Secreted by Granulosa Lutein Cells

A
  1. Progesterone

2. Estrogens

321
Q

HPG Axis: Neonatal Period

A
  • Active week after birth
  • FSH/LH elevated for first few months
  • Gradually declines after CNS exerts inhibitory effect
322
Q

General Causes of Defective Virilization in 46, XY Embryo (with normal Testes)

A
  1. Inborn error of Testosterone Biosynthesis

2. Inability to Respond to Androgens

323
Q

Anorectal Junction

A

Pierces posterior midline part of Pelvic Diaphragm

324
Q

Anterior Half of Perineum

A

Urogenital Triangle

325
Q

Fate of Cortical Cords in Female Differentiation

A

Cortical Cords break up into Primordial Follicles in the 3rd month.

326
Q

Main Blood Supply to Perineum

A

Internal Pudendal Artery

327
Q

Function of IGF-1 Produced by Dominant Follicle

A

Enhances Granulosa Cell responsiveness to FSH.

328
Q

Epithelium of Mucosal Layer (Vagina)

A

Stratified Squamous Epithelium (Non-Keratinized)

329
Q

Structures Derived from Urogenital Sinus

A
  • Prostatic Buds (Male)

* Lower pt. of Vagina (Female)

330
Q

Primary Regulator Granulosa Cell Activity

331
Q

Regulator of Epididymis Function

A

Testosterone

332
Q

Prostatic Carcinoma Metastasis Path

A

Prostatic Venous Plexus > Vesical Venous Plexus > Internal Iliac Vein > Lateral Sacral Vein >…

  • Vertebral Column: Internal Vertebral Venous Plexus
  • Spinal Cord: Radicular Veins
333
Q

Transverse Rectal Folds

A

3 semicircular horizontal folds of Rectal Mucosa (2 left, 1 right). Located at each sharp rectal flexure

Hard Stool or Protoscope can tear folds, leading to Rectal Wall infection

334
Q

Benign Prostatic Hyperplasia (BPH)

A

Median (less commonly, Lateral) lobe bulges into bladder at Internal Urethra Orifice. Dripping of urine into urethra causes urination at night

335
Q

Pelvic Brim Components: Posterior/Medial to Anterior/Medial

A
  1. Sacral Promotory
  2. Ala (Sacrum)
  3. Linea Terminalis (itself has 3 components)
  4. Pubic Symphysis
336
Q

Decapacitation

A

Epididymis secretions coat Spermatozoa with substances blocking Acrosomal reaction

337
Q

Promotes Acidification of Vaginal Lumen

338
Q

Components of Testosterone Circulation

A
  1. Sex Hormone-Binding Globulin (SHBG) (40-60%)
  2. Free Testosterone (2-3%)
  3. Albumin (Rest)
339
Q

Alevolar Ventilation in Pregnancy

A
  1. Rises throughout
  2. Mainly due to 30-40% increase in Tidal Volume
  3. Decrease in Alveolar PCO2
  4. Respiratory Alkalosis prevented by Renal Bicarb Excretion
  5. Progesterone increases sensitivity of Central Chemoreceptors to CO2
340
Q

All Primordial Follicles Formed by This Time

A

6 month old infant

341
Q

Types of Estrogen

A
  1. Estradiol (E2)
  2. Estrone (E1)
  3. Estriol (E3)
342
Q

What stage does the Zona Pellucida form

A

Forms around Oocyte after Primordial Follicle leaves pool of inactive follicles. Seen in the Primary Follicle

343
Q

5α-Reductase Deficiency

A

Cannot convert Testosterone to DHT

  • Internal Genitalia Male
  • External Genitalia Ambiguous
  • Further Masculinization will occur at puberty
344
Q

Intrauterine Growth Restriction (IUGR)

A

Occurs from sustained reduction in placental perfusion

345
Q

Adaptation During Pregnancy: Plasma ADH Levels

A

Normal (note this is abnormally high given the Osmolality, however. Set point changes)

346
Q

Supplied by Deep Arteries of the Clitoris

A

Crura and Corpus Cavernosum of the Body

347
Q

Fundiform Ligament of Penis

A

Supports body of penis. Descends from Linea Alba, splits into two bands that pass on either side of penis.

348
Q

Adaptation During Pregnancy: Systolic Blood Pressure, Diastolic Blood Pressure, and Mean Arterial Pressure

A

All decrease

SBP falls least due to disproportionate decrease in peripheral resistance.

Blood pressure does increase during 3rd trimester, may return to normal or exceed pre-pregnancy

349
Q

Primary Secretion of Thecal Cells

A

Androstenedione

350
Q

External Urethral Sphincter: Location

A

Surrounds urethra within Urogenital Diaphragm

351
Q

Uterine Tube Blockage

A

Major cause of infertility. Result of adhesions from healed infections that have spread from Vagina/Uterus or Peritoneal Cavity

352
Q

Follicular Cell without 17α-hydroxylase Activity

A

Granulosa Cells

353
Q

Excessive Androgen After 12 Weeks in 46, XX Embryo

A

Leads to Clitoral Hypertrophy

354
Q

Which is Posterior? Sacrotuberous and Sacrospinous Ligaments

A

Sacrotuberous Ligament

355
Q

Layers of Muscular Wall of Ductus Deferens

A
  1. Outer Longitudinal
  2. Middle Circular
  3. Inner Longitudinal
356
Q

Origin of Superior Vesical Arteries

A

Umbilical Artery

357
Q

Stimulate Androgen Binding Protein (ABP)

A

FSH and Testosterone

358
Q

Older Age-Related Changes to Androgen in Males

A
  1. Decline in Total Serum Testosterone

2. Increase in SHBG (lowers bioavailability)

359
Q

Round Ligament of the Uterus

A

Ligament from Uterus through Inguinal Canal to Labia Majora

Remnant of the distal part of the Gubernaculum. Attaches to Uterus inferior to Uterine Tube

360
Q

Layers of the Vagina (Superficial to Deep)

A
  1. Mucosal Layer
  2. Muscular Layer
  3. Fibrous Layer
361
Q

Pubococcygeus

A

Part of Levator Ani

  • Originates from Body of Pubis
  • Inserts on Anococcygeal Body and Coccyx
362
Q

Mesovarium

A

Two-layered reflection from posterior layer of Broad Ligament of the Uterus, associated with the Ovary

363
Q

Primary Hormonal Influence in Secretory Phase (Menstrual Cycle)

A

Progesterone

364
Q

Innervated by Pudendal Nerve

A
  1. Skeletal Muscles of Perineum
  2. Sensory to Lower 1/2 of Anal Canal
  3. Skin of External Genitalia
365
Q

Irradiation (Primary Hypogonadism)

A

Seminiferous Tubules most sensitive. Leydig cells more resistant

366
Q

Sex Steroids Secreted by Theca Lutein Cells

A
  1. Progesterone

2. Androgens

367
Q

Hormones Affecting Erythropoiesis

A
  1. Testosterone (Stimulates Erythropoietin Synthesis)
  2. Cortisol
  3. GH
  4. Prolactin (Enhance Erythropoietin Effect)
  5. hPL (Enhance Erythropoietin Effect)
368
Q

Limits Migration of Implanted Embryo through Stroma

A

Compact Layer formed by Decidual Reaction

Involves secretion of factors that inhibit Hydrolytic Enzymes released by Synctiotrophoblasts

369
Q

Tearing of Anal Valves

A

Torn by hard stool or protoscope. Anal canal infected and forms a fistula through wall into Ischiorectal Fossa

Can result in Perianal Abscess

370
Q

Cells with Prominent Aromatase Activity (Male)

A
  1. Certain CNS Nuclei
  2. Leydig Cells
  3. Sertoli Cells
  4. Adipose Tissue
371
Q

Fate of Indifferent Gonad Medulla

A
  • Differentiates in Testis

* Regresses in Ovary

372
Q

Phase where Follicles become FSH-dependent for growth and survival

A

Larger Antral Follicles become dependent on FSH. Prior to that, FSH just growth promoting

373
Q

Start of Uteroplacental Circulation

A

Lacunae development by Synctiotrophoblasts as they invade Endometrium

374
Q

Reasons Germ Cells in Ovary Peak at 20 Weeks

A
  1. Decreased Oogonial Mitosis (stops at 7 months)
  2. Atresia of Non-Dominant Oogonia
  3. Atresia of Maturing Follicles (Pre-Puberty)
375
Q

Primary Regulator of Testosterone Secretion (Males)

A

Lutenizing Hormone (LH)

376
Q

Formation of the Thecal Layer

A

Forms from Stroma Cells surrounding Basal Lamina in response to Paracrine Factors from Granulosa Cells

377
Q

Episiotomy

A

Surgical incision of the Perineum and Inferoposterior Vaginal Wall to enlarge Vaginal Orifice. To decrease excessive tearing of Perineum and uncontrolled jagged tears of the musle. (Birth)

378
Q

Major Blood Supply to Rectum

A

Superior Rectal Artery

379
Q

Causes of Renin Secretion in Pregnancy

A
  1. Response to Decreased Blood Pressure
  2. Uterus Secretes Renin
  3. Estrogen/Progesterone stimulate Renin Synthesis
380
Q

Areola

A

Pigmented area around nipple with sebaceous glands near surface. Pink until first pregnancy, may become more pigmented

381
Q

Parts of a Mature Spermatozoa

A
  1. Head
  2. Midpiece
  3. Tail
382
Q

Supplies Middle and Inferior Parts of Rectum

A

Middle Rectal Arteries

383
Q

Rete Testis

A

Labyrinth of spaces located within Mediastinum/Tunica Albuginea of Testis. Passage from Tubuli Recti to Efferent Ductules

384
Q

Tubuli Recti

A

Passage for Spermatozoa produced in Seminiferous Tubules to Rete Testes

385
Q

Blood-Testis Barrier

A

Formed by Tight Junctions between adjacent Sertoli Cells. Limits exchange between Interstitial Fluid and Seminiferous Tubule Lumen

Creates environment for spermatogenesis and defends against auto-antibody attack

386
Q

Function of Androgen Binding Protein (ABP)

A

Secreted into Seminiferous Tubules to keep Testosterone levels elevated

387
Q

Mesenchymal Layer Separating Genital Ridge from Medulla

A

Tunica Albuginea (well it becomes that)

388
Q

Divides Anal Canal into Two Halves

A

Pectinate Line, indicated by Anal Valves

389
Q

Breast Development: Puberty

A

Response to rise in Estrogen and GH

  1. Increase mostly in Stromal and Adipose Tissue
  2. Areola/Nipple diameters increase
  3. Ducts elongate and branch
  4. Ductal Growth/Branching increases due to Estradiol/Progesterone in monthly cycles
390
Q

Initiates Menses

A

Sudden drop in Estrogen and Progesterone in the Menstrual Phase (High in Secretory Phase)

391
Q

Function of Epididymis Epithelium

A
  1. Tight Epithelium forms Blood-Epididymis Barrier

2. Secretes Proteins and Glycoproteins

392
Q

Two Phases of Ejaculatory Response

A
  1. Emission

2. Ejaculation

393
Q

Initial Mitotic Division of Fertilized Zygote

A

Happens while unattached in Fallopian Tube. Does not increase in size because of Zona Pellucida around it

394
Q

External Urethral Sphincter: Innervation

A

Perineal Branch of Pudendal Nerve

395
Q

Muscle in Lesser Sciatic Forament

A

Obturator Internus Muscle

396
Q

Mesometrium

A

Forms the majority of the Broad Ligament of the Uterus.

Lateral to Uterus, inferior to Mesovarium

397
Q

Time of Cyclic Recruitment of Follicles

A

Late Luteal Phase of PRECEDING Cycle

398
Q

Promotes Transabdominal Movement of Testes to Internal Inguinal Ring in Week 12

A

Insulin-like Peptide 3 (INSL3)

399
Q

Continuation of Bulb in Penis

A

Corpus Spongiosum

400
Q

Prostate Gland: Lymphatic Drainage

A

Internal Iliac Nodes

401
Q

Factors Decreasing Systemic Vascular Tone in Pregnancy

A
  1. Estrogen (endothelial cells have ER, which elicits NO production)
  2. Progesterone (smooth muscle relaxer)
  3. Decreased Angiotensin II Sensitivity
  4. Prostacycline (PI2)
  5. Relaxin
402
Q

Capacitation

A

Process of hyperactivation of Spermatozoa, 5-7 hours after ejaculation.

403
Q

Why is LH required for Spermatogenesis?

A
  • Sertoli Cells don’t have LH Receptors. BUT
  • LH stimulates Testosterone release from Leydig Cells
  • Testosterone activates genes in Sertoli Cells promoting Spermatogenesis
404
Q

Hyperactivation of Spermatozoa

A

Causes flagellum to beat in whip-like fashion and the head to move laterally. Helps sperm move through Tubular Mucus and Cumulus Oophorus

Intracellular Ca2+ rise (permeability) triggers exocytosis of Acrosome. The Acrosome contains Hydrolytic Enzymes which dissolve the Zona Pellucida

405
Q

Prepuce

A

Folded double layer of Superficial Penile Fascia and skin that surrounds Glans Penis

406
Q

Ligaments of the Sacroiliac Joint (Anterior to Posterior)

A
  1. Anterior Sacro-Iliac Ligaments
  2. Interosseous Ligaments
  3. Posterior Sacro-Iliac Ligaments
407
Q

Distal dilated part of Ductus Deferens

408
Q

Syndrome of Complete Androgen Resistance

A
  • Testes capable of secreting Androgens are located in Abdominal Cavity
  • Male and Female Internal Genital Tracts Absent
  • External Genitalia / Secondary Sex Traits Female
  • Pubic Hair Scant/Absent
409
Q

Maternal Response to Endometrium Invasion

A

Trophoblasts trigger Decidual Reaction

410
Q

Necessary for Syncytiotrophoblast to Synthesize Estrogen

A
  1. Dehydroepiandrosterone (DHEA)

2. 16α-hydroxy-dehydroepiandrosterone (16α-OH DHEA)

411
Q

Origin of Primordial Germ Cells

A

Migrate from Yolk Sac Endoderm in about Week 5

412
Q

Layers of the Urogenital Diaphragm

A
  1. Superior Fascial Layer
  2. Deep Perineal Pouch
  3. Inferior Fascial Layer / Perineal Membrane
413
Q

Sacral Plexus Nerves Which Remain in True Pelvis

A
  1. Branches to Pelvic Diaphragm

2. Pelvic Splanchnic Nerves

414
Q

Adaptation During Pregnancy: Cortisol

A
  1. Increase in Maternal Cortisol (increased ACTH, Estrogen-induced CBG synthesis)
  2. Contributes to Insulin Resistance
  3. Leads to appearance of Striae (Stretch marks)
415
Q

Location of Testosterone Inactivation

416
Q

Uterine Tubes: Arterial Supply

A

Uterine and Ovarian Arteries

417
Q

Referred Pain from Bladder

A
  1. Tip of Penis (S2-S4)

2. Hypogastric Region of Anterior Abdominal Wall (L1)

418
Q

Sertoli Cell Secretions

A
  1. Androgen Binding Protein (ABP)
  2. Anti-Mullerian Hormone (TGFβ Family)
  3. Inhibins (TGFβ Family)
  4. Activins (TGFβ Family)
  5. Estradiol
419
Q

Tunica Albuginea (Penis)

A

Fibrous covering directly investing each cavernous body. Fuses in midline of penis to form a septum.

420
Q

Ovarian Dysgenesis

A

Caused by Germ Cell absence OR only single X Chromosome

Ovaries regress. Associated with Turner Syndrome (45,X)

421
Q

Venous Anastomosis in Rectum

A
  1. Portal: Superior Rectal Vein

2. Caval: Middle and Inferior Rectal Veins

422
Q

Distinct Layers of Granulosa Cells

A
  1. Mural Cells

2. Cumulus Cells

423
Q

Phases of Ovarian Cycle

A
  1. Follicular Phase
  2. Ovulatory Phase
  3. Luteal Phase
424
Q

Part of Endometrium Shed During Menstruatioon

A

Stratum Functionalis – Upper 2/3

425
Q

Prostatic Sinus

A

Groove on each side of Urethral Crest, on the Posterior Wall of the Prostatic Urethra

Receives 20-30 Prostatic Ducts

426
Q

Veins in Penis

A
  1. Deep Dorsal Vein of Penis

2. Superficial Dorsal Vein of Penis

427
Q

Cholesterol Esters

A

Found in yellowish liquid droplets inside corpus Luteum.

428
Q

Supplies Anorectal Junction and Anal Canal

A

Inferior Rectal Arteries

429
Q

Parasympathetic Preganglionic Fibers in Sacral Plexus

A

Pelvic Splanchnic Nerves

Innervate Terminal Ganglia which go to Hindgut derivatives

430
Q

Connections between Sertoli Cells and Germ Cells

A
  1. Adherens Junctions

2. Gap Junctions

431
Q

Granulosa Cell Type Which Becomes Corpus Luteum

A

Mural Cells

432
Q

Which is Anterior? Sacrotuberous and Sacrospinous Ligaments

A

Sacrospinous Ligament

433
Q

Peritoneal Exudates

A

Mass of cell/fluid leaving the Peritoneal tissue during Peritonitis.

Drains into Rectovesical (Male) or Rectouterine (female) pouches when sitting or supine due to being lowest point in peritoneal cavity. Can cause tenderness.

434
Q

Rectovesical Pouch

A

Males only

Formed by reflection of Peritoneum from Rectum to superior-posterior surface of Bladder

435
Q

Landmark for Beginning of Anal Canal

A

Coccyx (begins at narrowing of Rectal Ampulla

436
Q

Relaxin

A

Peptide hormone produced by Corpus Luteum, Decidua (Endometrium), and Placenta

Promotes Decidualization and other growth factors. Contributes to decrease in systemic vascular resistance

437
Q

Exogenous Inhibitors of Ovulation

A
  1. COX-2 Inhibitors

2. Progesterone Inhibitors

438
Q

Vascular Endothelial Growth Factor (VEGF)

A

Secretion by Granulosa-Lutein Cells stimulated by LH

Promotes Angiogenesis around Corpus Luteum

439
Q

Major Type of Estrogen Produced by Placenta

A

Estriol.

Levels measured during pregnancy

440
Q

Estriol

A

E3

Weaker estrogen. Derived from metabolism of E1 and E2 in non-pregnant women. Placenta synthesizes large amount

441
Q

Cytotrophoblasts

A

Differentiate from Trophoblasts.

Inner layer of continuously dividing cells

442
Q

Upper Half of Anal Canal: Lymphatic Drainage

A

Pararectal Nodes then to Inferior Mesenteric Nodes

443
Q

General/Regional Location of Sacral Plexus

A

Against Posterior Pelvic Wall

444
Q

Nipple

A

Circularly-arranged Myoepithelial (Smooth) Muscle; Contains 15-20 Lactiferous Duct openings. Moves milk into duct

445
Q

Arteries Supplying Rectum

A
  1. Superior Rectal Artery (1)
  2. Middle Rectal Arteries (2)
  3. Inferior Rectal Arteries (2)
446
Q

Rectouterine Pouch

A

Female only

Formed by reflection of Peritoneum from Rectum to Posterior Vagina/Uterus

447
Q

Median Lobe (Prostate Gland)

A

Located between Urethra and Ejaculator Ducts

Common site for Benign Prostatic Hyperplasia

448
Q

Sympathetic Innervation to Rectum

A

Superior and Inferior Hypogastric Plexuses

449
Q

Resumption of Meiosis I in Preovulatory Follicles

A

Stimulated by LH via Mural Granulosa Cell release of Growth Factors acting on Cumulus Granulosa Cells. Occurs several hours before ovulation.

Cumulus Cells transmit signal to Oocyte which causes a decline in cAMP. Oocyte completes Meiosis I and extrudes a Polar Body

450
Q

Primary Function of Inhibin B

A

Negative feedback regulation of FSH Secretion

Blocks GnRH stimulated FSH Release (Pituitary)

451
Q

Nerve affected by a diseased Ovary and resulting in medial thigh pain

A

Obturator Nerve

It passes along the Obturator Internus m. in the Ovarian Fossa

452
Q

Bioavailable Tesosterone

A

Free + Albumin-Bound Testosterone.

The latter dissociates readily whereas SHBG has a high affinity for Testosterone.

453
Q

Lab Findings in Klinefelter Syndrome

A
  1. Elevated FSH and LH
  2. Testerosterone Low to Normal
  3. Estradiol Elevated
454
Q

Urethral Crest

A

Median Ridge on Posterior Wall of the Prostatic Urethra

455
Q

Psychic Stimulus Pathway Initiating Erection

A

Corticospinal Pathway

456
Q

Adaptation During Pregnancy: Renal Blood Flow

A

Increase due to Renal Vasodilation

457
Q

3β-HSD

A

Converts Pregnenolone to Progesterone

LH induces expression in Granulosa-Lutein Cells

458
Q

Name for Bones Surrounding Pelvic Inlet

A

Pelvic Brim

459
Q

LH Receptor and Intracellular Mechanism

A
  • G-Protein Coupled

* cAMP signaling pathway

460
Q

Deep Arteries of the Penis

A

Supplies erectile tissue of Crura and Corpora Cavernosa

461
Q

Major Circulating Estrogen in Pregnant Female

462
Q

Principal Actions of hCG in Pregnancy

A
  1. Prevent Luteolysis of Corpus Luteum

2. Promote Progesterone Production

463
Q

Prevents Luteolysis During Pregnancy

A

Human Chorionic Gonadotropin (hCG)

464
Q

Lacunae

A

Spaces developed by the Synctiotrophoblasts as they invade the Endometrium. Connect with Sinusoids and fill with Maternal Blood.

Finger-like projections will form Vili over time

465
Q

Rectal Prolapse

A

Abnormal descent of rectum through anal canal. Can occur in young children because sacrum not curved like an adult

Can also occur if not enough support from Puborectalis Muscle (Levator Ani)

466
Q

Location of Cauda Equina

A

Sacral Canal

467
Q

Mechanism of Estradiol Thickening Endometrium

A

Estradiol stimulates Stromal Cells to release Growth Factors. Superficial Epithelial and underlying Stromal Cells then proliferate.

468
Q

Head (Mature Spermatozoa)

A

Mostly the nucleus. Contains the acrosome on the tip.

469
Q

Causes of Primary Hypogonadism (Male)

A
  1. Klinefelter Syndrome (most common)
  2. Orchitis
  3. Irradiation
470
Q

Stimulate Inhibin B Production

A

Secreted by Sertoli Cell

  1. FSH
  2. Testosterone
471
Q

Organize Seminiferous Tubules in Lobules

A

Septa creating by invaginations of the Tunica Albuginea

472
Q

Adaptation During Pregnancy: Cardiac Output

A

Increases during first trimesters, remains elevated. Increase is to compensate for fall in systemic vascular resistance

Increases due to Stroke Volume and Heart Rate increases.

473
Q

Estrogen Effect on Bones

A

Inhibits Bone Resorption

474
Q

Barr Body

A

Inactivated X chromosome. Pseudoautosomal region escapes inactivate X

475
Q

Adaptation During Pregnancy: Pulmonary Resistance

A

Decreases due to relaxation of Smooth Muscle in Airways

476
Q

External Anal Sphincter: Innervation

A

Inferior Rectal Nerve

477
Q

True Pelvis: Posterior Wall

A
  1. Sacrum
  2. Coccyx
  3. Piriformis Muscle
478
Q

Origin of Primitive Sex Cords

A

Projections from Genital Ridge epithelium into underling mesenchyme before and during Primordial Germ Cell Migration

479
Q

Adaptation During Pregnancy: Anterior Pituitary

A

Increases in size by 33%, has little effect on pregnancy post-implantation.

  1. Major Change: Hyperplasia of Lactotropes (due to high estrogen)
  2. Serum PRL increases
  3. ACTH Increases (drops just before birth, increases during delivery)
  4. Pituitary GH decreases
  5. TSH lower in 1st trimester than 2nd/3rd
  6. FSH and LH become very low
480
Q

Adaptation During Pregnancy: GI System

A

Mostly due to Progesterone. Decrease in:

  1. GI Motility
  2. Food Absorption
  3. LES Tone
  4. Gall Bladder function
  5. gastric emptying
481
Q

Deep Dorsal Vein of the Penis

A

Drains blood from Corpora of Penis. Drains into Prostatic Venous Plexus and/or Vesical Venous PLexus

482
Q

Epithelial Lining of Uterine Tube

A
  1. Ciliated Simple Columnar

2. Secretory Peg (darker, not ciliated, protrude into Lume)

483
Q

Pudendal Nerve Block

A

Peripheral nerve block providing local anesthesia over S2-S4 dermatomes to relieve pain during childbirth.

Needle is passed through the Vaginal Wall, toward Ischial Spine and through the Sacrospinous ligament.

484
Q

Efferent Ductules

A

10-20 Efferent Ductules connect Rete Testis to head of Epididymis. Reabsorbs some extra fluid in the process.

485
Q

Primary Hormone Influencing Follicular Phase

486
Q

HPG Axis: Fetal Development

A
  • Established during First Trimester
  • Activity Peak Mid-Gestation
  • Declines toward birth due to negative feedback of Placental Estrogens
487
Q

Tail of the Epididymis

A

Lower, tubular portion of the Epididymis continuous with Ductus Deferens

488
Q

Progestins

A

Steroid hormone promoting gestation (carrying of embryo/fetus in womb)

  1. Progesteron (most potent)
  2. 17α-hydroxyprogesterone
489
Q

PRL Action on Milk Production

A

Acts on Epithelial Cells of Alveoli. Cortisol/Insulin permissive

Induces Transcription of:

  1. Milk Protein (Casein)
  2. Alpha Lactalbumin (enzymes for lactose synthesis)
  3. Enzymes for Lactose/Triglyceride production
490
Q

Differentiated Mesenchymal Cells Resulting from Sertoli Cell Recruitment via Paracrine Factors

A
  1. Peritubular Myoid Cells
  2. Endothelial Cells forming Male-Specific Vasculature
  3. Leydig Cells
491
Q

Contributes to Preeclampsia / Hypertension

A

Failure of invasion of Spiral Arteries by Cytotrophoblasts

492
Q

Adaptation During Pregnancy: Plasma Protein Composition

A
  1. Albumin concentration decreases (production increases)
  2. Fibrinogen/Clotting factors increase
  3. Binding Globulins
493
Q

Piriformis Muscle: Course

A

Leaves True Pelvis through Greater Sciatic Forament

494
Q

Blastocyst (and components)

A

Hollow, fluid-filled sphere developed from the Morula entering the Uterus.

Cell Types:

  1. Inner Cell Mass (become Fetus)
  2. Outer Layer of Trophoblastic Cells (responsible for implantation, formers fetal part of Placenta)
495
Q

Placental Progesterone (when it takes over, source, and secreting cell)

A
  1. Placenta major source after 8th week
  2. Secreted by Syncytiotrophoblasts from maternal LDL/VDL
  3. 90% goes into Maternal circulation
496
Q

Binding Globulins Stimulated by Estrogen During Pregnancy

A
  1. Thyroxine-Binding Globulin
  2. Corticosteroid-Binding Globulin
  3. Sex Steroid-Binding Globulin
497
Q

Muscle Immediately Posterior to Sacral Plexus

A

Piriformis

498
Q

Deep Transverse Perineal Muscle: Innervation

A

Pudendal Nerve

499
Q

Invasion of Spiral Arteries Post-Implantation

A

Done by Cytotrophoblasts, causing destruction of the Smooth Muscle Layer and Elastic Fibers. Replaced by Fibrous Tissue.

Creates low resistance vessels, unresponsive to normal vascular tone modulation and enhancing flow into placenta .

500
Q

Median Episiotomy

A

Midline incision of posterior wall of vagina, Fourchette, and Perineal Body. Less common than Mediolateral due to risk of cutting External Anal Sphincter

501
Q

Floor of the Pelvic Cavity

A

Pelvic Diaphragm

502
Q

Action(s) of Ischiocavernosus Muscle

A

Aids in erection by compressing crus of penis

503
Q

Parts of External Anal Sphincter (Superficial to Deep)

A
  1. Subcutaneous Part (slender, surrounds anus)
  2. Superficial Part (Anchors anal canal by attaching to Perineal Body/Anococcygeal Body)
  3. Deep Part (fuses with Puborectalis muscle)
504
Q

Leavtor Ani: Subdivisions (medial to lateral)

A
  1. Puborectalis
  2. Pubococcygeus
  3. Iliococcygeus
505
Q

Prostate Gland: Arterial Supply

A

Branches of Inferior Vesical Artery

506
Q

Structures Differentiating from the Wolffian Ducts

A
  1. Epididymis
  2. Ductus Deferens
  3. Seminal Vesicles
  4. Ejaculatory Ducts
507
Q

Lobes of the Prostate Gland

A
  1. Median Lobe
  2. R Lateral Lobe
  3. L Lateral Lobe
  4. Posterior Lobe
  5. Anterior Lobe
508
Q

Syncytiotrophoblasts

A

Multinucleated structure formed by fusion of Cytotrophoblasts as Endometrium is bound/penetrated. Push through epithelial cells

Releases proteolytic enzymes to digest matrix proteins holding epithelial cells of Endometrium together and matrix proteins of the Stroma

509
Q

Sacrotuberous Ligament: Attachments

A
  1. Sacrum

2. Ischial Tuberosity

510
Q

Oxytocin Receptor Mechanism

A

G protein-coupled. Activates IP3/DAG pathway

511
Q

Continuation of Crura in Penis

A

Corpora Cavernosa

512
Q

Kallman Syndrome

A
  • Isolated Gonadotropin Deficiency
  • Deficient GnRH release by Hypothalamus
  • GnRH neurons from Olfactory Placode fail to migrate to Hypothalamus
  • Arrested Spermatogenesis in Testes
  • Associated with defective smell
513
Q

Puborectalis

A

Part of Levator Ani

  • Originates from Body of Pubis
  • Forms important sling around Anorectal Junction
514
Q

Coccygeus relation to Sacrospinous Ligament

515
Q

Hormones in Male Genital Duct Differentiation

A
  1. Anti-Mullerian Hormone

2. Testosterone for Wolffian Ducts (fetal Leydig Cells)

516
Q

Enhance Solubility of Inactivated/Excretory Metabolites of Testosterone

A
  1. Sulfate

2. Glucoronic Acid

517
Q

Signal Responsible for Induction of Ovulation

A

Massive increase in plasma LH.

Result of positive feedback effect of LARGE amount of Estradiol on Pituitary and Hypothalamus (normally a negative feedback mechanism!)

518
Q

Epithelium of Cervix

A
  • Facing Vagina: Stratified Squamous (non-keratinized)

* Facing Uterus: Simple Columnar Epithelium

SF4 (5 decks)

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