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Urology > Structure and Function of the Male Genitourinary System > Flashcards

Structure and Function of the Male Genitourinary System Flashcards

1
Q
  1. First ____ days after conception the gonads of males and females are similar in appearance.
  2. Cells that will give rise to spermatogonia and oogonia migrate from where to where?
  3. What promotes the conversion to testes?
  4. Seminiferous tubules appear within _____ days following conception.
  5. What do they Produce?
  6. What appears around day 65?
A
  1. 40
  2. yolk sac to developing embryonic gonads.
  3. Testis-determining factor (TDF)
  4. 43-50
    • Germinal cells: sperm.
    • Nongerminal cells: Sertoli cells.
  6. Leydig cells:
    Appear about day 65.
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2
Q
  1. Leydig cells secrete what?
  2. When does this begin and when does it peak?
  3. Masculinizes _________ structures.
  4. [Testosterone] then does what until puberty?
  5. Testes descend into scrotum shortly when?
  6. Functions? 2
A
  1. testosterone.
  2. Begins at the 8th week and peaks at 12-14th week.
  3. embryonic
  4. declines to very low levels
  5. before birth.
  6. spermatogenesis and testosterone production
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3
Q
  1. Testes, or male gonads, are what?
  2. Testes develop in the what?
  3. and then descend through the inguinal canal into what?
  4. ___% spermatogenesis and ___% testosterone production

Arteries, Veins, and Nerves

A
  1. two egg-shaped structures outside the abdominal cavity in the scrotum.
  2. abdominal cavity
  3. pouch of peritoneum (tunica vaginalis)
  4. 80, 20
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4
Q

Testicular Descent
1. How mant stages?

  1. When are they? 2
  2. Why is this important?
A
  1. Two stages
    • 7-12 weeks fetal life (AMH)- so they dont turn into ovarian
    • and 7-9 months fetal life (Testosterone)- actual descent
  3. Increased risk for testicular cancer
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5
Q

What structures are the scrotum?

3

A
  1. Houses Testes
  2. Dartos Muscle (wrinkles em)- changes in temperature modifies surface area
  3. Cremaster Muscle (elevates em)- and layers of fascia = spermaticord
    (3 degrees lower generally)
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6
Q

Genital Duct System:
1. Testes are composed of several hundred what?

  1. Each contains one or more what?
  2. These tubules are the site of what?
  3. Tubules lead into the efferent ducts, and become the what?
  4. 10,000 to 20,000 efferent ducts emerge to join the ________ (sperm finishing school)
  5. Sperm still can’t swim, so they rely on the what?
A
  1. lobules
  2. coiled seminiferous tubules (sperm factories)
  3. sperm production!!!
  4. rete testis
  5. epididymis
  6. peristaltic movements of the ductal walls of the epididymis
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7
Q

Genital Duct System:
1. Spermatozoa continue their migration through the what?

  1. The ampulla of the vas deferens serves as a what?
  2. They camp out here happily awaiting what?
  3. Vasectomy? How long can they live here?
A
  1. vas deferens
  2. storage reservoir for sperm
  3. ejaculation
  4. 42 days they are present. So you can still maintain your fertility for 42 days!
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8
Q

Accessory Organs? 3

A
  1. Seminal Vesicles (adds fructose)
  2. Prostate Gland (adds alkaline fluid to semen so it can protect them in cervical/vaginal secretion and urine)
  3. Bulbourethral Glands (Cowper Glands)- also secrete the alkaline agent
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9
Q

Penis:
1. Shaft that ends in a tip called the _____?

  1. What is the foreskin?
    - Foreskin removed with circumcision
  2. What are the tissues types in the penis? 2
A
  1. glans
  2. Loose skin of the penis shaft folds to cover the glans (foreskin)
    • Corpora cavernosa (lateral mass)
    • Corpus spongiosum (ventral mass- engorged with blood in erection)
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10
Q

Endocrine Regulation

Negative feedback? 3

A
  1. Inhibits GnRH from hypothalamus.
  2. Inhibits anterior pituitary response to GnRH.
  3. Inhibin secretion inhibits anterior pituitary release of FSH.
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11
Q

Female sex steroids? 2

Male sex steriods? 1

A
  1. Female:
    Estrogen and progesterone.
  2. Male:
    Testosterone.
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12
Q

Control of LH and FSH Secretion:
1. Negative feedback:
Testosterone inhibits what?

  1. Maintain relatively constant secretion of what?
  2. Declines gradually in men over ___ years of age.
  3. Testosterone converted to ____, which inhibits LH.
  4. What inhibits FSH secretion?
  5. Aromatization reaction producing _______ in the brain, is required for the negative feedback effects.
A
  1. LH and GnRH production.
  2. LH and FSH.
  3. 50
  4. DHT
  5. Inhibin
  6. estradiol
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13
Q

Endocrine Function of the Testes:
1. Testosterone and its derivatives are responsible for what?

  1. Stimulate growth of what? 3
  2. Promote ________ synthesis.
  3. Act in paracrine fashion, responsible for what?
A
  1. initiation and maintenance of body changes in puberty.
    • muscles,
    • larynx, and
    • bone growth until sealing of the epiphyseal discs.
  3. hemoglobin
  4. spermatogenesis.
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14
Q

Testes:
1. Seminiferous tubules:
Contain receptor proteins for what? and where is it?

  1. ____ stimulates spermatogenesis to occur.
  2. Leydig cells:
    ___ stimulates secretion of testosterone.
  3. Contain receptor proteins for ____.
A
  1. FSH in Sertoli cells.
  2. FSH
  3. LH, LH
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15
Q

Male Sex Hormones

  1. Androgens: secreted by the what? (20% of the mass of the testes)
  2. under the influence of ___ from anterior pituitary.
  3. Leydig cells not fully mature until after approximately ___yo
  4. ___________ is the significant hormone responsible for the male hormonal effects!
A
  1. interstitial cells of Leydig
  2. LH
  3. 10
  4. Testosterone
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16
Q

Testosterone

Embryonically what is THE determining factor in the development of male or female genital organs and characteristics?

A

testosterone

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17
Q
  1. Injection of large quantities of testosterone into gravid animal causes development of what?
  2. Removal of fetal testes in a male fetus causes development of what?
  3. If the Leydig cells aren’t mature till after the age of 10, how does this differentiation occur?
A
  1. male sexual organs in the fetus even when the fetus is genetically female
  2. female sexual organs
  3. Human Chorionic Gonadotropin (or hCG, which is produced by the placenta) from mom stimulates testosterone secretion in the fetal testes
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18
Q

Testosterone:
1. Stimulus for descent of the testes during the last what of pregnancy?

  1. If a male child is born with undescended testicles, what can cause testes to descend in usual manner if inguinal canals large enough?

(not usually done, 80-90% of undescended testes will descend by one year of age)

A
  1. 2-3 months

2. administration of testosterone or LH (a gonadotropin)

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19
Q

Testosterone:
Primary sexual characteristics:
Causes what? 3

A
  1. penis,
  2. scrotum, and
  3. testes to all enlarge during puberty
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20
Q

Testosterone: Secondary sexual characteristics
1. Molecularly almost all of these effects occur because of increased what?

  1. What are they? 6
A
  1. rate of protein formation (PP)
    • Distribution of body hair
    • Baldness (a man without functional testes does not become bald)
    • Deepened Voice
    • Skin: increases thickness, more prone to acne
    • Muscular development
    • Bone growth, bone density, calcium retention
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21
Q

Disorders of Embryonic Sexual Development
1. What does intersex mean?

  1. Individual with either what?
  2. Have accessory sex organs and external genitalia that are what?
  3. Most common cause of female pseudohemaphroditism is what?
  4. In the male, one cause is testicular feminizing syndrome: Which is what?
A
  1. Both ovarian and testicular tissue is present in the body.
  2. testes or ovaries but not both.
  3. incompletely developed or inappropriate.
  4. congenital adrenal hyperplasia.
  5. Normal functioning testes, but lack receptors for testosterone.
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22
Q

Low testosterone etiologies? 7

A
  1. Hypogonadism
  2. Trauma to Leydig cells
  3. Mumps
  4. RX/Chemo
  5. Testicular tumors
  6. HIV/AIDS
  7. ETOH (beer)

(primary from testicles, secondary from pituitary, tertiary from hypothalamus)

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23
Q

What are the products of mitosis in spermiogensis? 5

A
  1. Germ cells
  2. Primary spermatocyte (2n)
  3. Secondary spermatocyte (n)
  4. Spermatid (n)
  5. Spermatozoa(n)

Continuously happening in sertoli cells in the seminiferous tubules

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24
Q

Spermatogenesis:

  1. Spermatocytes divide in two stages, one of which is by the process of meiosis to form what?
    - How many chromosomes do they have?
  2. Spermatids mature for how long until they become spermatozoa?
  3. Function of Sertoli Cells?
A
  1. four spermatids, each containing 23 unpaired chromosomes
  2. two months
  3. Actually envelope spermatids for processing before release into lumen (protect and nurse sperm)
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25
Q

Sertoli Cells:
1. They form what?

  1. What is the function of this? 2
  2. Secrete? 2
  3. Phagocytize what?
    - What does this do?
A
  1. Form blood-testes barrier:
    • Prevents autoimmune destruction of sperm.
    • Produce FAS ligand which binds to the FAS receptor on surface to T lymphocytes, triggering apoptosis of T lymphocytes.(Prevents immune attack.)
    • Secrete inhibin.
    • Secrete androgen-binding protein (ABP):
  4. Phagocytize residual bodies:
    - May transmit information molecules from germ cells to Sertoli cells.
26
Q

Function of Secrete androgen-binding protein (ABP)?

A

Binds to testosterone and concentrates testosterone in the tubules.

27
Q

Hormonal Control of Spermatogenesis
1. Formation of primary spermatocytes and entry into early prophase I, begin during when?

  1. Spermatogenesis arrested until when?
  2. Testosterone required for completion of what? 2
  3. Secrete paracrine regulators:
    such as? 3
  4. ____ necessary in the later stages of spermatid maturation.
A
  1. embryonic development.
  2. puberty.
    • meiosis
    • spermatid maturation.
    • IGF-1.
    • Inhibin.
    • Transforming growth factor.
  5. FSH
28
Q

Spermatogenesis:
1. Sperm formed in the where?

  1. Sperm emptied into where?(maturation)
  2. Then where until the urethra where it exits through the meatus? 2
A
  1. seminiferous tubules (900 seminiferous tubules make up the testis
  2. epididymis
    • Vas Deferens
    • Prostate Gland (Seminal vesicle empties at this point)
29
Q

Spermatogenesis:

  1. Once in the epididymis, sperm become what?
    - Why not before this?
  2. and go through final maturation and become capable of what?
  3. Most of the mature sperm is stored in the where?
    - For how long?
A
  1. fully motile
    - (inhibitory proteins in epididymal fluid prevent motility until after ejaculation)
  2. fertilizing ovum
  3. Vas Deferens
    - can maintain fertility for at least a month
30
Q

Spermatogenesis:

Seminiferous tubules contain? 6

A
  1. Spermatogonia>
  2. Primary Spermatocyte>
  3. Secondary Spermatocyte>
  4. Spermatid>
  5. Spermatozoa (Sperm cell)
  6. Also Sertoli Cells
31
Q

Spermatogenesis starts where?

A

Pituitary gland

32
Q
  1. FSH regulates conversion of what?
  2. ________ necessary for final maturation of sperm cells and this is stimulated by ___.
  3. Both _________ come from pituitary
  4. Begins at about ___yo and continues throughout life
A
  1. spermatogonia into spermatocytes
  2. Testosterone, LH
  3. LH and FSH
  4. 13
33
Q

Seminal Vesicle functions? 2

A
  1. secrete mucoid material containing fructose, citric acid, prostaglandins, and fibrinogen
  2. Provides nutrients to sperm; prostaglandins thought to work on cervical mucus making it more receptive to sperm movement
34
Q

Spermatogenesis:
1. Where is semen coming from? 4

  1. Once ejaculation has occurred, maximal life span of a sperm is only _______ at body temperature;
  2. may be stored for several weeks at ___________________ and preserved for years if frozen.
  3. Average sperm count per ejaculate is about how much?
  4. if this count falls below approx what person is likely to be infertile?
A
  1. Semen:
    - fluid from vas deferens,
    - seminal vesicles,
    - prostate gland,
    - as well as the bulbourethral glands and glands throughout the urethra
  2. 24-48 hours
  3. lower temperatures
  4. 400 million
  5. 70 million (for 3.5ml of ejaculate)
35
Q

Male Fertility:

  1. Oligospermia is what?
  2. Decreased fertility caused by what? 3
  3. Male contraception:
    Compounds that suppress ________ secretion.
    -Such as?
A
  1. Sperm count of less than 20 million/ml ejaculate.
  2. Decreased fertility caused by
    - heat,
    - pharmaceuticals, and
    - illicit drugs.
3. Male contraception:
Compounds that suppress gonadotropin secretion.
-Testosterone.
-Progesterone and 
-GnRH antagonist.
36
Q
  1. Vasectomy: What happens in the procedure?
  2. Interferes with what?
  3. May develop what?
A
  1. Each ductus deferens is cut and tied.
  2. sperm transport.
  3. anti-sperm antibodies.
37
Q
  1. Epididymis responsible for:
  2. Ductus (vas) deferens:
    Carries sperm from where to where?
  3. Seminal vesicles secrete what?
  4. Prostate secretes what? 4
A
    • Maturational changes.
    • Resistance to pH changes and temperature.
    • Storage of sperm between ejaculations.
  2. epididymis into pelvic cavity.
  3. Fructose.
    • Alkaline fluid.
    • Citric acid.
    • Ca2+.
    • Coagulation proteins.
38
Q

Puberty:
1. First ten years of life the pituitary secretes almost no ____________ and consequently the testes secretes almost no __________?

  1. Following this, progressively increasing amounts of ______________ released (What initiates the cascade is unknown)
  2. Usually by age ___yo, the male child reaches adult sexual capability
A
  1. gonadotropins, testosterone.
  2. gonadotropins
  3. 13
39
Q

Male Sexual Act
1. Most important sensory nerve signals are located in the what?

  1. Impulse is via which path? 4
  2. What alone can cause the male sexual act to occur and culminate in ejaculation?
  3. Direct stimulation can also cause ejaculation independent of what?
    - Where do we occassionally see this?

In general, combination of both is what allows the sexual act to occur

A
  1. glans penis
    • pudendal nerve>
    • sacral plexus>
    • sacral portion of spinal cord,
    • finally up the cord to undefined areas of the brain
  3. Psychic stimuli
  4. the brain (seen in the occasional human being after spinal cord has been cut above the lumbar region)
40
Q
  1. What is the first stage of the male sexual act?

2. What is it caused by?

A
  1. Erection:

2. caused by parasympathetic impulses from sacral portion of spinal cord to penis.

41
Q

Describe the pathway in which erection occurs? 3

A
  1. Parasympathetic signals>
  2. dilates arteries of penis>
  3. high pressure flow into erectile tissue
42
Q
  1. What is the second stage of the male sexual act?

2. What is stimulated for this to occur? 2

A
  1. Lubrication:
  2. parasympathetic impulses also stimulate
    - mucous glands (along the urethra) and
    - bulbourethral glands to secrete mucus through urethra during intercourse to aid in lubrication of coitus.

Most of the lubrication however is provided by female sexual organs.

43
Q
  1. What is the third stage of the male sexual act?

2. Stimulated by what?

A
  1. Emission and Ejaculation:

2. (Sympathetic nervous function)

44
Q
  1. What is the definition of emission?
  2. What is the definition of ejaculation?
  3. Describe the resolution?
A
  1. Emission: When stimulus intense enough, contraction of vas deferens and ampulla to cause expulsion of sperm into internal urethra, then seminal vesicles and prostate gland follow forcing sperm forward followed by:
  2. Ejaculation: Rhythmic release of ejaculate
  3. Resolution: Within 1-2 minutes, excitement disappears and erection ceases
45
Q

Prostate Gland (Protector)

  1. What is it?
  2. Remains relatively small throughout childhood but begins to grow when?
  3. Store and secrete ___% of semen
  4. Stays the same size in what age range?
  5. Size of prostate is influenced by what?
  6. Needs what?
  7. Divided into? 2
A
  1. Tubuloalveolar exocrine gland
  2. begins to grow at puberty under influence of testosterone
  3. Store and secrete 25% of semen
  4. Stationary size from 20yo – 50yo
  5. Size of the prostate is influenced by testosterone
  6. Needs androgens
  7. Zones and lobes
46
Q

What does semen contain? 2

pH?

A

milky fluid containing
-citrate,
-calcium,
among other items with

pH of (6.5-7.5)

47
Q
  1. The prostate secretes fluid that does what?
  2. During ejaculation, the prostate squeezes this fluid into the what?
  3. Alpha-blockers: MOA?
  4. 5-alpha-reductase inhibitors: MOA?
A
  1. nourishes and protects sperm.
  2. urethra, and it’s expelled with sperm as semen.
  3. Alpha-blockers relax the muscles around the urethra in men with symptoms from an enlarged prostate. Urine then flows more freely. (Orthostatic HTN can be an issue)
  4. These medications reduce the level of a certain form of testosterone (DHT). The prostate shrinks when less DHT is present, improving urine flow.
48
Q

The Urinary Bladder

  1. Located where?
  2. Holds how much urine?
  3. What kind of tissue? (so it doesnt produce what?)
  4. What is the smooth muscle called and what is it innervated by?
  5. Fibers extend where?
  6. Contraction is what?
  7. increases _______ to expel urine?
A
  1. Between the pubic symphysis and rectum
  2. Holds 300-350 ml of urine
  3. Transitional epithelium (does not produce mucous)- bladder cancer also affected
  4. Smooth muscle is called the detrusor muscle and is innervated by parasympathetic fibers:
    Smooth muscle chamber
  5. Fibers extend in all directions
  6. Contraction (which is a reflex, NOT voluntary)
  7. increases pressure…bladder expels urine
49
Q

The Urinary Bladder
1. External sphincter is a skeletal muscle WHICH IS under what?

  1. This can be used to consciously prevent what?
  2. Internal sphincter is smooth muscle that is controlled how?
  3. with natural tone, and therefore prevents what?
A
  1. voluntary control
  2. urination even when involuntary controls are attempting to empty the bladder.
  3. INVOLUNTARILY CONTROLLED
  4. emptying of the bladder until the pressure in the main part of the bladder rises above a critical threshold.
50
Q

The Urinary Bladder
1. Sensory fibers detect degree of stretch in the bladder wall which triggers what?

  1. Ureters course _________ for several centimeters through the bladder wall
  2. Therefore, normal tone of the bladder prevents ______?
  3. What allows urine to deposit into the bladder?
A
  1. the reflexes responsible that cause bladder emptying.
  2. obliquely
  3. reflux
  4. Peristaltic contractions of ureter
51
Q

Urinary Obstruction and Stasis
Several things can cause urinary obstruction and stasis including:
6

A
  1. Congenital narrowing of external meatus
  2. Sacral nerves damage
  3. Compression of urethra (enlarged prostate gland)
  4. Urethral strictures (often from STDs)
  5. Compression of bladder neck or urethra from bladder tumors
  6. Constipation and fecal impaction can compress the urethra
52
Q
  1. How many sperm does it take to fertilize one ovum?
  2. Where is most of the mature sperm stored?
  3. Where does spermatogenesis begin?
A
  1. One..
  2. The Vas Deferens, NOT the testis or the epididymis
  3. The hypothalamus and pituitary gland, NOT the testis
53
Q

Is timing important for the blood draw when ordering testosterone level?

A

NOT AS IMPORTANT LIKE LH AND FSH/PROGESTERONE AND ESTROGEN because it isnt cyclic

Testosterone Levels: When Should I have Them Checked?
If you have your testosterone levels checked in the middle of the day, you are much more likely to present low testosterone levels, because testosterone levels naturally decline as the day goes on. Therefore, your results may be skewed.

We try to draw blood as early as possible in the morning (between 8 and 8:30 a.m.) because that’s your best bet for catching testosterone in a low level if it really is low

54
Q

Jack’s physical exam: Well nourished muscular teenager with benign physical exam except for grade II-III acne and bilateral borderline shrunken testes (Just over 3cm in length, normal is about 3.5-5.5cm)?

So what is Jack’s likely diagnosis?

A

Exogenous anabolic steroid abuse
-Time to do some lab work and have a long talk with Jack and his father pending positive results

Extra testosterone so they dont need to make it so they get a negative feedback loop and it comes back around to pitutary. So no LH and no testosterone from ledig cells.

Also less sperm being made and potentially gynecomastia.

Decreased libido and increased aggression

55
Q
  1. Spermatogenesis starts in the where?
    2
  2. If you disrupt the highway of transport (________), you can’t get your troops to where they need to be
  3. Semen does not equal sperm. The semen is a mix of fluids from where? 5
  4. Maximal life span of a sperm at room temperature is only about how long? and the window for fertilization is very short.
A
  1. hypothalamus and pituitary
  2. vasectomy
    • vas deferens,
    • seminal vesicles,
    • prostate gland, as well as the
    • bulbourethral glands and
    • glands throughout the urethra
  4. 24-48 hours
56
Q
  1. If a man’s ejaculate falls below around what concentration of sperm (at about 3.5ml) then there are not likely enough troops to get that one special soldier to the ovum?
  2. Erection and lubrication are caused by what?
  3. Emission and ejaculation by what?
  4. You need both what to produce mature sperm? 2
  5. When you think LH, you think what? 2
  6. when you think FSH, you think what?
A
  1. 70,000,000
  2. parasympathetic signals.
  3. sympathetic signals
  4. FSH and testosterone
  5. Leydig and testosterone
  6. facilitation of sperm production
57
Q
  1. The Leydig cells aren’t the only things that secrete testosterone
    Remember, testosterone is THE determining factor for whether or not the fetus develops what?
  2. This holds true regardless of what?
  3. So if you had an XX with congenital adrenal hyperplasia secreting testosterone during embryologic development, what do you end up with?
  4. If you shut down the hypothalamus and pituitary (from exogenous androgens for example), then you cant do what?
A
  1. male genitalia.
    - If you have testosterone  male genitalia… No testosterone  female genitalia!
  2. your chromosomes say.
  3. Intersex?
  4. can’t stimulate the testes.
58
Q

If you dont stimulate the testes you get what?

A

If you don’t stimulate the testes, you get shrinkage

59
Q
  1. Testosterone DOES stimulate the growth of what, so use with clinical discretion?
  2. A man is never supposed to have _____. So if they do, something’s going on, and it might be testicular CA
  3. That bladder reflex deal is what, but muscles can only go for so long before they fatigue?
  4. There’s a point to at which those ____________ signals will override your voluntary control of the external sphincter
  5. If you want to counteract an ________________ (too much parasympathetic activity), then you use something that opposes the parasympathetic system
A
  1. prostate CA
  2. hCG
  3. self regenerative
  4. parasympathetic
  5. overactive bladder
60
Q

Describe the pathway of endocrine regulation of spermatogenesis? 3

A
  1. Hypothalamus- GnRH
  2. Anterior pituitary- FSH and LH
  3. Gonads- sex steriods and inhibin
61
Q
  1. FSh works on what? 2

2. LH works on what?

A
    • Sertori cells- intiates spermatogenesis
    • Seminiferous tubules- Inhibin (inhibin suppressed FSH).
  2. Ledig cells

Urology (12 decks)

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