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Phase 1 Cards > SUGER > Flashcards

SUGER Flashcards

1
Q

What does Onuf’s nucleus do?

A

Controls the rhabdosphincter muscle which is voluntary

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2
Q

What is the rhadosphincter?

A

A striated muscle sphincter - it is part of the external urethral sphincter

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3
Q

What are the types of incontinence?

A

Stress incontinence
Urge incontinence
Retention with overflow

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4
Q

What is the lower urinary tract comprised of?

A

Bladder
Bladder neck
Prostate gland (in man)
Urethra and urethral sphincter

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5
Q

What is the function of the lower urinary tract?

A

To convert the continuous process of excretion into an intermittent and controlled process

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6
Q

What does micturition mean?

A

The discharge of urine from the bladder

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7
Q

What is stress incontinence?

A

A condition found mainly in women in which there is involuntary discharge of urine when the pressure of the abdomen increases suddenly e.g. jumping or coughing

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8
Q

What is urge incontinence?

A

A condition where you have an urgent desire to go to pass urine and there is often leakage - this is due usually to an overactive bladder

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9
Q

What is retention with overflow?

A

This is where there is an obstruction and this leads to difficulty fully passing urine - pressure build ups lead to frequent leaks

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10
Q

What are the three main functions of the kidneys?

A

1) Excretion of waste products
2) Maintenance of salt, water and pH balance
3) Endocrine function - secreting hormones

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11
Q

What parts of the nephron are in the cortex of the kidney?

A
  • Bowman’s capsule
  • Proximal tubule (convoluted part)
  • Distal tubule
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12
Q

What parts of the nephron are in the medulla of the kidney?

A
  • Loop of Henle

- Collecting duct

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13
Q

What is the structure of the loop of Henle?

A
  • Thin descending limb
  • Thin ascending limb
  • Thick ascending limb
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14
Q

What proportion of the cardiac output is received by the kidneys (both together)?

A

1/5th - 1L/min

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15
Q

What is the normal urine flow per minute?

A

1ml/min

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16
Q

What are the divisions of the renal arteries in the kidneys?

A 
Renal artery 
Interlobar artery
Arcuate artery
Interlobular artery
Afferent arteriole
Glomerular capillary
Efferent arteriole
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17
Q

What is the glomerulus?

A

A capillary tuft that is fenestrated and lined on the outside by podocytes with foot process

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18
Q

What is the role of the podocytes and their foot processes?

A

To aid in the filtration - regulating the passage of proteins from the capillary into bownmans space

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19
Q

What is the role of mesangial cells in the glomerulus?

A

They alter the filtration rate by contracting and reducing the surface area of the glomerulus

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20
Q

What is the approx. surface area of the glomerulus?

A

1m squared

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21
Q

What makes up the filtration barrier?

A

1) Capillary endothelium
2) Basement membrane
3) Foot process and podosytes

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22
Q

What determines the what crosses the filtration barrier?

A

1) Pressure
2) Size of molecule
3) Charge of the molecule
4) Rate of blood flow
5) Binding to plasma proteins e.g. calcium and hormones such as thyroxine

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23
Q

Negatively charged anions are repelled at the barrier, why?

A

The basement membrane has a fixed negative charge

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24
Q

What factors favour filtration into bowman’s space?

A

Increased hydrostatic pressure of capillary

Decreased oncotic pressure of capillary

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25
Q

What factors favour moevement of filtrat back into the capillary?

A

Decreased hydrostatic pressure of capillary

Increased oncotic pressure of capillary

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26
Q

What is the glomerular filtration rate?

A

The filtration volume per unit of time

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27
Q

What is the equation for GFR?

A

GFR = Kf (Pgc-Pbs) - (Onc.gc)

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28
Q

What affect on GFR would the constriction of the afferent arteriole have?

A

It would decrease

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29
Q

What affect on GFR would constriction of the efferent arterioles have?

A

It would increase

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30
Q

What affect would dilation of the afferent arteriole have on GFR?

A

It would increase

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31
Q

What affect would dilation of the efferent arteriole have on GFR?

A

It would decrease

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32
Q

What is the name of the process in which renal blood flow is maintained?

A

Autoregulation

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33
Q

What is Tubuloglomerular feedback? Describe it

A

This is where GFR is regulated by the by the following:

1) Macula densa cells detect NaCl arrival
2) Macular densa release prostaglandins in response to reduced delivery
3) Prostaglandins trigger renin release from granular cells
4) Renin activates renin-angiotensin system
5) GFR increases

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34
Q

What three characteristics must a substance have to be used to measure GFR?

A

1) Freely filtered
2) Not secreted or absorbed in tubules
3) Not metabolised

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35
Q

How can GFR be calculated using a marker substance?

A

GFR = Conc in urine x flow rate/Conc in plasma

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36
Q

What is the normal GFR?

A

approx. 125ml/min

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37
Q

What substance is used clinically to meausre GFR?

A

Creatinine

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38
Q

What is the filtration fraction equation?

A

FF = GFR/Renal plasma flow

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39
Q

What is the normal filtration fraction?

A

20%

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40
Q

What is the concept of renal clearance?

A

The colume of plasma from which a substance is completely removed by the kidney per unit of time (usually a minute)

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41
Q

What is the calculation for renal clearance?

A

Clearance = Urine concentration x urine volume/plasma concentration

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42
Q

What does it mean if the renal clearance of a substance in lower than the GFR?

A

That it is freely filtered but partially reabsorbed?

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43
Q

What does it mean if the renal clearance of a substance is the same as the GFR?

A

That it is freely filtered and not absorbed or secreted

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44
Q

What does it mean if the renal clearance of a substance is greater than the GFR?

A

that it is freely filtered and secreted

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45
Q

What is the volume of filtrate produced each day?

A

180L

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46
Q

What happens at the proximal tubule?

A 
Bulk reabsorption of: 
Na+
Cl-
Glucose
Amino acids
HCO3-

Secretion of organic ions

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47
Q

What happens in the Loop of Henle?

A

1) More Na+ reabsorption
2) Urinary dilution
3) Generation of hypertonic medullary interstitium

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48
Q

What happens at the distal tubule?

A

1) Fine regulation of: Na+, K+, Ca2+, Pi

2) Seperation of Na+ and H2O

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49
Q

What happens at the collecting duct?

A

1) Similar to distal tubule
2) Acid secretion
3) Regulated H2O reabsorption

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50
Q

Does the proximal tubule have high or low permeability to water?

A

High

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51
Q

What is the bulk reabsortion driven by?

A

1) Basolateral Na/K ATPase

2) Secondary active transport for glucose, amino acids and lactate

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52
Q

What is secondary active transport?

A

Where the energy used to move a substance across a membrane is not directly from ATP e.g. by an electrochemical gradient

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53
Q

What is glomerulotubular balance?

A

Where a greater filtered load is matched by more proximal tubular reabsorption

1) Greater filtration load increases oncotic pressure in peritubular capillaries
2) Efferent arteriolar constriction reduces peritubular capillary hydrostatic pressure

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54
Q

Which part of the Loop of Henle is permeable to water?

A

Descending limb - ascending limb is impermeable

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55
Q

What occurs in the thick ascending limb?

A

Solute reabsorption

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56
Q

What is the name for the process in which a hypertonic medullary interstitium is generated?

A

Countercurrent multiplication

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57
Q

Describe the process of countercurrent multiplication

A

1) Solute reabsorption occurs in the ascending limb i this increases the medullary osmolarity
2) This draws water out from the descending limb which increases luminal osmolality
3) This causes the process to repeat increasing interstitium osmolarity

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58
Q

What are the two types of cell present in the collecting ducts?

A

1) Principal

2) Intercalated

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59
Q

What cells in the collecting duct are affected by ADH?

A

Principal cells

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60
Q

What is the role of principal cells?

A

Involved in sodium/potassium balance via sodium and potassium channels

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61
Q

What is the role of intercalated cells?

A

Involved in acid-base homeostasis

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62
Q

What are the limits of urine volume?

A

400ml-20L/day

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63
Q

What actions does angiotensin II have?

A

1) Vasoconstrictor
2) Stimulates aldosterone release
3) Increases Na reabsorption of proximal tubule

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64
Q

What is the action of ANP?

A

1) Renal vasodilator
2) Inhibits aldosterone release
3) Closes ENaC channels in collecting tubules

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65
Q

What is the normal pH range for blood?

A

7.35 to 7.45

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66
Q

Briefly describe how bicarbonate reabsorption occurs

A

1) Hydrogen ions are pumped into lumen of tubule
2) Bicarbonate and hydrogen ion form carbonic acid
3) Carbonc acid is broken down by carbonic anhydrase to CO2 and H2O
4) CO2 and H2O diffuse into cell
5) Recombine to form carbonic acid with CA enzyme
6) Dissociation occurs - HCO3- is pumped into capillary, H+ pumped back out into lumen

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67
Q

How does phosphate act as a buffer?

A

1) Alkaline phosphate accepts proton
2) Acid phosphate is impermeable to apical membrane
3) H+ don’t pass into capillaries - excreted

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68
Q

How does the urinary ammonia buffer work?

A

1) NH3 sythesised from glutamate
2) NH3 diffuses into lumen
3) NH4+ is impermeable to apical membrane
4) Excreted

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69
Q

What type of compensation takes place in respiratory acidosis?

A

Renal compensation

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70
Q

What is the renal compensation for respiratory acidosis?

A

1) H+ secretion increases
2) Acid excreted as ammonium
3) HCO3- increases further

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71
Q

What is the renal compensation for respiratory alkalosis?

A

1) H+ secretion decreases
2) H+ retained

Note: Insufficient H+ secretion for HCO3- reabsorption

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72
Q

What happens to HCO3- and CO2 in Respiratory acidosis?

A

HCO3- increases

CO2 increases

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73
Q

What happens to HCO3- and CO2 in respiratory alkalosis?

A

HCO3- decreases

CO2 decreases

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74
Q

What happens to HCO3- and CO2 in metabolic acidosis?

A

HCO3- decreases

CO2 decreases

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75
Q

What happens to HCO3- and CO2 in metabolic alkalosis?

A

HCO3- increases

CO2 increases

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76
Q

What two hormones do the kidneys release?

A

1) Erythropoietin

2) Renin

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77
Q

What is the function of erythropoietin (EPO)?

A

Stimulates bone marow - promotes RBC maturation

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78
Q

Where is EPO made?

A

Peritubular cells in interstitial space of renal cortex

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79
Q

What does the urinary system originate from embryologically?

A

Intermediate mesoderm

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80
Q

What are the three overalpping kidney systems that develop from the intermediate mesoderm?

A

1) Pronephros
2) Mesonephros
3) Metanephros

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81
Q

Which of the three overlapping embryological systems does the permenant kidney form from?

A

Metanephros

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82
Q

What does the pronephros comprise of?

A

7-10 solid cell groups called Nephrotomes (they disappear at the end of the fourth week)

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83
Q

What does the mesonephros comprise of?

A

A ridge and a duct - the duct is lateral to the ridge (appears at 4th week)

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84
Q

Where does the urogenital ridge form?

A

On the medial side of the mesonephric ridge

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85
Q

What are the two sources of the metanephros system?

A

1) Metanephric blastema

2) Ureteric bud

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86
Q

What does the metanepheric blastema give rise to?

A

Excretory units

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87
Q

What does the ureteric bud give rise to?

A

Collecting system

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88
Q

Describe what happens as the ureteric bud forms the collecting system?

A

1) Dilates - forms renal pelvis
2) Splits - future major calyces
3) Major calyces bud to form minor cayces and collecting tubules

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89
Q

What is the position of the kidneys in development?

A

Develop in pelvis then move cranially

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90
Q

How does the blood supply change to the kidneys during development?

A

In pelvis they receive pelvic branches of aorta but when they ascend they receive blood directly from aorta - lower vessels usually degerate

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91
Q

At what point does the metanephros start functioning?

A

12th week

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92
Q

Where does the urogenital sinus come from?

A

Cloaca - divided by urorectal septum

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93
Q

What are the parts of the urogenital sinus? What do they form?

A

Upper - Urinary bladder
Pelvic (middle) - Prostatic and membranous urthra
Phalic - Penile urethra

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94
Q

How does the prostate develop (briefly)?

A

Prostatic urethra proliferates forming outgrowths (endodermal origin)
Prostate connective tissue and smooth muscle is mesoderm in origin

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95
Q

Which parts of the hindgut remain intraperitoneal?

A

Transverse colon - maintains dorsal mesentery

Sigmoid colon - also retains mesentery

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96
Q

Which part of the hingut is retroperitoneal?

A

Descending colon - loses mesentery

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97
Q

What type of organs are the rectum and anal canal?

A

Infraperitoneal - develop in intraperitoneal space

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98
Q

What does the cloaca divide into?

A

1) Primitive urogenital sinus

2) Anorectal canal

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99
Q

What is the epithelial lining of the anal canal?

A

Upper 2/3 = Simple columnar

Lower 1/3 = stratified squamous

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100
Q

What is the name of the line which divides the upper 2/3 and lower 1/3 of the anal canal?

A

Pectinate line

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101
Q

The lower 1/3 of the anal canal differs superiorly and inferiorly, how?

A

Superiorly - stratified non-keratinized squamous epithelium

Inferiorly - stratified keratinized squamous epithelium

The line between - Hilton’s white line

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102
Q

What is the blood supply to the anal canal?

A

Upper 2/3 = superior rectal artery

Lower 1/3 = inferior rectal artery

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103
Q

What is the embryological origin of the upper 2/3 of the anal canal?

A

Endoderm

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104
Q

What is the embryological origin of the lower 1/3 of the anal canal?

A

Ectoderm

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105
Q

What does the epidermis originate from embryologically?

A

Ectoderm

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106
Q

What are the main type of cells that make up skin?

A

Keratinocytes

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107
Q

What are the non-keratinocytes that are present in skin?

A

Melanocytes
Langerhans cells
Merkel cells

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108
Q

What are keratinocytes?

A

Epithelial cells that contain keratin

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109
Q

Keratinocytes have immune properties how?

A

They produce:
Interleukins
Interferons
Growth Factor

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110
Q

What are the 5 epidermal layers?

A 
Stratum Basale
Stratum Spinosum
Stratum Granulosum
Stratum Lucidum
Stratum Corneum
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111
Q

What is the Stratum Basale?

A

A single layer of mitotically dividing cells attached to the basement membrane - these cells produce the keratinocytes

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112
Q

What are melanocytes developed from?

A

Melanoblasts which originate in neural crest

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113
Q

What do melanocytes do?

A

Produce melanin - transfer to keratinocytes

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114
Q

What are Langerhans cells in skin developed from?

A

haemopoetic bone marrow cells

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115
Q

What is the role of Langerhan’s cells in the skin?

A

They are antigen-presenting cells so have immune function

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116
Q

What is the role of merkel cells?

A

Neuroendocrine cells - act as mechanoreceptors and mediate tactile tension

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117
Q

What does the dermis originate from embryologically?

A

Mesoderm

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118
Q

Where do the primordial germ cells originate from?

A

Epiblast

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119
Q

Where do the germ cells migrate to?

A

Genital ridge

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120
Q

The arrival of germ cells causes the epithelium of the genital ridge to proliferate and form what?

A

Primitive sex chords

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121
Q

What signals the development of MALE genitals?

A

Y chromosome has gene called the Sex Determining Region which codes for a protein called Testis Determining Factor

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122
Q

What happens in the absence of the Testis-Determining Factor?

A

Female development occurs

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123
Q

In males what do the Primitive sex cords form?

A

Testis cords (medullary cords)

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124
Q

When the Testis cords break up what do they form?

A

Rete testis

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125
Q

What is the name of the fibrous connective tissue that forms under the epithelium of the genital ridge?

A

Tunica Albuginea

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126
Q

What do the remaining excretory tubules of the mesonephric system give rise to?

A

Efferent ducts that link the rete testis and Mesonephric duct

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127
Q

What structures does the Mesonephric duct form?

A

Epididymis
Vas deferens
Seminal vesicles
Ejactulatory duct

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128
Q

The seminferous tubules are formed at birth. True or false?

A

False - the testis cords remain solid until puberty

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129
Q

Where do the testis form?

A

Posterior abdominal wall - they descend into the scrotum before birth

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130
Q

What happens to the Mullerian Duct in males?

A

It degenerates

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131
Q

What causes the Mullerian Duct to degenerate in males?

A

Anti-Mullerian hormone

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132
Q

What cells produce the Anti-Mullerian Hormone?

A

Stertoli cells

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133
Q

What do the urethral folds form in males?

A

Scrotum

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134
Q

What substance mediates the majority of male genital development?

A

Testosterone

135
Q

What happens to the primitive sex cords in females?

A

They dissociate into cell clusters

136
Q

Second generation cords form called cortical cords what happens to them?

A

They split into isolated cell clusters and surround the germ cells - form follicular cells

137
Q

What happens to the mesonephric duct and excretory tubules in females?

A

They degenerate

138
Q

What does the Mullerian ducts form?

A

1) Uterine tubes
2) Uterus
3) Cervix
4) Upper Vagina

139
Q

What is the differentiation of the Mullerian duct stimulated by?

A

Oestrogen

140
Q

Where does the oestrogen come from in embryonic development?

A

1) Ovaries
2) Mother
3) Placenta

141
Q

What does the urogenital sinus form in females?

A

1) Lower vagina
2) Labia Majora
3) Labia Minora
4) Clitoris

142
Q

What do the urethral folds form in females?

A

Labia Majora

143
Q

What is the name for the production of spermatozoa?

A

Spermatogenesis

144
Q

What is the name for the extention of peritoneum that covers the testes anteriorly?

A

Tunica vaginalis

145
Q

What is the role of stertoli cells?

A

1) Nurture sperm development

2) Form blood-testis barrier

146
Q

Why is there a blood testis barrier?

A

It is to protect the developing sperm from the immune system as the sperm do not have the same genetic information as somatic cells in the body

147
Q

What do the seminiferous tubules drain into?

A

Rete testis

148
Q

What is another name for the foreskin?

A

Prepuce

149
Q

Why are the testes outside of the body?

A

To keep the testes at a lower temperature than the body - this is needed for their development

150
Q

What is the mechanism for keeping the testes cooler than the body?

A

Heat exchange in the Pampiniform plexus - this is where the returning blood in the veins cools the warmer blood coming in the testicular artery

151
Q

What happens in meiosis I to the genetic material?

A

The homologous chromosome pairs are seperated

152
Q

What happens in meiosis II to the genetic material?

A

The duplicate sister chromatids

153
Q

Spermatogonia produce two types of daughter cells, what happens to them?

A

Type A remain outside blood-testis barrier and produce more daughter cells

Type B differentiate into primary spermatocytes

154
Q

What is formed after meiosis I?

A

2 Secondary spermatocytes

155
Q

What is formed after meiosis II?

A

4 spermatids

156
Q

What is spermiogenesis?

A

The transformation of spermatids into spermatozoa

157
Q

What happens in spermiogenesis?

A

The spermatids sprout a tail and they discard their cytoplasm

158
Q

How many sperm are made per gram of testis per second?

A

300-600

159
Q

What is the blood-testis barrier formed by?

A

Tight junctions between the basement membrane under the sertoli cells

160
Q

How long does it take for spermatogenesis to be completed?

A

64 days

161
Q

What are the efferent tubules?

A

Ciliated ducts that collect spermatazoa from the rete testes and transport them to the epididymis

162
Q

What is semen made up of?

A
  • Seminal vesicle fluid
  • Prostatic secretions
  • Sperm
  • Bulbourethral fluid
163
Q

Semen also contains fructose, why?

A

To provide energy for the sperm so they can be mobile

164
Q

Semen contains prostaglandins, why?

A

To stimulate female peristaltic contractions

165
Q

Why is meiosis important in gamete formation?

A

1) Prevents polyploidy - where there is two (or more) copies of the genetic information
2) Increases genetic variability

166
Q

When does meiosis I begin in female gamete formation?

A

In utero before 12 weeks

167
Q

When does meiosis I end?

A

Puberty - it arrested at metaphase 1 until puberty occurs

168
Q

When does meiosis II occur?

A

Puberty

169
Q

When does meiosis II end?

A

Fertilization - it is arrested until fertilization

170
Q

At what point do male and female gonads differentiate?

A

Week 6

171
Q

What is the hormonal state before puberty?

A

1) Low pulsatility amplitude of GnRH and secretion

2) Low levels of FSH, LH and gonadal sex steroids

172
Q

What happens to the relevant hormones at puberty?

A

1) Increased amplitude of GnRH and GHRH
2) Increased levels of FSH, LH and sex steroids
3) Increased levels of growth hormone

173
Q

What are primordial follicles?

A

They are single oocytes surrounded by a layer of epithelial cells (granulosa cells)

174
Q

What stimulates follicular development?

A

Cyclic FSH secretion

175
Q

What happens in the formation of the primary follicle?

A

1) Granulosa cells proliferate
2) Oocyte enlarges
3) Stroma organised into connective tissue
4) Zona pellucida forms directly around oocyte

176
Q

What happens in the formation of the secondary follicle?

A

1) Formation of antrum - filled with follicular fluid
2) Connective tissue differentiates into theca interna and theca externa
3) Oocyte supported in antrum by stalk of granulosa cells

177
Q

What is the name of the stalk of granulosa cells that supports the oocyte?

A

Cumulus oophorus

178
Q

What is the name of a mature follicle?

A

Graafian follicle

179
Q

What happen in the formation of the Graafian follicle?

A

1) Ovum surrounded by thick zona pellucida
2) Layer of granulosa cells surround oocyte known as corona radiata
3) There is a basal lamina
4) There is a developed theca interna and externa

180
Q

What happens to the follicle after ovulation?

A

It converts into a corpus luteum

181
Q

What does the corpus luteum do?

A

Secretes progesterone and oestrogen

182
Q

What is the fate of the corpus luteum?

A

It persists if pregnancy occurs, if not it regresses

183
Q

What happens to the corpus luteum after it regresses?

A

Forms a corpus albicans - eventually resorbed or replaced by ovarian stroma

184
Q

What are the four segments of the uterine tube?

A

1) Intramural
2) Isthmus
3) Ampulla
4) Infundibulum

185
Q

What is the intramural part of the fallopian tube?

A

The part that is inside the uterine wall

186
Q

What is the isthmus part of the fallopian tube?

A

A thick-walled part - narrow

187
Q

What is the ampulla part of the fallopian tube?

A

An expanded part of the Fallopian tube

188
Q

What is the infundibulum of the fallopian tube?

A

A trumpet-shaped opening to the peritoneum which has fimbrae

189
Q

What are the layers of the fallopian tube lining?

A

1) Mucosa
2) Muscularis
3) Serosa

190
Q

Describe the structure of the mucosa of the fallopian tube

A

Thrown into branching folds - plicae

has three types of cells: Secretory, ciliated and intercalated

191
Q

Describe the structure of the muscularis of the fallopian tube?

A

Inner circular layer with outer longitudinal layer

192
Q

What is the serosa of the fallopian tube?

A

Connective tissue covered by mesothelium

193
Q

What are the three layers of the uterus?

A

1) Endometrium
2) Myometrium
3) Serosa

194
Q

The endometrium is composed of two layers, what are they?

A

1) Stratum basalis

2) Stratum compactum and stratum spongiosum (functional layer)

195
Q

The endometrium undergoes a proliferation phase, what is it?

A

Where glands proliferate, become tortuous and show mitotic activity

There is no luminal secretions

Stomal cells are spindled and compact

196
Q

What is the proliferation phase stimulated by?

A

Oestrogen

197
Q

The endometrium undergoes a secretory phase, what happens in the early phase?

A

sub-nuclear vacuoles form

198
Q

What happens in the mid part of the secretary phase?

A

Intraluminal secretions occur, glands become more rounded and there stroma oedema

199
Q

What happens in the late part of the secretory phase?

A

The glands become elongated and there are more luminal secretions

Stroma has spiral arterioles

200
Q

What stimulates the secretory phase?

A

Progesterone

201
Q

What happens in the menstrual phase?

A

Stomal haemorrhage occurs and theres stromal and glandular fragmentation

202
Q

What initiates the menstrual phase?

A

Progesterone withdrawl

203
Q

Describe the myometrium

A

Three layers (poorly defined)

Inner longitudinal
Middle circular
Outer longitudinal

204
Q

What is the endocervix?

A

The part of the cervix past its enterance

205
Q

What is the ectocervix?

A

The entrance to the cervix

206
Q

What is the endocervix lined by?

A

Simple ciliated columnar epithelium

207
Q

What is the ectocervix lined by?

A

Stratified non-keratinized squamous epithelium

208
Q

What is the vagina lined by?

A

Stratified non-keratinizing squamous epithelium

209
Q

What are the three layers of the vagina?

A

1) Mucosa
2) Muscularis
3) Adventitia

210
Q

What is the labia minora lined by?

A

Mostly stratified non-keratinizing squamous epithelium

211
Q

What is the labia majora lined by?

A

Stratified keratinizing squamous epithelium

212
Q

What are the two main glands in the female genitalia?

A

1) Bartholin’s gland - mucus secreting

2) Minor vestibular glands - mucus secreting

213
Q

What occurs to the female genitalia in menopause?

A

There is ovary, endometrium, cervix and vagina atrophy

214
Q

How long is the menstrual cycle normally?

A

28 days

215
Q

Between what days does menstruation take place in the cycle?

A

Day 1-7 (lasts between 3 and 7 days)

216
Q

What happens in days 8-11 of the menstrual cycle?

A

The endometrium thickens in preparation for an egg

217
Q

What day does ovulation take place in the cycle?

A

Day 14

218
Q

What happens between days 18-25?

A

Corpus lueum fades away if pregnancy has not occurred

219
Q

What happens at days 26-28 in the menstrual cycle?

A

The endometrium detaches from the uterus wall and leads to menstruation

220
Q

What two mechanisms are responsible for sperm transport in the female reproductive tract?

A

1) Sperm motility

2) Contractions of the female reproductive tract

221
Q

How long can sperm be “stored” in the human female reproductive tract?

A

5 days

222
Q

What process do sperm have to go through before they can fertilize the ovum?

A

Capacitation

223
Q

What happens in capacitation?

A

1) Sperm head membrane is changed so it can fuse more easily

2) The sperms motility increases

224
Q

What is the Zona Pellucida?

A

A glycoprotein layer that surrounds the oocyte and is vital in binding spermatozoa for fertilization

225
Q

What is a pronuclei?

A

The nucleus of a sperm of oocyte in the process of fertilization before fusion has taken place - they are still haploid

226
Q

What is the process syngamy?

A

1) Male and female pronuclei migrate to centre
2) Haploid chromosomes pair and replicate
3) Pronuclear membranes breakdown
4) Mitotic spindles form
5) 46 chromosomes line at the equator

227
Q

How long after fertilization does the first cleavage occur - division?

A

Approx. 24 hours

228
Q

What is responsible for developmental control prior to the 4-8 cell stage?

A

Maternally derived stores of RNA laid down in oogenesis

229
Q

What is responsible for development control at the 4-8 cell stage and onwards?

A

The embryonic genome - at this stage it is activated

230
Q

At day 4 compaction occurs, what does this involve?

A

1) Cells flatten - maximising intracellular contacts
2) Tight junctions form
3) Polarisation of the outer cells occurs

231
Q

At what stage does differentiation start to occur?

A

Day 5

232
Q

At day 6 the oocyte undergoes “hatching” what does this refer to?

A

The embryo hatching from the zona pellucida

233
Q

What two groups of layers have you got a differentiation?

A

1) Trophoectoderm

2) Inner mass cells

234
Q

What do the inner mass cells comprise of?

A

1) Extra embryonic membrane
2) Extra embryonic mesoderm
3) Extra embryonic endoderm
4) Embryonic ectoderm
5) embryonic mesoderm
6) Embronic endoderm

235
Q

What forms the chorian and placenta?

A

1) Chrorioic ectoderm (from trophoectoderm)

2) Extra embryonic mesoderm

236
Q

What forms the amnion?

A

Extra embryonic membrane and mesoderm

237
Q

What forms the yolk sac?

A

Extra embryonic mesoderm and endoderm

238
Q

What forms the fetus?

A

Embryonic ectoderm, mesoderm and endoderm

239
Q

What is the metabolic and biosynthetic activity and nutritional requirements at early cleavage?

A

Low - nutritional requirements are simple (low glucose and non-essential amino acids

240
Q

What is the metabolic and biosynthetic activity and nutritional requirements at the blastocyst stage?

A

High - nutritional requirements are complex (high glucose and essential and non-essential amino acids and vitamins

241
Q

What provides the exogenous nutrients to the blastocyst?

A

1) Cumulus cells
2) Fallopian tube secretions
3) Uterine secretions

242
Q

What is the implanation window of the blastocyst?

A

19-22 days

243
Q

What causes attachment of the blastocyst to occur?

A

1) Apical surface of endometrium has integrins
2) Trophoblastic cells also express intergrins

Integrins are adhesion molecules

244
Q

What does the trophoblast differentiate into?

A

1) Cytotrophoblast

2) Syncytiotrophoblast

245
Q

What does the synctiotrophoblast do?

A

Penetrates the basal lamina and erodes endometrial stroma - this erodes the vessels forming blood filled lacunae

246
Q

What happens in the decidual reaction phase?

A

Progesterone primed endometrial stromal cells adjacent to blastocyst differentiate into metabolically active secretory cells - decidual cells

247
Q

What prevents the embryo being attacked by the mother immune system?

A

Leucocytes in the endometrial stroma release interleukin-2 which prevents maternal recognition

248
Q

What is the role of hCG?

A

Sustains early pregnancy, supports the corpus luteum and therefore progesterone production

249
Q

In addition to supporting the development of sperm what else do sertoli cells do?

A

Phagocytose faulty sperm

250
Q

Describe Leydig cells’ function, appearance and location?

A

1) Cluster of cells in the interstitium between tubules
2) Produce testosterone
3) Large amount of SER
4) Reinke’s crystals

251
Q

What are the tubuli recti?

A

They connect the seminiferous tubules to the rete testis

252
Q

Describe the rete testis

A

1) Irregular anastomosing channels
2) Cuboidal epithelium
3) Microvilli and cillia

253
Q

What are the three parts of the epididymis?

A

Head, body and tail

254
Q

What is the function of the epididymis?

A

Storage and maturation of sperm

255
Q

What is the epithelium of the epididymis?

A

Pseudostratified columnar epithelium with stereocilia

256
Q

What is the structure of the Vas deferens?

A

Pseudostratified columnar epithelium with 3 layers of muscle

257
Q

What happens to the prostate in aging?

A

Stroma and glands both undergo hyperplasia

258
Q

What is another name for Bulbourethral glands?

A

Cowper’s

259
Q

What do the bulbourethral glands do?

A

Secrete lubricating mucus

260
Q

What are the parts of the uterus?

A

Body
Fundus
Neck
Os - opening

261
Q

What is the uterus supported by?

A

1) Broad ligament
2) Round ligament
3) Cardinal ligaments
4) Rectouterine ligament
5) Vesicouterine ligament

262
Q

What is a transvaginal ultrasound used for??

A

To assess thickness of the uterus lining and the ovaries - involves insertion of probe

263
Q

What is a sonohysterography?

A

A more in-depth investigation into the uterus using ultrasound and injected fluid

264
Q

What are the benefits of ultrasound?

A

1) Real-time imaging
2) Minimally invasive
3) Not believed to be harmful

265
Q

What happens in a hysterosalpinography?

A

1) Catheter inserted into uterine cavity
2) Contrast injected
3) Contrast flows into fallopian tubes
4) X-ray image obtained

266
Q

When are scans usually taken in pregnancy?

A

1) 12 weeks

2) 20 weeks

267
Q

What is the purpose of the 12 week scan?

A

To assess date of pregnancy: looks at heart beat, crown-rump length, number of fetuses and nuchal translucency

268
Q

What is the purpose of the 20 week scan?

A

To assess for any abnormailites

269
Q

What happens if possible abnormalities are found?

A

1) Second scan
2) Councelling
3) Further investigations

270
Q

When are MRI’s NOT done in pregnancy ?

A

First trimester

271
Q

When do the exocrine functions of the pancreas begin?

A

After birth

272
Q

When do the endocrine functions of the pancreas begin?

A

10-15 weeks

273
Q

Is the pancreas retroperitoneal or intraperitoneal?

A

Retroperitoneal

274
Q

What cells carry out exocrine functions?

A

Acinar cells

275
Q

What cells carry out endcrine activity?

A

Islets of Langerhans

276
Q

Which type of cells is significantly dominant in the pancreas?

A

Exocrine

277
Q

What doe the alpha cells in the islets of Langerhans produce?

A

Glucagon

278
Q

What do the beta cells in the islets of Langerhans produce?

A

Insulin

279
Q

What do the delta cells in the islets of Langerhans produce?

A

Somatostatin

280
Q

Describe briefly the process of insulin secretion from the beta cells?

A

1) Glucose enters through GLUT2 transporter
2) Glucose metabolism occurs - ATP formed
3) Potassium channels close - depolarises membrane
4) Calcium channels open
5) Insulin secretory granules fuse with membrane and release insulin

281
Q

What feature shows that insulin has been produced endogenously?

A

Presence of C peptide

282
Q

What is proinsulin?

A

Contains A and B chains of insulin joined by C peptide (disulphide bridges hold the two chains together)

283
Q

The release of insulin is biphasic, what does this mean?

A

1) First phase is rapid release of stored hormone

2) Second phase is slow as it is the release of newly synthesised hormone

284
Q

Describe the mechanism in which insulin acts of muscle and fat cells

A

1) Insulin binds to insulin receptor on cell
2) Intracellular signalling takes place
3) GLUT4 vesicle mobilized to plasma membrane
4) GLUT4 allows glucose to move into cell

285
Q

What is the short-term response to high glucose?

A

Glycogenesis

286
Q

What is the long-term response to high glucose?

A

Lipogenesis

287
Q

What is the short-term response to low glucose?

A

Glycogenolysis - breaking down glycogen

288
Q

What is the long-term response to low glucose?

A

Gluconeogenesis - make glucose

289
Q

Where are the primary glucose sensors?

A

Pancreatic islets

290
Q

Where are glucose sensors found other than pancreatic islets?

A

Medulla
Hypothalamus
Carotid bodies

291
Q

What is the gut hormone that stimulates insulin release?

A

Incretins

292
Q

Where does glucose go in the body?

A

40% liver

60% periphery (mainly muscle)

293
Q

What supplies the anterior pituitary with blood?

A

Through portal venous circulation from the hypothalamus

294
Q

What are the hormones released by the hypothalamus?

A

1) GHRH
2) GnRH
3) TRH
4) Dopamine

295
Q

What hormones are released from the anterior pituitary galnd?

A

1) GH
2) LH
3) FSH
4) ACTH
5) TSH
6) Prolactin

296
Q

What are three main issues that can occur from a pituitary tumour?

A

1) Pressure on nerves - particularly optic nerves
2) Pressure on normal pituitary - hypopituitarism
3) Functioning tumour - secretes hormones

297
Q

What would happen if the pituitary tumour pressed on the optic chiasm?

A

Bitemporal hemianopia

298
Q

What does the posterior pituitary gland originate from?

A

Neural tissue - large numbers of glial-type cells

299
Q

What two hormones are released by the posterior pituitary gland?

A

1) Vasopressin

2) Oxytocin

300
Q

What is the function of vasopressin?

A

Controls water reabsorption

301
Q

What is the function of oxytocin?

A

1) Expression of milk from the glands to the nipples

2) Contractions of the uterus - initation of labour

302
Q

Where in the posterior pituitary gland is vasopressin released from?

A

Supraoptic nuclei

303
Q

Where in the posterior pituitary gland is oxytocin released from?

A

Paraventricular nuclei

304
Q

The hormones released by the posterior pituitary are formed in the hypothalamus - how do they get to the posterior pituitary gland?

A

In the axoplasm of the neurons

305
Q

What triggers vasopressin release?

A

Osmoreceptors in hypothalamus - day to day

Baroreceptors in brainstem and great vessels - in emergency

306
Q

What is the condition in which you lack vasopressin?

A

Crainial diabetes insipidus

307
Q

What is the condition in which you are resistant to vasopressin?

A

Nephrogenic diabetes insipidus

308
Q

What is oxytocin stimulated by in women?

A

Suckling

309
Q

What leads to the release of thyroid hormones from the thyroid gland, starting at hypothalamus?

A

1) Hypothalamus releases Thyrotropin-releasing hormone
2) This stimulates the release of Thyroid-stimulating hormone from the anterior pituitary gland
3) this stimulates the release of the thyroid hormones

310
Q

What are the hormones produced by the thyroid gland?

A

1) Thyroxine (T4)
2) Triiodothyronine (T3)
3) Calcitonin

311
Q

What is stored in the follicles of the thyroid gland?

A

Thyroglobulin

312
Q

What is the actions of thyroid hormones?

A

1) Increasing metabolism
2) Growth and development
3) Increased catecholamine effect

313
Q

What is the action of calcitonin?

A

Works to reduce calcium levels by:

1) Inhibiting osteoclasts
2) Stimulating osteoblast activity
3) Inhibits calcium reabsorption in renal tubules

314
Q

What effect does calcitonin have that is the same as PTH?

A

It inhibits phosphate reabsorption in the renal tubules

315
Q

What cells produce calcitonin?

A

C cells or parafollicular cells

316
Q

What is produced in the Zona glomerulosa of the adrenal glands?

A

Mineralocorticoids - Aldosterone

317
Q

What is produced in the Zona fasciculata of the adrenal gland?

A

Glucorticoids - cortisol

318
Q

What is produced in the Zona reticularis?

A

Androgens

319
Q

What is produced in the medulla of the adrenal gland?

A

Catecholamines - e.g. adrenaline

320
Q

What is the name for the part of the adrenal gland that contains the Zona glomerulosa, fasciculata and reticularis?

A

Adrenal cortex

321
Q

What is the function of ACTH?

A

It stimulates corticosteroid synthesis

322
Q

What are the actions of glucocorticoids?

A

1) Increased glucose mobilisation
2) Maintenance of circulation - vascular tone, salt and water balance
3) Immunomodulation - dampens immune response

323
Q

How are glucocorticoids transported?

A

1) Corticosteroid-binding globulin (CBG) (90%)
2) Albumin-bound (5%)
3) Free (5%)

324
Q

What affect do glucocorticoids have on hypothalamus and pituitary gland?

A

Inhibit CRH and ACTH release - negative feedback

325
Q

What happens in the plasma and urine when there is endocrine salt loss?

A

Plasma: Sodium = low, potassium = high
Urine: Sodium = high, potassium = low

326
Q

What stimulates androgen production in the adrenal glands?

A

ACTH (not gonadotrophins like in gonads)

327
Q

What is different about the adrenal medulla?

A

It is part of the autonomic nervous system

328
Q

Which is produced in greater amounts in the adrenal medulla, adrenaline or noradrenaline?

A

Adrenaline - 80%

Noradrenaline - 20%

329
Q

What does endocrine mean?

A

“Within” - this is where the glands secrete into the blood stream

330
Q

What does exocrine mean?

A

“Outside” This is where the glands secrete substances into ducts which transport to site of action

331
Q

What is the other name for the anterior pituitary gland?

A

Adenohypophysis

332
Q

What is the other name for the posterior pituitary gland?

A

Neurohypophysis

333
Q

What inhibits prolactin secretion?

A

Dopamine

Phase 1 Cards (13 decks)

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