The reproductive system (17) Flashcards

1
Q

What do the Fallopian tubes have that help move the egg towards the central components of the female reproductive tract?

A

cilia- help ‘waft’

spiral muscle- peristalsis

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2
Q

What do we cut in a vasectomy?

A

vas deferens

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3
Q

What would cause an ectopic pregnancy?

A
  • any defect in cilia or spiral muscles of Fallopian tube (can lead to infertility bc fertilisation usually occurs in widest part- ampulla)
  • if fertilisation occurs further up–> ectopic pregnancy: as embryo grows- Fallopian tubes rupture–> catastrophic haemorrhage
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4
Q

What is uterine prolapse?

A

loss of tone of the pelvic floor (levator ani and coccygeus)

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5
Q

What is the arterial blood supply to the female reproductive tract?

A

ovaries: ovarian arteries (from aorta)

uterus/vagina: uterine arteries (from internal iliac artery)

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6
Q

What are the 2 main functions of the gonads?

A

gametogenesis and reproductive hormone production

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7
Q

What is the lifespan of germ cells in males?

A
  • gametogenesis begins at puberty
  • spermatogonia differentiate and self-renew–> pool available for subsequent spermatogenic cycles throughout life (continuous fertility)
  • produce around 1500 mature sperm/second
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8
Q

What is the lifespan of germ cells in females?

A

before birth

  • multiplication of oogonia to around 6 million/ ovary
  • form 1y oocytes (primordial follicles) within ovarian follicles–> get suspended in prophase of meiosis
  • some degenerate (atresia)
  • at birth, around 2 million/ovary

by puberty
- <0.5 million/ ovary (due to further atresia)

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9
Q

What is the process of spermatogenesis?

A

2n germ cell
2n spermatogonium–> mitosis
2n 1y spermatocytes–> 1st meiotic divison
n 2y spermatocytes–> 2nd meiotic division
n spermatids–> differentiation
spermatozoa/sperm

in seminiferous tubules- move inwards as develop

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10
Q

What are the Sertoli cells?

A
  • within seminiferous tubules
  • has FSH receptors
  • supports developing germ cells: assists movement to tubular lumen, transfers nutrients from capillaries to developing germ cells, and involved in phagocytosis of damaged germ cells
  • hormone synthesis: release inhibin and activin, AMH and ABP
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11
Q

What are the Leydig cells?

A
  • between seminiferous tubules (not inside)
  • pale cytoplasm bc cholesterol-rich
  • has LH receptors
  • hormone synthesis: when stimulated by LH, secrete androgens e.g. testosterone
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12
Q

What hormones are produced in the testes?

A
  • androgens (testosterone, dihydrotestosterone, androstenedione)
  • inhibin: acts on pituitary to inhibit FSH secretion
  • oestrogens (from androgen aromatisation)
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13
Q

What is the process of oogenesis?

A

N.B. in 2nd trimester of pregnancy, all oogonia develop into 1y oocytes- locked here

2n germ cell
2n oogonium–> mitosis
2n 1y oocytes–> 1st meiotic division at menarche
n 2y oocytes (+1st polar bodies) –> 2nd meiotic divison when sperm fuses
n ootids (+2nd polar bodies)–> differentiation
n ova

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14
Q

What is menarche?

A

start of menstrual cycle

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15
Q

What is the process of folliculogenesis?

A
  1. PRIMORDIAL FOLLICULE- contains 1y oocyte at birth
  2. becomes 1Y FOLLICLE- surrounded by layers of granulosa and theca cells
  3. mature to form 2Y FOLLICLE w/ fluid-filled cavity (antrum) and FSH+LH receptors
  4. MATURE FOLLICLE/Graafian/Preovulatory- forms halfway through menstrual cycle- 2y oocyte in cumulus mass
  5. RUPTURED FOLLICLE- 2y oocyte ruptures out
  6. follicle degenerates into CORPUS LUTEUM- secretes progesterone
  7. degenerates into CORPUS ALBICANS
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16
Q

How can we tell if someone has ovulated?

A
  • measure day 21 progesterone and
  • maybe ultrasound (presence of corpus luteum)

if corpus luteum–> must be successful ovulation

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17
Q

What hormones are made by the ovaries?

A
  • oestrogens (oestradiol, oestrone, oestriol)
  • progestogens (progesterone)
  • androgens (testosterone, androstenedione, DHEA)
  • relaxin
  • inhibin
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18
Q

What is a theca cell?

A
  • outer part of ovarian follicles
  • support folliculogenesis: structural and nutritional
  • hormone synthesis: make androgens- stimulated by LH (theca cell overactivity–> high androgen levels)
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19
Q

What is a granulosa cell?

A
  • inner part of ovarian follicles
  • hormone synthesis: convert androgens to oestrogen (by aromatase)- stimulated by FSH
    AND secrete inhibin and activin (affect FSH)
  • after ovulation–> turn into granulosa lutein cells- produce progesterone (maintain endometrium) and relaxin (prepare endometrium for pregnancy)
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20
Q

What is the common initial substrate for all gonadal steroid hormones?

A

cholesterol

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21
Q

How does the Hypothalamic-Pituitary-Gonadal Axis (HPG) work?

A

kisspeptin neurons secrete kisspeptin onto receptors on GnRH neurons in hypothalamus–> secrete GnRH

  • -> released via hypophyseal portal circulation in pulses to gonadotrophs in pituitary gland
  • -> gonadotrophs make LH/FSH- enter systemic circulation
  • -> these act on gonads to make oestrogen/testosterone (diurnal- high levels in morning)
  • -> oestrogen/testosterone feedback directly onto pituitary AND kisspeptin neurons (mainly -ve)
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22
Q

What happens to the HPG axis in hyperprolactinaemia?

A
  • prolactin binds to prolactin receptors on kisspeptin neurons in hypothalamus
  • inhibits kisspeptin release
  • dec. in downstream GnRH/LH/FSH/T/Oest
  • leads to oligo or amenorrhoea/low libido/infertility/osteoporosis
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23
Q

What is the overall structure of the menstrual cycle?

A

day 1: first day of bleeding due to drop in progesterone- degradation of endometrial lining
1-14: follicle phase then luteal phase (potential pregnancy)
day 14: ovulation
then up to 28 days

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24
Q

What is it called when menstrual cycle >35 days?

A

oligomenorrhoea

25
Q

Why does body temperature increase by at least 0.5 degrees the day after ovulation?

A

due to progesterone increase

26
Q

What are the basic principles of pregnancy?

A
  • semen formation and voyage
  • capacitation
  • fertilisation (acrosome and cortical reaction)
  • implantation (attachment and decidualisation)
  • hormonal changes of pregnancy
  • parturition (labour)
  • lactation
27
Q

What structures does the spermatic cord contain?

A
  • testicular artery
  • paminiform plexus
  • autonomic + GF nerves
  • lymph vessels
  • Vas deferens
28
Q

Why are do the testes hang outside the body?

A

keep temperature slightly lower for sperm formation by 2-3 degrees

29
Q

What are the 3 muscles in the penis?

A

2 X corpora cavernosa

1 X corpora spongiosum

30
Q

What type of stimulation, sympathetic or parasympathetic, is responsible for erection/ejaculation?

A

Point and Shoot

parasympathetic- erection generation- arterial relaxation allowing blood into penis- inc. pressure- blocks venous drainage

sympathetic- ejaculation

31
Q

What are the parts of the male reproductive system?

A

testes: make sperm
epididymis: where sperm mature + are stored
vas deferens/ductus deferens: tube from testes taking sperm to back of prostate
seminal vesicle: help provide seminal fluid together with prostate and bulbourethral gland- also important in secreting pre-ejaculate

32
Q

What does seminal fluid contain?

A
  • fructose and citric acid- nutrients
  • bicarbonate- helps neutralise acidic environment of vagina
  • fibrinogen- thickening agent
  • fibrinolytic enzymes- help sperm break through
33
Q

What is the arterial blood supply to the testes?

A

testicular arteries from the aorta via the spermatic cord

34
Q

What is the lymphatic drainage to the testes?

A

para-aortic lymph nodes

35
Q

What are the 3 layers of the capsule of the testes?

A

inside- tunica vasculosa
then tunica albuginea
then tunica vaginalis- covers both testes and epididymis

36
Q

What are the linings of the uterus?

A

outside- perimetrium
myometrium- muscle
endometrium- specialised layer of endometrial cells- shed at menses due to vasoconstriction of arterioles

37
Q

How is sterility maintained superior to the cervix?

A
  • monthly shedding of endometrial lining
  • thick cervical mucus
  • narrow os
  • pH <4.5 acidic
38
Q

What is the lymphatic drainage to the ovaries?

A

para-aortic lymph nodes

39
Q

What is the lymphatic drainage to the uterus/vagina?

A

iliac, sacral, aortic and inguinal lymph nodes

40
Q

What happens to hormones levels during the menstrual cycle?

A
  • both slowly rise during follicular phase
  • stimulates more oestrogen production–> gets to high point and switches to +ve feedback
  • causes LH surge–> triggers final steps of follicle maturation
  • then forms corpus luteum produces progesterone- levels increase until corpus luteum dies–> levels dec.
41
Q

How far does the sperm have to travel from testis to Fallopian tube?

A

100,000 x its length

42
Q

What is inside semen?

A
  • spermatozoa
  • seminal fluid
  • leukocytes
  • potential viruses e.g. HIV
43
Q

What is capacitation of sperm?

A

achieving ability to fertilise- occurs in the female reproductive tract:

  • lose glycoprotein coat
  • change in surface membrane characteristics
  • develop whiplash movements of tail

N.B. takes place in ionic + proteolytic environment of Fallopian tube… dependent on oestrogen and calcium

44
Q

What is the acrosome reaction?

A
  • when capacitated sperm gets to egg in ampulla (widest part of Fallopian tube)
  • sperm binds to ZP3 glycoprotein
  • acrosome releases hyaluronidase and proteolytic enzymes
  • can then penetrate zona pellucida
45
Q

What happens during fertilisation and the cortical reaction?

A
  • occurs within fallopian tube (ampulla)
  • triggers cortical reaction to stop more sperm entering
    AND final step of maturation 2y oocyte–> ovum
  • cortical granules degrade zona pellucida–> so no more ZP3 binding sites
  • haploid–> diploid zygote
46
Q

What happens after fertilisation with the development of conceptus?

A
  • zygote continues to divide as it moved down Fallopian tube to uterus for implantation
  • receives nutrients from uterine secretions driven by progesterone
  • ‘free living’ phase can last for up to 9-10 days
47
Q

*What happens during implantation?

A

attachment phase: outer trophoblast cells contact uterine surface epithelium
THEN
decidualisation: changes in underlying uterine stromal tissue

N.B. requires progesterone domination in the presence of oestrogen

48
Q

What is LIF?

A

leukaemia inhibitory factor

  • from endometrial cells
  • stimulates adhesion of blastocyst to endometrium
49
Q

*What is IL11?

A

interleukin-11

  • from endometrial cells
  • released into uterine fluid
  • may be involved in attachment
50
Q

*What is decidualisation?

A

endometrial changes due to progesterone:

  • glandular epithelial secretion
  • glycogen accumulation in stromal cell cytoplasm
  • growth of capillaries
  • inc. vascular permeability –> oedema
51
Q

What factors are involved in decidualisation?

A

IL11, histamine, certain prostaglandins and TGFb

52
Q

Where is hCG produced?

A

placenta

53
Q

What is measured in a pregnancy test?

A

hCG (human chorionic gonadotrophin)

54
Q

What is progesterone and oestrogen production like during pregnancy?

A

first 40 days

  • progesterone and oestrogen made by corpus luteum in maternal ovary (stimulated by hCG- taking over role of LH)
  • essential for developing fetoplacental unit
  • inhibit maternal LH+ FSH by -ve feedback

from day 40
- placenta starts to take over in production of hormones^

55
Q

*What are the hormones involved in parturition?

A

oxytocin–> uterine contraction and cervical dilation

cortisol, oestrogen

56
Q

*What hormones increase during pregnancy?

A

ACTH, adrenal steroids, prolactin, IGF2, iodothyronines, PTH related peptides

57
Q

*What hormones decrease during pregnancy?

A

gonadotrophin, pituitary GH, TSH

58
Q

What is the endocrine control involved in lactation (both mechanisms)?

A
  1. mechanical stimulation of nipple and surrounding area activates afferent pathways
  2. afferent signals integrated in the hypothalamus–> stimulate oxytocin-releasing neuron activity and inhibit dopamine release from dopaminergic neurons
    • less dopamine in hypothalamic-pituitary portal system–> less inhibition of anterior pituitary lactotrophs
      - APs travel down oxytocin neurones–> oxytocin secreted into bloodstream
    • inc. plasma prolactin inc. milk secretion in mammary glands
      - inc. plasma oxytocin inc. milk ejection in mammary glands