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The reproductive system Flashcards

1
Q

What is found in seminal fluid?

A

Fructose- nutrients for sperm
Citric Acid- nutrients for sperm
Bicarbonate- neutralises acidic pH of vagina
Fibrinogen- thickening agent
Fibrinolytic enzymes- helps sperm break through and find egg

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2
Q

What is erection and ejaculation due to ?

A

Erection is due to parasympathetic stimulation

Ejaculation is due to sympathetic stimulation

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3
Q

What structures are found in the penis?

A 
2x Corpora cavernosa
1x Corpora spongiosum
Testes surrounded by 3 connective tissues:
- Tunica vasculosa (innermost)
- Tunica albuginea
- Tunica vaginalis (outermost)
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4
Q

What is the spermatic cord?

A 
Formed at deep inguinal ring
Contains several structures:
- testicular artery
- pampiniform plexus
- autonomic and GF nerves
- Lymph vessels
- Vas deferens
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5
Q

What supplies the testes?

A

Arterial blood supply: testicular arteries from the aorta via spermatic cord
Lymphatic drainage: para-aortic lymph nodes

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6
Q

Where can the ovaries be found?

A

Inside the peritoneal cavity (remainder outside)

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7
Q

How are the Fallopian tubes structures and what is their role?

A

Fallopian tubes have cilia and spiral muscle

Peristalsis and wafting of cilia causes oocytes to move down the tube

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8
Q

Where does fertilisation occur in the female reproductive tract?

A

In the ampulla (wider part of Fallopian tube)

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9
Q

How is the uterus supported?

A

Uterus supported by tone of pelvic floor (elevator ani and coccyges) and ligaments (broad, round and uterosacral)

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10
Q

Why does the endometrium shed?

A

Endometrium sheds at menses due to vasoconstriction of arterioles

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11
Q

What structures can be found in close proximity to the cervix?

A

1cm lateral to the cervix is ureter

All areas superior to cervix are sterile

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12
Q

What supples blood to the ovaries, uterus and vagina?

A

Ovaries: Ovarian arteries (from aorta)

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

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13
Q

What structures carry lymphatic drainage in the ovaries, uterus and vagina?

A

Ovaries: Para-aortic lymph nodes

Uterus/ Vagina: Iliac, sacral, aortic and inguinal lymph nodes

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14
Q

How are spermatogonia produced?

A

Gametogenesis occurs at puberty
Spermatogonia undergo differentiation and self- renewal- continuous fertility through life due to subsequent spermatogenic cycles throughout life
Produces ~1500 mature sperm/ sec

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15
Q

How are oogonia produced?

A 
BEFORE BIRTH:
multiplication of oogonia ~6 mil/ovary
Primary oocytes are formed within ovarian follicles (= primidoral follicle)
These begin meiosis (halted at prophase)
Some primordial follicles degrade 
At birth ~2 mil/ovary remain
AT PUBERTY:
By puberty <0.5mil/ovary remain
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16
Q

What is gametogenesis known as in males?

A

Spermatogenesis

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17
Q

How are spermatozoa produced?

A

Spermatogonium (44XY) divide by mitosis to form primary spermatocytes (44XY)
Primary spermatocytes undergo 1st meiotic division to form secondary spermatocytes (22X or 22Y)
Secondary spermatocytes undergo second meiotic division to form spermatids (22X OR 22Y)
Spermatids then differentiate to spermatozoa (22X OR 22Y)
This process occurs in seminiferous tubules

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18
Q

Where can a Sertoli cell be found and what’s its function?

A

Location: within seminiferous tubules
Have FSH receptors
Support developing germ cell:
- assist movement of germ cells to tubular lumen
- transfer nutrients from capillaries to developing germ cells
- phagocytosis of damaged germ cells
Hormone synthesis:
- Inhibin (inhibits FSH) and activin (activates FSH)
- Anti- mellerian hormone (AMH)
- Androgen-binding protein (ABP)

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19
Q

Where can leydig cells be found and what is their function?

A

Location: between seminiferous tubules
Pale cytoplasm and cholesterol rich
Have LH receptors
Hormone synthesis: On LH stimulation, secrete androgens:
- Testosterone
- Androstenedione
- Dehydroepiandrosterone (DHEA) (can be aromatised to oestrogen)

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20
Q

What is gametogenesis in females called?

A

Oogenesis

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21
Q

How are Ova formed?

A

In 2nd trimester of pregnancy, oogonium (44XX) undergoes mitosis to form primary Oocytes (44XX) (primary oocytes form primordial follicles)
Primary oocytes undergo 1st meiotic division to form secondary oocytes (22X) (stay in prophase until menarche after which they continue rest of cycle)
After fertilisation, secondary oocytes undergo 2nd meiotic divisor to form ootids (22X)
Ootids undergo differentiation to form Ova (22X)

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22
Q

How does folliculogenesis (development of follicles) occur?

A
  1. Primordial follicle- primary oocyte at birth
  2. Primary (preantral) follicle- primary oocyte and layers of granuloma cells and outer theca cells
  3. Secondrary (antral) follicle- Fluid filled cavity (antrum) develops, FSH and LH receptors develop
  4. Mature (Graafian/preovulatory) follicle- forms due to LH surge, secondary oocyte formed
  5. Ruptures surface of ovary
  6. Corpus Luteum- produces progesterone and oestrogen (stimulate by LH/HCG). In pregnancy progesterone and oestrogen production taken over by placenta
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23
Q

What is progesterone formed by and what is its role?

A

Corpus luteum is source of progesterone

Progesterone is important for pregnancy, supports uterus in preparation for implantation

24
Q

How do we assess if someone has ovulated?

A

Measure:
Day 21 progesterone: rise in progesterone if corpus lutem has formed
Ultrasound- can see corpus luteum

25
What 2 cells are found in the ovary?
Theca cells | Granulosa cell
26
Where can theca cells be found and what is the function?
Location: associated with outer part of ovarian follicles Support folliculogeneis: - structural and nutritional support of growing follicle Hormone synthesis: - LH stimulates synthesis of androgens. Overactivity= high androgen levels (hyperandrogenism)
27
Where can granuloma cells be found and what is their function?
Location: associated with inner part of ovarian follicles Hormone synthesis: - FSH stimulates granuloma cells to convert androgens to oestrogen (by aromatase) -Secrete inhibin and activin (effects on FSH) After ovulation turn into granuloma lutein cells that produce: - progesterone (neg. feedback, promote pregnancy by maintaining endometrium) - relaxin (helps endometrium prepare for pregnancy and softer pelvic ligaments/cervix)
28
What is the hypothalmo- pituitary- gonadal axis?
1. Kisspeptin nerves are at top of axis- secrete kisspeptin 2. kisspeptin acts on kisspeptin receptors on GnRH (gonadotrophin releasing hormone) nerves 3. GnRH nerves secretes GnRH into hypophyseal portal circulation- secretion is in pulsatile fashion, frequency and amplitude governs downstream actions 4. GnRH stimulates gonadotrophs in anterior pituitary which release FSH and LH (also in pulsatile fashion) 5. LH and FSH travel to gonads through systemic circulation and act on gonads to cause production of hormones (testosterone, oestrogen, progesterone, activin and inhibin) There's negative feedback from oestrogen, progesterone and testosterone on kisspeptin nerves or gonadotrophs in anterior pituitary
29
How does hormone production change across the day?
Oestrogen and progesterone are diurnal
30
What happens in hyperprolactinaemia?
High levels of prolactin causes prolactin to bind to prolactin receptors on kisspeptin neurones in hypothalamus This inhibits kisspeptin release This leads to a downstream decrease in GnRH, LH, FSH, Testosterone and oestrogen This can lead to oligo-amenorrhoea, low libido, infertility and osteoporosis
31
What happens in the menstrual cycle?
Day 1: progesterone drop leads to first day of bleeding (blood and cellular debris from necrotic endometrial lining) Ovulation- approx. day 14, theres an LH surge and smaller FSH surge along with high oestrogen levels Progesterone increase occurs after ovulation, increases then drops- causes pain and shedding Menstruation cycle lasts ~28 day, can range from 21 to 35 days
32
What do we call a menstrual cycle over 35 days?
oligomenorrhoea
33
What drives the menstrual cycle?
Hypothalmic kisspeptin and GnRH Pituitary LH and FSH Ovarian oestrogen, progesterone, activin and inhibin
34
What occurs in the ovarian cycle?
Follicular phase- follicle forms Ovulation (pre-ovulatory phase) Leuteal phase
35
What occurs in the uterine cycle?
Menstrual phase Proliferative phase Secretory phase
36
How is semen produced?
Spermatozoa travel through seminiferous tubules, tubular resorption results in concentration of sperm driven by oestrogen Nutrients e.g. fructose and glycoprotein are secreted into epididymal fluid
37
How far does sperm travel?
It travels 100 000 times its length from testes to Fallopian tube
38
What does semen consist of?
Spermatozoa Seminal fluid Leucocytes Potential viruses e.g. hep B, HIV
39
How many spermatozoa reach the ovum?
1/100 enter the cervix 1/10000 go from cervix to ovum Overall 1/1 million reach ovum
40
Where does seminal fluid come from?
``` Small contribution from epidermis/ testes Mainly from accessory sex glands: seminal vesicles prostate bulbourethral glands ```
41
What happens in the capacitation of sperm?
Capacitation of sperm is the process by which sperm achieves the ability to fertilise in the female reproductive tract Capacitation involves: loss of glycoprotein coat change in surface membrane characteristic develop whiplash movements of tail Its oestrogen dependant and Ca2+ dependent
42
Where does capacitation take place?
Takes place in ionic and proteolytic environment of Fallopian tube
43
What happens after capacitation?
Acrosome reaction: sperm binds to ZP3 there is a Ca2+ influx into sperm (Stimulated by progesterone) Release of hyaluronidase and proteolytic enzymes (from acrosome) which breaks down zona pellucida Spermatozoon penetrates zona pellucida
44
Where does fertilisation occur and what happens?
occurs in the Fallopian tube Triggers cortical reaction: Cortical granules release molecules which degrade zone pellucida (e.g. ZP2 and 3) This prevents further sperm binding as here's no receptors It triggers the final maturation of secondary oocyte to form ovum Ends with diploid zygote
45
What happens after fertilisation?
Development of conceptus Continues to divide as it moves down Fallopian tube to uterus (3-4 days) Receives nutrients from uterine secretions This free-living phase can last for 9-10 days
46
What happens in implantation?
Attachment phase: outer trophoblast cells contact uterine surface epithelium THEN Decisualisation phase: changes in underlying uterine stromal tissue This requires progesterone domination in the presence of oestrogen
47
What happens to the blastocyst?
Inner cell mass forms embryo | Trophoblast cells form placenta
48
What occurs in attachment?
2 factors allow the adhesion of blastocyst to endometrial lining: Leukaemia inhibitory factor (LIF) from endometrial cells stimulates adhesion of blastocyst to endometrial cells Interleukin-11 also from endometrial cells is released into uterine fluid and may be involves Many other molecules are involved into the process (HB-EGF)
49
What occurs in decidualisation?
Endometrium changes due to progesterone - glandular epithelial secretion - glycogen accumulation in stromal cell cytoplasm - growth of capillaries - increased vascular permeability
50
What factors are involved in decidualisation?
IL 11, histamine, certain prostaglandins and TGF beta
51
What hormone is present in pregnancy?
hCG- human chorionic gonadotrophin produced by placenta by trophoblasts
52
How does progesterone and oestrogen production vary during pregnancy?
In the first 40 days: Produced in corpus luteum- stipulated by hCG which acts on LH receptors Essential for developing fetoplacental unit Inhibits maternal LH and FSH From day 40: Placenta takes over
53
What physiological changes occur in maternal hormones?
Increase: - ACTH - Adrenal steroids - Prolactin - IGF1 - Iodothyronines - PTH related peptides Decrease: - Gonadotrophin - Pituitary GH - TSH
54
What is labour also known as?
Parturition
55
What is the main hormone in parturition?
Oxytocin from posterior pituitary | Theres an increase in oxytocin receptors on myometrial and endometrial cells towards end of pregnancy
56
What is oxytocin important for?
Uterine contraction Cervical dilation Milk ejection

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