Unit 13 Chapter 43, 45, 46 Flashcards
spermatogenesis
Generation of spermatozoa or sperm
when does spermatogenesis begin
13
sperm is formed in
seminiferous tubules
sperm travels through ________ __________ to epididymis
efferent ductules
where is the final site of sperm maturation
epididymis
the migration through _____ _________
vas deferens
what is the storage reservoir for sperm
ampulla
how long does fertility continues after vasectomy
4-5 weeks
vasectomy babies, how did this happen?
sperm was living in the ampulla for 4-5 weeks and did not use proper protection
how long should you continue to use protection after a vasectomy
4-5 weeks
what creates fluid for semen
seminal vesicles
_________ provide energy for sperm motility
fructose
______________ assist in fertilization by making cervical mucus more receptive
prostaglandin
testosterone produced by cells in _____
testes
where is testosterone is metabolized in _______
liver
where is testosterone secreted by
kidneys
testosterone functions as anabolic agents in male and females to promote _____________ and ______________ _______
metabolism, musculoskeletal growth
erection is under control of parasympathetic or sympathetic
parasympathetic
what must be intact and available to get an erection (2 things)
parasympathetic innervation must be intact
nitric oxide synthesis must be active
drugs treat erectile dysfunction at the __________ level
mediator
ejaculation is under what nervous system
sympathetic
detumescence is under what nervous system
sympathetic
what is detumescence
going soft, losing the erection
erectile dysfunction is caused by
psychogenic, organic, or mixed
erectile dysfunction neurogenic causes
parkinsons disease, stroke, cerebral trauma; spinal cord depends on level, location and extent lesion
erectile dysfunction arterial insufficiency causes
hypertension, hyperlipidemia, cigarette smoking, DM, pelvic irradiation
drugs that can cause erectile dysfunction
antidepressant, antipsychotic, antihypertensive
erectile dysfunction causes excessive ___________ and ________
alcohol, aging
treatment for erectile dysfunction
selective inhibitor of phosphodiesterase type 5
what does the treatment for erectile dysfunction target
nitric oxide
phosphodiesterase type 5 is an enzyme that inactivates _______, ______ ___________ _________ _________, and _______________ ___________
cGMP, alpha adrenergic receptor antagonist, prostaglandin analog
priapism
involuntary, prolonged, abnormal, painful erection
priapism is most common with males suffering from what disease
sickle cell disease
during priapism with patients with sickle cell _______________ and states of ___________ blood during reception is thought to increase sickling
deoxygenation, cavernosal
testes develop from ____________ _______
embryonic kidneys
testes embryologically develop in abdomen and descend through ___________ _____ in 7-9th month
inguinal canal
testes descend into scrotum through
inguinal canal
in the testes failure to close canal leads to __________ _______
inguinal hernia
inguinal hernia
protrusion of parietal peritoneum and intestine through and abnormal opening from the abdomen
testicular torsion
twisting of spermatic cord that suspends the testies
testicular torsion with present with
pain radiation to inguinal area, nausea and vomiting, affected testes are large and tender
epididymitis
sexual and non sexual transmission of bacterial pathogens
orchitis can be precipitated by primary
UTI
orchitis can be caused by what other disease
mumps
what percent of boys that had mumps will develop orchitis
20-25%
________________ irreversibly impaired in 30% of testes damaged by mumps orchitis
spermatogenesis
with orchitis is this reversible or irreversible impaired
irreversibly
what is detumescence
going soft, losing the erection
what might cause someone to get scrotal cancer
chimney sweeps, poor hygiene, external causes
testicular cancer most common age group is
15-35 age group
how would you be able to notice testicular cancer
self examination at least once a month
tesitular cancer is associated with
cryptorchidism
what is cryptoorchidism
undescended testes
the higher the cryptorchidism the ___________ the risk
greater
prostatitis
inflammation of prostate
is benign prostatic hyperplasia cancer
no it is benign
benign prostatic hyperplasia occurs in 50% of men older than
60
benign prostatic hyperplasia risk factor? what specific race
African american
benign prostatic hyperplasia: discovery that DHT is the active factor in BPH is the rationale for use of
5 alpha reductase inhibitors (alpha reductase inhibitor)
benign prostatic hyperplasia: location contributes to ___________ and ____________
pathophysiology and symptomatology
benign prostatic hyperplasia: increase in prostatic size
weak stream, frequency
BPH symptom index 7 questions
incomplete emptying
frequency
intermittency
urgency
weak stream
straining
nocturia
what is the most severe BPH number
7
a patient comes in for BPH and a scale of 3, you know that this patient is suffering from
mild conditions
a patient comes in for BPH and a scale of 7, you know that this patient is suffering from
severe conditions
in BPH what drives treatment
symptoms
in BPH is there a drug that treats all symptoms
no
_____________ in bladder readily infected due to incomplete emptying
diverticula
diverticula in bladder
little pockets that could become infected due to incomplete empyting
what is the most common male cancer
cancer of the prostate
what is the major race that is affected by cancer of the prostate
AFRICAN AMERICAN MEN
cancer of the prostate is the __________ leading cause of death
second
what are some risk factors for cancer of the prostate
age (85% >65), African American race, environment, high fat diet
PSA stands for
prostate surface antigen
PSA is what type
glycoprotein
PSA is secreted into the cytoplasm of __________ and _________ prostatic cells
benign, malignant
is PSA specific to cancer
no
what will also cause PSA to be released/increased
infection and inflammation
cancer of the prostate annual screening and digital exam over
40-50
cancer of the prostate diagnosis- transrectal ultrasound; ___________ grading system
Gleason
Gleason grading scale 1
well differentiated
Gleason grading scale 5
poorly differentiated
do Gleason grade 1 and 5 have the same treatments
no, different treatments
Gleason grading system is associated with what cancer
prostate
seven questions is associated with what disease
benign prostatic hyperplasia
prostate tumor grading system
T1-T4
prostate tumor T1
primary stage tumors are asymptomatic and discovered on histological examination or prostatic tissue specimens
prostate tumor T2
tumors are palpable on digital examination but are confined to the prostate gland
prostate tumor T3
tumors have extended beyond the prostate
prostate tumor T4
tumors have pushed beyond the prostate to involve adjacent structures
for Gleason, BPH grading, and Prostate tumor grading, as the numbers go up
more worse the condition is
if someone has a palpable prostate tumor but is confined to the prostate gland what level is this
T2
if someone has a prostate tumor but they are asymptomatic this is what level
T1
hypospadias
urethra ends below penis
epispadias
urethra ending above penis
phimosis
tightening of the foreskin
paraphimosis
fighting of the foreskin so tight it cannot cover glans
cryptorchidism
undescended testes
cryptorchidism is related to
birth weight and gestational age
spontaneous descent of testes often occurs during
3-6 months
consequences of cryptorchidism/undescended testes
infertility, malignancy and psychological effects
two infant boys had undescended testes in 2 different locations, the first boys were located 3 inches below the bellybutton and the second boys we located on the inner thigh right next to the testes, who has the greater chance of testicular cancer
first boy
testosterone maybe used in older men with low androgen levels to improve
muscle strength and vigor
is normal vaginal bacterial flora harmful or protective
protective
doderlein bacilli metabolize glycogen and in the process produce
lactic acid
normal vaginal pH is
3.8-4.5
is vaginal pH acidic or basic
acidic
normal bacterial flora protect against
infections
normal vaginal bacterial flora can be disrupted by
- abnormal estrogen levels
- increased glycogen availability
- antibiotics
why would normal glycogen availability cause normal flora to be disrupted
sugar is source of energy and if there is an increase in fuel then the bacteria will overgrow
individuals with what conditions might have disrupted vaginal bacterial floras
diabetic and immunocompromised
vaginal cancer will present with
abnormal bleeding, abnormal vaginal discharge, palpable mass, pain during intercourse
vaginal cancer discharge
abnormal vaginal discharge
vaginal cancer may be cause by the spread of what other cancer
cervical cancer
what STD would cause vaginal cancer
HPV
what type of irritation might cause vaginal cancer
chronic local irritation
cervical cancer is related to what infection
HPV
diagnosis of cervical cancer
Pap smear
evidence suggests a casual link between HPV infection and __________ cancer
cervical
what might cause someone to develop a HPV infection
early age at first intercourse, multiple sexual partners, a promiscuous male partner, smoking, history of STDS
Gardasil
prevent infection with the HPV subtypes 16, 18, 6, and 11
cervical cancer is present with HPV types
16, 18, 31, 33, 45
PID
pelvic inflammatory disease
in PID the infection ascends through uterus to what 2 organs
Fallopian tubes, ovary
PID disrupts what tissue
endothelial tissue
PID inflammation causes pain in lower abdomen and
cervix
what type of discharge is present with PID
purulent discharge
PID will have 2 increased counts of what
WBC
C- reactive protein
since people with PID have increase C-reactive protein will the inflammation only be in the uterus or be all over
not specific to the uterus, inflammation all over
PID may result in what if long lasting
infertility, etopic preganancies
a patient comes in with pain in lower abdomen and a purulent discharge and is also showing increase WBC count? what might she have
PID
endometriosis affects what precent of pre menopausal women
10-15%
endometriosis is functional endometrial tissue found in
ectopic sites outside the uterus
how did the tissue get there in endometriosis
up through the Fallopian tubes (retrograde menstruation)
what is retrograde menstration
menstruate backwards
tissue of endometriosis are found in ________ sites
ectopic
since the tissue of endometriosis is still functional the tissue will or will not go through mental cycle
it will go through a mental cycle, the tissue dies and bleeds and pain and adhesions result
endometriosis is the result of what type of mentration
RETROGRADE
with endometriosis where are some spots that functional endometrial tissue can be found
bladder, colon, ovary, small bowel, Fallopian tube, umbilicus
what is the most frequent invasive cancer of female reproductive track in the US
endometrial cancer
15-25% of POSTmenopasual women with bleeding have
endometrial cancer
can endometrial cancer occur in postemopausal women
yes
endometrial cancer risk factor is prolonged stimulated exposure to what hormone
estrogen
a person who is 50 pounds overweight will have what precent increase to getting endometrial cancer
10%
what are some other risk factors with endometrical cancer
diabetes, nulliparity, early menarche, late menopause
type 1 risk is prolonged ___________ stimulation
estrogenic
nulliparity
no children
menarche
first period
if there is a early menarche and late menopause we are widening the window for
estrogen stimulation
endometrial cancer will present with
abnormal. painless bleeding
a patient comes in a states how she is has just went through menopause at the age of 70 and she started her period at the age of 9. She is experiencing abnormal painless bleeding? what could she have
endometrial cancer
the good thing about endometrial cancer is the survival rate, what is the percent
80-85%
leiomyomas are
fibroids
leiomyomas/fibroids are benign or malignant
benign
where are leiomyomas/fibroids origin
smooth muscle
leiomyomas/fibroids are in 1/4 women over the age of
35
leiomyomas/fibroids growth rate and size greater in what race
African american
are leiomyomas/fibroids asymptomatic and symptomatic
asymptomatic
leiomyomas/fibroids may cause
menorrhagia
menorrhagia
excess menstral flow
do leiomyomas/fibroids have a defined border or no clear borders
borders are clearly defined
a patient comes in for an anaul exam and the physician notices a nodule in the patients vagina area but the patient claims she had no symptoms. what disease is this
leiomyomas/fibroids
a patient was just diagnosed with fibroids and she presents concern that the tumors could be cancerous, what would you tell her?
all leiomyomas/fibroids are benign
cystocele
bladder prolapse into vagina
rectocele
anus prolapse into vagina
uterine prolapse
uterus into vagina
PCOS
polycystic ovary syndrome
PCOS is known as the
silent thief of fertility
PCOS can cause
infertility
a patient was just diagnosed with fibroids and she presents concern that the tumors could be cancerous, what would you tell her?
all leiomyomas/fibroids are benign
PCOS causes hyper___________
androgenism
PCOS is a common source of
chronic anovulation
PCOS could present with
central irregularity, metabolic dysfunction including dislipidemia, insulin resistance, and obesity
PCOS is in what percent of the population
5-15%
Ovarian cancer may present with
asymptomatic or vague
ovarian cancer is related to
nulliparity
are there any good screens for ovarian cancer
no
what is CA 125 (cell surface antigen) used for
monitoring therapy and recurrences with ovarian cancer
mastitis
post partum, tumors, tramsa, skin infections, or hormonal fluctuations
fibrocystic changes
lumpy breasts with non discrete nodules
breast cancer is what percent hereditary
10%
risk factors for breast cancer
age, history, promotion of breast maturation, 1st child >30, not term pregnancies
detection of breast cancer
mammography, MRI, biopsy
positive breast cancer may result in a lumpectomy or a mastectomy, whats the difference
lumpectomy= take out just tumor
mastectomy= take out whole brest
with breast cancer it is important to inject blue dye in the tumor before removing the tumor, why?
to test the lymph node that the cancer drained to
what is genetic testing for breast cancer
BRAC1 and BRAC2
what are some notable common risk factor that is encouraged to do to prevent hyperlipidemia
alcohol. too much can increase chances of breast cancer
what do BRAC1 and BRAC2 do
they are genes that code for proteins that help repair DNA after it has mutated
a mutation of BRAC1 and BRAC2 would cause the gene to not code for protein that would repair DNA after it was mutated which would result in
increase in cancer chances
what hormones make breast cells divide
estrogen and growth factor
breast cells with too much _________ or __________ ______ receptors are more likely to become cancerous
estrogen, growth factor
why does breast cancer that result from estrogen/growth factor come from receptors and not the actual amount of hormone
more receptors cause more hormone to be taken in by the cell, it doesn’t matter the amount of hormone unless there is enough receptors to bind to the hormones
Condylomata
genital warts
genital warts are caused by
HPV
genital warts may be transient or
persistent
genital warts can they be asymptomatic
yes
genital warts are associated with
genital cancers
Herpes simplex virus 2 is related to
chickenpox and cold sores
genital herpes causes genital
ulcers
genital herpes grows in
neurons
genital herpes can remain dormant in ___________ for years
neurons
do genital herpes go away
no
vaginal infetions
candidiasis
trichomoniasis
bacterial vaginitis
candidiasis
yeast infection/thrush
candidiasis is present in what precent of healthy women without causing symptoms
20%-50%
candidiasis results in
inflammation
thick odorless discharge
a patient comes in with inflammation around her vagina but no other symptoms but has a thick odorless discharge what is the disease
candidiasis
discharge of candidiasis
thick odorless
what is causes of candidiasis
antibiotic therapy
high hormone levels owing to pregnancy
the use of oral contraceptives
Diabetes mellitus
HIV infection
how does antibiotic therapy cause candidiasis
suppress the normal protective bacterial flora
how does the use of oral contraceptives cause candidiasis
cause an increase in vaginal glycogen stores
how does DM or HIV cause candidiasis
compromise the immune system
trichomoniasis is what type of protozoan
anaerobic protozoan
trichomoniasis feeds on the
vaginal mucosa and ingest bacteria and leukocytes
discharge of trichomoniasis
copious, frothy, malodorous, green or yellow discharge
trichomoniasis presents with occasional
itching and irritation
with trichomoniasis sometimes ______________ spots will appear on the cervix
strawberry spots
one difference between trichomoniasis and candidiasis is that trichomoniasis is associated with
tubular infertility or PIVD
bacteria vaginosis may present with what type of discharge
homogenous (frothy, grayish, yellowish white)
bacteria vaginosis may produce a fishy amine odor when 10% ____________ _____________ solution is dropped onto the secretions
potassium hydroxide
bacteria vaginosis may present with pH above ____
4.5
bacteria vaginosis is usually treated only if ____________ or associated with other risk conditions
symptomatic
bacteria vaginosis is nonspecific meaning
it may be caused by many different bacteria
bacteria vaginosis also may present with thin discharge with
fishy ordor
chlamydia may have signs at site of infection like
hypertrophy and drainage
chlamydia may have signs of UTI like
urinary frequency, dysuria, discharge postcoital bleeding
chlamydia may have signs of upper genital tract infection like
irregular uterine bleeding, abdominal/pelvic discomfort
chlamydia complications include
infertility and ectopic pregnancy
chlamydia may cause __________ in infant
conjunctivitis
gonorrhea may be cause
conjunctivitis
gonorrhea in women will have what kind of discharge
thick yellow or gray vaginal discharge
gonorrhea symptoms women
burning/pain with urination or bowel movement
abnormal periods
abdominal pain or cramps
gonorrhea discharge men
thick yellow/greenish drip from penis
gonorrhea symptoms men
burning pain with urination or bowel movement
need to urinate more often
tender or swollen testicles
in females gonorrhea may lead to ________ which ultimately could lead to infertility
PID
syphilis is cause by what kind of bacteria
spirochete, treponema pallidum
primary syphilis
chancer at site of exposure
secondary syphilis
lasts from 1 week to 6 months
disseminates to other organs
secondary syphilis symptoms
skin rash, fever, sore throat, stomatitis, nausea, loss of appetite and inflamed eyes
tertiary syphilis
Gumma lesions develop in organs
CNS and heart often affected
what is the only STD that causes systemic issues
syphilis
gonorrhea and chlamydia both cause what in neonates
ocular disease and blindness
gonorrhea and chlamydia both cause what in neonates
ocular disease and blindness
is syphilis transferred to the fetus from the mother through the placenta
yes
when syphilis progresses to the tertiary stage it takes one of three forms
development of localized destructive granuloma like lesions called gummas
development of cardiovascular lesions
development of central nervou system lesions
name of lesions in tertiary syphilis when they are developed on localized destructive granuloma
gummas
women with abnormal vaginal discharge
vaginal cancer
purulent discharge
PID
thick odorless discharge
candidiasis
copious, frothy, malorodorous, green or yellow discharge
trichomoniasis
homogenous discharge (frothy grayish, yellowish white) or thin discharge with fishy odor
Bacterial vaginosis
women: thick yellow or gray vaginal discharge
gonorrhea
men: thick yellow greenish drip from penis
gonorrhea
do all people with gonorrhea have symptoms
no some people do not have symptoms
a 60 year old man comes to the clinic and has been found to have a history of type 2 diabetes mellitus and cardiovascular disease. the manifestations of these diseases will warrant the nurse to assess the patient for which of the following problems
-undescended testicles
- prostate cancer
- erectile dysfunction
- increased sperm production
erectile dysfunction
an elderly male patient is complaining of dribbling after he urinates and feeling like he never empties his bladder. The nurse suspects the patients may have a problem with
- kidney stones
- an enlarged prostate gland
- blood clots clogging the urethra
- calcium sediment in the bladder
an enlarged prostate gland (benign prostatic hyperplasia)
after an office visit with her primary health provider, a female patient with an elevated CA-125 test results asks the nurse if that means she has ovarian cancer. Which of the following is the nurses best response
- “the test is not specific for ovarian cancer but suggests further evaluation to find the cause of the elevation”
- “the test is an accurate screening tool for early detection of ovarian cancer”
- “you will need to ask your doctor to explain the test to you”
-“don’t worry about it. The test is too general to cause you to be alarmed.”
“the test is not specific for ovarian cancer but suggests further evaluation to find the cause of the elevation”
