Week 10-Repro Flashcards
1
Q
Gluteus maximus:
Action?
Innervation?
A
- action: keeps knee fully extended, hip extension, lateral rotation of the hip, abduction of the hip
- innervation: inferior gluteal nerve
2
Q
Gluteus medius:
Action?
Innervation?
A
- action: hip extension, lateral rotation of the hip, abduction of the hip*, prevents hip drop
- innervation: superior gluteal nerve
3
Q
Gluteus minimus:
Action?
Innervation?
A
- action: hip flexion, medial rotation of the hip, abduction of the hip, prevents hip drop
- innervation: superior gluteal nerve
4
Q
Tensor fascia latae:
Action?
Innervation?
A
- action: keeps knee fully extended, hip flexion, medial rotation of the hip, abduction of the hip
- innervation: superior gluteal nerve
5
Q
What is IT band syndrome?
A
IT band runs over the lateral condyle of the femur causing pain, often seen in runners
6
Q
What are the lateral rotators of the hip, from superior to inferior?
A
- piriformis
- gemellus superior
- obturator internus
- gemellus inferior
- quadratus femoris
7
Q
Where does the sciatic nerve run in relation to the lateral rotators of the hip?
A
between the piriformis and gemellus superior
8
Q
What is piriformis syndrome?
A
tightening of the piriformis can compress the sciatic nerve
9
Q
What muscle runs between the superior and inferior gluteal nerves?
A
the piriformis
10
Q
What are the boundaries of the perineum?
A
pubic symphysis, coccyx, and ischial tuberosities
11
Q
What triangles form the peirneum?
A
the anal (posterior) and urogenital (anterior)
12
Q
What are the boundaries of the anal triangle?
What is contained within it?
A
- the ischial tuberosities and the coccyx
- anal canal and anal sphincters
13
Q
Why is the pectinate line important?
A
-it separates visceral from parietal
14
Q
Above the pectinate line: Vein drainage? Type of nerves? Hemorrhoid classification? Painful? Embryological origin?
A
- to the portal system
- visceral
- internal, not painful
- endoderm
15
Q
Below the pectinate line: Vein drainage? Type of nerves? Hemorrhoid classification? Painful? Embryological origin?
A
- systemically
- somatic
- external, painful
- ectoderm
16
Q
External anal sphincter:
Type of muscle?
Innervation?
A
- skeletal muscle
- somatic pudendal nerves
17
Q
Internal anal sphincter:
Type of muscle?
Innervation?
A
- smooth muscle
- visceral involuntary nerves
18
Q
What are the boundaries of the ischiorectal fossa?
What does it contain?
A
- lateral wall: obturator fascia and pudendal canal
- roof: pelvic diaphragm
- medial wall: external anal sphincter
- floor: skin
- fat and inferior rectal nerve, artery, and vein
19
Q
Superficial uritogenital pouch:
Boundaries?
Contents in males?
Contents in females?
A
- superficial perineal fascia (Colle’s) and the perineal membrane
- males: ischiocavernous muscles, bulbospongiosus muscle, superficial transverse perineal muscles, crura and bulb of penis
- females: ischiocavernosus muscles, bulbospongiosus muscle, superficial transverse perineal muscles, crura of the clitoris, bulbs of vestibule, greater vestibular glands (Bartholin’s)
20
Q
Deep uritogenital pouch:
Boundaries?
Contents in females?
In males?
A
- pelvic diaphragm and perineal membrane
- females: sphincter muscles, urethra, vagina
- males: sphincter muscles, bulbourethral gland (Cowper’s), membranous part of urethra
21
Q
Why is the perineal body important?
A
it is the anchoring point for many muscles, therefore important for maintaining perineal tone and support to the pelvic organs
22
Q
What things make up the root of the penis?
A
the crura and the bulb
23
Q
What binds together the erectile bodies and vessels of the penis?
A
the deep penile fascia (Buck’s)
24
Q
Describe the fundiform ligament.
A
it is a remnant of Scarpa’s fascia that forms a sling around the penis to suspend it
25
What is the pudendal canal?
| What runs through it?
- a sleeve of obturator fascia
| - the pudendal nerve and internal pudendal vessels
26
What is the major nerve of the perineum?
the pudendal nerve
27
How do S2-3 leave the pelvis?
the greater sciatic foramen
28
Describe the course of the pudendal nerve.
1. passes out of the pelvic cavity through the greater sciatic foramen
29
What does the deep dorsal vein of the penis drain into?
the prostatic plexus
30
What does the deep dorsal vein of the clitoris drain into?
the vesical venous plexus
31
What is the function of the testis?
- spermatogenesis (in seminiferous tubules)
| - testosterone production
32
What is the function of the epididymis and vas deferens?
- sperm maturation and storage
| - exit route for sperm from the testis
33
What is the function of the seminal vesicle?
- supplies bulk of semen volume
- supplies fructose to seminal plasma
- secretes prostaglandins for sperm motility
- supplies precursors for semen clotting
34
What is the function of the ejaculatory duct?
-links the vas deferens and seminal vesicles to the urethra
35
What is the function of the bulbourethral glands?
-secretes mucous for lubrication
36
What is the function of the penis?
- erection and ejaculation
| - urinary conduit
37
What is the general structure of the testis?
it is divided into about 250 lobules by septae, with each lobule containing 1-4 seminiferous tubules
38
Where do Sertoli cells live in relation to the seminiferous tubules?
Leydig cells?
- Sertoli cells live inside the seminiferous tubules
| - Leydig cells live outside the seminiferous tubules
39
How long does spermatogenesis take to occur?
| Each phase?
- 74 days overall
| - 50 days in the testis, 24 days in the epididymis
40
In the sperm, what does the neck contain?
The principal/middle piece?
The tail?
- neck: centrioles
- principal/middle: mitochondria
- tail: flagella
41
What are the functions of Sertoli cells?
- support attachment of spermatogenetic cells
- nutrition of sperm
- secrete androgen binding peptide (ABP), inhibin, plasminogen activator, transferrin, and ceruloplasmin
- phagocytosis of residual bodies
- create tight Sertoli-Sertoli cell junctions to form the blood-testis barrier
42
What do Sertoli cells look like?
| What is a prominent feature?
- tall columnar cells
| - they have a prominent nucleolus
43
Why is the blood-testis barrier important?
it shelters the foreign haploid sperm from the immune system
44
What is the function of androgen binding peptide (ABP)?
| What secretes it?
- it allows for concentration of testosterone
| - Sertoli cells
45
```
Leydig Cells:
What is their general function?
What do they do during embryonic development?
During puberty?
During adulthood?
```
- secrete steroids, mainly testosterone
- embryo: testosterone helps develop the male gonads
- puberty: testosterone initiates spermatogenesis, accessory sex gland secretion, secondary sex characteristics
- adulthood: maintains spermatogenesis and secondary sex characteristics
46
What is the function of LH in males?
it tells Leydig cells to secrete testosterone
47
What is the function of FSH in males?
it tells Sertoli cells to make ABP in order to concentrate testosterone at the site of spermatogenesis
48
In reproductive years in males, do you have more LH or FSH produced?
more LH as compared to FSH
49
What converts androgens to estrogen?
| Where is it found in males?
- aromatase
| - seminiferous tubules and fat
50
What converts testosterone to DHT?
| Where is it found?
- 5a-reductase
| - hair, external genetalia, and prostate gland
51
What happens to sperm in the epididymis?
| Why does the epididymis produce a glycoprotein?
- sperm mature, get transported, get concentrated, and acquire motility
- to inhibit capacitation (don't want that to happen until inside female)
52
What is the epithelium of seminal vesicles?
columnar epithelium with secretory granules
53
What does the prostate secrete?
prostatic acid phosphate (PAP) and prostate specific antigen (PSA)
54
What is BPH?
What problem can it cause?
How do you therapeutically target it?
- benign prostatic hypertrophy, androgen-dependent growth of stromal and epithelial cells forms nodules
- urinary obstruction
- inhibition of DHT formation or smooth muscle relaxants
55
What is DHT's role in prostatic hyperplasia?
| How/where is it made?
- it is a potent growth factor
| - made in stromal cells that cross-talk with the epithelial cells
56
What type of erectile tissue surrounds the penile urethra?
the corpus spongiosum
57
What epithelium do you find in the penile urethra?
pseudostratified columnar epithelium
58
What epithelium is the glans penis lined by?
squamous epithelium
59
What is the most important molecule for erection?
Where does it come from?
What is important for terminating an erection?
- nitric oxide
- nitric oxide synthase in parasympathetic nerves and endothelial cells
- alpha adrenergics and PDE5
60
What are the hormones made by the ovaries responsible for?
- prepare the endometrium for conception
| - maintain pregnancy after fertilization
61
What is the purpose of the stroma in the ovary?
1. provides structural support for the developing ova
2. with hormonal stimulation, the stroma around the ovum differentiates into hormone producing layers (theca externa and interna)
62
Outline the difference between primordial follicles, primary, secondary, and mature follicles?
- primordial: oocyte in stroma
- primary: oocyte surrounded by a flat layer of granulosa cells
- secondary: oocyte enveloped by zona pellucida, granulosa cells, theca interna, and theca externa
- mature: a cavity develops in the granulosa cell layer (antrum)
63
What happens to the corpus luteum of menstruation?
in the absence of hCG, the corpus luteum degenerates into the corpus albicans in 10-12 days
64
How is the corpus luteum of pregnancy maintained?
the corpus luteum is sustained by paracrine hormones (estrogen and IGF-1) and endocrine hormone (placental hCG, LH, and prolactin)
65
What happens to the myometrium during gestation?
| To the endometrium?
- myometrium: smooth muscle cells undergo hyperplasia and hypertrophy
- endometrium: exaggerated secretory changes followed by endometrial stromal cell transformation into decidual cells
66
What is the epithelium of the vagina?
squamous epithelium
67
What is the epithelium of the cervix?
the vaginal portion is lined by squamous, and the uterine portion is lined by columnar epithelium
68
Detail the path of milk in the breast.
1. ductules drain into
2. terminal ducts, drains into
3. interlobular ducts, drains into
4. extralobular ducts, drains into
5. large mammary (interlobar) ducts, drains into
6. collecting ducts, drains into
7. lactiferous sinuses, opens into
8. the nipple
69
When does a woman's amount of germ cells peak?
How many does she have at birth?
At puberty?
At onset of menopause?
- week 20-24 of gestation
- 2 million
- 400,000
- zero (basically)
70
How long can the 1st stage of follicular development last?
13 (1st menstruation) to 50 (menopause) years
71
At what stage do follicles stay at (and can go no further than) in a pre-pubertal ovary?
the primary follicle
72
What is one of the earliest events of puberty in young girls?
large nocturnal pulses of LH during REM sleep
73
How does hormonal feedback work during the follicular phase of the menstrual cycle?
- GnRH tells the pituitary to make FSH/LH, tells the ovary to make estrogen
- estrogen feeds back negatively on the pituitary
74
How does hormonal feedback work during the midcycle phase of the menstrual cycel?
- GnRH tells the pituitary to make FSH/LH, tells the ovary to make estrogen
- estrogen feeds back positively on the pituitary
75
How does hormonal feedback work during the luteal phase of the menstrual cycle?
- GnRH tells the pituitary to make FSH/LH, tells the ovary to make estrogen and progesterone
- progesterone feeds back negatively on the pituitary
76
What are the effects of estrogen on the brain?
- maintains body temperature
- delays memory loss
- regulates parts of the brain that prepare the body for sexual and reproductive development
77
What are the effects of estrogen on the heart and liver?
-regulates the liver's production of cholesterol, thus decreasing the buildup of plaque in the coronary arteries
78
What are the effects of estrogen on the ovary?
- stimulates maturation of the ovaries
| - stimulates start of a menstrual cycle
79
What are the effects of estrogen on the vagina?
- stimulates maturation of the vagina
| - helps to maintain a thick and lubricated vaginal lining
80
What are the effects of estrogen on bone?
- helps preserve bone density
| - high levels close the growth plates at the epiphyses
81
What are the effects of estrogen on the uterus?
- stimulates maturation of the uterus
| - helps prepare the uterus to nourish a developing fetus
82
What are the effects of estrogen on the breasts?
- stimulates the development of breasts at puberty
| - prepares the glands for future milk production
83
What are the key actions of estrogen?
1. development of secondary sex characteristics at puberty
2. proliferation of ovarian granulosa cells
3. maintenance of vagina, cervix, uterus, and fallopian tubes
4. regulates tissue responsiveness to estrogen, progesterone, and LH
5. negative and positive feedback on FSH/LH
6. decreases threshold for uterine contraction
7. stimulates prolactin secretion, but blocks its action at the breast
8. decreases LDL cholesterol
9. maintains bone density
84
What are the key actions of progesterone?
1. maintains endometrial secretion in the luteal phase
2. negative feedback control of FSH/LH
3. maintenance of pregnancy
4. increases threshold for uterine contraction (decreased sensitivity)
85
What happens to body temperature right after ovulation?
| Why?
- body temperature will rise up to 1 degree
| - progesterone is thermogenic
86
What effect does estrogen have on the cervical mucous?
it takes it from being tacky and thick to stretchy, thin, and watery that gives a ferning pattern on slides
87
What hormone is secreted at very high levels in the 1st trimester and then drops off?
hCG
88
What is hCS/HPL responsible for during pregnancy?
increases plasma glucose in the mother to ensure adequate nutrition of the fetus
89
What effect does suckling have on the brain?
1. oxytocin neurons: causes contraction of myoepithelial cells in breast causing milk ejection (immediate meal)
2. prolactin neurons: dopamine suppressed and milk made and stored for later
3. GnRH neurons: inhibits GnRH production to inhibit the menstrual cycle
90
What do birth control pills do?
- no LH surge from inhibition of gonadotropin release
- inhibits follicular development
- prevents ovulation
- thickens cervical mucous
91
In childhood prior to puberty, do you have more FSH or LH?
more FSH
92
During the adult reproductive period in females, do you have more FSH or LH?
more LH
93
During the post-menopausal senescence period, do you have more FSH or LH?
more FSH
94
What are the symptoms associated with menopause?
| What causes all of these symptoms?
- thinning of vaginal epithelium
- decreased vaginal secretions
- decreased breast mass
- accelerated bone loss
- vascular instability (hot flashes)
- emotional lability
-loss of the ovarian source of estrogen
95
If all goes as planned, what happens 1 day after ovulation?
5 days?
8 days?
10 days?
- 1 day: fertilization
- 5 days: implantation
- 8 days: trophoblast secreting hCG
- 10 days: trophoblast "rescues" the corpus luteum
96
Embryologically, where does the GU system primarily come from?
the intermediate mesoderm
97
What divides the cloaca?
| What does it get divided into?
- the urorectal septum
| - the rectum and the urogenital sinus (bladder and urethra)
98
What is a urachal fistula?
communication between the bladder and the belly button
99
What does the urogenital ridge differentiate into?
the genital and nephrogenic ridges
100
What forms the paramesonephric duct?
| What forms the mesonephric duct?
- invagination of the peritoneum
| - the mesoderm
101
What is the default sex in mammals?
What determines whether you get testis or ovaries?
What encodes that protein?
- female
- presencce of TDF (testis determining factor) makes testis, no TDF makes ovaries
- the SRY gene on the Y chromosome encodes the TDF protein
102
What is the difference between the development of the primitive testis vs ovary?
- testis: primary sex chords persist and get filled with spermatagonia to become the seminiferous tubules
- ovary: surface epithleium migrates in to produce secondary sex chords (7th week), and later become follicles (4th month)
103
What things bud off of the urethra in the male?
the prostate and the bulbourethral glands
104
What system does the male retain that will become all of his sex organs?
The female?
- male: the mesonephric system
| - female: paramesonephric system
105
What is the vagina formed from?
- caudal part: paramesonephric duct
| - distal part: urogenital sinus
106
How do you get a double cervix?
when the uterovaginal canal fails to fuse
107
When do the testes descend into the scrotum?
about week 32
108
What does the gubernaculum become in females?
the round and ovarian ligaments
109
What is Scarpa's fascia called in the scrotum?
Dartos fascia
110
What is the external spermatic fascia continuous with?
the external obilque aponeurosis
111
What is the cremasteric fascia/muscle derived from?
the internal oblique
112
What is the internal spermatic fascia derived from?
the transversalis fascia
113
```
What do the following things on the anterior abdominal wall correspond to in the testis/spermatic cord:
Skin?
Scarpa's fascia?
External oblique aponeruosis?
Internal oblique aponeurosis?
Transversalis abdominus muscle?
Transversalis fascia?
Parietal peritoneum?
```
- skin: skin
- Scarpa's: Darto's fascia
- EO: external spermatic fascia
- IO: cremaster muscle/fascia
- TA: none (parts to allow testis through)
- Transversalis fascia: internal spermatic fascia
- Parietal peritoneum: tunica vaginalis
114
What does testosterone do to the indifferent stage of external genetalia?
induces the urogenital folds and labioscrotal swellings to zip up along the midline
115
What is the navicular fossa formed from?
invagination of the ectoderm
116
What separates the greater from the lesser sciatic foramen?
the sacrospinous ligament
117
What are the components of the pelvic diaphragm?
| What runs through the middle?
- levator ani and coccygeus
| - urogenital hiatus
118
What makes up the levator ani?
- pubococcygeus
- puborectalis
- iliococcygeus
119
What is the function of the puborectalis muscle?
it forms a sling around the anorectal junction to make the perineal flexure and is important for anal continence
120
What makes up the points of the trigone of the bladder?
- ureteral orifices
| - internal urethral orifice
121
What are the parts of the broad ligament of the uterus?
- mesometruim
- mesovarium
- mesosalpinx
122
When talking about the angles of the uterus, what does flexion refer to?
Version?
What position is the uterus usually in?
- flexion: the angle between the uterine body and the cervix
- version: the angle between the cervix and the vagina
- anteflexion and anteversion
123
What is the relationship of the uterine artery to the ureter?
the artery runs over top of the ureter
124
What does the superior rectal vein drain into?
The middle?
The inferior?
- superior: portal system (inferior mesenteric)
- middle: the iliacs (systemic)
- inferior: pudendal (systemic)
125
What does the common iliac artery divide into?
the internal and external iliac
126
What does the internal iliac artery divide into?
| What does each of those branches feed?
- anterior trunk: to the visceral organs (vagina, bladder, urethra, penis, etc)
- posterior trunk: feeds the posterior body wall
127
In males, what does the Wolffian duct differentiate into?
What is the stimulus for it to differentiate?
What is the Wolffian duct aka?
- epididymis, vas deferens, and seminal vesicles
- testosterone
- the mesonephric duct
128
Where is the earliest site of androgen production?
the adrenal glands
129
In females, what does FSH do?
| LH?
- FSH: stimulates granulosa cell production of estrogen
| - LH: enhances thecal cell production of androgens and granulosa cell production of progesterone
130
What causes ovulation?
the LH surge
131
What hormone does the placenta make?
| Analog of?
- hCG
| - LH
132
What is the job of thecal cells in females?
they provide the substrate that allows granulosa cells to make estrogen
133
Describe the steps of menstruation.
1. withdrawal of progesterone
2. activation of matrix metalloproteinase
3. enzyme digestion of tissue causes endometrial sloughing
4. platelet plug forms causing vasoconstriction of vessels
5. estrogen exposure cause re-epithelialization
134
What does withdrawal of progestrone cause?
| What molecule's production does it trigger?
- menstruation
| - prostaglandins (cramps)
135
Changes in what structures cause erection?
smooth muscle relaxes, closing the venous outflow by pressing on the tunica albuginea
136
Describe the process of erection.
1. nerve stimulation causes release of NO
2. NO goes into smooth muscle of penis and stimulates production of cGMP
3. cGMP causes relaxation of penile smooth muscles, increasing bloodflow in and decreasing bloodflow out (erect penis)
4. PDE5 causes breakdown of cGMP, leading to contraction of smooth muscle (flaccid penis)
137
Describe the process of ejaculation.
1. contraction of smooth muscle in prostate, seminal vesicles, and vas deferens
2. closure of bladder neck
3. rhythmic contraction of periurethral skeletal muscle and external sphincter muscle
138
What are the zones of the prostate?
| What do they do?
1. transitional zone: surrounds the urethra
2. central zone: surrounds the ejaculatory ducts
3. peripheral zone: surrounds central zone and forms posteriolateral part of prostate gland
4. fibromuscular stroma: occupies anterior part of prostate
139
In what zone do most hyperplasias of the prostate occur?
the transitional zone
140
What are the branches of the anterior trunk of the internal iliac artery?
- inferior gluteal
- middle rectal
- umbilical / superior vesicular
- inferior vesicular
- uterine
- vaginal
- obturator
- internal pudendal
141
What are the branches of the posterior trunk of the internal iliac artery?
- superior gluteal
- iliolumbar
- lateral sacral artery
142
What bony landmark do you use to perform a pudendal nerve block?
the ischial spine
143
What does the Wolffian duct become in males?
| In females?
- males: epididymis, vas deferens, and seminal vesicles
| - females: nothing
144
What does the Mullerian duct become in males?
| In females?
- males: nothing
| - females: fallopian tubes, uterus, and upper vagina
145
Why does the Wolffian duct regress in females?
no presence of testosterone
146
Why does the Mullerian duct regress in males?
anti-Mullerian hormone
147
What prompts formation of the penis and scrotum in males?
How is that hormone made?What prompts formation of the penis and scrotum in males?
How is that hormone made?
- DHT
| - from testosterone by 5a-reductase
148
Where does the majority of vaginal lubrication come from?
vaginal transudate from the subepithelial vascular bed
149
What are the terminal branches of the pudendal nerve?
- perineal nerve
| - dorsal nerve of the penis/clitoris
150
What is the negative feedback signal for spermatogenesis?
| Where does it act on?
- inhibin
| - on the anterior pituitary
151
What is the negative feedback signal for Leydig cells?
| Where does it act on?
- testosterone
| - on the anterior pituitary and hypothalamus
152
Name the parts of the fallopian tube.
- uterine part
- isthmus
- ampulla
- infundibulum
- fimbrae
153
In a vaginal examination, what structure would you pierce to reach the rectouterine pouch?
the posterior fornix
154
Where does the vagus nerve end?
| Where are the rest of the parasympathetic innervations gotten from?
- around the splenic flexure of the colon
| - from the pelvic splanchnics
155
What things are made from the metanephric duct?
| What is it aka?
- ureter, renal pelvis, major and minor calicies, and collecting tubules
- aka the ureteric bud
156
What things are made from the metaneprhic mesoderm?
the bulk of the kidney, the cortex, ect (NOT the ureter, renal pelvis, major and minor calicies, or the collecting tubules)
157
Blockage by what can sometimes cause a pelvic kidney?
the umbilical or iliac artery
158
Where do horseshoe kidneys get caught?
the inferior mesenteric artery
159
What divides the cloaca?
| What does it divide into?
- the urorectal septum
| - into the rectum and urogenital sinus
160
What does the urachus become?
the median umiblical ligament
161
What does the labioscrotal swelling become in females?
the labia majora
162
What does the urogenital fold become in females?
the labia minora
