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ESA3 wrong answers > Repro > Flashcards

Repro Flashcards

1
Q

what is in the spermatic cord

A

nerves- cremasteric, ilioingual, sympathetic
arteries and veins- cremasteric, to vas, testicular
vas deferens, lymph, pampiniform plexus, processus vaginalis

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2
Q

coverings of spermatic cord

A

external spermatic fascia, cremaster fasia, internal spermatic fascia

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3
Q

venous drainage r/l testis, scrotum and prostate

A

l testis- renal vein
r testis- IVC
scrotum- scrotal veins
prostate- prostatic venous plexus>internal iliac

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4
Q

lymphatic drainager r/l testis, scrotum and prostate

A

r testis- para-aortic
l testis- para-aortic
scrotum- superficial inguinal
prostate- internal iliac/sacral

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5
Q

artery r/l testis, scrotum and prostate and penis

A

penis- pudendal
r/l testis- testicular artery
scrotum- scrotal artery
prostate- prostatic artery

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6
Q

what do seminal vesicles, prostate and bulbourethral glands release

A

seminal vesicles- fructose, alkaline fluids and coagulating agents. 65%
prostate gland- enzymes to break down clotting factors. 25%
bulbourethral glands- alkaline mucus. 10%

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7
Q

label the 4 missing sections on the prostate

A

top left- transitional zone

bottom left- anterior region

top right- peripheral zone

bottom right- central zone

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8
Q

label the 4 missing ligaments

A

suspensory ligament

ovary

broad ligamet

round ligament

ovarian ligament

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9
Q

fill in the missing blood suppplies

A

top: L- ovarian artery

R-uterine artery

Bottom: left- internal pudundal

middle- vaginal artery

right- internal iliac

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10
Q

label the anatomy

A

from top clockwise

internal os

posterior fornix

external os

vagina

anterior fornix

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11
Q

label the ligaments of the pelvic floor

A

top down:

pubocervical

transverse/cardinal

uterosacral

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12
Q

label the muscles of the pelvic floor

A

from top anticlockwise

ischiocavernosus

bulbospongiosus

perineal body

superficial transverse perineal muscle

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13
Q

label the deep muscles of the pelvic floor

A

top down

puborectalis

pubococcygeus

iliococcygeus

coccygeus

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14
Q

give the deep and superficial muscles of the pelvic floor

A

deep- puborectalis, coccygeus, iliococcygeus, pubococcygeus

superficial- ischiocavernosus, bulbospongiosus, perineal body, superverse transverse perineal muscle

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15
Q

what muscles make up levator ani

A

puborectalis, pubococcygeus, and iliococcygeus

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16
Q

venous drainage of ovaries, uterus, cervix, vagina

A

L ovary- ovarian, L renal

R ovary- ovarian, IVC

uterus- uterine venous plexus, internal iliac

cervix- uterine venous plexus, internal iliac

vagia- vaginal venous plexus

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17
Q

lymphatic drainage of ovaries, uterus, cervix, vagina

A

ovaries- paraaortic

uterus- external and internal iliac, para aortic

cervix- internal iliac/sacral

vagina- internal and extrenal iliac

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18
Q

which ligament is a remnant of gubernaculum

A

ovarian and round

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19
Q

normal position of uterus

A

anteverted and anteflexed

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20
Q

what do vas deferens and uterus develop from

A

vas deferens- mesonephric duct

uterus- paramesonephric duct

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21
Q

where do FSH and LH act, female and male

A

FSH

  • male at sertoli cells to produce sperm and inhibin
  • female at granulosa cells to produce oesterogen and inhibin

LH

  • male at leydig cells to produce testosterone
  • female at theca interna cells to produce progesterone and androgens
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22
Q

define

gonadarche

menarche

thelarche

adrenarche

A

gonadarche- activation of repro glands by FSH/LH

menarche- first periods

thelarche- onset breast development

adrenarche- adrenal activation

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23
Q

3 things that control timing of puberty

A

pineal gland, leptin, body weight

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24
Q

when does puberty start/male and female

A

male- 9-14

female- 8-13

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25
Q

order of puberty male and female

A

male

  • testicular enlargement, pubic hair and spermatogenesis, growth spurt

female

-breasts, hair, growth, period

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26
Q

compare peripheral and central precocoius puberty and their causes

A

central- low GnRH

-pituitary/hypothalaic adenomas

peripheral- normal GnRH

ovarian cyst/CAH to increase androgens, HCG germ line tumour eg. granulosa cell to increae oestrogen, hypothyroidism to increase B-HCG

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27
Q

describe follicular phase

A
  • activin increases FSH release, causing increases follcilar and ovum development. reduces androgens in theca cells
  • theca interna develops which prooduces oestrogen and inhibin
  • dominant follicle selected
  • oestrogen begins to exert positive feedback as levels rise. increases FSH and LH, however presence of inhibin reduces FSH. causes LH surge and ovulation
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28
Q

describe luteal phase

A
  • the egg is released. leaves behind corpus luteum
  • corupus luteum is leutinised and secretes oestrogen and progesterone.
  • oestrogen inhibits FSH and LH release, to prevent further follicle development
  • in no fertilisation, progesterone and oestrogen fall and corupus luteum becomes corpus albicans.
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29
Q

causes of heavy menstrual bleeding

A

Polyps
Adeomyosis
Leiomyoma
Malignancy

Coagulopathy
Ovulatory
Endometrial
Iatrogenic
Not yet classified

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30
Q

causes dysmenorrhoea

A

endometriosis

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31
Q

cause oligomenorrhoea

A

ovarian insufficiency, thyroid problems, ED, contraception

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32
Q

cause primary amenorrhoea

A

imperforate hymen, vaginal septum, androgen insensitivity syndrome, GnRH deficiency

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33
Q

cause secondary amenorrhoea

A

cervical stenosis, asherman, PCOS, thyroid disease, hyperprolactinoma, prolactinoma, pituitary necrosis

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34
Q

describe changes in pre and peri menopause

A

pre- slight decrease in oestrogen, incresae in FSH/LH, decrease in fertility, cycle irregularity

peri- follicular phase shortens, ovulation absent, menopause

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35
Q

describe completion of meiosis II

A
  • calcium waves activate to fuse oocute and sperm membranes
  • meiosis II resumes
  • pronuclei move togehter
  • mitotic spindle forms leading to cleavage
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36
Q

acrosome reaction

A

sperm pushes through corona radiata,

sperm cell surface receptor binds to ZP ZP3 glycoprotein

triggers acrosone

ZP digested

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37
Q

describe what occurs in capacitation

A

further maturation

  • sperm cell membrane changes to fuse with oocyte membrane
  • tail changest from beat to whip movement
  • can now acrosome
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38
Q

symptoms in men

  • chlamydia
  • gonorrhoea
  • NGU
A

C-asymptomatic but can cause testicular pain/discharge/dysuria

G-thick yellow discharge and dysuria

NGU- white discharge, dysuria, urethritis

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39
Q

which male STIs tested for by urethral swab

A

gonorrhea

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40
Q

which male STIs treated for with ueine sample

A

gonorrhea, chlamydia, urethritis

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41
Q

symptoms in women

trichomoniasis

candidiasis

BV

A

T- copious yellow odorous discharge

C- itchy white discharge

B- offensive smelling white discharge

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42
Q

which STI low vaginal swab and high vaginal swab

A

low- Chlamydia trachomatis, neisseria gonorrhoea

high- candida, trichomonas vaginalis

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43
Q

cause of

syphillis

gonorrhoea

chlamydia

NGU

trichomonias

BV

A

S- treponema palladium

G- neisseria gonorrhora

C- chlamydia trichomatis

NGU- chlamydia trichomatis, mycoplasma genitalium, trichomonas vaginalis

T- trichonomias vaginalis

BV- gardenella vaginalis

44
Q

male causes of infertility

A

pre testicular- HPG axis

testicular- testicular torsion, varicoceole, y chromosome deletion, STIs, chemotherapy

post testicular- vasectomy, erectile dysfunction

45
Q

female causes infertility

A

ovulatory- Hypothalamic pituitary, hypothalamic pituitary ovarian (PCOS), ovarian failure (turners syndrome)

uterine/peritoneal- uterine fibroids, endometriosis, PID

tubal- endometriosis, ectopic pregnancy, STI

46
Q

male and female investigations infetility

A

male

-sperm count, testicular USS, exclude STI, karyotype, hormone levels

female

-pelvic USS, hormone levels, STI, tubal patency test

47
Q

protein hormones produced by placenta

A

hPL. hCG, hCC, hCT

48
Q

describe structure of umbillical cord

A

2 umbillical arteries carry blood from fetus to placents

1 umbillical vein carries blood from placenta to fetus

49
Q

describe respiratory changes in pregnancy

A
  • tidal volume increases causing hyperventillation as minute ventillation = RR x TV (RR SAME)
  • causes reduction in pa02, causing dyspnoea
  • ERV and TLC also reduce due to compression of uterus on xiphoid process
50
Q

describe CVS changes in pregnancy

A

CO= SV x HR

early SV increases late HR increaes

  • TPR reduces due to prostoglandins
  • hypercoaguable state
  • RAAS activates causing oedema
  • increased plasma volume causes dilutional anaemia
51
Q

renal changes pregnancy

A
  • reduced PCT absorption causing glucosuria
  • increased GFR
  • smooth muscle relaxation
52
Q

MSK changes pregnancy

A
  • increaed lordosis and kyphosis changes centre of gravity
  • abdominal muscles stretch
  • increased motility of sacroiliac jonts and anterior tilt of pelvis
53
Q

cause and effets of pre eclampsia

A

cause- impaired invasion of trophoblast causes shallow invasion of spiral arteries. causes hypoperfusion and ischameia.

  • protinurea and hypertension, tendon reflex reduced, headache
  • seizure, cerebral haemorrage, renal failure, anaemia, dic
54
Q

describe fetal development of the respiratory system

A

pseudoglandular- formation of bronchioles from bronchpulmonary tree

canicular- respiraotry bronchioles form

terminal sac- t1/t2 pneumocytes from and produce surfactant. terminal sacs form

55
Q

describe adaptations to increase o2 suppyl to fetus

A
  • increases maternal 2,3BPG
  • HBF has lower affinity for 2,3BPG and so accepts O2 more readily
  • double bohr effect.

mother- as co2 passes into intervilloius blood from fetal circulation pH decreases. pushes curve to left. reduced o2 affinity so o2 given up

fetus- as co2 is given up into maternal circulation pH rises. this increases o2 affinity

56
Q

adaptations to incfrease co2 removal from fetus

A
  • progesterone driven hypeventillation reduces maternal pco2, and so increases upatake from fetus
  • double haldane effect. as maternal blood gives ip O2 it can accept more co2. as fetal Hb accepts o2 it gi es up more co2.
57
Q

describe the different shunts

A

DA- between pulmonary artery and aorta. bypasses lungs

DV- between. umbillical vein and IVC. bypasses liver

FO- between RA and LA

58
Q

what position will arm be in if damaage to upper brachial plexus occurs

A

Erb’s palsy (waiter’s tip):

  • Arm medially rotated
  • Forearm pronated
  • Wrist flexed
59
Q

describe first stage of labour

A
  • cervical effacement
  • cervical ripening due to prostoglandins. reduction in collagen aggergation and increase in hyaluronic acid
  • thinning of leavator ani and perineal boduy
60
Q

desribe movement of fetus through birth canal

A

internal rotation and flexion

crowning

external rotation and extension

shoulder born

61
Q

effect of prostoglandins and oxytocin on contractions

A

oxytocin reduces threshold for action potential. prostoglandins cause release of Ca2+ from stores

62
Q

what are the different lie and presentations of fetsu

A

lie- axis of spine to uterus

longitudinal, transverse, oblique

presentation

cephalic, shoulder, breach

63
Q

describe what happens to the shunts after birth

A

pulmonary vascular resistance and pulmonary arterial pressure reduce.

this causes left atrial pressure to increae relative to right atrial pressure. closes FO.

the rising pO2 in blood causes DV to constrict.

64
Q

structure of breast

A

lobule>ductule>ducr>ampulla

65
Q

why does suckling stop menstruation

A

inhibits arcuate nucleus, no GnRH

66
Q

4 types of hormone affecting the breasy

A

Mammogenic (promote proliferation of alveolar & duct cells)

Lactogenic (promote initiation of milk production)

Galactokinetic (promote contraction of myoepithelial cells)

Galactopoietic (maintain milk production).

67
Q

effect of suckling on lactationm

A

suckling stimulates neurons from the spinal cord to inhibit dopamine release, and the levels of PRL therefore increase. This leads to stimulation of milk production by the breast. Suckling thus maintains milk production, i.e. suckling in one feed orders the next feed.

68
Q

describe Puerperal Mastitis

A

​

condition where milk accumulation in the breast can lead to inflammation, with or without infection.

occurs if the mother does not breastfeed with both breasts, and therefore milk can build up in the lactiferous ducts of the unused breast.

If infection is present, it is usually caused by Staphylococcus aureus, and can lead to abscess formation.

69
Q

most common cancer female

A

endometrial adenocarcinoma

70
Q
  • most common vulval tumour
  • causative factor
  • where spread
  • treatment
A
  • squamous carcinoma
  • HPV causing vulval intraepithelial neoplasia (presence of atypical squamous cellls in epithelia)
  • spreads locally and to inguinal lymph nodes
  • excision
71
Q
  • most common cancers of the cervic
  • causes
  • where spread
A
  • mainly squamous cell carcinomas but also adenocarcinoma
  • HPV causing CIN
  • uterus/bladder/rectum. iliac and aortic lymph nodes.
72
Q

CIN

A

cervical intraeithelial neoplasia

CIN I- reversible

CIN II- in situ carcinoma

CIN III- invasive carcinoma

73
Q

what does cervical screening detect

A

abnormally large nuclei with abnormal chromatin. in transformation zone

74
Q

how does HPV cause cancer

A

e6 and e7

c6 prevents p53. e7 prevents rb

75
Q
  • what cancer of endometrium
  • causes
  • where spread
A

-serous carcinoma which is more agressive but less common.

endometriod carcinoma which is less agressive

  • unapposed oestrogen from obesity, exogenous oestrogen or hormone secreting tumour.
  • blasdder, cervix, rectum, peritoneal cavity, lymph nodes
76
Q
  • tumour of myometrium
  • symptoms
  • cause
  • spread
A

benign- leiomyoma. causes heavy menstural bleeding and infertility. caused by oestrogen

malignant

  • leiomyosarcoma. similar symptoms.
  • metastasis to lungs
77
Q

main types of ovary tumours

A

-surface epithelium/germ cell/sex cord stromal

78
Q

describe ovarian epithelial tumours

A
  • serous, mucinous, endometriod
  • malignant present late and have poor prognosis. cause acites and intestinal obstruction
  • caused by BRAC1/2
79
Q

describe ovarian + testicular germ cell tumours

A
  • benign: teratoma that contains tissue from all 3 germ laters.
  • malignant: (testes)

dysgerminoma, yolk sac

80
Q

describe sex cord stromal tumours

A
  • derived from ovarian stroma
  • granulosa cell tumours produce oestrogen and cause precocoius pberty and endometrial hyperplasia
  • sertoli-leydig tumours produce androgens to cause amenorrhoea and infertility
81
Q

what is a kruckenberg tumour

A

metastatic GI tumout within ovary from stomach

82
Q

describe sex cord tumour of testes

A

sertoli or leydig tumours

uncommon

benign

83
Q
  • types of male germ cell tumours
  • cause of germ cell tumours

-

A
  • seminomas and non seminomatous germ cell tumour (NSGCT)
  • family history, cryptorchidism. treated by orchioplexy
84
Q
  • types NSGCT
  • markers
A
  • pure: yolk sac tumour, embryonal carcinoma, choriocarcinoma, teratoma.
  • mixed: contain 2 differnt pure NSGCT
  • all produce AFP
  • choriocarcinomas product hCG
  • mixed produce both
85
Q

compare seminomna and NSGCT

  • spread
  • treatment
  • presentation
A
  • seminomas spread rarely and if they do it is to iliac and paraaortic lymph nodes. NSGCT spread early and via lymphatics and blood vessels
  • testicular tumours treated by radical orchoectomy. then tested to seee if seminoma or NSGCT. seminoma is radiosensitive so treated qith radiotherapy. NSGCT treared with chemotherapy
86
Q
A

1- vas deferens

2- body epididimys

3- tail epididimys

4- tunica albuginea

5- seminiferous tubules

6- head epididymis

87
Q

tunica albuginea vs tunica vaginalis

A

Beneath the tunica vaginalis is the capsule of the testis, termed the tunica albuginea

88
Q

what do Ad Ap spermatogonia do

A

Ap- produce spermatocytes

Ad- reserve stock

89
Q

describe sperm production

A

spermatogonium

primary spermatocyte

spermatid

spermatazoa

90
Q

define spermiation and spermiogenesis

A

Spermiation is the release of spermatids into the lumen of seminiferous tubules

Spermiogenesis is when a haploid spermatid differentiates into a spermatozoon

91
Q

what occurs in spermiogenesis

A

⇒ Spermiation

⇒ Spermatid remodelling (seminiferous tubule)

⇒ Spermatid moves through rete testis and ductuli efferentes and into the epididymis

92
Q

Which three processes are stimulated by the female genital tract?

A
  • Removal of glycoproteins and cholesterol from sperm membrane
  • Activation of sperm signalling pathways
  • Allow sperm to bind to zona pellucida of oocyte
93
Q

what occurs in pre antral, antral and pre ovulatory

A

pre antral

  • Primordial follicle grows to form the primary follicle
  • Follicular cells change and proliferate to form a stratified cuboidal epithelium of granulosa cells

antral

  • Fluid-filled spaces appear between granulosa cells
  • These spaces coalesce to form the antrum

pre ovulatory

  • Meiosis I completion results in 2 haploid cells of unequal size
  • One cell receives most of cytoplasm the first polar body receives practically none
94
Q

How is the corpus luteum formed?

A
  • After ovulation, remaining granulosa and theca interna cells become vascularized
  • They develop a yellowish pigment and change into lutein cells, which form the corpus luteum
95
Q

how does genetic variation occur in meiosis

A

• Crossing-over
(exchange of regions of DNA between 2 Bivalent
homologous chromosomes)

• Independent assortment
(random orientation of each bivalent duplicates during along the metaphase plate with respect meiosis I producing to other bivalents)

• Random segregation
(random distribution of alleles among the four gametes)

96
Q

which ligaent is a neurovascular pathway bulging into peritoneum

A

suspensory

97
Q

which ligament is a peritoneal fold

A

broad

98
Q

which ligament is a remantt of the gubernaculum

A

round and ligament of ovary

99
Q

how does perineal body maintain pelvic organ support

A

central point of attachment for perineal musculature

100
Q

risk factors for POP

A

obesity

heavy lifting

steroids

connective tissue disorder

101
Q

how can childbirth cause pelvic floor dysfunction

A

stretching pudundal nerve, injury perineal body

102
Q

normal sperm concentration and normal volume per ejaculate

A
  • 20-200
  • 2-4ml
103
Q

spermatogenesis

spermiogenesis

A

spermatogenesis- formation of spermatids from spermatogonia. ST

spermiogenesis- spermatid final maturation to spermatozoa. ST

104
Q

what is CIN

A

dysplasia

105
Q

what cell produces human choroinic gonadotrophin

A

syncytiotrophoblast

106
Q

changes to placenta over time

A

thinning of syncytiotrophoblast

loss of cytotrophoblast

ESA3 wrong answers (5 decks)

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