Semen Analysis Flashcards

1
Q

What are the four fractions in the semen that are contributed by the testes

A

epididymis, seminal vesicles, prostate gland, bulbourethral glands

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2
Q

Function for the secretion of sperm

A

seminiferous tubules

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3
Q

This contributes to the lower scrotum
temperature that is optimal for sperm development

A

external location of the scrotum

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4
Q

Function for the production of spermatozoa and are located in the epithelial cells of the seminiferous tubules

A

Germ cells

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5
Q

Provide support and nutrients for the germ cells as they undergo mitosis and meiosis (spermatogenesis)

A

Specialized Sertoli cells

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6
Q

Percent of the spermatozoa in the semen

A

5%

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7
Q

Percent of the seminal vesicle in the semen

A

60%

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8
Q

Percent of the bulbourethral glands in the semen

A

5%

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9
Q

Percent of the prostate fluid in the semen

A

20% to 30%

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10
Q

Semen is composed of

A

-Spermatozoa
-Seminal fluid
-Prostate fluid
-Bulbourethral gland

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11
Q

When spermatogenesis is complete, the immature sperm (nonmotile) enter the?

A

epididymis

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12
Q

Where does the sperm mature and develop a flagella?

A

epididymis

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13
Q

The entire process of sperm maturation takes approximately how many days?

A

90 days

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14
Q

They receive both the sperm from the
ductus deferens and fluid from the seminal vesicles

A

Ejaculatory ducts

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15
Q

They produce most of the fluid present in semen (60% to 70%)

A

seminal vesicles

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16
Q

The transport medium for the sperm and contains a high concentration of fructose and flavin

A

seminal vesicle fluid

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17
Q

Provides energy needed for
the flagella to propel them through the female reproductive tract

A

Fructose

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18
Q

Without this, sperm will not display motility in the semen analysis

A

Fructose

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19
Q

Responsible for the gray appearance of semen.

A

Flavin

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20
Q

Surrounds the upper urethra and aids in propelling the sperm through the urethra by contractions during ejaculation

A

muscular prostate gland

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21
Q

The muscular prostate gland is located at?

A

located just below the bladder

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22
Q

How many percent of the semen volume is acidic fluid?

A

Approximately 20% to 30%

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23
Q

Acidic fluid is produced by the?

A

prostate gland

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24
Q

The milky acidic fluid contains
high concentrations of?

A

acid phosphatase, citric acid, zinc
proteolytic enzymes

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25
Q

The functions of acid phosphatase, citric acid, zinc, and proteolytic enzymes are?

A

coagulation and
liquefaction of the semen following ejaculation

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26
Q

Contribute about 5% of the fluid volume in the form of a thick, alkaline mucus that helps to neutralize acidity from the prostate secretions and the vagina

A

bulbourethral glands

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27
Q

In order to neutralize the vaginal acidity present as a result
of normal bacterial vaginal flora the semen must be?

A

alkaline

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28
Q

Without ______, sperm motility would be diminished.

A

neutralization

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29
Q

Most of the sperm are contained in
the?

A

first portion of the ejaculate

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30
Q

When part of the first portion of the ejaculate is missing

A

-sperm count will decreased
-the pH falsely increased
-specimen will not liquefy

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31
Q

When part of the last portion of ejaculate is missing

A

-semen volume is decreased
-sperm count is falsely increased
-pH is falsely decreased
-specimen will not clot

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32
Q

Specimens are collected following a period of sexual abstinence of?

A

at least 2 days and not more than 7 days

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33
Q

Specimens collected following prolonged abstinence tend to have

A

higher volumes and decreased motility

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34
Q

This organ is important for spermatogenesis

A

Seminiferous
tubules of testes

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35
Q

Organ responsible for sperm maturation

A

Epididymis

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36
Q

They propel sperm to ejaculatory ducts

A

Ductus deferens

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37
Q

They provide nutrients for sperm and fluid

A

Seminal vesicles

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38
Q

Provide enzymes and proteins for
coagulation and liquefaction

A

Prostate gland

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39
Q

These glands add alkaline mucus to neutralize
prostatic acid and vaginal acidity

A

Bulbourethral
glands

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40
Q

Containers used for sperm collection should be

A

Prewarmed sterile glass or plastic containers

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41
Q

Specimens awaiting analysis should be kept at ______ and delivered to the laboratory within ______ of collection.

A

37°C & 1 hour, respectively

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42
Q

Ideal method for sperm collection

A

Masturbation

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43
Q

The only type of condom used for sperm collection

A

non-lubricant containing rubber or polyurethane
condoms

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44
Q

Why are ordinary condoms not acceptable for specimen collection?

A

because they contain spermicides

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45
Q

This is not a reliable means of semen collection because the first portion of the ejaculate, which contains the highest number of spermatozoa, may be lost and the low pH of the vaginal fluid may affect sperm motility

A

Coitus interruptus

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46
Q

Why are standard precautions must be observed at all times during semen analysis?

A

Because all semen specimens are potential reservoirs for HIV and hepatitis viruses

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47
Q

What type of materials and techniques must be used when semen culture is performed?

A

Sterile

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48
Q

Parameters reported for semen analysis include

A

-appearance
-volume
-viscosity
-pH
-sperm concentration and count
-motility
-morphology

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49
Q

Characteristics of a normal semen

A

gray-white color, appears translucent, and has a characteristic musty odor

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50
Q

The specimen may appear almost clear if?

A

sperm concentration
is very low,

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51
Q

Increased
white turbidity indicates the presence of?

A

white blood cells
(WBCs) and infection within the reproductive tract

52
Q

May be useful to screen for the presence of WBCs in semen.

A

leukocyte esterase reagent strip test

53
Q

There presence in the semen is considered abnormal

A

Red coloration associated with the presence of red blood cells (RBCs)

54
Q

May be caused by urine contamination, specimen collection following prolonged abstinence, and medications

A

Yellow coloration

55
Q

This is considered toxic to sperm, thereby
affecting evaluation of motility

A

Urine

56
Q

Reference Values for Semen Analysis: Volume

A

2 to 5 mL

57
Q

Reference Values for Semen Analysis: Viscosity

A

Pours in droplets

58
Q

Reference Values for Semen Analysis: pH

A

7.2 to 8.0

59
Q

Reference Values for Semen Analysis: Sperm concentration

A

> 20 million/mL

60
Q

Reference Values for Semen Analysis: Round cells

A

<1.0 million/mL

61
Q

Characteristics of a fresh semen specimen

A

clotted and should liquefy within
30 to 60 minutes after collection

62
Q

This is very essential for evaluating semen liquefaction

A

recording the time of collection

63
Q

Failure of liquefaction to occur within 60 minutes may be caused by?

A

deficiency in prostatic enzymes and should be reported

64
Q

Take note: Analysis of the specimen cannot begin until?

A

liquefaction has
occurred

65
Q

Methods of specimen collection in semen analysis

A
  • Masturbation
  • Condom method
  • Vaginal vault aspiration
  • Coitus interruptus
66
Q

Semen specimen must be kept at?

A

37°c

67
Q

The specimen must be delivered to the lab within?

A

1 hour of collection

68
Q

In fertility testing, how many samples must be tested?

A

2-3 samples at 2-week intervals

69
Q

What are the dilution and the diluting fluid used in the microscopic examination of semen

A

1:20 using sodium bicarbonate in formalin, saline, or distilled water

70
Q

Formula used when counting in the typical WBC squares

A

Sperm/mL = sperm counted (average of sides) × 100,000

71
Q

Formula used when counting in the typical RBC squares

A

Sperm/mL = sperm counted (average of sides) × 1,000,000

72
Q

Formula used to solve for total sperm count

A

Sperm/ejaculate = sperm/mL × specimen volume

73
Q

Normal value for sperm concentration

A

> 20 million/mL

74
Q

Normal value for sperm count

A

> 40 million/ejaculate

75
Q

How many abnormal sample/s is/are considered significant?

A

2 abnormal samples

76
Q

What is the clinical significance of gray-white or transparent appearance of the semen?

A

Normal

77
Q

What is the clinical significance of a red or rust color appearance of the semen?

A

bleeding

78
Q

An important part of patient preparation before semen collection

A

Emptying the bladder

79
Q

Speed and direction of sperm motility are both evaluated using how many HPFs?

A

20 HPFs

80
Q

What is the clinical significant of an abnormal sperm motility?

A

Midpiece & tail abnormalities

81
Q

The normal viscocity of semen

A

Pour in droplets

82
Q

If semen does not liquefy after more than 2 hours, what does this implies? (clinical significance)

A

Deficiency in prostatic enzymes

83
Q

A semen specimen was delivered to the laboratory within 30 minutes of collection. Upon doing gross exam, you noticed that the volume of the specimen is less than 2 ml. What is the possible clinical significance of this?

A

Improper functioning of one of the semen-producing organs

84
Q

The clinical significance of a semen specimen with a pH of <7.2

A

Increased prostatic fluid

85
Q

The clinical significance of a semen specimen with a pH of >8.0

A

Infection within the reproductive tract

86
Q

What is the normal pH value of semen?

A

7.2 to 8.0

87
Q

The semen was clumped, stringy, or gel-like. What is its clinical significance?

A

Deficiency in prostatic enzymes

88
Q

If the semen has a volume of >5 mL what is its clinical significance?

A

Prolonged abstinence

89
Q

If the motility of the sperm is <50% after 2 hours of collection the patient possibly has?

A

Asthenozoospermia or infertility

90
Q

The normal sperm motility

A

> 50% with forward progression
25% with rapid progression

91
Q

Motility grading: rapid, straight-line motility

A

4.0

92
Q

Motility grading: no forward progression

A

1.0

93
Q

Motility grading: slow forward progression, noticeable lateral movement

A

2.0

94
Q

Motility grading: no movement

A

0

95
Q

Motility grading: slower speed, some lateral movement

A

3.0

96
Q

The normal sperm morphology

A

> 14% with normal morphology (strict criteria)
30% with normal morphology (routine criteria)

97
Q

Characteristics of normal sperm (morphology)

A
  • oval-shaped head 5x3 um
  • long, flagellar tail, 45 um
  • unremarkable neck and middle piece
  • acrosomal cap encompassing 1/2 of the head
98
Q

Abnormal sperm tail characteristics

A

short, multiple, hairpin, broken, irregular width, coiled, with terminal droplets

99
Q

Abnormal sperm head characteristics

A

large with small, tapering, pyriform, amorphous vacuolated, double

100
Q

Abnormal cytoplasmic droplets characteristic

A

greater than 1/3 of the head

101
Q

Abnormal neck and midpiece characteristics

A

absent or non-inserted/ bent tail; distended, irregular, bent, thin

102
Q

Sperm morphology evaluation is done on a thin smear stained with?

A

Wright, Giemsa or Papanicolaou

103
Q

Thee best and ideal stain to use for sperm morphology evaluation

A

Papanicolaou

104
Q

______ is evaluated under OIO for abnormalities in the head, midpiece, and tail

A

200 sperm area

105
Q

If there is a decreased motility with normal count what additional test would be done? And what is the clinical significance of an abnormal result?

A

Eosin-rigrosin stain: necrospermia

106
Q

If there is a decreased count what additional test would be done? And what is the clinical significance of an abnormal result?

A

Fructose level determination: lack of support medium

107
Q

What is the clinical significance of a yellow color appearance of the semen?

A

Pyospermia, contamination, prolonged abstinence, medication

108
Q

What is the clinical significance of a turbid appearance of the semen?

A

Infection

109
Q

A condition in which there is a complete absence of spermatozoa in the ejaculate

A

Azoospermia

110
Q

Decreased numbers of sperm in the ejaculate (<15 million sperm/mL)

A

Oligospermia

111
Q

A condition in which there is a low percentage of live and a very high percentage of immotile spermatozoa in semen.

A

Necrospermia

112
Q

An infertility condition in which a person experiences reduced sperm motility

A

Asthenozoospermia

113
Q

In this test, ovum penetration is evaluated

A

Hamster egg penetration

114
Q

In this test, the ability to produce enzyme essential for ovum penetration is evaluated

A

In vitro acrosome reaction

115
Q

In this test, the ability to penetrate the partner’s midcycle cervical mucus is evaluated

A

Cervical mucus penetration

116
Q

In this test, membrane integrity and sperm viability is evaluated

A

Hypo-osmotic swelling test

117
Q

Normal value for neutral alpha-glucosidase

A

> 20 mU/ejaculate

118
Q

Normal value for citric acid

A

> 52 umol/ejaculate

119
Q

Normal value for zinc

A

> 2.4 umol/ejaculate

120
Q

Normal value for acid phosphatase (ACP)

A

> 200 units/ejaculate

121
Q

What is the clinical significance of a decrease in the value of zinc, citric acid, and acid phosphatase?

A

Lack of prostatic fluid

122
Q

What is the clinical significance of a decrease in the value of neutral alpha-glucosidase?

A

Disorder of the epididymis

123
Q

If there is a decreased motility with clumping what additional tests would be done? And what is the clinical significance of an abnormal result?

A

MAR, Immunobead test, Agglutination with male serum: Male antisperm antibodies

124
Q

If there is a normal analysis with continued infertility what additional test would be done? And what is the clinical significance of an abnormal result?

A

Agglutination with female serum: female antisperm antibodies

125
Q

A condition in which there is an unusually high number of white blood cells in the semen

A

Pyospermia