Ch. 8 & 9 - Female & Male Reproductive System Flashcards

Question

human chorionic gonadotropin (hCG)

Answer 1

Hormone produced by the placenta to sustain pregnancy by stimulating (-tropin) the ovaries to produce estrogen and progesterone.

Answer 2

Mucous membrane partially or completely covering the opening to the vagina.

Answer 3

Lips of the vagina; labia majora are the larger, outermost lips, and labia minora are the smaller, innermost lips. lactiferous ducts Tubes that carry milk from the mammary glands to the nipple.

Answer 4

Secreted by the pituitary gland to promote ovulation.

Answer 5

Nipple of the breast. A papilla is any small nipple-shaped projection

Answer 6

Beginning of the first menstrual period and ability to reproduce.

Answer 7

Gradual ending of menstruation.

Answer 8

Monthly shedding of the uterine lining. The ﬂow of blood and tissue normally discharged during menstruation is called the menses (Latin mensis means month).

Answer 9

Muscle layer of the uterus.

Answer 10

Study of the medical care of the newborn (neonate).

Answer 11

Branch of medicine and surgery concerned with pregnancy and childbirth.

Answer 12

An opening.

Answer 13

Developing sac enclosing each ovum within the ovary. Only about 400 of these sacs mature in a woman's lifetime.

Answer 14

One of a pair of female organs (gonads) on each side of the pelvis. Ovaries are almond-shaped, about the size of large walnuts, and produce egg cells (ova) and hormones.

Answer 15

Release of the ovum from the ovary.

Answer 16

Mature egg cell (female gamete). Ova develop from immature egg cells called oocytes.

Answer 17

Act of giving birth.

Answer 18

Outermost layer of the uterus; uterine serosa.

Answer 19

In females, the area between the anus and the vagina.

Answer 20

Endocrine gland at the base of the brain. It produces hormones that stimulate the ovaries. The pituitary gland also regulates other endocrine organs.

Answer 21

Vascular organ attached to the uterine wall during pregnancy. It permits the exchange of oxygen, nutrients, and fetal waste products between mother and fetus.

Answer 22

Gestation.

Answer 23

Hormone produced by the corpus luteum in the ovary and the placenta of pregnant women.

Answer 24

Period of adolescent development at which secondary sex characteristics appear and gametes are produced.

Answer 25

Hollow, pear-shaped muscular female organ in which the embryo and fetus develop, and from which menstruation occurs. The upper portion is the fundus; the middle portion is the corpus; and the lowermost, neck-like portion is the cervix (see Figure 8-3).

Answer 26

Muscular, mucosa-lined canal extending from the uterus to the exterior of the body.

Answer 27

External female genitalia; includes the labia, hymen, clitoris, and vaginal orifice.

Answer 28

Stage in prenatal development from fertilization and implantation up to 2 weeks.

Answer 29

amnion amniotic ﬂuid = Produced by fetal membranes and the fetus.

Answer 30

Bartholin gland bartholinitis A Bartholin cyst is a ﬂuid-ﬁlled sac caused by blockage of a duct from the Bartholin gland. If bacterial infection occurs, an abscess may form.

Answer 31

cervix, neck e.g. endocervicitis

Answer 32

vagina e.g. colposcopy

Answer 33

cul-de-sac e.g. culdocentesis = A needle is placed through the posterior wall of the vagina and fluid is withdrawn for diagnostic purposes.

Answer 34

vulva e.g. episiotomy = An incision through the skin of the perineum enlarges the vaginal orifice for delivery. The incision is repaired by perineorrhaphy.

Answer 35

milk e.g. galactorrhea = Abnormal, persistent discharge of milk, commonly seen with pituitary gland tumors.

Answer 36

woman, female e.g. gynecomastia = Enlargement of breasts in a male. It often occurs with puberty or aging, or the condition can be drug-related.

Answer 37

uterus, womb hysterectomy = Total abdominal hysterectomy (TAH) is removal of the entire uterus (including the cervix) through an abdominal incision (Figure 8-11). Vaginal hysterectomy (VH) is removal through the vagina. Laparoscopic supracervical hysterectomy (see Figure 8-11) is a partial hysterectomy that preserves the cervix. hysteroscopy = A gynecologist uses an endoscope (passed through the vagina and cervix) to view the uterine cavity.

Answer 38

milk lactation = The normal secretion of milk.

Answer 39

breast inframammary [Infra- means below.] mammoplasty [Includes reduction and augmentation(enlargement) operations.]

Answer 40

breast mastitis = Usually caused by streptococcal or staphylococcal infection. mastectomy = Mastectomy procedures are discussed under breast cancer.

Answer 41

menses, menstruation amenorrhea = Absence of menses for 6 months or for more than three of the patient’s normal menstrual cycles. dysmenorrhea oligomenorrhea = Infrequent menstrual periods or scanty menses. menorrhagia = Abnormally heavy or long menstrual periods. Fibroids are a leading cause of menorrhagia.

Answer 42

uterus metrorrhagia = Bleeding between menses. Possible causes of metrorrhagia include ectopic pregnancy, cervical polyps, and ovarian and uterine tumors. menometrorrhagia = Excessive uterine bleeding during and between menstrual periods.

Answer 43

muscle, muscle tumor

Answer 44

birth e.g. neonatal

Answer 45

pregnancy and childbirth obstetrics = From the Latin obstetrix, midwife.

Answer 46

egg oogenesis oocyte = Immature ovum.

Answer 47

ovary e.g. oophorectomy Oophor/o means to bear (phor/o) eggs (o/o). In a bilateral oophorectomy, both ovaries are removed.

Answer 48

egg e.g. ovum = Mature egg cell.

Answer 49

egg e.g. anovulatory

Answer 50

fallopian tubes

Answer 51

vagina e.g. vaginal oriﬁce = An orifice is an opening. vaginitis = Bacteria and yeasts (usually Candida) commonly cause this infection. Use of antibiotic therapy may cause loss of normal vaginal bacteria, resulting in an environment allowing yeast to grow.

Answer 52

vulva vulvodynia = Chronic pain (with no identiﬁable cause) that affects the vulvar area (labia, clitoris, and vaginal opening).

Answer 53

pregnancy pseudocyesis = Pseudo- means false. No pregnancy exists, but physical changes such as weight gain and amenorrhea occur.

Answer 54

pregnant primigravida = A woman during her ﬁrst pregnancy (primi- means ﬁrst). Gravida also is used to designate a pregnant woman, often followed by a number to indicate the number of pregnancies (gravida 1, 2, 3).

Answer 55

bearing, bringing forth primiparous = An adjective describing a woman who has given birth to at least one child. Para also is used as a noun, often followed by a number to indicate the number of deliveries after the 20th week of gestation (para 1, para 2, para 3). When a woman arrives in the birthing facility, her gravidity and parity are important facts to include in the medical and surgical history. For example, G2P2 is medical shorthand for a woman who has had 2 pregnancies and 2 deliveries.

Answer 56

discharge leukorrhea = This vaginal discharge is normal or becomes more yellow (purulent or pus-containing) as a sign of infection. menorrhea

Answer 57

fallopian (uterine) tube

Answer 58

labor, birth dystocia = pain of birth/labor oxytocia = Oxy- means sharp or quick. The pituitary gland releases oxytocin, which stimulates the pregnant uterus to contract (labor begins). It also stimulates milk secretion from mammary glands.

Answer 59

act of turning cephalic version = The fetus turns so that the head is the body part closest to the cervix (version can occur spontaneously or can be performed by the obstetrician). Fetal presentation is the manner in which the fetus appears to the examiner during delivery. A breech presentation is buttocks ﬁrst, or feet ﬁrst in a footling breech; a cephalic presentation is head ﬁrst.

Answer 60

painful dyspareunia = (dis-pah-RU-ne-ah) Pareunia means sexual intercourse.

Answer 61

within endometritis - Usually caused by a bacterial infection.

Answer 62

many multigravida = A woman who has been pregnant more than once.

Answer 63

no, not, none

Answer 64

backward retroversion = The uterus is abnormally tilted backward. This occurs in 30% of women.

Answer 65

Malignant cells within the cervix. Human papillomavirus (HPV) is the cause and risk factor for developing cancer. Other factors that may act together with HPV to increase the risk of developing cervical cancer include cigarette smoking, having multiple sexual partners, and having a weakened immune system (e.g., patients with AIDS). Human papillomavirus is the most widespread sexually transmitted infection in the world. In countries with high rates of HPV infection, cervical cancer may become the most common cancer in adult women. There are over 200 types of HPV. Some cause genital warts (benign growths on the vulva, cervix, vagina, or anus), whereas others can cause cancer, most commonly of the cervix, vagina, vulva, anus, penis, or head and heck. Most HPV infections are cleared by a person’s immune system. A persistent infection may lead to precancerous changes called cervical intraepithelial neoplasia (CIN). See Figure 8-14 showing CIN progression. CIN is also known as cervical dysplasia (abnormal cell growth). Carcinoma in situ (CIS) is considered an early, localized, precancerous form of cervical cancer and local resection (conization) of CIS may be necessary to prevent development of invasive cancer. Figure 8-15 shows a normal cervix and one with cervical cancer. Surgical treatment for cervical cancer requires radical hysterectomy, in which the entire uterus with ligaments, supportive tissues, and the top one third of the vagina are removed. Radiation therapy and chemotherapy with cisplatin are used to treat disease that has spread beyond the cervix, into neighboring pelvic tissues, and to distant organs. Brachytherapy (radioactive seeds implanted into the cervix) may also be an effective treatment.

Answer 66

HPV vaccines are given in a series of three shots over 6 months to protect females and males against HPV infections. Girls can get this vaccine to prevent cervical cancer, vulvar and vaginal cancer, and genital warts. Boys get the vaccine to prevent anal cancer and genital warts. The names of these vaccines are Cervarix, Gardasil, and Gardasil 9.

Answer 67

Inﬂammation of the cervix. Bacteria such as Chlamydia trachomatis and Neisseria gonorrhoeae commonly cause cervicitis. In acute cervicitis, the cervix is reddened and can have an exudate (discharge) or even ulcerations. After the presence of malignancy has been excluded (by Pap test or biopsy), cryocauterization (destroying tissue by freezing) of the diseased area and treatment with antibiotics may be indicated.

Answer 68

Malignant tumor of the uterine lining (adenocarcinoma). The most common sign of endometrial cancer is postmenopausal bleeding. This malignancy occurs more often in women exposed to high levels of estrogen, either from estrogen replacement therapy, estrogen-producing tumors, or obesity (estrogen is produced by fat tissue). Physicians perform endometrial biopsy, hysteroscopy, and dilation (widening the cervical canal) and curettage (scraping the inner lining of the uterus) for diagnosis. When the cancer is conﬁned to the uterus, surgery (hysterectomy and bilateral salpingo-oophorectomy) is curative. Radiation oncologists administer radiation therapy as additional treatment.

Answer 69

Endometrial tissue located outside the uterus. In endometriosis, endometrial tissue may be found in ovaries, fallopian tubes, supporting ligaments, or small intestine, causing inﬂammation and scar tissue. When the endometrium sheds and bleeds in its monthly cycle, it may cause dysmenorrhea or pelvic pain. Infertility (inability to become pregnant) and dyspareunia may also occur. Most cases are the result of growth of bits of menstrual endometrium that have passed backward through the lumen (opening) of the fallopian tube and into the peritoneal cavity. When endometriosis affects the ovaries, large cysts ﬁlled with menstrual blood (“chocolate cysts”) develop. Symptoms may not correlate with the amount of the endometriosis. Women may have extensive disease but no symptoms, while others may have minimal endometriosis but severe symptoms. Treatment ranges from symptomatic relief of pain and hormonal drugs that suppress the menstrual cycle to surgical removal of ectopic endometrial tissue and hysterectomy.

Answer 70

Benign tumors in the uterus. Fibroids, also called leiomyomata or leiomyomas (lei/o = smooth, my/o = muscle, and -oma = tumor), are composed of ﬁbrous tissue and muscle. If ﬁbroids grow and cause symptoms such as metrorrhagia (irregular periods), pelvic pain, or menorrhagia, (heavy periods), either a myomectomy or hysterectomy is indicated. Fibroid ablation (destruction) without surgery may be accomplished by uterine artery embolization (UAE), in which tiny pellets (acting as emboli) are injected into a uterine artery, blocking the blood supply to ﬁbroids, causing them to shrink. Figure 8-16A and B shows the location of uterine ﬁbroids.

Answer 71

Malignant tumor of the ovary (adenocarcinoma). Each year, about 22,000 women in the United States are diagnosed with ovarian cancer. Two types of ovarian cancer are most common: serous (clear ﬂuid) and mucinous (thick, pasty ﬂuid) cystadenocarcinomas. The tumor usually is discovered in an advanced stage as an abdominal mass and may produce few symptoms in its early stages. When the disease metastasizes beyond the ovary before diagnosis, ascites (accumulation of ﬂuid in the abdominal cavity) is often present. Treatment consists of surgery to remove as much of the tumor as possible (tumor debulking). This may include hysterectomy, bilateral salpingooophorectomy, and removal of the omentum (fatty tissue that covers abdominal organs and often contains deposits of tumor). Surgery is followed by systemic drug therapy, which is dependent on the type of ovarian cancer. A protein marker produced by tumor cells, CA 125, can be measured in the bloodstream to assess effectiveness of treatment. Inherited mutations (changes) in genes greatly increase the risk of developing ovarian and breast cancer. These mutations are BRCA1 and BRCA2 (short for breast cancer 1 and breast cancer 2). Women with a strong family history of ovarian cancer (with multiple members of the family affected) may seek genetic counseling to determine if they should be tested for these inherited defects. Prophylactic (preventive) oophorectomy signiﬁcantly reduces the odds of developing ovarian cancer if a woman is at high risk.

Answer 72

Fluid-ﬁlled sacs within the ovary. Some cysts are benign and lined with typical ovarian cells. These cysts originate in unruptured ovarian follicles (follicular cysts) or in follicles that have ruptured and have immediately been sealed (luteal cysts). Other cysts are malignant and lined with tumor cells (cystadenocarcinomas). Physicians decide to remove these cysts to distinguish between benign and malignant tumors. Other benign ovarian cysts are dermoid cysts. They contain a variety of cell types, including skin, hair, teeth, and cartilage, and arise from immature egg cells in the ovary. Because of the strange assortment of tissue types in the tumor (Figure 8-17), this tumor often is called a benign cystic teratoma (terat/o = monster) or a mature teratoma. Surgical removal of the cyst cures the condition.

Answer 73

Inﬂammation and infection of organs in the pelvis and abdomen; salpingitis, oophoritis, endometritis, endocervicitis. PID is caused by sexually transmitted infections. Repetitive episodes of these infections lead to formation of adhesions and scarring within the fallopian tubes. After PID, women have an increased risk of ectopic pregnancy and infertility. Signs and symptoms include fever, vaginal discharge, abdominal pain in the left and right lower quadrants (LLQ and RLQ), and tenderness to palpation (examining by touch) of the cervix. Antibiotics treat PID.

Answer 74

gonorrhea (gonococcal bacteria) chlamydia (chlamydial bacteria) syphilis (spirochete bacteria) genital herpes (herpes simplex virus—HSV) HPV infection and genital warts (human papillomavirus)

Answer 75

Malignant tumor of the breast (arising from milk glands and ducts). The most common type of breast cancer is invasive ductal carcinoma (IDC). Invasive means that the tumor has spread to surrounding breast tissue. Figure 8-18A shows the tumor on a mammogram. Figure 8-18B shows a cut section of an invasive ductal carcinoma. Other histopathologic (histo- means tissue) types are lobular and medullary carcinoma of the breast. Ductal carcinoma in situ (DCIS) is non-invasive breast cancer. It starts in milk ducts and does not spread beyond its original location (in situ). DCIS can increase the risk of developing invasive breast cancer and is treated by lumpectomy. Breast cancer spreads ﬁrst to lymph nodes in the axilla (armpit) nearest the affected breast and then to the skin and chest wall. From the lymph nodes it also may metastasize to other body organs, including bone, liver, lung, and brain. The diagnosis is ﬁrst established by biopsy, either core needle aspiration or surgical removal of the specimen (solid mass or area of microcalciﬁcation). A stereotactic core needle biopsy is performed with the help of mammography for guidance. For small primary tumors, the lump with immediately surrounding tissue can be removed (lumpectomy). To determine whether the tumor has spread to lymph nodes, a sentinel node biopsy (SNB) is performed. For this procedure, a blue dye or a radioisotope is injected into the tumor site and tracks to the axillary (underarm) lymph nodes. See Figure 8-19. After lumpectomy, radiation therapy to the breast and to any involved lymph nodes then follows, to kill remaining tumor cells. An alternative surgical procedure is mastectomy (Figure 8-20A), which is removal of the entire breast. After either lumpectomy or mastectomy if lymph nodes are involved, or if the primary tumor was large, adjuvant (aiding) chemotherapy is given to prevent recurrence of the tumor. Breast reconstruction is an option after mastectomy. See Figure 8-20B. In patients with large primary tumors, neoadjuvant chemotherapy (added prior to surgery) may be administered to reduce tumor bulk and allow for complete surgical removal of the tumor. After surgery, further treatment may be indicated to prevent recurrence. To determine which treatment is best, it is important to test the breast cancer tumor for the presence of estrogen receptors (ERs). Two thirds of breast cancers are ER-positive (ER +). These receptor proteins indicate that the tumor will respond to therapy that blocks estrogen stimulation. If metastases should subsequently develop, this information will be valuable in selecting further treatment. There are two types of drugs that block the effects of estrogen and thereby kill ER-positive breast cancer cells. Drugs of the ﬁrst type directly block the ER reception. An example is tamoxifen. Drugs of the second type block the production of estrogen by inhibiting the enzyme aromatase. These aromatase inhibitors are particularly useful in treating postmenopausal women. Examples are anastrozole (Arimidex) and letrozole (Femara). A second receptor protein, HER2, is found in some breast cancers and signals a high risk of tumor recurrence. Herceptin, an antibody that binds to and blocks HER2, is effective in stopping growth when used with chemotherapy. A new drug, pertuzumab, also targets HER2 and, combined with Herceptin, is effective in treating HER2–positive advanced breast cancer. Triple-negative tumors lack estrogen, progesterone, and HER2 and are rapidly growing but respond well to chemotherapy. Testing for hereditary mutations BRCA1, BRCA2, and PALB2 (partner and localizer of BRCA1 and BRCA2) is advised for women with a strong family history of breast cancer. Some women who test positively for the breast cancer genes elect to have prophylactic (preventive) bilateral mastectomy with reconstruction to eliminate the risk of developing a new breast cancer. See the In Person: Prophylactic Mastectomy story.

Answer 76

Numerous small sacs of ﬂuid surrounded by dense strands of ﬁbrous tissue in the breast. Women with this common benign condition notice a nodular (lumpy) consistency of the breast, often associated with premenstrual tenderness and fullness. Mammography and surgical biopsy are often indicated to differentiate ﬁbrocystic changes from breast cancer.

Answer 77

Premature separation of the normally implanted placenta. Abruptio placentae (Latin ab, away from; ruptus, ruptured) occurs because of trauma, such as a fall, or may be secondary to vascular insufﬁciency resulting from hypertension or preeclampsia. Signs and symptoms of acute abruption include sudden searing (burning) abdominal pain and bleeding. It is an obstetric emergency.

Answer 78

Malignant tumor of the placenta. This extremely rare cancerous tumor comes from cells that were part of the placenta in a normal pregnancy. Treatment of metastatic choriocarcinoma may include chemotherapy and radiation therapy to distant sites of cancer.

Answer 79

Implantation of the fertilized egg outside the uterus. The condition occurs in 1-2% of all pregnancies, and most of these occur in the fallopian tubes (tubal pregnancy). Rupture of the ectopic implant within the fallopian tube can lead to massive abdominal bleeding and death. Surgeons can remove the implant, or treatment with medication (methotrexate) can destroy it, thereby preserving the fallopian tube before rupture occurs. Other sites of ectopic pregnancy include the ovaries and abdominal cavity; whatever the location, ectopic pregnancy often constitutes a surgical emergency.

Answer 80

Presence of more than one embryo developing in the uterus during pregnancy. Multiple births are increasing in the United States. This is because of assisted reproductive technology (ART) such as ovulation induction followed by intrauterine insemination (IUI) or in vitro fertilization (IVF). These pregnancies are at higher risk for preterm delivery, fetal growth restriction, high blood pressure, and diabetes.

Answer 81

Implantation of the placenta over the cervical opening or in the lower region of the uterus (Figure 8-21). Maternal signs and symptoms include painless bleeding, hemorrhage, and premature labor. Cesarean delivery usually is recommended.

Answer 82

Abnormal condition associated with pregnancy, marked by high blood pressure, proteinuria, edema, and headache. Mild preeclampsia can be managed by bed rest and close monitoring of blood pressure. Women with severe preeclampsia need treatment with medications such as magnesium sulfate to prevent seizures, and the baby is delivered as quickly as possible. The Greek word eklampein means to shine forth, referring to the convulsions and hypertension—typically with visual symptoms of ﬂashing lights— that accompany the condition. Eclampsia is the ﬁnal and most severe phase of untreated preeclampsia. It often causes seizures and even death of the mother and baby.

Answer 83

Chromosomal abnormality (trisomy 21) results in mental retardation, retarded growth, and a ﬂat face with a short nose, low-set ears, and slanted eyes. hemolytic disease in the newborn (HDN) Destruction of red blood cells in the newborn caused by a blood group (Rh factor) incompatibility between the mother and the fetus. See explanation in Chapter 4.

Answer 84

Acute lung disease commonly seen in the premature newborn. This condition is caused by deﬁciency of surfactant, a protein necessary for proper lung function. Surfactant can be administered to the newborn to cure the condition. This condition was previously called hyaline membrane disease.

Answer 85

Accumulation of ﬂuid in the spaces of the brain. In an infant with this condition, the entire head can enlarge because the bones of the skull do not completely fuse together at birth. Infants normally have a soft spot or fontanelle between the cranial bones that allows for some swelling during the birth of the baby. Hydrocephalus occurs because of a problem in the circulation of ﬂuid within the brain and spinal cord, resulting in ﬂuid accumulation.

Answer 86

Abnormal inhalation of meconium produced by a fetus or newborn. Meconium, a thick, sticky, greenish to black substance, is the ﬁrst intestinal discharge (stools) from newborns. Intrauterine distress can cause its passage into amniotic ﬂuid. Once the meconium has passed into the surrounding amniotic ﬂuid, the fetus may breath meconium into its lungs. It can cause breathing problems due to inﬂammation in the baby’s lungs after birth.

Answer 87

Narrowing of the opening of the stomach to the duodenum. This condition may be present at birth and frequently is associated with Down syndrome. Surgical repair of the pyloric opening may be necessary.

Answer 88

Microscopic examination of stained cells removed from the vagina and cervix. After inserting a vaginal speculum (instrument to hold apart the vaginal walls), the physician uses a small spatula to remove exfoliated (peeling and sloughing off) cells from the cervix and vagina (Figure 8-23). Microscopic analysis of the cell smear detects cervical or vaginal cellular abnormalities.

Answer 89

Blood or urine test to detect the presence of hCG.

Answer 90

X-ray imaging of the uterus and fallopian tubes after injection of contrast material. This radiologic procedure is used to evaluate tubal patency (adequate opening) and uterine cavity abnormalities.

Answer 91

X-ray imaging of the breast. Women are advised to have a baseline mammogram at 40-44 years of age for later comparison if needed. The most recent method of mammography is digital tomosynthesis. See Figure 8-24. In this procedure, an x-ray tube moves in an arc around the breast as several images are taken. These images are sent to a computer and clear, highly focused three-dimensional pictures are produced. This procedure makes breast cancer easier to ﬁnd in dense breast tissue; also called 3D mammography.

Answer 92

Technologies using sound waves and a magnetic ﬁeld to create images of breast tissue. These imaging techniques conﬁrm the presence of a mass and can distinguish a cystic from a solid mass. MRI is very useful in detecting masses in young women with dense breasts or in women with a strong family history of breast cancer and at high risk for this condition. Breast ultrasound imaging is useful to evaluate a speciﬁc area of cancer on a mammogram.

Answer 93

Recording images of sound waves as they bounce off organs in the pelvic region. This technique can evaluate fetal size and anatomy, as well as fetal and placental position. Uterine tumors and other pelvic masses, including abscesses, also are diagnosed by ultrasonography. Transvaginal ultrasound allows the radiologist a closer, sharper look at organs within the pelvis. The sound probe is placed in the vagina instead of over the pelvis or abdomen; this method is best used to evaluate ﬂuid-ﬁlled cysts.

Answer 94

Destruction of tissue by burning. Destruction of abnormal tissue with chemicals (silver nitrate) or an electrically heated instrument. Cauterization is used to treat cervical dysplasia or cervical erosion. The loop electrocautery excision procedure (LEEP) (see Figure 8-26A) is used to further assess and often treat abnormal cervical tissue.

Answer 95

Visual examination of the vagina and cervix using a colposcope. A colposcope is a lighted magnifying instrument resembling a small, mounted pair of binoculars. Gynecologists prefer colposcopy for pelvic examination when cervical dysplasia is present because it identiﬁes the speciﬁc areas of abnormal cells. A biopsy specimen can then be taken for more accurate diagnosis (Figure 8-25).

Answer 96

Removal of a cone-shaped section (cone biopsy) of the cervix. The physician resects the tissue using a LEEP (loop electrocautery excision procedure), or with a carbon dioxide laser or surgical knife (scalpel). Figure 8-26A shows conization with LEEP, and Figure 8-26B shows the cone biopsy specimen removed surgically.

Answer 97

Use of cold temperatures to destroy tissue. A liquid nitrogen probe produces the freezing (cry/o means cold) temperature. Also called cryocauterization.

Answer 98

Needle aspiration of ﬂuid from the cul-de-sac. The physician inserts a needle through the vagina into the cul-de-sac. The presence of blood may indicate a ruptured ectopic pregnancy or ruptured ovarian cyst.

Answer 99

Widening the cervix and scraping off the endometrial lining of the uterus. Dilation is accomplished by inserting a series of dilators of increasing diameter. A curet (metal loop at the end of a long, thin handle) is then used to sample the uterine lining. This procedure helps diagnose uterine disease and can temporarily halt prolonged or heavy uterine bleeding. When necessary, a D&C is used to remove the tissue during a spontaneous or therapeutic abortion (Figure 8-27).

Answer 100

Removal of internal organs within a cavity. Pelvic exenteration is removal of the organs and adjacent structures of the pelvis.

Answer 101

Withdrawal of ﬂuid or tissue from a cyst or solid mass by suction with a needle. FNA is a valuable diagnostic technique in evaluating lumps of the breast.

Answer 102

Visual examination of the abdominal cavity using an endoscope (laparoscope). In this procedure, a form of minimally invasive surgery (MIS), small incisions (5 to 10 mm long) are made near the woman’s navel for introduction of the laparoscope and other instruments. Uses of laparoscopy include inspection and removal of ovaries and fallopian tubes, diagnosis and treatment of endometriosis, and removal of ﬁbroids. Laparoscopy also is used to perform subtotal (cervix is left in place) and total hysterectomies (Figure 8-28). Morcellation (cutting up uterine tissue in the abdomen) is commonly performed when the uterus or ﬁbroids are removed laparoscopically. It is contraindicated in situations of suspcious or pre-malignancy.

Answer 103

Blocking the fallopian tubes to prevent fertilization from occurring. This sterilization procedure (making an individual incapable of reproduction) is performed using laparoscopy or through a hysteroscope inserted via the cervical os (opening). Ligation means tying off and does not pertain solely to the fallopian tubes—which may be “tied” using clips or bands, or by surgically cutting or burning through the tissue.

Answer 104

Termination of pregnancy before the embryo or fetus can exist on its own. Abortions are spontaneous or induced. Spontaneous abortions, commonly called “miscarriages,” occur without apparent cause. Induced abortions can be therapeutic or elective. A therapeutic abortion is performed when the health of the pregnant woman is endangered. An elective abortion is performed at the request of the woman. Major methods for abortion include vaginal evacuation by D&C or vacuum aspiration (suction) and stimulation of uterine contractions by injection of saline (salt solution) into the amniotic cavity (in second-trimester pregnancies).

Answer 105

Needle puncture of the amniotic sac to withdraw amniotic ﬂuid for analysis (Figure 8-29). The cells of the fetus, found in the ﬂuid, are cultured (grown), and cytologic and biochemical studies are performed to check fetal chromosomes, concentrations of proteins and bilirubin, and fetal maturation.

Answer 106

Surgical incision of the abdominal wall and uterus to deliver a fetus. Indications for cesarean section include cephalopelvic disproportion (the baby’s head is too big for the mother’s birth canal), abruptio placentae or placenta previa, fetal distress (fetal hypoxia), and breech or shoulder presentation. The name comes from a law during the time of Julius Caesar requiring removal of the fetus before a deceased pregnant woman could be buried.

Answer 107

Sampling of placental tissues (chorionic villi) for prenatal diagnosis. The sample of tissue is removed with a catheter inserted into the uterus. The procedure can be performed earlier than amniocentesis, at 10 or more weeks of gestation.

Answer 108

Continuous recording of the fetal heart rate and maternal uterine contractions to assess fetal status and the progress of labor.

Answer 109

Egg and sperm cells are combined outside the body in a laboratory dish (in vitro) to facilitate fertilization. After an incubation period of 3 to 5 days, the fertilized ova are injected into the uterus through the cervix. (Latin in vitro means in glass, as used for laboratory containers.) From 30% to 50% of all IVF procedures are now associated with intracytoplasmic sperm injection (ICSI). This is the direct injection of sperm into harvested ova.

Answer 110

abortion hemolytic disease of the newborn alpha-fetoprotein—high levels in amniotic ﬂuid of fetus or maternal serum indicate increased risk of neurologic birth defects in the infant. human papillomavirus Assisted Reproductive Techniques including IVF and sperm donation hormone replacement therapy

Answer 111

breast cancer 1 and 2 —genetic mutations associated with increased risk for breast cancer hysterosalpingography breast self-examination intrauterine device; contraceptive protein marker elevated in ovarian cancer invasive ductal carcinoma cesarean section

Answer 112

infant respiratory distress syndrome cervical intraepithelial neoplasia in vitro fertilization carcinoma in situ loop electrocautery excision procedure chorionic villus sampling luteinizing hormone

Answer 113

cervix last menstrual period dilation (dilatation) and curettage multipara; multiparous ductal carcinoma in situ; a precancerous breast lesion that indicates a higher risk for invasive ductal breast cancer obstetrics dysfunctional uterine bleeding a woman’s reproductive history: 2 full-term infants, 0 preterm, 1 abortion, and 2 living children

Answer 114

fetal heart rate test for cervical or vaginal cancer ﬁne needle aspiration pelvic inﬂammatory disease follicle-stimulating hormone premenstrual syndrome gravida (pregnant) primipara; primiparous gonadotropin-releasing hormone— secreted by the hypothalamus to stimulate release of FSH and LH from the pituitary gland

Answer 115

sentinel lymph node biopsy—blue dye or a radioisotope (or both) identiﬁes the ﬁrst lymph node draining the breast lymphatics gynecology total abdominal hysterectomy with bilateral salpingo-oophorectomy human chorionic gonadotropin uterine artery embolization vaginal hysterectomy

Answer 116

Pair of exocrine glands near the male urethra. They secrete fluid into the urethra. Also called Cowper glands.

Answer 117

Removal of the prepuce (foreskin). It is a common elective procedure performed shortly after birth.

Answer 118

Ejection of sperm and fluid from the male urethra. ejaculatory duct Tube through which semen enters the male urethra.

Answer 119

One of a pair of long, tightly coiled tubes above each testis. It stores and carries sperm from seminiferous tubules to the vas deferens.

Answer 120

Inability of an adult male to achieve an erection; impotence.

Answer 121

Hair-like projection on a sperm cell that makes it motile (able to move).

Answer 122

Fold of skin covering the head of the penis; prepuce.

Answer 123

Two infants resulting from fertilization of two separate ova by two separate sperm cells (Figure 9-5).

Answer 124

Sensitive tip of the penis; comparable to the clitoris in the female.

Answer 125

Two infants resulting from division of one fertilized egg. Conjoined (“Siamese”) twins are incompletely separated identical twins.

Answer 126

In a man, any problem that lowers the chances of his female partner getting pregnant.

Answer 127

Specialized cells that lie adjacent to the seminiferous tubules in the testes. These cells produce testosterone and are also called Leydig cells.

Answer 128

Essential distinctive cells of an organ. In the testis, the seminiferous tubules that produce sperm are parenchymal.

Answer 129

Male external organ of reproduction.

Answer 130

External region between the anus and scrotum in the male.

Answer 131

Foreskin; fold of skin covering the tip of the penis.

Answer 132

Exocrine gland at the base of the male urinary bladder. The prostate secretes fluid that contributes to semen during ejaculation. * HINT: Don’t confuse prostate with prostrate, which means lying down.

Answer 133

External sac that contains the testes.

Answer 134

Spermatozoa (sperm cells) and seminal fluid (prostatic and seminal vesicle secretions), discharged from the urethra during ejaculation.

Answer 135

Paired sac-like exocrine glands that secrete fluid (a major component of semen) into the vas deferens. seminiferous tubules Narrow, coiled tubules that produce sperm in the testes.

Answer 136

Sperm cell.

Answer 137

Procedure that removes a person’s ability to produce or release reproductive cells; removal of testicles, vasectomy, and oophorectomy are sterilization procedures.

Answer 138

Supportive, connective tissue of an organ, as distinguished from its parenchyma. Also called stroma.

Answer 139

Male gonad (testicle) that produces spermatozoa and testosterone. Remember : Testis means one testicle, and testes are two testicles.

Answer 140

Hormone secreted by the interstitial tissue of the testes; responsible for male sex characteristics.

Answer 141

Narrow tube (one on each side) carrying sperm from the epididymis toward the urethra. Also called ductus deferens.

Answer 142

Don’t confuse perineum, which is the area between the anus and scrotum in the male and the anus and vagina in females, with the peritoneum, which is the membrane surrounding the abdominal cavity!

Answer 143

Don’t confuse semen with sperm. Semen is the thick, whitish secretion discharged from the urethra during ejaculation. Sperm (spermatozoa) are cells that develop in the testes. Semen contains sperm.

Answer 144

Don’t confuse sterilization, which can be performed in men and women, with impotence, which is the inability of a male to sustain an erection or achieve ejaculation.

Answer 145

male androgen = Testosterone is an androgen. The testes in males and the adrenal glands in both men and women produce androgens.

Answer 146

glans penis (Greek balanos, means acorn) balanitis = An inflammation usually caused by overgrowth of organisms (bacteria and yeast) (Figure 9-6A).

Answer 147

cold cryogenic surgery = Technique for prostate cancer treatment using freezing temperatures to destroy cancer cells.

Answer 148

hidden cryptorchidism = In this congenital condition, one or both testicles do not descend, by the time of birth, into the scrotal sac from the abdominal cavity (Figure 9-6B).

Answer 149

epididymis epididymitis = This is an inflammation usually caused by bacteria. Signs and symptoms are fever, chills, pain in the groin, and tender, swollen epididymis.

Answer 150

seed (Greek gone, seed)

Answer 151

water, fluid

Answer 152

testis, testicle orchiectomy = Castration in males. (Also called orchidectomy.) orchitis = Caused by injury or by the mumps virus, which also infects the salivary glands.

Answer 153

penis penile -ile means pertaining to. penoscrotal

Answer 154

prostate gland prostatitis = Bacterial (E. coli) prostatitis often is associated with urethritis and infection of the lower urinary tract. prostatectomy = Robotic assisted laparoscopic prostatectomy (RALP) is a treatment option for prostate removal.

Answer 155

semen, seed seminiferous tubules The suffix -ferous means pertaining to bearing, or bearing or carrying.

Answer 156

spermatozoa, semen spermolytic Noun suffixes ending in -sis, such as -lysis, form adjectives by dropping the -sis and adding -tic. oligospermia aspermia Lack of semen (sperm and fluid). One cause of aspermia is retrograde ejaculation (sperm flows backward into the urinary bladder) as a result of prostate surgery.

Answer 157

monster (Greek teras, monster) teratoma This tumor occurs in the testes or ovaries and is composed of different types of tissue, such as bone, hair, cartilage, and skin cells. Teratomas in the testes are malignant.

Answer 158

testis, testicle testicular The term testis originates from a Latin term meaning witness. In ancient times men would take an oath with one hand on their testes, swearing by their manhood to tell the truth.

Answer 159

varicose veins variocele = Collection of varicose (swollen, twisted) veins above the testis.

Answer 160

vessel, duct; vas deferens vasectomy Remember: In this term, vas/o refers to the vas deferens, and not to any other vessel or duct.

Answer 161

animal life azoospermia = Lack of spermatozoa in the semen. Causes include testicular dysfunction, chemotherapy, blockage of the epididymis, and vasectomy.* HINT: Azoospermia is semen without sperm, while aspermia is no semen at all.

Answer 162

hormone testosterone Ster/o indicates that this is a type of steroid compound. Examples of other steroids are estrogen, cortisol, and progesterone.

Answer 163

fixation, put in place orchiopexy = A surgical procedure to correct cryptorchidism.

Answer 164

new opening vasovasostomy Reversal of vasectomy; a urologist rejoins the cut ends of the vas deferens.

Answer 165

Malignant tumor of the testicles. Testicular tumors are rare except in the 15- to 35-year-old age group. The most common tumor, a seminoma, arises from embryonic cells in the testes (Figure 9-7A). Other tumors are embryonal carcinoma (Figure 9-7B), teratoma, choriocarcinoma, and yolk sac tumor. Teratomas contain a mixture of mature tissue such as bone, hair, cartilage, and skin cells (terat/o means monster). Testicular cancers are curable with surgery (orchiectomy), followed by chemotherapy. Seminomas are treated with radiotherapy and/or chemotherapy. Tumors produce the proteins human chorionic gonadotropin (hCG) and alphafetoprotein (AFP). Serum levels of these proteins are used as tumor markers to determine success of treatment.

Answer 166

Male factor infertility is the cause of up to 40% of infertility issues. The most common causes of male infertility are azoospermia and oligoasthenozoospermia (low numbers and poor motility of sperm). The combining form asthen/o means lack of strength.

Answer 167

Undescended testicles. Orchiopexy is performed to bring the testes into the scrotum, if they do not descend on their own by the age of 1 or 2 years. Undescended testicles are associated with a high risk for sterility and increased risk of developing testicular cancer.

Answer 168

Sac of clear fluid in the scrotum. Hydroceles (Figure 9-8) may be congenital or occur as a response to infection or tumors. Often idiopathic, they can be differentiated from testicular masses by ultrasound imaging. If the hydrocele does not resolve on its own, the sac fluid is aspirated using a needle and syringe, or hydrocelectomy may be necessary. In this procedure, the sac is surgically removed through an incision in the scrotum.

Answer 169

Twisting of the spermatic cord (see Figure 9-8). The rotation of the spermatic cord cuts off blood supply to the testis. Torsion occurs most frequently in childhood. Surgical correction within hours of onset of symptoms can save the testis.

Answer 170

Enlarged, dilated veins near the testicle. Varicocele (see Figure 9-8) may be associated with oligospermia and azoospermia. Oligospermic men with varicocele and scrotal pain should have a varicocelectomy. In this procedure, the internal spermatic vein is ligated (the affected segment is cut out and the ends are tied off). This procedure may increase fertility.

Answer 171

Benign growth of cells within the prostate gland. BPH is a common condition in men older than 60 years of age. Urinary obstruction and inability to empty the bladder completely are symptoms. Figure 9-9 shows the prostate gland with BPH and with carcinoma. Surgical treatment by transurethral resection of the prostate (TURP) relieves the obstruction, but overgrowth of cells may recur over several years. In this procedure, an endoscope (resectoscope) is inserted into the penis and through the urethra. Prostatic tissue is removed by an electrical hot loop attached to the resectoscope. Several drugs to relieve BPH symptoms have been approved by the FDA. Finasteride (Proscar) inhibits production of a potent testosterone that promotes enlargement of the prostate. Other drugs, alpha blockers such as tamsulosin (Flomax), act by relaxing the smooth muscle of the prostate and the neck of the bladder. Lasers also may be used to destroy prostatic tissue and relieve obstruction. A laser TURP or GreenLight PVP procedure uses a green light laser at the end of an endoscope.

Answer 172

Malignant tumor (adenocarcinoma) of the prostate gland. This cancer commonly occurs in men older than 50 years. Digital rectal examination (DRE) (Figure 9-10) can detect the tumor at a later stage, but early detection depends on finding a high level of a prostate-specific antigen (PSA) in the blood. PSA is secreted into the bloodstream by tumor cells. The normal PSA level is 4.0 ng/mL or less. Diagnosis requires finding tumor in a needle biopsy of the prostate. Transrectal ultrasound (TRUS) guides the needle biopsy taken through the rectal wall. Multiple needle biopsy specimens are taken through the rectal wall. Computed tomography (CT) detects lymph node metastases. Treatment consists of surgery (prostatectomy) or radiation therapy for localized tumor. Hormonal therapy is used for locally advanced or metastatic disease. Because prostatic cells are stimulated to grow in the presence of androgens, antiandrogen drugs slow tumor growth. One such drug is Lupron, which reduces the level of androgens in the bloodstream. Tumor cells also can be destroyed by brachytherapy (brachy = near), which means that radioactive seeds are implanted directly into the prostate gland. See the In Person: Prostate Cancer story.

Answer 173

Congenital abnormality in which the male urethral opening is on the undersurface of the penis, instead of at its tip. Hypospadias (-spadias means the condition of tearing or cutting) occurs in 1 in every 300 live male births and can be corrected surgically (Figure 9-11A).

Answer 174

Abnormal curvature of the penis This condition is quite common and is caused by scar tissue in the connective tissue of the penis. Drug treatment can be effective by breaking down the buildup of fibrous tissue that causes penile curvature.

Answer 175

Narrowing (stricture) of the opening of the prepuce over the glans penis. This abnormal condition (phim/o = muzzle) in adolescent and adult males can interfere with urination and cause secretions to accumulate under the prepuce, leading to infection. Treatment is by circumcision (cutting around the prepuce to remove it) (Figure 9-11B).

Answer 176

infections transmitted by sexual or other genital contact. Also known as sexually transmitted diseases (STDs) or venereal diseases (from Latin Venus, the goddess of love), they occur in both men and women and are some of the most prevalent communicable diseases in the world.

Answer 177

Bacterial infection (by Chlamydia trachomatis) of the urethra and reproductive tract. Within 3 weeks after becoming infected, men may experience a burning sensation on urination and notice a white or clear discharge from the penis. Infected women may notice a yellowish vaginal discharge (from the endocervix), but often the disease is asymptomatic. Antibiotics cure the infection, but if untreated, this STI can cause salpingitis (pelvic inflammatory disease [PID]) and infertility in women.

Answer 178

Inflammation of the genital tract mucosa, caused by infection with gonococci (berry-shaped bacteria). Other areas of the body, such as the eye, oral mucosa, rectum, and joints, may be affected as well. Signs and symptoms include dysuria and a yellow, mucopurulent (purulent means pus-filled) discharge from the male urethra (Figure 9-12A). The ancient Greeks mistakenly thought that this discharge was a leakage of semen, so they named the condition gonorrhea, meaning discharge of seed (gon/o = seed). Many women carry the disease asymptomatically, whereas others have pain, vaginal and urethral discharge, and salpingitis (PID). As a result of sexual activity, men and women can acquire anorectal and pharyngeal gonococcal infections as well. Chlamydia and gonorrhea often occur together. When treating these infections, doctors give antibiotics for both and treat both partners.

Answer 179

Infection of skin and genital mucosa, caused by the herpes simplex virus (HSV). Most cases of herpes genitalis are caused by HSV type 2 (although some are caused by HSV type 1, which commonly is associated with oral infections such as cold sores or fever blisters). The usual clinical presentation is reddening of skin with formation of small, fluid-filled blisters and ulcers (Figure 9-12B). Initial episodes also may involve inguinal lymphadenopathy, fever, headache, and malaise. Remissions and relapse periods occur; no drug is known to be effective as a cure. Neonatal herpes affects infants born to women with active infection near the time of delivery. Gynecologists may deliver infants by cesarean section to prevent infection of these babies by HSV. Studies suggest that women with herpes genitalis are at a higher risk for developing vulvar and cervical cancer.

Answer 180

Infection of the skin and mucous membranes in the anogenital region by the human papillomavirus. Some types of HPV cause genital warts (see Figure 9-13A) and lead to cancer of the cervix as well as cancer in men. A vaccine is available for young girls and boys that protects against nine types of HPV.

Answer 181

Chronic STI caused by a spirochete (spiral-shaped bacterium). A chancre (hard ulcer or sore) usually appears on the external genitalia a few weeks after bacterial infection (Figure 9-13B). Two to six months after the chancre disappears, secondary syphilis begins. Tertiary syphilis includes damage to the brain, spinal cord, and heart, which may appear years after the earlier symptoms disappear. Syphilis (which was so often fatal in early times that it was known as the “great pox”—versus the more familiar smallpox) can be congenital in the fetus if it is transmitted from the mother during pregnancy. Penicillin is effective for treatment in most cases.

Answer 182

Measurement of levels of prostate-specific antigen (PSA) in the blood. PSA is produced by cells within the prostate gland. Elevated levels of PSA are associated with enlargement of the prostate gland and may be a sign of prostate cancer.

Answer 183

Microscopic examination of ejaculated fluid. Sperm cells are counted and examined for motility and shape. The test is part of fertility studies and is required to establish the effectiveness of vasectomy. Men with sperm counts of less than 20 million/mL of semen usually are sterile (not fertile). Sterility can result in an adult male who becomes ill with mumps, an infectious disease affecting the testes (inflammation leads to deterioration of spermatozoa).

Answer 184

Surgical excision of testicles or ovaries. Castration may be performed to reduce production and secretion of hormones that stimulate growth of malignant cells (in breast cancer and prostate cancer). When a boy is castrated before puberty, he becomes a eunuch (Greek, eune, couch; echein, to guard). Male secondary sex characteristics fail to develop.

Answer 185

Surgical procedure to remove the prepuce (foreskin) of the penis.

Answer 186

Finger palpation through the anal canal and rectum to examine the prostate gland.

Answer 187

Removal of tissue to treat benign prostatic hyperplasia (BPH) using a green light laser (“laser TURP”). This minimally invasive procedure in selected cases replaces TURP for treatment of BPH.

Answer 188

Removal of portions of prostate gland through the urethra. This procedure treats benign prostatic hyperplasia (BPH). An electrical hot loop cuts the prostatic tissue; the bits of tissue (chips) are removed through the resectoscope (Figure 9-14).

Answer 189

Bilateral surgical removal of a part of the vas deferens. A urologist cuts the vas deferens, removes a piece, and performs a ligation (tying and binding off) of the free ends with sutures (Figure 9-15); this is repeated on the opposite side. The procedure is performed using local anesthesia and through an incision in the scrotal sac. Because spermatozoa cannot leave the body, the vasectomized man is sterile, but not castrated. Normal hormone secretion, sex drive, and potency (ability to have an erection) are intact. The body reabsorbs unexpelled sperm. In some cases, a vasovasostomy can successfully reverse vasectomy.

Answer 190

benign prostatic hyperplasia rapid plasma reagin [test]; a test for syphilis digital rectal examination sexually transmitted disease erectile dysfunction

Answer 191

sexually transmitted infection genitourinary transrectal ultrasound [examination]; test to assess the prostate and guide precise placement of a biopsy needle human papillomavirus transurethral incision of the prostate; successful in less enlarged prostates and less invasive than TURP

Answer 192

herpes simplex virus transurethral microwave thermotherapy nonspecific urethritis (not due to gonorrhea or chlamydia) transurethral needle ablation; radiofrequency energy destroys prostate tissue pelvic inflammatory disease

Answer 193

transurethral resection of the prostate prostatic intraepithelial neoplasia; a precursor of prostate cancer prostate-specific antigen photoselective vaporization of the prostate; GreenLight PVP robotic assisted laparoscopic prostatectomy

Ch. 8 & 9 - Female & Male Reproductive System Flashcards

from The Language of Medicine, 12th Edition (229 cards)