Male accessory glands Flashcards

(42 cards)

1
Q

Seminal vesicles

What are they?

Function?

A

Paired, elongated, high-coiled tubular glands on the posterior wall of the urinary bladder

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2
Q

Function of seminal vesicles

A

Secrete and store seminal fluid

These alkaline secretions form 60-70% of seminal fluid and are expelled in the second fraction of the ejaculate to

  • wash sperm out of the ejaculatory duct & urethra
  • dilute the thick mass of sperm so they can be motile
  • neutralize acidity of vagina
  • energy source for sperm via fructose
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3
Q

Describe the seminal vesicle secretion

A
  • Fructose - source of energy for spermatozoa
  • Prostaglandins - stimulate contractions to transport sperm
  • Fibrinogen - precursor of fibrin to clot the semen deep in the vagina
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4
Q

Appearance of seminal vesicle

A
  • One large lumen that stores seminal fluids
  • Convoluted folds in mucosa to increase secretory surface area
  • Pseudostratified columnar epithelium w
    • tall non-ciliated secretory columnar cells
    • short, round basal cells
    • simple columnar cells
  • Connective tissue lamina propria w elastic fibers
  • Muscularis - inner circular & outer longitudinal for ejaculation
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5
Q

Are there sperm in here?

A

no - this is the seminal vesicle (seminal fluid)

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6
Q

The secretory funciton and morphology of the seminal vesicles is controlled by

A

testosterone

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7
Q

What kind of epithelium do seminal vesicles have?

A

Pseudostratified columnar

note: basal cells at the arrows

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8
Q

How can you differentiate the oviduct ampulla form teh seminal vesicle?

A

Oviduct folds don’t connect because it wants to let the ovum through; its more round; it has peg cells

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9
Q

Prostate surrounds the __ just below the ___

A

Surrounds the urethra

Just below the urinary bladder

It’s the largest accessory male sex gland

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10
Q

Prostatic fluid function

A
  • Clotting enzymes and fibrinolysin
    • Clotting enzymes act on fibrinogen from seminal vesicles -> fibrin, which clots the semen in deep vagina -> fibrinolysin breaks down the seminal clot to release motile sperm in the female tract
  • Prostate-specific antigen (PSA): serine protease to liquefy coagulated semen
    • Usually very low in the blood, but
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11
Q

Prostate gland function

A
  • Secretes and stores a thin, milky, slightly alkaline fluid that constitutes 25-30% of seminal fluid
    • Expelled in the first ejaculate fraction (mixed seminal + prostatic fluid in the ejaculatory duct)
  • PSA, clotting enzymes, and fibrinolysin
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12
Q

What cells of the prostate gland produce the enzymes?

A

epithelial cells

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13
Q

PSA - clinical marker

A

Prostate cancer patients & Prostatitis (benign prostatic hyperplasia) have a lot of PSA misdirected into the blood

The only way to differentiate is via biopsy or rectal exam

Previously PAP was used instead of PSA as a marker for prostate cancer

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14
Q

Prostate gland structure

A

30-50 tubuloalveolar exocrine glands embedded in fibromuscular stroma and emptying into excurrent ducts that open to the urethra.

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15
Q

What is the brownish bluish part that makes up the majority of this photo?

A

Fibromuscular stroma of the prostate!

smooth muscle mixed w collagenous ct

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16
Q

Prostatic glandular epithelium

A

Has all kinds!

  • Mostly simple columnar
  • Patches of simple cuboidal, squamous, pseudostratified (pictured)
  • Changes to transitional epithelium near opening of ducts into urethra
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17
Q

5a-reductase

A

in prostate

converts testosterone & adrenal androgens to DHT (most potent androgen)–> growth of normal prostatic epithelium and proliferation

DHT responsible for the growth of BPH and prostate cancer.

18
Q

Identify

A

Tubuloalveolar glands

&

fibromuscular stroma (red smoothmuscle + pale ct)

= prostate gland

19
Q

Prostatic concretions (corpora amylacea)

A

Characteristic feature of prostate in the alveoli

Concentric lamellated bodies formed by precipitation of secretory material around cell fragments

Increases w age (like brain sand in pineal gland)

20
Q

How to differentiate between prostate gland and the lactating mammary gland?

A

Mammary gland has

  • clear lobules
  • no concretions, just milk
  • no smooth muscle
21
Q

Division of adult prostatic parenchyma into 4 zones

A

Peripheral zone surrounding distal urethra

Central zone surrounding the ejaculatory duct

Transitional zone surounding the proximal urethra

Periurethral zone next to proximal urethra

22
Q

Prostate cancer is most common in which region of the prostate?

A

Peripheral zone is most susceptible to inflammation and prostate cancer - this is what we’re palpating upon digital recti exam

Because it’s only surrounding the distal urethra, early prostate cancer usually doesn’t come w clear symptoms

23
Q

What zone of the prostate is responsible for benign prostatic hyperplasia (BPH) and ~34% of prostate cancers?

A

Transitional zone surrounding proximal prostatic urethra

–> patients have problems urinating during BPH because of the nodular masses compressing the urethra

24
Q

In the later stage of BPH, the ____ zone may undergo pathologic growth but mainly from the __ compartment

A

Periurethral zone

Mainly stromal compartments –> worsens urethral compression & urine retention in the bladder

25
The **fibromuscular stroma** of the prostate gland is ___ connective tissue w large amts of \_\_\_muscle fibers occupying the __ surface of the prostate gland.
The **fibromuscular stroma** of the prostate gland is **dense irregular** ct w large amts of **smooth muscle** occupying the **anterior surface** of the prostate gland.
26
Prostate cancer review
27
Which side is abnormal for the prostate gland? Whats wrong?
**Left side is prostate cancer** - not as much stroma bc so many cells invade the basement membrane
28
Prostate cancer treatment
Orchiectomy (testis removal) & radiation, but **hormone therapy** is the best: * **GnRH agonists or antagonists** to reduce circulating androgens * **Androgen receptor antagonists** **Almost always leads to recurrence -\> mortality**
29
Orchiectomy
remove testis in prostate gland ## Footnote **low T & DHT** --\> **high LH & FSH**
30
GnRH antagonists and GnRH agonists in response to prostate cancer
**GnRH antagonists** work bc they immediately stop LH to suppress T --\> low LH, T, DHT, and FSH **GnRH agonists** will produce an initial surge in LH, FSH, T, and DHT, but the **continuous** (nonpulstaile) pituitary stimulation will downregulate and desensitize the GnRH receptor --\> ow LH, T, DHT, and FSH
31
Cowper's / Bulbourethral glands function
Secrete a clear, mucus-like pre-ejaculate to **lubricate** the urethra for sperm transport ## Footnote **Neutralizes acidic urine in urethra** **Flush out residual urine or foreign matter**
32
Semen pre-ejaculate, first fraction, second fraction
10% sperm, 90% plasma ## Footnote **Pre-ejaculate:** bulbourethral gland **First fraction of ejaculate:** sperm & prostatic fluid **Second fraction:** seminal vesicle secretion
33
Recap on glands
34
contribution of excretory system to sperm production
35
36
BPH Not all BPH pts have high PSA
37
BPH treatment
Remember that DHT is the main androgen at play
38
three erectile tissues of the penis
**corpora cavernosa-** 2 dorsal masses **copora spongiosum** - 1 ventral mass tunica albuginea wraps the whole thing
39
Corpora Cavernousa
* **Contains most of the blood** * Contain numerous **wide, irregularly shaped vascular spaces** lined with endothelium * Surrounded by ***_thin_* trabeculae** (collagen+elastic fibers+smooth muscle), which is why blood tends to go more here instead of spongiosum * **Central artery** that gives off corkscrew-shaped **helicine arteries** (if flaccid) * Helicine arteries are distributed through trabeculae and open into vascular spaces; dilates during erection
40
corpus cavernosa you can see corkscrew-shaped helices arteries
41
corpus spongiosum
42
spongiosum