Repro Flashcards
(106 cards)
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
2
Q
coverings of spermatic cord
A
external spermatic fascia, cremaster fasia, internal spermatic fascia
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
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
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
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%
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
8
Q
label the 4 missing ligaments
A
suspensory ligament
ovary
broad ligamet
round ligament
ovarian ligament
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
10
Q
label the anatomy
A
from top clockwise
internal os
posterior fornix
external os
vagina
anterior fornix
11
Q
label the ligaments of the pelvic floor
A
top down:
pubocervical
transverse/cardinal
uterosacral
12
Q
label the muscles of the pelvic floor
A
from top anticlockwise
ischiocavernosus
bulbospongiosus
perineal body
superficial transverse perineal muscle
13
Q
label the deep muscles of the pelvic floor
A
top down
puborectalis
pubococcygeus
iliococcygeus
coccygeus
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
15
Q
what muscles make up levator ani
A
puborectalis, pubococcygeus, and iliococcygeus
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
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
18
Q
which ligament is a remnant of gubernaculum
A
ovarian and round
19
Q
normal position of uterus
A
anteverted and anteflexed
20
Q
what do vas deferens and uterus develop from
A
vas deferens- mesonephric duct
uterus- paramesonephric duct
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
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
23
Q
3 things that control timing of puberty
A
pineal gland, leptin, body weight
24
Q
when does puberty start/male and female
A
male- 9-14
female- 8-13
25
order of puberty male and female
male
- testicular enlargement, pubic hair and spermatogenesis, growth spurt
female
-breasts, hair, growth, period
26
compare peripheral and central precocoius puberty and their causes
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
27
describe follicular phase
- 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
28
describe luteal phase
- 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.
29
causes of heavy menstrual bleeding
Polyps
Adeomyosis
Leiomyoma
Malignancy
Coagulopathy
Ovulatory
Endometrial
Iatrogenic
Not yet classified
30
causes dysmenorrhoea
endometriosis
31
cause oligomenorrhoea
ovarian insufficiency, thyroid problems, ED, contraception
32
cause primary amenorrhoea
imperforate hymen, vaginal septum, androgen insensitivity syndrome, GnRH deficiency
33
cause secondary amenorrhoea
cervical stenosis, asherman, PCOS, thyroid disease, hyperprolactinoma, prolactinoma, pituitary necrosis
34
describe changes in pre and peri menopause
pre- slight decrease in oestrogen, incresae in FSH/LH, decrease in fertility, cycle irregularity
peri- follicular phase shortens, ovulation absent, menopause
35
describe completion of meiosis II
- calcium waves activate to fuse oocute and sperm membranes
- meiosis II resumes
- pronuclei move togehter
- mitotic spindle forms leading to cleavage
36
acrosome reaction
sperm pushes through corona radiata,
sperm cell surface receptor binds to ZP ZP3 glycoprotein
triggers acrosone
ZP digested
37
describe what occurs in capacitation
further maturation
- sperm cell membrane changes to fuse with oocyte membrane
- tail changest from beat to whip movement
- can now acrosome
38
symptoms in men
- chlamydia
- gonorrhoea
- NGU
C-asymptomatic but can cause testicular pain/discharge/dysuria
G-thick yellow discharge and dysuria
NGU- white discharge, dysuria, urethritis
39
which male STIs tested for by urethral swab
gonorrhea
40
which male STIs treated for with ueine sample
gonorrhea, chlamydia, urethritis
41
symptoms in women
trichomoniasis
candidiasis
BV
T- copious yellow odorous discharge
C- itchy white discharge
B- offensive smelling white discharge
42
which STI low vaginal swab and high vaginal swab
low- Chlamydia trachomatis, neisseria gonorrhoea
high- candida, trichomonas vaginalis
43
cause of
syphillis
gonorrhoea
chlamydia
NGU
trichomonias
BV
S- treponema palladium
G- neisseria gonorrhora
C- chlamydia trichomatis
NGU- chlamydia trichomatis, mycoplasma genitalium, trichomonas vaginalis
T- trichonomias vaginalis
BV- gardenella vaginalis
44
male causes of infertility
pre testicular- HPG axis
testicular- testicular torsion, varicoceole, y chromosome deletion, STIs, chemotherapy
post testicular- vasectomy, erectile dysfunction
45
female causes infertility
ovulatory- Hypothalamic pituitary, hypothalamic pituitary ovarian (PCOS), ovarian failure (turners syndrome)
uterine/peritoneal- uterine fibroids, endometriosis, PID
tubal- endometriosis, ectopic pregnancy, STI
46
male and female investigations infetility
male
-sperm count, testicular USS, exclude STI, karyotype, hormone levels
female
-pelvic USS, hormone levels, STI, tubal patency test
47
protein hormones produced by placenta
hPL. hCG, hCC, hCT
48
describe structure of umbillical cord
2 umbillical arteries carry blood from fetus to placents
1 umbillical vein carries blood from placenta to fetus
49
describe respiratory changes in pregnancy
- 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
describe CVS changes in pregnancy
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
renal changes pregnancy
- reduced PCT absorption causing glucosuria
- increased GFR
- smooth muscle relaxation
52
MSK changes pregnancy
- increaed lordosis and kyphosis changes centre of gravity
- abdominal muscles stretch
- increased motility of sacroiliac jonts and anterior tilt of pelvis
53
cause and effets of pre eclampsia
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
describe fetal development of the respiratory system
pseudoglandular- formation of bronchioles from bronchpulmonary tree
canicular- respiraotry bronchioles form
terminal sac- t1/t2 pneumocytes from and produce surfactant. terminal sacs form
55
describe adaptations to increase o2 suppyl to fetus
- 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
adaptations to incfrease co2 removal from fetus
- 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
describe the different shunts
DA- between pulmonary artery and aorta. bypasses lungs
DV- between. umbillical vein and IVC. bypasses liver
FO- between RA and LA
58
what position will arm be in if damaage to upper brachial plexus occurs
Erb's palsy (waiter's tip):
- Arm medially rotated
- Forearm pronated
- Wrist flexed
59
describe first stage of labour
- cervical effacement
- cervical ripening due to prostoglandins. reduction in collagen aggergation and increase in hyaluronic acid
- thinning of leavator ani and perineal boduy
60
desribe movement of fetus through birth canal
internal rotation and flexion
crowning
external rotation and extension
shoulder born
61
effect of prostoglandins and oxytocin on contractions
oxytocin reduces threshold for action potential. prostoglandins cause release of Ca2+ from stores
62
what are the different lie and presentations of fetsu
lie- axis of spine to uterus
longitudinal, transverse, oblique
presentation
cephalic, shoulder, breach
63
describe what happens to the shunts after birth
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
structure of breast
lobule\>ductule\>ducr\>ampulla
65
why does suckling stop menstruation
inhibits arcuate nucleus, no GnRH
66
4 types of hormone affecting the breasy
Mammogenic (promote proliferation of alveolar & duct cells)
Lactogenic (promote initiation of milk production)
Galactokinetic (promote contraction of myoepithelial cells)
Galactopoietic (maintain milk production).
67
effect of suckling on lactationm
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
describe Puerperal Mastitis
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
most common cancer female
endometrial adenocarcinoma
70
- most common vulval tumour
- causative factor
- where spread
- treatment
- squamous carcinoma
- HPV causing vulval intraepithelial neoplasia (presence of atypical squamous cellls in epithelia)
- spreads locally and to inguinal lymph nodes
- excision
71
- most common cancers of the cervic
- causes
- where spread
- mainly squamous cell carcinomas but also adenocarcinoma
- HPV causing CIN
- uterus/bladder/rectum. iliac and aortic lymph nodes.
72
CIN
cervical intraeithelial neoplasia
CIN I- reversible
CIN II- in situ carcinoma
CIN III- invasive carcinoma
73
what does cervical screening detect
abnormally large nuclei with abnormal chromatin. in transformation zone
74
how does HPV cause cancer
e6 and e7
c6 prevents p53. e7 prevents rb
75
- what cancer of endometrium
- causes
- where spread
-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
- tumour of myometrium
- symptoms
- cause
- spread
benign- leiomyoma. causes heavy menstural bleeding and infertility. caused by oestrogen
malignant
- leiomyosarcoma. similar symptoms.
- metastasis to lungs
77
main types of ovary tumours
-surface epithelium/germ cell/sex cord stromal
78
describe ovarian epithelial tumours
- serous, mucinous, endometriod
- malignant present late and have poor prognosis. cause acites and intestinal obstruction
- caused by BRAC1/2
79
describe ovarian + testicular germ cell tumours
- benign: teratoma that contains tissue from all 3 germ laters.
- malignant: (testes)
dysgerminoma, yolk sac
80
describe sex cord stromal tumours
- 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
what is a kruckenberg tumour
metastatic GI tumout within ovary from stomach
82
describe sex cord tumour of testes
sertoli or leydig tumours
uncommon
benign
83
- types of male germ cell tumours
- cause of germ cell tumours
-
- seminomas and non seminomatous germ cell tumour (NSGCT)
- family history, cryptorchidism. treated by orchioplexy
84
- types NSGCT
- markers
- pure: yolk sac tumour, embryonal carcinoma, choriocarcinoma, teratoma.
- mixed: contain 2 differnt pure NSGCT
- all produce AFP
- choriocarcinomas product hCG
- mixed produce both
85
compare seminomna and NSGCT
- spread
- treatment
- presentation
- 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
1- vas deferens
2- body epididimys
3- tail epididimys
4- tunica albuginea
5- seminiferous tubules
6- head epididymis
87
tunica albuginea vs tunica vaginalis
Beneath the tunica vaginalis is the capsule of the testis, termed the tunica albuginea
88
what do Ad Ap spermatogonia do
Ap- produce spermatocytes
Ad- reserve stock
89
describe sperm production
spermatogonium
primary spermatocyte
spermatid
spermatazoa
90
define spermiation and spermiogenesis
**Spermiation** is the release of spermatids into the lumen of seminiferous tubules
**Spermiogenesis** is when a haploid spermatid differentiates into a spermatozoon
91
what occurs in spermiogenesis
⇒ Spermiation
⇒ Spermatid remodelling (seminiferous tubule)
⇒ Spermatid moves through rete testis and ductuli efferentes and into the epididymis
92
Which three processes are stimulated by the female genital tract?
- Removal of glycoproteins and cholesterol from sperm membrane
- Activation of sperm signalling pathways
- Allow sperm to bind to zona pellucida of oocyte
93
what occurs in pre antral, antral and pre ovulatory
**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
How is the corpus luteum formed?
- 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
how does genetic variation occur in meiosis
• 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
which ligaent is a neurovascular pathway bulging into peritoneum
suspensory
97
which ligament is a peritoneal fold
broad
98
which ligament is a remantt of the gubernaculum
round and ligament of ovary
99
how does perineal body maintain pelvic organ support
central point of attachment for perineal musculature
100
risk factors for POP
obesity
heavy lifting
steroids
connective tissue disorder
101
how can childbirth cause pelvic floor dysfunction
stretching pudundal nerve, injury perineal body
102
normal sperm concentration and normal volume per ejaculate
- 20-200
- 2-4ml
103
spermatogenesis
spermiogenesis
spermatogenesis- formation of spermatids from spermatogonia. ST
spermiogenesis- spermatid final maturation to spermatozoa. ST
104
what is CIN
dysplasia
105
what cell produces human choroinic gonadotrophin
syncytiotrophoblast
106
changes to placenta over time
thinning of syncytiotrophoblast
loss of cytotrophoblast
