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ESA 4 - 2017 - Incomplete/Some errors > Repro 7 > Flashcards

Repro 7 Flashcards

(98 cards)

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1
Q

Where are sprematozoa produced?

A

Seminferous tubules of the testis

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2
Q

What is the original cell type that eventually differentiates to spermatozoa?

A

Spermatogonia

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3
Q

How many sperm cells are produced by the testes each day? How many of those become viable?

A

200-300 million

only 1/2 wil be viable

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4
Q

Describe the role of LH in spermatogenesis control

A

Acts on leydig cells to produce testosterone causing spermatogenesis

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5
Q

Describe the role of FSH in spermatogenesis control

A

Acts on androgen binding protein in Sertoli cells which form blood/testis barrier and increasing testosterone conc.

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6
Q

What is Oestrogen’s role in spermatogenesis?

A

Acts on Leydig cells to increase sperm viability

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7
Q

How does Inhibin control spermatogenesis?

A

-ve feedback loop. Inhibin from sertoli cells reduced FSH

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8
Q

What is spermiogenesis?

A

The differentiation of spermatids into spermatozoon

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9
Q

What is the function of the Acrosome?

A

Enables sperm to penetrate the ovum

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10
Q

Describe the midpiece of a spermatozoa

A

Mitochondira packed around contractile filaments

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11
Q

What structural change does testosterone induce in spermatozoa?

A

Stripping of organelles and cytoplasm

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12
Q

What is spermation?

A

Release of spermatozoa from sertoli cells into lumen of seminiferous tubules

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13
Q

How are spermatozoa transported to epididymis?

A

In testicular fluid (produced by sertoli cells) in peristaltic contraction

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14
Q

What happens to spermatozoa if not expelled?

A

Phagocytosed by epididymal epithelial cells

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15
Q

What are the four phases of coitus?

A

Excitement
Plateau
Orgasmic
Resolution

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16
Q

Breifly describe the male excitement phase of coitus

A

Limibc system stimulation
Sacral parasympathetic neurons activated
Arteriolar vasodilation in corpora cavernosa
Increased penile blood flow
Erection

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17
Q

Breifly describe the male plateau phase of coitus

A

Sacrospinous reflex
Ischiocavernosus contraction
Decreased arterial flow
Accessory secretion glands stimulated

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18
Q

What are the two stages of male orgasm?

A

Emission

Ejaculation

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19
Q

Breifly describe male emission

A

Smooth muscle contration; vas defrens, ampulla, seminal vesicle, prostate
Internal & external urethral sphincters contract
Semen pools in urethral bulb

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20
Q

Breifly describe male ejaculation

A 
Spinal reflex
Contraction of glands and ducts
IUS contracts 
Internal urethral filling stimulaes pudendal nerve
Expulsion
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21
Q

Breifly describe male resolution

A

Thoracolumbar sympathetic pathway activated
Smooth muscle contraction in corpora cavernosa
Flaccidity and resolution

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22
Q

Breifly describe the female excitement phase of coitus

A 
Sacral parasympathetic neurones fire
Vaginal lubrication
Clitoris engorges
Uterus elevates
INcrease muscle tone, heart rate, BP
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23
Q

Breifly describe the femal sexual plateau phase

A

Labia minor deepens
Clitoris withdraws under hood
Bartholin’s gland lubricates vestibule

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24
Q

Breifly descibe the female orgasm phase of coitus

A

Orgasmic platform contracts rhythmically 3-15 times
Uterus and anal sphincter contract
No refractory period

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25
Breifly describe femal resolution
Clitoris descends as engorement subsides | General return to unaroused state
26
Breifly describe the changes in breasts during sexual response
Excitement - breast increase in size, nipple becomes erect Plateau/Orgasm - continued increase in size, areola increases in size, sexual flush may appear Resolution - return to unaroused state
27
What is the 'G' spot?
An area of erotic sensitivity located along the anterior wall of the vagina
28
List the possible impacts of ageing on the female sexual response cycle
Reduced desire Reduced vaginal lubrication Loss of elasticity of vaginal/urethral tissue Reduced expansile ability of inner vagina during arousal Number of orgasmic contractions may reduce
29
What is the most common sexual dysfunction
Desire i.e. little/no interest for age etc. - can be a result of abuse
30
List the causes of male impotence | Hint: 4
Psychological Tears in fibrous tissue of corpora cavernosa Vascular e.g. atherosclerosis Drugs e.g. alcohol
31
How does viagra work?
Inhibition of cGMP breakdown in corpus cavernosum
32
Describe the normal composition of Semen
2-4ml per ejaculate 20-200x10^6 sperm per ml. Lquefaction within 1hr
33
List the 7 possible morphologicl defects of sperm
Giant, micro, double headed, long head, rough head, abnormal middle piece
34
What are the bulbourethral glands?
AKA Cowper's - secrete 5% semen volume, alkaline fluid to lubricate tip of penis and urethral lining
35
What do the seminal vesicles produce?
60% of semen, alkaline fluid to neutralise acidic environs, contains; fructose, prostaglandins and clotting factors
36
What is the Fructose in semen used for?
ATP production
37
What are the prostaglandins in semen used for?
To increase; sperm motility and female genital smooth muscle contraction
38
What does the prostate contribute to semen production?
25% of total volume, milky/slightly acidic fluid, contains; proteolytic enzymes, citric acid and phosphatase
39
Which seminal proteolytic enzymes are produced by the prostate?
PSA and pepsinogen
40
What function do the prostatic proteolytic enzymes serve in semen?
re-liquefaction by breakdown of clotting factors from seminal vesicles
41
what is the citric acid in semen used for?
ATP production
42
What function does Oxtytocin serve in the uterus?
Contraction
43
Outline the process of oocyte maturation of the nucleus
Meiosis 1 -> nuclear membrane disappears -> 1st polar body separates-> meiosis II occurs -> arrested in metaphase II
44
Outline the process of oocyte maturation of cytoplasm
``` Mitochondria disperse ER accumulates in cortex Protein and lipid synthesis creates coritcal granules Lipid dorplets provide energy Cytoskeleton forms ```
45
How many sperm are needed for successful fertilization?
200-300 per ejaculate 300 reach site 299+ neededto disperse zona pellucida
46
How long can sperm survive in female genital tract?
Up to 5 days
47
How long does the oocyte survive?
6-24hrs, then phagocytosed
48
How long, then, is the fertile period?
As early as 3 days prior to or on the day of ovulation
49
How long does oocyte take to reach the body of the uterus?
3-4 days
50
Where does fertilisation take place?
Fallopian tube
51
What process do sperm cells need to undergo in order to penetrate oocyte?
Capacitation
52
Describe capacitation
Further maturation of sperm in female reproductive tract; protein coat removed & acrosomal enzymes exposed + tail starts to whip
53
What is the Acrosome reaction?
Activation of acrosomal enzymes, on binding to zona pellucida, to digest path through it
54
Describe the regions of the oocyte plasma membrane. Which one does sperm bind and fuse to?
Region overlying metaphase chromosomes (devoid of microvilli) Remainder (rich in micfrovilli), this is where sperm binds
55
Describe the fast block to polyspermy
Electrical change in oocyte membrane as sodium channels open in wave starting fromsperm entry site
56
Desribe the slow block to polyspermy
Ca2+ released from ER induces local exocytosis fo cortical granules in wave
57
How do the cortical granules from the oocyte prevent polyspermy?
The proteases inside induce the zona reaction
58
What is the zona reaction?
An alteration in the Zona pellucida structure. It hardens and sperm receptors are destroyed
59
What is syngamy?
Union of male and female pronuclei forming diploid zygote (occurs after meiosis II)
60
What is the importance of cleavage?
It increases the ratio of nucleus to cytoplasm
61
Describe the actions of Oestrogen on the HPG axis before ovulation
Negative feedback on bot the pituitary and hypothalamus
62
Describe the actions of oestrogen on the HPG axis at ovulation
Positive feedback on Pituitary and hypothalamus
63
Descirbe the actions of Porgesterone on the HPG axis at lower doses
No inhibition of LH surge at ovulation (cervical mucus thickens)
64
Describe the actions of progesterone on the HPG axis at moderate or high doses before ovulation
Enhances -ve feedback of oestrogen on the HPG axis before ovulation reducing LH and FSH secretion
65
Describe the actions progesterone has on the HPG axis at omderate or high doses at ovulation
Inibits +ve feedback of oestrogen so no LH surge or ovulation
66
What are the 6 normal methods of contraception?
``` Natural Barrier Prevention of ovulation Inhibition of spermtransport Inhibition of implantation Sterilisation ```
67
Describe the natural method of contraception
Using fertility indicators to identify fertile and infertile periods e.g. cycle monitoring OR lactational amenorrhoea period
68
Describe the method of preventing ovulation
Combined pill Porgesterone depot Progesterone implant
69
What are the secondary actions of the combined pill?
Reduces endometrial receptivity inhibiting implantation | Thickens cervical mucus to inhibit sperm entry
70
List some disadvantages of the combined pill
``` User dependent Mood disturbances Breast tenderness INcreased risk of MI Many contraindications ```
71
List some disadvantages of the Progesterone Depot
LAtered or irregular bleeding Delayed return of fertility for as much as one year after Small loss of bone mineral density
72
Describe how sperm transport is inhibited
Porgesterone only pill. lower dose so ovulation occurs but thickens cervical mucus
73
What is the main advantage of the progestrone only pill?
Can be used when combined pill contraindicated
74
What are the disadvantages of the progesterone only pill?
Menstrual problems common | Must be taken at same time each day (only 3 hour window)
75
Describe inhibition of implantation
Coils: Inrauterine system (progesterone) or device (copper)
76
What is teh mechanism of action of an IUS?
Slow release (low dose) progesterone reduces endometrial proliferation and prevents implantation for 3-5yrs
77
What are the disadvantages of an IUS?
Unpleasant insertion IUS displacement or expulsion may occur ~2/1000 risk of perforation
78
What is the mechanism of action of and IUD?
Copper is toxic to ovum and sperm. Can last 5-10 years
79
What are the advantages and disadvantages of IUDs
Can be used as emergency contraception up to 5 days after intercourse But periods may be heavier or longer or more painful
80
Describe male sterilisation
Vasectomy - Vas Deferens interuppted
81
Describe female sterilisation
Fallopian tubes cut or blocked
82
What are the advantages of sterilisation?
Permanent | No hormonal side effects
83
How is infertility defined?
Failure of conception in a couple having regular, unprotected coitus for one year
84
What is teh difference between primary and secondary infertility?
``` Primary = no previous pregnancy Secondary = previous pregnancy, successful or not ```
85
How many people have difficulty conceiving?
~1/7 couples, approx. 3.5 million in UK
86
Outline the aetiological profile of infertility
Male factors ~35% Ovulatory disorder ~25% Tubal damage ~20% Uterine or peritoneal disease <10%
87
List some male factors of infertility
Idiopathic oligospermia Varicocele Abnormal sperm production Hypospadias
88
What is varicocele?
Enlarged veins in scrotum similar to varicose vein that can cause low sperm count
89
What is polycystic ovary syndrome?
Lots of cyst in ovaries, elevated androgen levels and resulting problems. Unknown pathophysiology but some genetic component
90
What are the clinical features of POD?
``` Hirsuitism (abnormal hair growth) Acne Obesity Male-pattern baldness Oligomenorrhoea Psychological Sx ```
91
What is oligomenorrhoea?
Infrequent menstrual periods
92
List some uterine or peritoneal diseases
``` Endometriosis Asherman's syndrome Uterine fibroids Cervical stenosis Cervical hostility ```
93
What is endometriosis?
Presence of endometrial tissue in sites outside uterine cavity e.g. pelvic cavity
94
What are the clinical features of endometriosis?
Dysmenorrhoea Dyspareunia (painful intercourse) Chronic pelvic pain
95
When should a woman be referred for further investigations?
1yr without conceiving unknown cause | Not conceived after 6 cycles of AI unknown cause
96
What are the common investigations of infertile women?
``` Follicular phase LH and FSH (day 2) Luteal phase progesterone (day 21 if regular) Thyroid function test Androgens, prolactin Cervicsl smear Pelvic USS Tubal patency ```
97
List some investigations of male infertility
``` Sperm analysis (count, motility) Antisperm antibodies Androgens USS Karyotype CF test Testicular biopsy ```
98
What is the usual pH range of semen?
7.2 - 7.8

ESA 4 - 2017 - Incomplete/Some errors (19 decks)

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