Reproduction- Studyguide Set Flashcards
(120 cards)
1
Q
A
2
Q
What forms the anterior wall of the inguinal canal?
A
Aponeurosis of the external oblique muscle (reinforced laterally by internal oblique fibres).
3
Q
What forms the posterior wall of the inguinal canal?
A
Transversalis fascia (reinforced medially by the conjoint tendon).
4
Q
What forms the roof of the inguinal canal?
A
Arching fibres of the internal oblique and transversus abdominis muscles.
5
Q
What forms the floor of the inguinal canal?
A
The inguinal ligament (rolled edge of the external oblique aponeurosis).
6
Q
Which nerve traverses the inguinal canal but does not pass through the deep ring?
A
Ilio‑inguinal nerve.
7
Q
Name the main contents of the spermatic cord.
A
Ductus deferens, testicular artery, pampiniform plexus, cremasteric artery, genital branch of genitofemoral nerve, lymphatics, autonomic fibres, remnant of processus vaginalis.
8
Q
Which type of inguinal hernia is more common in young males and follows the processus vaginalis?
A
Indirect inguinal hernia.
9
Q
Which inguinal hernia passes through Hesselbach’s triangle?
A
Direct inguinal hernia.
10
Q
What are the boundaries of Hesselbach’s triangle?
A
Inferior epigastric vessels (lateral), rectus abdominis (medial), inguinal ligament (inferior).
11
Q
Which ligament contains the ovarian vessels?
A
Suspensory (infundibulopelvic) ligament of the ovary.
12
Q
Which ligament contains the uterine vessels?
A
Cardinal (transverse cervical) ligament.
13
Q
Which ligament anchors the uterus to the labia majora?
A
Round ligament of the uterus.
14
Q
What are the root values of the pudendal nerve?
A
S2‑S4.
15
Q
In the mnemonic ‘water under the bridge’, what is the ‘water’ and what is the ‘bridge’?
A
‘Water’ is the ureter; the ‘bridge’ is the uterine artery (ureter runs under the uterine artery).
16
Q
The uterine artery is a branch of which larger artery?
A
Anterior division of the internal iliac artery.
17
Q
Where do lymphatics from the testes drain?
A
Para‑aortic (lumbar) lymph nodes.
18
Q
Where do lymphatics from the scrotum drain?
A
Superficial inguinal lymph nodes.
19
Q
Which zone of the prostate is most commonly enlarged in benign prostatic hyperplasia (BPH)?
A
Transitional zone.
20
Q
Which zone of the prostate is most commonly affected by prostate cancer?
A
Peripheral zone.
21
Q
List the three named segments of the male urethra that traverse the prostate and perineum.
A
Prostatic urethra, membranous urethra, spongy (penile) urethra.
22
Q
What fills the ischio‑anal fossa?
A
Fat plus inferior rectal vessels and nerves.
23
Q
What is the perineal body?
A
A fibromuscular node where multiple perineal muscles converge; key to pelvic floor integrity.
24
Q
Name the three components of the levator ani muscle.
A
Puborectalis, pubococcygeus, iliococcygeus.
25
Which peritoneal pouch lies between the uterus and rectum?
Recto‑uterine pouch (Pouch of Douglas).
26
Which peritoneal pouch lies between the uterus and bladder?
Vesico‑uterine pouch.
27
What is the normal position of the uterus?
Anteverted and anteflexed.
28
What is the function of the pampiniform plexus?
Cools arterial blood before it reaches the testes (counter‑current heat exchange).
29
Which nerves provide the afferent and efferent limbs of the cremasteric reflex respectively?
Afferent: ilio‑inguinal; efferent: genital branch of genitofemoral.
30
Define the obstetric conjugate.
Distance from sacral promontory to the thickest point of the pubic symphysis; determines pelvic inlet size.
31
Which pelvic shape is most favourable for vaginal delivery?
Gynaecoid pelvis.
32
Which hormone surge triggers ovulation?
Luteinising hormone (LH) surge.
33
On which day does ovulation occur in a 32‑day cycle?
Approximately day 18 (cycle length minus 14).
34
Which hormone dominates the luteal phase of the menstrual cycle?
Progesterone.
35
Which pituitary hormone is characteristically elevated after menopause?
Follicle‑stimulating hormone (FSH).
36
What is the source of human chorionic gonadotropin (hCG)?
Syncytiotrophoblast of the placenta.
37
What is the primary function of hCG in early pregnancy?
Maintains corpus luteum progesterone secretion until placental takeover.
38
Which placental hormone is thought to play a role in timing of labour?
Corticotrophin‑releasing hormone (CRH).
39
What does anti‑Müllerian hormone (AMH) indicate clinically?
Ovarian reserve.
40
What is the mnemonic for autonomic control of erection and ejaculation?
‘Point and Shoot’ – Parasympathetic for erection, Sympathetic for ejaculation.
41
What is considered the lower limit of normal sperm concentration?
Greater than 15 million sperm per millilitre.
42
At roughly what age does menarche occur on average?
Around 11.5 years.
43
What is the average age of natural menopause?
Approximately 51 years.
44
Describe the typical LH:FSH ratio seen in polycystic ovary syndrome (PCOS).
Elevated LH:FSH ratio, usually >2 : 1.
45
Name two first‑line pharmacologic treatments for PCOS.
Metformin and clomiphene citrate.
46
High‑frequency GnRH pulses favour the release of which pituitary hormone?
Luteinising hormone (LH).
47
Low‑frequency GnRH pulses favour the release of which pituitary hormone?
Follicle‑stimulating hormone (FSH).
48
Which hormone causes the post‑ovulatory rise in basal body temperature?
Progesterone.
49
How does elevated prolactin affect GnRH secretion?
Inhibits GnRH, leading to hypogonadism (e.g., lactational amenorrhoea).
50
Which cells secrete inhibin B in the testis?
Sertoli cells.
51
Which pituitary hormone stimulates Leydig cells to produce testosterone?
Luteinising hormone (LH).
52
Which pituitary hormone stimulates aromatase activity in granulosa cells?
Follicle‑stimulating hormone (FSH).
53
Early activation of the HPG axis before age 8 (girls) or 9 (boys) is termed what?
Central (true) precocious puberty.
54
Which enzyme converts testosterone to dihydrotestosterone (DHT)?
5‑alpha reductase.
55
Give two key functions of DHT.
Development of external male genitalia and prostate; stimulation of hair follicles (beard growth).
56
What hormonal change triggers menstrual bleeding?
Drop in progesterone following corpus luteum regression.
57
List the male derivatives of the mesonephric (Wolffian) ducts.
Epididymis, vas deferens, seminal vesicles, ejaculatory ducts.
58
List the female derivatives of the paramesonephric (Müllerian) ducts.
Fallopian tubes, uterus, upper portion of the vagina.
59
Which gene on the Y chromosome initiates testis development?
SRY gene.
60
Which hormone causes regression of Müllerian ducts in the male embryo?
Anti‑Müllerian hormone (AMH).
61
The gubernaculum becomes which two structures in females?
Ovarian ligament and round ligament of the uterus.
62
Persistence of the processus vaginalis predisposes to which condition?
Indirect inguinal hernia or hydrocoele.
63
Failure of urethral fold fusion results in which congenital abnormality?
Hypospadias.
64
A bifid scrotum results from failure of fusion of which embryological structures?
Labioscrotal swellings.
65
A bicornuate uterus results from incomplete fusion of what embryologic structures?
Paramesonephric (Müllerian) ducts.
66
Which type of twins share a chorion but have separate amnions?
Monochorionic‑diamniotic (MC‑DA) twins.
67
Which twin type carries the highest perinatal risk?
Monochorionic‑monoamniotic (MC‑MA) twins.
68
How many vessels are in a normal umbilical cord?
Three – two arteries and one vein.
69
At approximately what gestational age does the placenta take over progesterone production from the corpus luteum?
Around 8–10 weeks.
70
What maternal spiral‑artery change is critical for adequate placental perfusion?
Trophoblastic remodelling into low‑resistance vessels.
71
What forms the foetal part of the placenta?
Chorion frondosum (villous chorion).
72
What forms the maternal part of the placenta?
Decidua basalis.
73
What is the most common site of ectopic pregnancy?
Ampulla of the uterine tube.
74
What is the embryonic origin of the adrenal cortex?
Mesoderm.
75
What is the embryonic origin of the adrenal medulla?
Neural crest.
76
Which foetal hormone promotes surfactant production in the lungs?
Cortisol.
77
Name the three Rotterdam criteria for diagnosing PCOS (2 of 3 required).
Oligo/anovulation; hyperandrogenism (clinical or biochemical); polycystic ovaries on ultrasound.
78
What is the classic laparoscopic appearance of ovarian endometriosis?
‘Chocolate’ cyst (endometrioma) containing old blood.
79
Which HPV types are most commonly associated with cervical cancer?
HPV‑16 and HPV‑18.
80
What is another term for the transformation zone of the cervix?
Squamo‑columnar junction.
81
First‑line medical therapy for menorrhagia in women wishing to retain fertility?
Tranexamic acid during menses.
82
What does the PALM‑COEIN acronym stand for?
Polyp, Adenomyosis, Leiomyoma, Malignancy/Hyperplasia; Coagulopathy, Ovulatory dysfunction, Endometrial, Iatrogenic, Not yet classified.
83
What prostate finding on digital rectal exam suggests malignancy?
Hard, irregular, nodular prostate.
84
Why is a varicocele more common on the left side?
Left testicular vein drains into the left renal vein at 90°, leading to higher venous pressure.
85
Which degree of perineal tear involves the external but not the internal anal sphincter?
Third‑degree 3b tear.
86
Cryptorchidism increases the risk of which malignancy?
Testicular cancer.
87
What is a complete hydatidiform mole genetically?
46,XX all paternal genome (empty ovum fertilised by one sperm that duplicates).
88
How do β‑hCG levels in molar pregnancy typically compare with normal pregnancy?
Markedly higher than expected for gestational age.
89
Which serum marker pattern is typical for Down syndrome in second‑trimester screening?
↑hCG, ↓α‑fetoprotein, ↓unconjugated oestriol, ↑inhibin A.
90
Define azoospermia.
Absence of spermatozoa in the semen.
91
What is the best initial imaging modality for suspected ectopic pregnancy?
Transvaginal ultrasound.
92
Smoking which patient group is an absolute contraindication to the combined oral contraceptive pill?
Women aged >35 years who smoke ≥15 cigarettes per day.
93
Describe the mechanism of action of the levonorgestrel‑releasing intra‑uterine system (LNG‑IUS).
Local progestogen thickens cervical mucus and thins endometrium, inhibiting implantation.
94
Define the Pearl Index.
Number of unintended pregnancies per 100 woman‑years of exposure.
95
How does clomiphene citrate induce ovulation?
Selective oestrogen receptor modulator that blocks negative feedback at hypothalamus, increasing FSH/LH release.
96
Why is metformin useful in PCOS?
Improves insulin resistance and can restore ovulation cycles.
97
What is the effect of continuous (non‑pulsatile) GnRH agonist administration?
Down‑regulates GnRH receptors → suppressed LH/FSH (medical castration).
98
What major obstetric risk is increased with IVF due to multiple embryo transfer?
Multiple pregnancy → higher risk of pre‑term birth and twin‑twin complications.
99
First‑line medical treatment for symptomatic BPH.
α‑1 adrenergic antagonist (e.g., tamsulosin).
100
Name a 5‑alpha reductase inhibitor used in BPH.
Finasteride (or dutasteride).
101
What teratogenic effect is associated with ACE inhibitors during pregnancy?
Renal dysgenesis leading to oligohydramnios and neonatal renal failure.
102
Describe the key histological feature of proliferative (follicular) endometrium.
Straight tubular glands with numerous mitoses in the glandular epithelium.
103
Describe the key histological feature of secretory (luteal) endometrium.
Tortuous, saw‑toothed glands with glycogen‑rich vacuoles and oedematous stroma.
104
What is the primary function of Sertoli cells?
Support spermatogenesis and form the blood–testis barrier via tight junctions.
105
What is the primary function of Leydig cells?
Produce testosterone in response to LH.
106
Ultrasound finding described as a 'bag of worms' in the scrotum indicates what?
Varicocele (dilated pampiniform plexus).
107
What hysterosalpingogram finding confirms tubal patency?
Spillage of contrast medium into the peritoneal cavity.
108
On axial prostate MRI, which zone is peripheral and most prone to carcinoma?
Peripheral zone – appears hypointense relative to central gland.
109
Which pelvic structure is at risk when ligating the uterine artery during hysterectomy?
The ureter.
110
Prostate enlargement of which zone is typically responsible for obstructive symptoms on MRI?
Transition zone enlargement indicative of BPH.
111
Which placental layer forms part of the blood‑placenta barrier?
Syncytiotrophoblast.
112
Which lecturer’s anatomy slide decks account for >60 % of recalled exam anatomy questions?
Podesta’s anatomy PowerPoints.
113
Which resource has supplied questions lifted verbatim into past exams?
Clinical Tutorial Session (CTS) question bank.
114
Write the equation for mean arterial pressure (MAP).
MAP ≈ Diastolic BP + 1/3 Pulse Pressure (or MAP = CO × SVR).
115
According to Poiseuille’s law, how is flow related to vessel radius?
Flow is proportional to the fourth power of the radius (r⁴).
116
List the four key hormone graphs you must memorise for reproductive endocrinology.
Serum LH & FSH, oestradiol, progesterone, and basal body temperature across the menstrual cycle.
117
Which embryological structure gives rise to the epididymis, vas deferens, and seminal vesicles?
The Wolffian duct (mesonephric duct) develops into the epididymis, vas deferens, and seminal vesicles in the presence of testosterone and MIF (Müllerian Inhibiting Factor).
118
Through which structure does the ureter pass as it enters the true pelvis in females?
The broad ligament, specifically under the uterine artery (“water under the bridge”).
119
What forms the inferior boundary of the deep perineal pouch?
The perineal membrane — a tough fascia between ischiopubic rami.
120
Lymph from the lower half of the anal canal drains into which nodes?
Superficial inguinal lymph nodes.
