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Flashcards in Reproductive System Deck (23):
1

Chromosomal and genetic sex of an embryo is determined at fertilization by the kind of sperm that fertilizes the ovum but the male and female morphological characteristics do not begin to develop until the _____ week.
Gonadal sex is determined by the ____________________________ on the SRY gene on the Y chromosome

SRY = sex-determining region of the Y chromosome

Chromosomal and genetic sex of an embryo is determined at fertilization by the kind of sperm that fertilizes the ovum but the male and female morphological characteristics do not begin to develop until the 7th week.
Gonadal sex is determined by the testis-determining factor(TDF) on the SRY gene on the Y chromosome

SRY = sex-determining region of the Y chromosome

2

DEVELOPMENT OF TESTES
Leydig/interstitial cells
- On the ____ week secrete androgenic hormones (testosterone and androstenedione) which induce masculine differentiation of the ________________ duct and external genitalia
Sertoli cells
- secretes _____________________________________ which inhibits development of the paramesonephric ducts

DEVELOPMENT OF OVARIES
In the absence of a Y chromosome and the presence of two X chromosomes, ovaries develop, __________________ duct regresses and ________________ ducts develop.

DEVELOPMENT OF TESTES
Leydig/interstitial cells
- On the 8th week secrete androgenic hormones (testosterone and androstenedione) which induce masculine differentiation of the mesonephric/Wolffian ducts and external genitalia
Sertoli cells
- secretes anti-Müllerian hormone (a.k.a. Müllerian inhibiting substance) which inhibits development of the paramesonephric ducts

DEVELOPMENT OF OVARIES
In the absence of a Y chromosome and the presence of two X chromosomes, ovaries develop, mesonephric duct regresses and paramesonephric ducts develop.

3

DEVELOPMENT OF MALE GENITAL DUCTS
The mesonephric ducts develop into ___________, ____________ and ______________.

DEVELOPMENT OF FEMALE GENITAL DUCTS
Mesonephric ducts regress due to absence of ______________.
Paramesonephric ducts develop due to absence of _________, forming the _____________, _____________, and ______________.

DEVELOPMENT OF MALE GENITAL DUCTS
The mesonephric ducts develop into epididymis, ductus/vas deferens and ejaculatory duct.

DEVELOPMENT OF FEMALE GENITAL DUCTS
Mesonephric ducts regress due to absence of testosterone.
Paramesonephric ducts develop due to absence of MIH, forming the uterine tubes, uterus, and superior part of the vagina.

4

GAMETOGENESIS
- controlled by _____________ from the ____________ pituitary gland

GAMETOGENESIS
- controlled by FSH from the anterior pituitary gland

5

The ___________________ are the common origins of spermatozoa and oocytes and thus represent the ancestors of the germline.
The primordial germ cells undergo mitosis, forming oogonia.

OOGENESIS
During oogenesis, the oogonia become __________________.
All primary oocytes have been formed by _____ month of fetal life and remain dormant (arrested in __________) until puberty.
After puberty (ovulation), the primary oocyte completes meiosis I, forming one secondary oocyte and the first polar body.
The secondary oocyte remains arrested at _____________, until fertilization occurs.
During fertilization, meiosis II is completed, forming the _________ oocyte and the second polar body.

The primordial germ cells are the common origins of spermatozoa and oocytes and thus represent the ancestors of the germline.
The primordial germ cells undergo mitosis, forming oogonia.

OOGENESIS
During oogenesis, the oogonia become primary oocytes.
All primary oocytes have been formed by 5th month of fetal life and remain dormant (arrested in Prophase I) until puberty.
After puberty (ovulation), the primary oocyte completes meiosis I, forming one secondary oocyte and the first polar body.
The secondary oocyte remains arrested at Metaphase II, until fertilization occurs.
During fertilization, meiosis II is completed, forming the mature oocyte and the second polar body.

6

SPERMATOGENESIS
Primordial germ cells remain dormant until _________.
At _________, they differentiate into spermatogonia.
A spermatogonium undergoes mitosis and growth and become primary spermatocytes.
The primary spermatocyte undergoes __________, forming two secondary spermatocytes.
Each of the two secondary spermatocytes undergoes __________, forming four spermatids which would eventually become sperm cells.

SPERMATOGENESIS
Primordial germ cells remain dormant until puberty.
At puberty, they differentiate into spermatogonia.
A spermatogonium undergoes mitosis and growth and become primary spermatocytes.
The primary spermatocyte undergoes Meiosis I, forming two secondary spermatocytes.
Each of the two secondary spermatocytes undergoes Meiosis II, forming four spermatids which would eventually become sperm cells.

7

In normal meiosis, disjunction occurs, as a result, gametes with ____ single chromosomes are produced.
In abnormal meiosis, abnormal gametes are produced, either 22 or 24 single chromosomes are produced.

In normal meiosis, disjunction occurs, as a result, gametes with 23 single chromosomes are produced.
In abnormal meiosis, abnormal gametes are produced, either 22 or 24 single chromosomes are produced.

8

___________ Syndrome (47, XXY)
- sterility, testicular atrophy, gynecomastia
- 1 in 500 males

___________ Syndrome (45, XO)
- absence of ovaries, short stature, webbed neck, skeletal deformities, broad chest with widely spaced nipples

Klinefelter Syndrome (47, XXY)
- sterility, testicular atrophy, gynecomastia
- 1 in 500 males

Turner Syndrome (45, XO)
- absence of ovaries, short stature, webbed neck, skeletal deformities, broad chest with widely spaced nipples

9

Fertilization occurs at the _________ of the uterine tube.
Three phases:
1) sperm penetration of the ______________
2) sperm-binding and penetration of _____________ -> acrosome reaction -> releases __________
3) fusion of sperm and oocyte cell membranes -> secondary oocyte completes meiosis II, forming mature ovum and second polar body -> male and female pronuclei fuse, forming a _________

Fertilization occurs at the ampulla of the uterine tube.
Three phases:
1) sperm penetration of the corona radiata
2) sperm-binding and penetration of zone pellucida -> acrosome reaction -> releases acrosin
3) fusion of sperm and oocyte cell membranes -> secondary oocyte completes meiosis II, forming mature ovum and second polar body -> male and female pronuclei fuse, forming a zygote

10

BLASTOCYST FORMATION
_______ cell mass is positioned at one end of pole called as embryonic pole; also called as embryoblast -> embryo
_______ cell mass is called as trophoblast -> __________

BLASTOCYST FORMATION
Inner cell mass is positioned at one end of pole called as embryonic pole; also called as embryoblast -> embryo
Outer cell mass is called as trophoblast -> placenta

11

AFTER OVULATION
Fertilization - _____ hours after ovulation
2-cell stage - _____ hours after fertilization
Morula - ____ days of age
Blastocyst - ____ days of age

IMPLANTATION
- Day ___ after fertilization
- within the ________________ wall of the uterus (in the functional layer of endometrium during secretory phase of the menstrual cycle)

AFTER OVULATION
Fertilization - 12-24 hours after ovulation
2-cell stage - 30 hours after fertilization
Morula - 3 days of age
Blastocyst - 5 days of age

IMPLANTATION
- Day 7 after fertilization
- within the posterior superior wall of the uterus (in the functional layer of endometrium during secretory phase of the menstrual cycle)

12

ECTOPIC PREGNANCY
- ____________ implants abnormally
- most common type: _______ pregnancy, particularly in the _________
- delayed transport through the uterine tube
- produces abdominal pain ; lead to rupture and hemorrhage

ECTOPIC PREGNANCY
- blastocyst implants abnormally
- most common type: tubal pregnancy, particularly in the ampulla
- delayed transport through the uterine tube
- produces abdominal pain ; lead to rupture and hemorrhage

13

POUCH OF _________ (____________ pouch or ____________)
- most dependent part of the entire peritoneal cavity when the patient is in the standing position
- frequently becomes the site for the accumulation of blood (ruptured ectopic pregnancy) or pus (ruptured appendicitis or gonococcal peritonitis)

CULDOCENTESIS
- checks for abnormal fluid in the abdominal cavity behind the uterus
- needle may be passed into the pouch through the _________________
Structures passed:
- mucous membrane of vagina
- muscular coat of the vagina
- connective tissue coat of the vagina
- visceral layer of pelvic fascia
- visceral layer of peritoneum

POUCH OF DOUGLAS (rectouterine pouch or cul-de-sac)
- most dependent part of the entire peritoneal cavity when the patient is in the standing position
- frequently becomes the site for the accumulation of blood (ruptured ectopic pregnancy) or pus (ruptured appendicitis or gonococcal peritonitis)

CULDOCENTESIS
- checks for abnormal fluid in the abdominal cavity behind the uterus
- needle may be passed into the pouch through the posterior fornix
Structures passed:
- mucous membrane of vagina
- muscular coat of the vagina
- connective tissue coat of the vagina
- visceral layer of pelvic fascia
- visceral layer of peritoneum

14

TESTIS
- ______ is usually lower than the ______
- surrounded by fibrous capsule called ______________

DESCENT OF TESTES
______ weeks - descended retroperitoneally from posterior abdominal wall to the ______ inguinal rings; due to enlargement of fetal pelvis
2-3 days descent into the scrotum; controlled by ___________

TESTIS
- Left is usually lower than the right (Left Lower)
- surrounded by fibrous capsule called tunica albuginea

DESCENT OF TESTES
26-28 weeks - descended retroperitoneally from posterior abdominal wall to the deep inguinal rings; due to enlargement of fetal pelvis
2-3 days descent into the scrotum; controlled by androgens

15

What lymph nodes would be involved first in a metastatic testicular cancer?

Lumbar LNs

16

ABNORMALITIES of TESTICULAR DESCENT
Cryptorchidism
- 30% of premature males
- unilateral or bilateral
- may be in the abdominal cavity or COMMONLY in the _________________

ABNORMALITIES of TESTICULAR DESCENT
Cryptorchidism
- 30% of premature males
- unilateral or bilateral
- may be in the abdominal cavity or COMMONLY in the INGUINAL CANAL

17

EPIDIDYMIS
- ___________ to testis, with the vas deferens lying on its _______ side
- has head, body, tail
- for __________ and ___________ of sperm cells
- blood supply and venous drainage: __________
- lymphatic drainage: _______ LNs

EPIDIDYMIS
- posterior to testis, with the vas deferens lying on its medial side
- has head, body, tail
- for storage and maturation of sperm cells
- blood supply and venous drainage: testicular
- lymphatic drainage: lumbar LNs

18

VAS DEFERENS (45 cm long)
- thick-walled muscular tube that transports spermatozoa from the __________ to urethra
- from the lower end/tail of the __________
- passes through the _______ canal
- crosses the ureter to reach _________ bladder
- expands forming the ampulla
- joins ____________ -> ____________ duct

VAS DEFERENS (45 cm long)
- thick-walled muscular tube that transports spermatozoa from the epididymis to urethra
- from the lower end/tail of the epididymis
- passes through the inguinal canal
- crosses the ureter to reach posterior bladder
- expands forming the ampulla
- joins seminal vesicle -> ejaculatory duct

19

EJACULATORY DUCT (less than 1 ______)
- union of ampulla of _____________ and duct of ______________
- pierces the posterior surface of the _________ and opens into the prostatic urethra

EJACULATORY DUCT (less than 1 inch)
- union of ampulla of vas deferens and duct of seminal vesicle
- pierces the posterior surface of the prostate and opens into the prostatic urethra

20

______________ (5 cm long)
- two lobulated organs lying on the posterior surface of bladder
- secretions:
--- fluid
--- alkaline phosphatase
--- ascorbic acid
--- fructose
--- amino acids
--- prostaglandins
Blood supply: _________ artery
Venous drainage: drain into ___________ vein
Lymph drainage: ___________ LNs

SEMINAL VESICLES (5 cm long)
- two lobulated organs lying on the posterior surface of bladder
- secretions:
--- fluid
--- alkaline phosphatase
--- ascorbic acid
--- fructose
--- amino acids
--- prostaglandins
Blood supply: inferior vesical artery
Venous drainage: drain into internal iliac vein
Lymph drainage: internal iliac LNs

21

PROSTATE GLAND (___ cm) (must-know)
- fibromuscular glandular organ that surrounds the prostatic urethra
- inverted pyramid about the size of a walnut
- below the neck of the bladder
- above urogenital diaphragm
- produces a thin, milky fluid containing _________ and __________
- calcified secretions: ________________
- base is located inferior to the neck of the bladder
- apex rests on the ____________
5 lobes
--- __________: devoid of glandular tissue
--- __________: midline, palpable by DRE
--- __________ (2): each side of posterior, largest, palpable by DRE
--- __________: wedge-shaped superior portion, closely related to the neck of the bladder
Relations:
- Ant: symphysis pubis
- Post: rectum
- Sup: neck of the urinary Bladder
- Inf: urogenital diaphragm
- Lat: __________
Blood supply, venous and lymph drainage similar to seminal vesicles
Nerve supply: ___________ plexus

PROSTATE GLAND (3 cm) (must-know)
- fibromuscular glandular organ that surrounds the prostatic urethra
- inverted pyramid about the size of a walnut
- below the neck of the bladder
- above urogenital diaphragm
- produces a thin, milky fluid containing citric acid and acid phosphatase
- calcified secretions: corpora amylacea
- base is located inferior to the neck of the bladder
- apex rests on the sphincter urethra
5 lobes
--- anterior: devoid of glandular tissue
--- posterior: midline, palpable by DRE
--- lateral (2): each side of posterior, largest, palpable by DRE
--- middle: wedge-shaped superior portion, closely related to the neck of the bladder
Relations:
- Ant: symphysis pubis
- Post: rectum
- Sup: neck of the urinary Bladder
- Inf: urogenital diaphragm
- Lat: levator ani
Blood supply, venous and lymph drainage similar to seminal vesicles
Nerve supply: inferior hypogastric plexus

22

Largest ACCESSORY gland in males

Prostate gland

23

PROSTATE
- ______________________ blood test and a DRE are done to evaluate gland's size and presence of nodularity
- Benign prostatic hyperplasia commonly occurs in the ___________ zone of the prostate and may result in obstruction of prostatic urethra (impede urinary flow and result in incomplete emptying of the bladder); difficulty initiating urination and increase need to urinate
- Adenocarcinomas commonly develop in the ____________ of prostate in the main pancreatic glands (__________ part); urine flow may be altered and patients may pass blood in the urine; elevated blood vessels of prostatic _________________ and prostate ________________

PROSTATE
- Prostate Specific Antigen blood test and a DRE are done to evaluate gland's size and presence of nodularity
- Benign prostatic hyperplasia commonly occurs in the periurethral zone of the prostate and may result in obstruction of prostatic urethra (impede urinary flow and result in incomplete emptying of the bladder); difficulty initiating urination and increase need to urinate
- Adenocarcinomas commonly develop in the peripheral of prostate in the main pancreatic glands (posterior part); urine flow may be altered and patients may pass blood in the urine; elevated blood vessels of prostatic acid phosphatase and prostate specific antigen