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Anatomy - 2FF3 > Reproductive System > Flashcards

Reproductive System Flashcards

1
Q

Homologs

A
  • ovary = teste
  • round ligament = gubernaculum
  • labia majora = scrotum
  • glans clitoris = glans penis
  • crus of the clitoris = corpus cavernosum
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2
Q

Kidney stones

A
  • get caught in the ureterovesicular junction

- pain alternates depending on the location of the kidney stone

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3
Q

Hydroureter and hydronephrosis

A
  • causes = kidney stones, developmental

- developmental causes = two ureters that cross over, ureter blocked by a blood vessel

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4
Q

Layers of the ureter

A
  • inner longitudinal layer
  • outer circular layer
  • both smooth muscle
  • lined with epithelium (mucosal layer)
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5
Q

Female pelvis

A
  • light and thin
  • shallow false pelvis
  • large, oval brim
  • pubic arch greater than 90 degrees
  • coccyx slightly angled anteriorly
  • diameter > 10 cm
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6
Q

Male pelvis

A
  • heavy and thick
  • deep, cup shaped false pelvis
  • small, heart shaped pelvic brim
  • pubic arch less than 90 degrees
  • coccyx angled strongly anteriorly
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7
Q

Spine curvature

A
  • females = lordosis in L3, 4, 5

- highly accentuated in pregnancy to keep center of mass in the same place

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8
Q

Ligaments of the pelvic outlet

A
  • broad ligament
  • round ligament
  • utero-ovarian ligament
  • uterosacral ligament
  • suspensory ligament of the ovary
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9
Q

Prolapsed uterus

A
  • pushed up with a pessary
  • undergo a colpopexy procedure
  • different from uterine inversion
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10
Q

Muscles of the female perineum

A
  • ischiocavernosus
  • bulbospongiosus
  • superficial transverse perineal
  • deep transverse perineal
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11
Q

Muscles of the female pelvic floor

A
  • pubococcygeus
  • iliococcygeus
  • ischiococcygeus
  • all known as the levator ani muscles
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12
Q

Vaginal histology

A
  • stratified squamous epithelium (non keratinized)
  • low pH so pathogens can’t reside
  • mucosa layer manufactures sugar
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13
Q

Cervical histology

A
  • simple columnar epithelium (live cells)
  • the transition zone can easily be infected by viruses
  • Pap smear collects cells from the transition zone
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14
Q

Types of sex

A
  • genetic (XX vs XY)
  • phenotypic
  • gondal (testes vs ovaries)
  • behavioural/psychological
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15
Q

Embryo at the 5th week

A
  • mesonephric kidney (does not persist later on)
  • mesonephric duct (Wolffian)
  • paramesonephric duct (Müllerian)
  • indifferent gonad = potential ovary on outer surface, potential testis in stroma
  • cloaca = divides to become rectum and bladder
  • no leakage through the urogenital sinus (urachus)
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16
Q

XY phenotype

A
  • sex-determining region of Y chromosome makes Testis determining factor
  • TDF stimulates Sertoli glands to produce anti-Müllerian hormone to regress the ducts
  • TDF also affects Leydig cells to make testosterone and stimulate development of mesonephric ducts
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17
Q

XX genotype

A
  • mesonephric ducts are not stimulated (but not technically inhibited)
  • Müllerian ducts make the fallopian tube, fuse to make uterus, cervix, vagina
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18
Q

Renal and gonadal development in XY genotype

A
  • bud of mesonephric duct makes metanephros (develops into true kidney)
  • mesonephric duct becomes ureter
  • inferior part of mesonephric duct becomes vas deferens
  • gonads descend, dragging vas deferens over the ureter
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19
Q

Persistent Müllerian duct syndrome

A
  • paramesonephric duct does not degenerate (shortage of anti-Müllerian hormone)
  • testicles are held up in the abdomen
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20
Q

Inguinal descent of the testes

A
  • occurs through inguinal canal
  • deep ring and superficial ring
  • facilitated by the gubernaculum
  • also pulls down some peritoneum (tunica vaginalis)
  • space becomes scrotal cavity
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21
Q

Hydrocoele

A
  • accumulation of serous fluid in the scrotal cavity

- it it is blood that is accumulating = hematocoele

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22
Q

Orchidopexy

A
  • undescended testis
  • higher rate in premature babies, because it usually occurs in the third trimester
  • if the testis does not descend, undergo orchiodopexy
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23
Q

Temperature of the gonads

A
  • spermatozoa will only develop 2-3 degrees below body temperature
  • testes move up and down to keep the proper temperature
  • cremaster = upwards movement
  • dartos = compresses scrotum
  • cooled by pampiniform plexus
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24
Q

Hernias

A
  • males are more likely to have inguinal hernias
  • direct = hernia goes through abdominal wall (occurs later in life)
  • indirect = goes through deep ring of inguinal canal (newborns)
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25
Q

External genitalia development (males)

A
  • at 10 weeks under influence of androgens, urethral folds seal
  • near birth, the scrotum fuses at the midline (raphe)
  • urethra is sealed
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26
Q

External genitalia development (females)

A
  • labioscrotal swellings do not fuse
  • stay intact as the labia majora
  • urogenital folds do not meet, and persist as the vestibule and labia minora
  • genital tubercle becomes the clitoris
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27
Q

Intersex

A
  • having both male and female sexual characteristics and organs
  • 4 / 100 newborns = broadest definition
  • very few are gonadal intersex
  • greatest number have ambiguous genitalia
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28
Q

XX intersex

A
  • typically results because of virilization of female fetus by androgens
  • can arise from congenital adrenal hyperplasia
  • fuse labia majora, clitoromegaly
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29
Q

XY intersex

A
  • generally result from inadequate supply of male hormones
  • androgen insensitivity syndrome = receptors don’t work
  • micropenis, blind-ended vagina
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30
Q

Oogenisis

A
  • oogonia produce primary oocytes (diploid)
  • at birth = 2 million, at puberty = 300 000
  • menopause begins when there are no functional primary oocytes
  • maximum of 500 eggs can be released, others die
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31
Q

Ovarian cycle

A
  • primary oocytes at in prophase of meiosis I
  • a few become secondary oocytes
  • only one secondary oocyte will be released finishes meisosi I)
  • completion of meiosis II occurs at fertilization
32
Q

Phases of the ovarian cycle

A
  • follicular phase = egg and granulosa develop

- luteal phase = corpus luteum secretes progesterone to prepare endometrium for a zygote

33
Q

Menstrual cycle

A
  • purpose = prepares lining of the uterus for the zygote
  • takes 21 - 40 days
  • stratum functionalis is lost, but stratum basalis remains
  • functionalis is due to proliferation of endometrial stroma and elongation of endometrial glands
34
Q

Rescuing the endometrium

A
  • pregnancy stops the degeneration of the corpus luteum
  • egg and placenta release hCG
  • hCG acts like LH = stimulates corpus luteum to produce progesterone
  • progesterone = inhibit uterine contractions and disintegration of stratum functionalis
35
Q

Timing of fertilization

A
  • day to 2 days after ovulation is the only time sexual intercourse will result in fertilized egg that can also make it to the endometrium
  • if it’s too late, endometrium will be in the menstrual phase
36
Q

Parts of sperm

A
  • acrosome = has digestive enzymes to penetrate zona pellucida and corona radiata
  • nucleus = haploid
  • midpiece = mitochondria
  • flagellum = movement
37
Q

Spermatogenesis

A
  • process of making spermatozoa
  • spermatogonia divide to make mature sperm (70 days)
  • begins at 14 years (approx) to death
  • 400 million made per day
  • each mL of semen has 50 - 130 million sperm
38
Q

Components of semen

A
  • seminal vesicles = majority of sperm (fructose, clotting proteins), alkaline
  • prostate = acidic/neutral fluid and protein digesting enzymes
  • bulbourethral glands = alkaline fluid, mucus
39
Q

Similarities of gamete manufacturing

A
  • FSH stimulates growth of gametes (sperm, oocytes)
  • LH stimulates hormones
  • hormones provide a negative feedback to decrease production of gonadotropins
40
Q

Fertilization

A
  • acrosome helps penetrate corona radiata and zona pellucida
  • one sperm contacts plasma membrane
  • cell membrane depolarizes
  • zona pellucida hardens
  • haploid male and female pronuclei fuse to make a zygote
41
Q

Parts of the uterine tube

A
  • infundibulum
  • ampulla
  • isthmus
42
Q

Early development

A
  • fimbriae of the uterine tube are close to the ovary
  • most likely to meet sperm in ampulla
  • following fertilization, cell will start to divide in zona pellucida
  • blastocyst bursts through zona to implant
  • composed of trophoblast and inner cell mass
43
Q

Implantation into the endometrium

A
  • takes 5 days to implant into the uterus
  • amniotic cavity forms
  • trophoblast invades the endometrium
  • syncytiotrophoblast to cytotrophoblast
  • trophoblast and mesoderm from the fetus thicken to become the placenta (chorion)
44
Q

16 day embryo

A
  • connecting stalk = becomes umbilical cord
  • mesoderm = blood vessels, muscles
  • ectoderm = neural, skin
  • endoderm (yolk sac) = gut
  • allantois = getting rid of waste products
45
Q

28 day embryo

A
  • amniotic sac grows around baby
  • foregut, midgut, hindgut
  • heart starts to form
46
Q

Phases of development

A
  • pre-embryonic
  • embryonic
  • histogenesis
47
Q

Pre-embryonic

A
  • < 14 days after fertilization
  • tiny trophoblast
  • zona pellucida is present
48
Q

Embryonic (organogenesis)

A
  • 2-8 weeks after fertilization
  • all major organs are assembled
  • placenta is larger than fetus
  • sensitive to toxins
49
Q

Histogenesis

A
  • organs grow during this period
50
Q

Problems in embryonic development

A
  • thalidomide and phocomelia
  • valproic acid and spina bifida
  • major dysgenesis
51
Q

Problems in fetal development

A
  • microtia
  • cataracts (rubella)
  • incomplete/abnormal development
52
Q

Placenta

A
  • chorion = fetal contribution

- decidua = maternal contibution

53
Q

Placental circulation

A
  • maternal artery (uterine artery)
  • spiral arterioles
  • blood goes into intervillous space
  • comes back along non spiral venules
  • fetus = 2 arteries and 1 vein
54
Q

Umbilical cord cross section

A
  • lumen of umbilical arteries
  • lumen of umbilical vein
  • Wharton’s jelly = source for mesenchymal stem cells
55
Q

Extravillous trophoblasts

A
  • extravillous trophoblasts extend into the myometrium
  • this allows the fetus to always receive blood
  • incomplete invasion is associated with hypertension
56
Q

Maternal adaptation to pregnancy

A
  • cellular immunity decreases
  • blood volume increases 30 - 50%
  • cardiac output increases - 20 - 30%
  • tidal volume increases - 30 - 40 %
  • airway resistance decreases
  • myometrial mass increases
57
Q

Positive feedback in childbirth

A
  • pressure on cervix
  • stretch receptors send signal to hypothalamus
  • release of oxytocin
  • uterus contracts
58
Q

Control of parturition

A
  • ultimately fetus in control
  • placental steroid hormones
  • stretch of the uterus
  • fetal oxytocin from pituitary and placenta
59
Q

Contraceptives

A
  • work to keep sperm and egg from uniting

- eg. OCs, mini-pills, progesterone injections, patches, condoms

60
Q

Contragestational agents

A
  • work to keep the zygote from implanting

- eg. morning after, IUDs

61
Q

Abortifacients

A
  • cause the termination of an already established pregnancy

- eg. RU 486

62
Q

Fertility awareness

A
  • notice signs of ovulation
  • temperature, mucus, pain, position of cervix
  • intercourse is timed
  • 20% failure rate
  • through perfect use = 2%
63
Q

Rhythm method

A
  • practice abstinence 3 days before and 3 days after likely date of ovulation
  • 25% failure, 9% if perfect
64
Q

Ferning

A
  • crystallization of mucus

- due to presence of salt around time of ovulation

65
Q

Combination pills

A
  • estrogen and progestin
  • inhibit release of GnRH = low FSH, no LH surge
  • create thick mucus, hostile endometrium
  • failure rate = 0.7 per 100 women years
66
Q

Contraceptive patches

A
  • transdermal steroid release

- once a week

67
Q

Contraceptive ring

A
  • placed in the vagina for three weeks

- not a barrier, but delivers steroids

68
Q

Injectable combined contraceptives

A
  • Lunelle, Cyclofem

- not available in US or Canada

69
Q

Progestin-only

A
  • avoids side effects of estrogen
  • does not reliably suppress ovulation, but causes thick mucus
  • endometrium is kept in a pregnant state
  • take the dose at the same time every day
  • 0.5 - 1.1 pregnancies per 100 women years
70
Q

Progestin injections

A
  • Provera
  • given in the buttock or deltoids
  • mostly used postpartum
  • useful for 3 months
  • risks = dysfunctional uterine bleeding, amenorrheic, decreased libido, more ectopic pregnancies
71
Q

Long-acting reversible contraceptives

A
  • contraceptive implant
  • IUDs (copper, progestin)
  • 0.6 - 0.05% failure (very reliable)
  • return of fertility is rapid
  • no problems with compliance
72
Q

Progestin implants

A
  • plastic rod in inner side of upper, nondominant arm
  • 21 to 28 days postpartum
  • should be palpable
  • subdermal insertion is key
73
Q

Postcoital contraception

A
  • morning after / Plan B
  • 90% effective
  • inhibits progesterone and estrogen production and ovulation
  • less effective the longer you wait
  • fit an IUD after unprotected intercourse
74
Q

Antiprogestin

A
  • abortion pill
  • can be used up to 8 weeks
  • causes the endometrium to slough off
75
Q

Immunocontraception

A
  • vaccination with a synthetic zona pellucida peptide

- seen in animal trials

76
Q

Spermicide

A
  • acidified semen

- provides a moderate barrier

77
Q

Essure

A
  • inserted into the isthmus of the uterus
  • irreversible obstruction in the uterine tube when scars form over the inserts
  • can be surgically reversed, but fertility may not be restored

Anatomy - 2FF3 (6 decks)

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