SF4 Exam 3 General Flashcards
(518 cards)
1
Q
Ejaculatory Duct
A
Formed by joining of Ductus Deferens and duct of Seminal Vesicle. Pierces posterior surface of Prostate Gland through Prostatic Utricle, becoming Prostatic Gland
2
Q
Secreted by Leydig Cells
A
- Testosterone
2. Insulin-like 3 (INSL3)
3
Q
Parasympathetic Innervation to Rectum
A
Pelvic Splanchnic Nerves (via Inferior Hypogastric Plexus)
4
Q
Trigone
A
Smooth area on inner surface of Posterior Wall of Bladder. (The rest of it is loose and folded for expansion)
Shaped like a triangle pointing down
5
Q
Time of Dominant Follicle Selection
A
Early Follicular Phase. Attains dominance and matures in Mid-Late Follicular Phase
10-14 days before Ovulation
6
Q
Reactions Blocking Polyspermy
A
Fast Block:
Oocyte membrane depolarizes after fusing with Spermatozoa. Ca2+ wave causes electron-dense granules beneath oocyte to fuse with plasma membrane
Cortical Reaction:
Exocytosis of granule contents induced hardening of Zona Pellucida
7
Q
Inferior Gluteal Artery Passes Between Which Two Nerves
A
Posteriorly between Anterior Rami S1/S2 and S2/S3
8
Q
17α-hydroxylase
A
Converts Pregnenolone and Progesterone into Androgens
Not present in Granulosa Cell, reason why it needs Thecal Cell to produce Estrogen
9
Q
Vagina: Arterial Supply
A
Vaginal Artery and Vaginal Branch of Uterine Artery
10
Q
Actions of Progesterone on Female Reproductive Tract During Pregnancy
A
- Stimulates Production/Storage of Nutrient to Sustain Embryo (Secretory Phase / Prior to functional Placenta)
- Prepares Endometrium for Implantation
- Inhibits Uterine Contractions (Sustains pregnancy)
- Induces Viscous Mucus Production by Cervix
11
Q
Adaptation During Pregnancy: Serum Na
A
Decreased
12
Q
Syncytiotrophoblast Estradiol and Estrone Synthesis
A
- Fetal Zone of Adrenal Cortex releases DHEA-S
- Sulfate removed by Sulfatase in Syncytiotrophoblast
- Enzyme converts DHEA to Testosterone and Androstenedione
- T/Andro then converted to Estradiol and Estrone by Aromatase
13
Q
Adaptation During Pregnancy: Hematocrit
A
Decreases. However, RBC count increased.
Prolactin and hPL enhance effect of Erythropoietin
14
Q
Testis Cords
A
Primitive Sex Cords penetrating deep into Gonadal Medulla. Formed by Sertoli Cells aggregating around PGCs
15
Q
Tactile Stimulus Pathway Initiating Erection
A
- Afferent Tactile: Pudendal Nerve
- Reflex Integration: S2-S4
- Efferent: Parasympathetics in Cavernous Nerve
16
Q
Lactational Amenorrhea
A
Ovulatory cycle will resume if no breastfeeding for 8-10 weeks
Mechanisms:
- PRL inhibits release of GnRH (feedback loop)
- Afferent neural pathway to GnRH neurons in Hypothalamus
17
Q
Structures Derived from the Labioscrotal Swelling
A
- Labia Majora (Female)
* Scrotum (Male)
18
Q
Neurons Mediating Emission
A
L1-L2 Sympathetic Neurons
19
Q
Cell Types in Corpus Luteum
A
- Granulosa-Lutein Cells
2. Thecal-Lutein Cells
20
Q
How long does the Embryo stay in the Uterine Tube
A
First three days of pregnancy. Mostly in the Ampulla.
21
Q
Muscles of the Bladder
A
- Detrusor Muscles
2. Internal Urethral Sphincter (MALE)
22
Q
Involution
A
Name for the atrophy of the Corpus Luteum into the Corpus Albicans
23
Q
Fate of Indifferent Gonad Cortex
A
- Differentiates in Ovary
* Regresses in Testis
24
Q
Process of Releasing the Oocyte at the Stigma
A
- Proteolytic enzymes are released by Thecal and Granuosa cells in response to LH
- Extracellular Matrix proteins in Thecal Layer broken down
- Surface of Ovary at Stima broken down
- Antral fluid, Oocyte, and Cumulus Cells released
25
Common Site of Rupture of Spongy Urethra
Bulb of Penis after leaving Urogenital Diaphragm
26
Result of DHT Absence on External Genitalia Differentiation
Female or Ambiguous. Possibly male with micropenis with Hypospadias
27
Separates Pubic Bone and Bladder
Retropubic Space of Retzius
28
Afferent Aspect of Ejactulation
Filling of Urethra elicits signals sent to the sacral spinal cord via the Pudendal Nerve
29
Parts of the Posterior Wall of the Prostatic Urethra
1. Urethral Crest
2. Prostatic Sinus
3. Seminal Colliculus
30
Bony Landmark Found Between Greater and Lesser Sciatic Notches
Ischial Spine
31
Site of Entry of Caudal Injection / Epidural
Sacral Hiatus (Inferior opening to sacral canal)
32
Sleep-Associated LH Surge
First detectable change in Prepubertal period as puberty approaches. Diurnal LH release.
33
Sulfatase
Expressed by Syncytiotrophoblast to remove the Sulfate Group on DHEA-S (Fetal Adrenal) and 16α-OH DHEA (fetal liver)
34
Perineal Body
Small mass of connective tissue located between Anorectal Junction and Urogenital Gap in Pelvic Diaphragm
35
Primary Hormonal Influence in Proliferative Phase (Menstrual Cycle)
Estrogen
36
Epithelium Endometrium
Columnar Epithelium with Glands
37
Anal Columns
Upper Half of Anal Canal
Vertical folds of mucous membrane containing Superior Rectal Vessels.
38
Transurethral Resection
Surgical enlargement of Prostatic Urethra done in patients with BPH.
Can result in damage to the Internal Urethral Sphincter of Bladder and cause reflex of semen into bladder.
39
Obturator Internus Muscle: Origin
1. Obturator Membrane
| 2. Ischium/Pubis
40
Sacrospinous Ligament: Attachments
1. Sacrum
| 2. Ischial Spine (Not Iliac)
41
Internal Os
Opening between Uterine Cavity and Cervix
42
External Urethral Sphincter: Innervation
Perineal Branch of Pudendal Nerve
43
HPG Axis: Early Follicular Phase
1. FSH rises at end of Luteal Phase of previous cycle due to decline in negative inhibition
2. FSH increasing at start of Follicular Phase
3. LH constant
4. FSH promotes Granulosa Cell proliferation
5. FSH and LH stimulate Estradiol Synthesis
44
Spinal Roots of Sacral Plexus
1. Lumbrosacral Trunk L4-L5
| 2. Anterior Rami S1-S4
45
Epithelium of Primordial Follicles
Squamous
46
Levator Ani: Insertions
1. Coccyx
2. Anococcygeal Body
3. Perineal Body
47
LH Receptors on these Ovary Cells induce Androgen Biosynthesis
1. Thecal Cells
| 2. Interstitial Cells
48
Receptors on Male Accessory Organs
α1-adrenergic receptors
49
Regions of the Epididymis
1. Head
2. Body
3. Tail
50
Stimulates Hepatic Angiotensinogen Synthesis
Estrogen (pregnancy)
51
Obturator Internus Muscle: Course
Leaves True Pelvis via Lesser Sciatic Foramen
52
Structures Derived from Urethral Folds
* Labia Minora (Female)
| * Ventral Folds of Penis (Male)
53
Upper Half of Anal Canal: Arterial Supply
Superior Rectal Artery
54
Parts of the Uterus
1. Fundus
2. Body
3. Cervix
55
Converts DHEA-S to 16α-OH DHEA-S
Fetal Liver enzymes
56
Widest and Most Dilatable Part of Urethra
Prostatic Urethra
57
Innervated by Superior Gluteal Nerve
Gluteal Muscles
58
Prior to Week 8, Genital Ducts in Both Sexes
1. Wolffian (Mesonephric) Ducts
| 2. Mullerian (Paramesonephric) Ducts
59
Adaptation During Pregnancy: Pancreas
Hypertrophy and Hyperplasia of Beta Cells.
Increased insulin resistance in 2nd half of pregnancy (hPL and Cortisol)
60
Nerve innervation of Accessory Organs During Emission
Hypogastric Nerve (carrying L1-L2 sympathetics)
61
Mechanism of NO
1. Binds to soluble Guanylyl Cyclase in Cytoplasm
| 2. cGMP rise leads to smooth muscle relaxation and vasodilation
62
Estrone
E1
Much weaker than Estradiol. Formed by peripheral conversion of Estradiol and Androstenedione
63
Anococcygeal Body
Fibrous raphe connecting Anal Canal and Coccyx
64
Follicular Cell with limited cholesterol Supply
Granulosa Cells
Not close to vasculature. Separated by Basal Lamina during Follicular Phase. Secrete more Progesterone in Luteal Phase when Corpus Luteum vascularized
65
Change to Granulosa Cells when going from Primary to Mature Preantral Follicle
Begins to express FSH and Estrogen Receptors
66
Prostate Specific Antigen (PSA)
Breaks down clotting factors in semen (Fibrinogen from Seminal Vesicles)
67
Structures Attached to the Perineal Body (6)
1. External Anal Sphincter
2. Superior/Inferior Layers of Urogenital Diaphragm
3. Superficial Transverse Perineal Muscle
4. Deep Transverse Perineal Muscle
5. Superficial Perineal Fascia
6. Bulbospongiosus Muscle
68
Neurogenic Bladder
Dilated/flaccid bladder caused by spinal cord injury at S2-S4
69
Phagocytize Cytoplasm Released During Spermiogenesis
Sertoli Cells
70
Cumulus Cells
Granulosa cell type. Surround and maintain gap junctions with the Oocyte. Released with the Oocyte during ovulation
71
Navicular Fossa
Dilated part of Penile Urethra in Glans Penis
72
Required for External Genitalia Differentiation in Males
Dihydrotestosterone (DHT)
Derived from Testosterone, converted by 5α-reductase
73
Progesterone Role in Secretory Phase
1. Inhibits Epithelial Cell Proliferation
2. Promote Differentiation of Endometrium
3. Enhance Secretory Capacity
74
Detrusor Muscles: Innervation
Pelvic Splanchnic Nerves (Parasympathetic Fibers)
Inhibited by Sympathetics of T12-L2 (Hypogastric Nerves)
75
Cumulus Expansion
Hyaluronic Acid is secreted by the Cumulus Cells in response to LH stimulation.
Expands Extracellular Matrix and enlarges Cumulus-Oocyte complex. Enlargement facilitates Oocyte capture by the Fallopian Tubes
76
Change to Granulosa Cells Upon Being Selected as Dominant Follicle
FSH induces expression of LH Receptors. Allows it to respond to the LH surge.
Estradiol enhances the effect of FSH on LH receptor induction.
77
Pubic Arch
Angle between Inferior Rami and Bodies of Pubic Bones on both sides
78
Mediolateral Episiotomy
Surgical cutting of Vagina and Posterior Wall of Vulva (lateral to Perineal Body)
79
Receptor Binding AMH
TWO Serine-Threonine Kinase Receptors (R I and R II)
80
Bladder: Arterial Supply
Superior and Inferior Arteries
81
Oxytocin Effects on Uterine Contraction
1. Uterus Oxytocin Resistant (first 2 Trimesters)
2. Does NOT initiate labor
3. Distention of Cervix increases Oxytocin (pos. feedback)
4. Uterine sensitivity increases before/during contraction due to increase in receptors
82
Adaptation During Pregnancy: Lung Function Values
| RV, FRC, TLC, VC, TV
1. Residual Volume: Decreases
2. Functional Residual Capacity: Decreases
3. Total Lung Capacity: Decreases (slight)
4. Vital Capacity: Unchanged
5. Tidal Volume: Increases
83
Digests Extracellular Matrix and Basement Membrane in Menstrual Phase
Matrix Metalloproteinases
84
Source of Anti-Mullerian Hormone
Sertoli Cells
85
Decidual Reaction
Continues process started by Progesterone during Luteal Phase, transforming Endometrial Stromal Cells into enlarged cells forming an Epithelioid-like Compact Layer. Reaction spreads throughout Endometrium
86
Changes to Spermatozoa Membrane During Capacitation
Uterine Wall and Fallopian tube secretion destabilize plasma membrane near head.
Increased Ca2+ permeability
87
Artery of Bulb (of Penis)
Supplies erectile tissue of Bulb and Corpus Spongiosum
Anastomosis with Dorsal Artery of the Penis at Glans Penis
88
Action(s) of Bulbospongiosus Muscle
1. Aids in emptying urethra
| 2. Contributes to erection by compressing blood engorged bulb of penis
89
Induces Expression of Aromatase
FSH
90
Secreted by the Testes
1. Testosterone (by far major secretion)
2. Estrogens
3. Weak Androgens (Androstenedione and DHEA)
4. Various Biosynthetic Intermediates
91
Cyclooxygenase-2 (COX-2)
Catalyzes formation of Prostaglandins, derived from Arachidonic Acid metabolism
Expression by Granulosa Cells (Preovulatory Follicle) induced by LH
92
Adaptation During Pregnancy: Afterload
Decreases
Aorta more distensible (Estrogen/Progesterone), decrease in Peripheral Resistance
93
Interaction between R I and R II
AMH binds to R II, which is constitutively phosphorylated. Binding causes R II to recruit R I and phosphorylate it. R I kinase activity activated
94
Acrosomal Reaction
Triggered by Spermatozoa head proteins binding to ZP3 receptor on Zona Pellucida. The rise in intracellular Ca induces release of Hydrolytic Enzymes to digest through Zona Pellucida
95
Blood Supply to Penis are Branches off...
Internal Pudendal Artery
96
Stimulates Fetal Leydig Cell Testosterone Production
Chorionic Gonadotropin (hCG)
97
Negative Feedback of Ovarian Hormones
1. Estradiol on Ant. Pit / Hypothalamus
2. Progesterone on Ant. Pit / Hypothalamus
3. Inhibin A/B on Ant. Pit only
98
Iliococcygeus
Part of Levator Ani
* Originates on Tendinous Arch and Ischial Spine
* Inserts on Coccyx and Anococcygeal Body
99
Reason for Decreased Venous Efflux During Erection
Compression of Subtunical Venous Plexus against wall of Tunica Albuginea
100
Medial Umbilical Ligament
Obliterated Distal part of Umbilical Artery
101
Dorsal Artery of the Penis
Supplies skin of the penis and fascial sheath surrounding erectile tissue.
Anastomoses with Artery of Bulbs of Penis at Glans Penis.
102
Sensory Innervation to the Clitoris
Dorsal Nerve of Clitoris (Branch of Pudendal Nerve)
103
Midpiece (Mature Spermatozoa)
Packed with mitochondria for energy
104
External Os
Opening between Cervix and Vagina
105
Supplies Proximal Part of Rectum
Superior Rectal Artery
106
Fornix of Vagina
Part of Vaginal Lumen surrounding Cervix. Four Parts:
1. Anterior
2. Two Lateral
3. Posterior
107
Muscle Surrounding Anorectal Junction
Puborectalis Muscle (Levator Ani)
108
Requirements for Ovary Differentiation
1. Invasion of Cortex by PGCs
2. Reactivation of Inactivated X Chromosome
3. Absence of SRY Gene
109
Smad3
AMH Pathway
Cytoplasmic protein phosphorylated by R I. Nuclear Localization Signal unmasked when activated.
110
5α-Reductase
Converts Testosterone to DHT. Present in DHT-sensitive target tissue
111
Chorinonic Somatomammotropin (hCS) / Placental Lactogen (hPL)
Same structural family as GH/PRL. Secreted into the blood both by the mother and fetus. Functions to maintain glucose flow to fetus
1. Stimulates Lipolysis (Mother)
2. Antagonizes Insulin (Mother)
3. Required for Breast Development
4. Enhances Erythropoietin Effect (Mother)
112
Hysterosalpingography
Radiography of Uterus and Uterine tube following radiopaque injection. Determine patency (passability) of Uterine Tube
113
Ectopic Tubal Pregnancy
Ovum is fertilized but cannot pass down the tube. Uterine Tube will later rupture due to the placenta and result in life-threatening hemorrhage into Peritoneal Cavity
114
Cavernous Endothelial Cells
Release Nitric Oxide in addition to the efferent parasympathetics during erection
115
Nabothian Cyst
Pus-filled cyst, filled with mucus from a blocked cervical gland in the Cervix.
116
Promotes Descent of Testes Through Inguinal Canal into Scrotum
Testosterone
117
Epithelium of Efferent Ductules
"Scalloped" Look
Alternating:
1. Nonciliated Cuboidal Epithelium
2. Ciliated Simple Columnar Epithelium
118
Characterize Growth of Dominant Follicle
1. Graunlosa Cell Proliferation (Cumulus Oophorus)
2. Oocyte pushes to one side of follicle
3. Expansion of Antrum
119
Posterior Half of Perineum
Anal Triangle
120
Most Potent Postpartum Stimulus of Prolactin
Suckling
121
Location of Urogenital Diaphragm
Inferior to Pelvic Diaphragm in Perineum
122
Indicates present of a dominant follicle
Dramatic increase in circulating Estradiol
123
Anterior Lobe (Prostate)
Anterior to Prostatic Urethra
Little glandular tissue/significance
124
Secreted by Seminal Vesicles
1. Prostaglandins (Uterine Contraction)
2. Fructose
3. Fibrinogen (Helps clot semen together)
125
Oxytocinase
Enzyme resulting in Uterus' resistance to Oxytocin in the first two Trimesters
126
Syncytiotrophoblast Estriol Synthesis
1. DHEA-S from Fetal Adrenal Cortex Converted to 16α-OH DHEA-S in Fetal Liver
2. Placental Sulfatase removes Sulfate
3. 16α-OH DHEA converted to 16-hydroxyandrostenedione
4. Then to Estriol by Placental Enzymes
127
Posterior Lobe (Prostate)
Inferior to Ejaculatory Duct and Posterior to Prostatic Urethra
Common site for Carcinoma
128
Adaptation During Pregnancy: Baroreceptor Reflex
Lower set point
129
Site of Milk Storage
Lactiferous Sinus
130
Structures Derived from Genital Tubercle
* Clitoris (Female)
| * Glans Penis (Male)
131
FSH Receptor Intracellular Mechanism
cAMP Signaling Pathway
132
Destination of Ovarian Vein Drainage
* Right: Inferior Vena Cava
| * Left: Left Renal Vein
133
Actions of FSH on Sertoli Cell
1. Promotes Proliferation/Differentiation of the Cell (Immature Testes)
2. Maintains Function in Mature Testes
3. Induction of Proliferation, Development, and Anti-Apoptotic Effects on Spermatogonia
4. Promotes Synthesis/Release of ABP
5. Stimulates Inhibin Release
6. Upregulate Aromatase
134
Suspensory Ligament of the Ovary
Part of Broad Ligament of the Uterus
Suspends ovary from lateral pelvis walls. Contains Neurovascular supply to ovary
135
Decidua
Name for Endometrium post-implantation
136
HSD 2
Protein expressed by Placenta, protecting Fetus from Maternal Cortisol
137
Source of hCG in Pregnancy
Syncytiotrophoblast
138
True Pelvis: Superior and Inferior Boundaries
1. Superior -- Pelvic Inlet
| 2. Inferior -- Pelvic Outlet
139
Location of Portal-Caval Anastomoses in Anal Canal
Anal Columns
140
Spinal Roots of Pudendal Nerve
S2-S4
141
Placental Variant of Human Growth Hormone (hGH-V)
Secreted by Syncytiotrophoblast in two isoforms
Dominant form of GH in maternal secretion (pituiatry GH under negative feedback of IGF-1)
142
Actions of the Bulbospongosis Muscles (Female)
1. Constricts Vaginal Orifice
2. Aids in Expression of Greater Vestibular Glands
3. Contributes to Erection of the Clit
143
HPG Axis Feedback Regulation
1. Testosterone
Inhibits Hypothalamic Pulse Generator (GnRH frequency). Lowers ratio of LH to FSH.
2. Inhibin
Secreted by Sertoli Cells. Inhibits ONLY FSH release
144
HPG Axis: Late Follicular Phase
1. Increase in Estradiol from increase in Granulosa Cells in Dominant Follicle and FSH/LH stimulation
2. Positive feedback effect on Pit/Hypothalamus leads to LH surge/ovulation
145
Adaptation During Pregnancy: Resting Heart Rate
Increases by 10-20 bpm
146
Muscle in Greater Sciatic Foramen
Piriformis Muscle
147
ZP1, ZP2, and ZP3
Extracellular proteins secreted by Oocyte which embed into the Zona Pellucida, providing species specific binding sites for sperm
Binding of Spermatozoa to ZP3 triggers the Acrosomal Reaction
Added in the process of forming a Mature Preantral Follicle
148
Fourchette
Point where Labia Minora unites posteriorly (also called Frenulum of Labia Minora)
149
Layers of the Uterus (Superficial to Deep)
1. Endometrium
2. Myometrium
3. Perimetrium
150
Stigma
Poorly vascularized bulge on Ovary surface due to pressure of follicle against it
151
Broad Ligament of the Uterus
Two-layered reflection of Peritoneum from Uterus, extending laterally to the Pelvic Wall
152
Seminiferous Tubule Compartments
Formed by Tight Junctions between Sertoli Cells
1. Basal Compartment
2. Adluminal Compartment
153
Vagina: Venous Draiange
Vaginal Venous Plexus
154
Detrusor Muscles
Three-layered smooth muscular coat of Bladder
155
Fetal Zone of Adrenal Cortex During Pregnancy
Major Source of DHEA for Synctiotrophoblast Estriol secretion.
Released as DHEA-S
156
Breast Development: Pregnancy (Requirements for Development)
Development Requires:
1. Prolactin
2. hPL
3. Estrogens
4. Progesterone
Permissive:
1. GH
2. IGF-1
3. Insulin
4. Cortisol
157
Genes Induced by CREB
CREB induces transcription of the following Steroidogenic genes in the LH Pathway:
1. StAR
2. P450scc (Cholesterol to Pregnenolone)
3. 17α-Hydroxylase
4. Proteins/Enzymes involved in Cholesterol Synthesis/Uptake
158
Action of SOX9
Regulates expression of genes that promote Sertoli Cell Differentiation
159
Upper Half of Anal Canal: Venous Drainage
Superior Rectal Vein
160
Posterior Division Branches (Internal Iliac Artery)
1. Iliolumbar Artery
2. Lateral Sacral Artery
3. Superior Gluteal Artery
161
Termination of the Bulb of Vestibule
Glans of Clitoris
162
Obturator Fascia
Thick regional expression of Endopelvic Fascia covering Obturator Internus
163
Inhibits Lactation During Pregnancy
Progesterone
164
Adaptation During Pregnancy: Plasma Osmolality
Decreased
165
Anterior Division Branches (Internal Iliac Artery)
1. Obturator Artery
2. Umbilical Artery
3. Inferior Vesical Artery (Male)
4. Middle Rectal Artery
5. Vaginal Artery (Female)
6. Uterine Artery (Female)
7. Inferior Gluteal Artery (Terminal)
8. Internal Pudendal Artery (Terminal)
166
Source of Cholesterol for Granulosa-Lutein Cells
Obtain cholesterol from circulating LDL/HDL.
1. LH induces breakdown of Basal Lamina (Vascularized)
2. LH induces expression of LDL/HDL receptors
167
Obstetric Conjugate
True Conjugate.
Thickest Part of Pubic Symphysis to Sacral Promontory
168
Contained in Basal Compartment of Seminiferous Tubule
1. Spermatogonia
| 2. Early Stage Primary Spermatocytes
169
Structures of Upper Half of Anal Canal
1. Anal Columns
2. Anal Valves
3. Anal Sinuses
170
Glycosuria in Pregnant Women
Caused by an increase in filtered Glucose (see: GFR) and diminished ability to reabsorb
171
Contents of Superficial Perineal Pouch
1. Root of External Genitalia
2. Superficial Transverse Perineal Muscle
3. Bulbospongosus Muscle
4. Ischiocavernosus Muscle
5. Greater Vestibular Glands (FEMALE)
172
Mural Cells
Granulosa cell type. Develop in close contact with Thecal Layer and are actively engaged in steroidogenesis.
Retained after ovulation and differentiate into the Corpus Luteum
173
RSPO1
Gene which directly activates the WNT4 / Beta-Catenin Pathway. Promote ovarian differentiation and represses development of Testis.
174
Upper Half of Anal Canal: Innervation
Hypogastric Plexus of Autonomic System
175
Ovarian Cycle Day Breakdown
1. Follicular Phase (1-13)
2. Ovulation (14)
3. Luteal Phase (15-28)
176
Muscles of the Pelvic Diaphragm
1. Levator Ani (Anterior 3/4)
| 2. Coccygeus (Posterior 1/4)
177
Overview of AMH-Receptor Mechanism
1. R I and R II receptor dimer
2. R I phosphorylates Smad3
3. Smad3 + Smad4 move to nucleus
4. Promotes Apoptotic Genes
178
Colles' Fascia
Also called generically the Superficial Perineal Fascia (Anal Triangle part). Continuation of Scarpa's Fascia from Anterior Abdominal Wall
179
Round Ligament of the Ovary
Ligament from Uterus to Ovary
Remnant of proximal part of Gubernaculum, attached to lateral side of Uterus inferior to the Uteirne Tube
180
Innervation of Bladder
1. Sacral Nerves (S2-S4) via Pelvic Splanchnic Nerves
| 2. T11-L2
181
True Pelvis: Lateral Walls
1. Pelvic Bones
2. Obturator Internus Muscle
3. Sacrospinous Ligaments
4. Sacrotubeorus Ligaments
182
Contains the Proximal Part of Spongy Urethra
Bulb of Penis
183
Levator Ani: Origins
1. Anterior -- Body of Pubis
2. Middle -- Tendinous Arch
3. Posterior -- Ischial Spine
184
Adaptation During Pregnancy: Diastolic Volume (Preload)
Increases
Due to Estrogen and Progesterone increasing Compliance
185
Supplied by Arteries to Bulb of the Vestibule
Bulb and related parts of the Vagina
186
Used to treat erectile dysfunction
cGMP-Specific Phosphodiesterase Inhibitors
187
Histological Appearance of Prostate Gland
Has Prostatic Concretions (hardened/calcified protein)
188
Contents of Deep Perineal Pouch
1. Deep Transverse Perineal Muscle
2. External Urethral Sphincter
3. Membranous Urethra (Male)
4. Bulbourethral Glands (Male)
5. Urethra and Vagina (Female)
6. Internal Pudendal Artery, Veins, and Branches
7. Pudendal Nerve and Branches
189
Course of Genital Ducts
From Gonad to Urogenital Sinus
190
Components of Linea Terminalis: Posterior to Anterio
1. Arcuate Line (Ilium)
2. Pecten Pubis
3. Pubic Crest
191
Sperm Passage through Cervix
Moves through the Interstitial spaces created by Mucin molecules proliferate and accumulate water in response to mid-cycle estrogen peak
192
Myometrium
Middle layer of the Uterus
Thick muscular layer expelling the fetus during birth
193
Act as friction ridges during intercourse and allow for distention during childbirth
Vaginal Rugae
194
Marked by Lower Corner of Trigone
Internal Orifice of Urethra
195
Superficial Dorsal Vein of Penis
Drains blood from and fascia of penis into Superficial External Pudendal Vein
196
Ischioanal Fossa
Fat-filled space surrounding External Anal Sphincter in Anal Triangle of Perineum
197
Contained in Adluminal Compartment of Seminiferous Tubule
1. Late Stage Primary Spermatocytes
2. Secondary Spermatocytes
3. Spermatids
198
Prostaglandin F2α
1. Promotes Degradation During Luteolysis
| 2. Released by Endometrium to promote vasospasms in Menstrual Phase
199
Sacral Plexus Nerves Which Exit Greater Sciatic Foramen (4) [And Relation of Exit to Piriformis]
1. Superior Gluteal Nerve (above)
2. Inferior Gluteal Nerve (below)
3. Sciatic Nerve (below)
4. Posterior Cutaneous Nerve of Thigh (below)
200
Structures Differentiating from the Mullerian Ducts
1. Fallopian Tubes
2. Uterus
3. Cervix
4. Upper 1/3 of Vagina
201
Uterovaginal Primordium
Fusion of the Mullerian Ducts and the Caudal End
202
Bladder: Venous Drainage
Vesical Venous Plexus (Drains to Superior/Inferior Vesical Veins then Internal Iliac Veins)
203
Follicular Cell without Aromatase Activity
Thecal Cell
204
Major Estrogen in Post-Menopausal Women
Estrone
205
Cystitis
Bladder infection
Common in females due to short urethra
206
Gonocyte
Prespermatogonia
Differentiated PGCs within Testis Cords which have entered Mitotic Arrest at Weeks 10-12. Resume proliferation after birth (don't enter Meiosis until puberty)
207
Danger from Artery during Hysterectomy
Uterine artery crosses anterior to the Ureter, very close. Ureter can be damaged.
208
Clinical Manifestations of Declining Estrogen in Menopause
1. Uterine Atrophy
2. Dryness of the Vagina
3. Loss of Bone Mass
4. Rise in Circulating Gonadotropins
5. Hot Flashes
209
HPG Axis: Childhood (after neonatal)
Under CNS inhibition, quiet during childhood. Girls somewhat higher FSH
210
Marked by Upper Corners of Trigone
Opening of Ureters
211
Principal Steroid Hormones Secreted by Ovaries
1. Estradiol
2. Progesterone
3. Androstenedione
212
Equivalent of Bulbourethral Glands in Females
Greater Vestibular Glands (Bartholin's Glands)
213
Hormones Secreted During Pregnancy (6)
1. Chorionic Gonadotropin (hCG)
2. Progesterone
3. Estrogens
4. Chorionic Somatomammotropin (hCS) aka Placental Lactogen (hPL)
5. Placental Variant of Human Growth Hormone (hGH-V)
6. Relaxin
214
Obturator Internus Muscle: Insertion
Greater Trochanter of Femur
215
hCG Structure
* α subunit: identical to other Ant. Pit. glycoproteins
* β subunit similar to LH
Uses LH receptors but has longer half-life (glycosylated)
216
LH Receptor Pathway: Phosphorylated by PKA
CREB (Transcription Factor)
217
Rectovesical Septum
Fused to Inferior End of Peritoneum, lying between base of bladder and rectum.
Anterior to rectum (palpable during rectal exam)
218
Adaptation During Pregnancy: Plasma Volume
Increases due to Estrogen stimulation of Renin
219
Fetoplacental Unit
Collaboration between Placenta and Fetus to Produce Estrogen (Estriol)
1. Synctiotrophoblast can synthesize Progesterone and has Aromatase
2. Fetal Zone of Adrenal Cortex source of Androgens
220
Meiosis Arrest in Secondary Oocyte
Arrested at Metaphase II by Cytostatic factor until feritilzation
221
Orchitis
Inflammation of the Testes. Seminiferous Tubule destruction may occur. Usually secondary to Mumps
Leydig Cells NOT affected
222
Supine Hypotensive Syndrome
Cardiac output higher when mother in Lateral Recumbent Position as opposed to Supine (Third Trimester). Weight of Uterus compresses IVC when Supine
223
Adaptation During Pregnancy: Blood Viscosity
Lowered due to:
1. Decrease in Oncotic Pressure (Albumin conc. drop)
2. Decreased Hematocrit
224
Efferent Aspect of Ejaculation
Trigger rhythmic contractions of Striated Musculature of Perineum, especially the Bulbocavernosus Muscle
225
Continuations of Colles' Fascia
* Scrotum -- Dartos Fascia
| * Penis -- Superficial Penile Fascia
226
Secretion of Inhibin A vs Inhibin B (Female)
* Inhibin A: Granulosa-Lutein Cells of Corpus Luteum in Response to LH
* Inhibin B: Graunlosa Cell in Response to FSH
227
Composition of Indifferent Gonad
1. External Cortex (Thickened Epithelium)
| 2. Internal Medulla (Prim. Sex Cords and Mesen. Tissue)
228
Corona Radiata
Crown of Granulosa Cells between Oocyte and Antrum
229
Adaptation During Pregnancy: Urinary Protein Secretion
Increases due to increase in GFR and permeability of Glomerular Basement Membrane.
Decrease in Serum:
1. Creatinine
2. Urea
3. Uric Acid
230
Genital / Gonadal Ridge
Thickened area formed from Epithelial and Mesenchymal cell proliferation in Week 5. Found along ventromedial surface of Mesopehros
231
HPG Axis: Prepubertal Period
* Gradual Disinhibition of GnRH Pulse Generator
| * See: Sleep-Associated LH Surge (Dirunal)
232
Epithelium of Epididymis
Pseudostratified Epithelium surrounded by Smooth Muscle
233
Ischiocavernosus Muscle
Located in Superficial Perineal Pouch. Covers Crura of Penis/Clitoris
234
Cell Types Differentiated from Trophoblasts
1. Cytotrophoblasts
| 2. Syncytiotrophoblasts
235
Coccygeus: Origin
Ischial Spine
236
Alternate Branching of Obturator Artery
* Normal -- Anterior Division of Internal Iliac
| * Alternative -- Inferior Epigastric Artery
237
Progesterone Peak Stage
Mid-Luteal Phase of Ovarian Cycle
238
Right and Left Lateral Lobes (Prostate)
Separated by Prostatic Urethra. May become enlarged (BPH) and compress urethra
239
Histological Appearance of Corpus Albicans
cloudy
240
Precursor of the Seminiferous Tubules
Testis Cords
Solid structures until puberty. They then will develop a lumen and mature into functional tubules.
241
Blood Supply to Female Copulatory Organs
1. Arteries to Bulb of the Vestibule
2. Deep Arteries of the Clitoris
3. Dorsal Arteries of the Clitoris
242
HPG Axis: Luteal Phase
1. LH promotes development/secretions in Corpus Luteum
2. Hormone production declines with Luteolysis
3. FSH rises as Corpus Luteum fails (decreased neg. feedback)
243
Mechanism of Tonic Inhibition of Prolactin
Dopamine action on Lactotrope in Anterior Pituitary. G(i) protein
* α Subunit -- inhibits Adenylyl Cyclase
* βγ Subunits -- Activate K+ channel (Hyperpolarize)
244
Innervated by Posterior Cutaneous Nerve of Thigh
Back of Thigh
245
Prostate Gland: Venous Drainage
Prostatic Venous Plexus (valveless), drains into Internal Iliac Vein
246
Reason for Prolactin Rise During Pregnancy
Estrogen promotes:
1. Lactotrope Hypertrophy/Hyperplasia
2. Prolactin Synthesis
247
Histological Appearance of Seminal Vesicles
Elaborate mucosal foldings, filling most of the lumen
248
Major Hormonal Influence on Proliferative Phase of Menstrual Cycle
Estradiol
249
Actions of LH on Preovulatory Follicle
1. Induces release of Inflammatory Cytokines and Metalloproteinases (breakdown Ovary wall)
2. Induces Expression of COX-2 in Granulosa Cells
3. Triggers Ovulation w/in 36 hrs
4. Stimulates Progesterone and Receptor Synthesis
5. Promotes Cumulus Expansion / Detachment of Oocyte Cumulus Complex
6. Promotes Reorganization of Mural Cells into Corpus Luteum
7. Promotes Resumption of Meiosis I
250
Corresponding Endometrial Cycle Phase(s) of Luteal Phase
Secretory Phase
251
Ducts in Breast Lobules
1. Alveolar Duct
| 2. Lactiferous Duct
252
Adaptation During Pregnancy: Thyroid
1. Enlarged during 1st Trimester (hCG)
2. Iodide uptake increased (due to higher renal clearance)
3. T4 and T3 increase (estrogen-induced TBG synthesis)
253
Smad4
AMH Pathway
Forms complex with activated Smad3 and moves into nucleus to upregulate Apoptotic genes
254
Seminal Colliculus
Rounded emininence on Urethral Crest on the Posterior Wall of the Prostatic Urethra.
Slit-like orifice leads to small Vestigal Prostatic Utricle. Opening for Ejaculatory duct next to orifice to utricle
255
Released by Cavernous Nerve During Erection
1. Nitric Oxide (NO)
| 2. Vasoactive Intestinal Peptide (VIP)
256
Diagonal Conjugate
Approximation of Obstetric Conjugate. Attained during digital exam
Inferior Border of Pubic Symphysis to Sacral Promontory.
257
HPG Axis: Puberty
* Gonadotropins elevation persistent throughout day
| * HPG axis increasingly active (Adult regulation pattern established)
258
Urogenital Hiatus / Gap
Allows for passage of Urethra (both) and Vagina (females) through Pelvic Diaphragm
259
Lower Half of Anal Canal: Innervation
Inferior Rectal Nerve (branch of Pudendal Nerve)
Somatic sensory responding to pain, touch, and temperature
260
Mesosalpinx
Part of Broad Ligament of the Uterus located inferior to the Uterine Tube
261
Location of the Bulbourethral Glands
Below prostate, lateral to Membranous Urethra
262
Morula
Ball of cells from mitotic division of fertilized Zygote as it enters the Uterus. Remains unattached for another three days and subsists on uterine secretions
Develops into a Blasocyst
263
Phases of the Endometrial Cycle
1. Proliferative
2. Secretory
3. Menstrual
264
PRL Receptor Type
Tyrosine Kinase-Associated Receptor (JAK/STAT Pathway)
265
Peritoneal Coverings of Rectum:
* Superior 1/3: Anterior and Lateral Surface Covered
* Middle 1/3: Anterior Only
* Lower 1/3: none
266
Delays Capacitation
Binding of Sperm to the Uterine Tube epithelium. Extends the life of the sperm and prevents too many for reaching the egg
267
Piriformis Muscle: Insertion
Greater Trochanter of Femur
268
Mechanism of Blastocyst Escaping Zona Pellucida in Order to Implant
Trophoblast cell secrete proteases to digest Zona Pellucida, allowing embryo to escape
269
Sacral Plexus Nerves Which Exit Greater Sciatic Foramen and Re-Enter Through Lesser Sciatic Foramen
1. Pudendal Nerve
| 2. Nerve to Obturator Internus and Superior Gemellus Muscles
270
Part of Endometrium NOT Shed During Menstruation
Stratum Basalis -- Lower 1/3
271
Completion of Second Meiotic Division of Oocyte
Triggered by Ca2+ signal. Oocyte develops into Female Pronucleus, Spermatozoa into Male Pronucleus
Fuse to form Diploid Zygote.
272
Lower Half of Anal Canal: Arterial Supply
Inferior Rectal Artery (Branch of Internal Pudendal Artery)
273
Anal Valves
Upper Half of Anal Canal
Semilunar epithelial folds joining inferior ends of Anal Columns
274
Parts of the Broad Ligament of the Uterus
1. Mesometrium
2. Mesovarium
3. Mesosalpinx
4. Suspensory Ligament of Ovary
275
Arteries Supplying Penis
Branches of Internal Pudendal Artery
1. Artery of Bulb
2. Deep Arteries of the Penis
3. Dorsal Artery of the Penis
276
Klinefelter Syndrome
Extra X chromosomes in Male, 80% of time 47, XXY
* Small, firm testes
* Hyalinized Seminiferous Tubules
* Germ Cell Degeneration
277
Innervated by Inferior Gluteal Nerve
Gluteal Muscles
278
Ligaments of Cervix of Uterus
Condensations of Endopelvic Fascia on Superior Surface of Pelvic Diaphragm. Hold the cervix in place to maintain anteflexed/anteverted position of Uterus and prevent prolapse.
Stretching during childbirth could contribute to Prolapse
279
Milk Ejection
Promoted by Oxytocin acting on Myoepithelial Cells surrounding Alveoli.
Principal stimulus of reflex is suckling
* Psychic Stimuli: Crying of Infant
* Repression: Fear, Anger, Stress, Pain
280
Follicular Cell with constant cholesterol supply
Thecal Cells
Close to blood vessels so they have constant LDL Cholesterol
281
Internal Hemorrhoids
Varicosities of tributaries of Superior Rectal Veins in Anal Columns, covered by mucous membrane. Less painful than external hemorrhoids
282
Course of Ductus Deferens
1. Enters Pelvis crossing over External Iliac Artery
2. Crosses over Ureter at posterolateral angle of Bladder
3. Descends to posterior surface of Bladder
283
Deep Penile Fascia
Buck's Fascia
Deep to Superficial Dorsal Vein of Penis. Encloses deep dorsal arteries/vein of Penis and Corpora of penis
284
Structure becoming Body of Clitoris Anteriorly
Crura of Clitoris
285
Obturator Canal
Remaining space in Obturator Foramen after being covered by Obturator Membrane
286
Causes of Secondary Hypogonadism (Male)
1. Hypopituitarism
| 2. Kallman Syndrome
287
Cryptorchidism
One or both testes fail to descend. 3% of males
288
Nourish Embryo After Initial Implantation in Endometrium
Uterine Glands
289
Location of the Ovary
Found in the Ovarian Fossa on the lateral wall of the Pelvis. Bound superiorly by External Iliac Vessels and inferiorly by Internal Iliac Vessels and Ureter
290
Primary Regulator of Thecal Cell Activty
LH
291
Induces Vasospasms and Uterine Contractions in Menstrual Phase
Prostaglandin F2α
292
Syndrome of Persistent Mullerian Ducts
Normal genotypic/phenotypic male either:
1. Cannot Synthesize AMH
2. Receptor Defective
* Mullerian Duct derivatives persist in Inguinal Hernia
* Testes fail to descend
* Structures underdeveloped
293
Role of FSH in Selection of Dominant Follicle
1. Stimulates Granulosa Cell Proliferation and Estradiol Synthesis
2. Estradiol and Inhibin Negative Feedback deprives non-dominant follicles of FSH. Dominant has store in Antrum
3. Dominant Follicles also has more FSH Receptors than others
4. Induces Expression of LH Receptors in Granulosa Cell
294
Two Ways to have Iatrogenically Induced Sterility
1. Disruption to Sympathetics to Ductus Deferens, Prostate, and Seminal Vesicles as a result of surgery in Pelvis (does not affect erection)
2. Surgical enlargement of Prostatic Urethra (Transurethral Resection)
295
Causes of Lactation Cessation
1) Absence of Suckling -> no PRL
2) Absence of Suckling -> no Oxytocin
3) Milk Accumulation in Alveoli (pressure on epithelial cells)
296
Suspensory Ligament of Penis
Supports body of penis. Arises from Symphysis Pubis and inserts into fascia surrounding penis
297
Ovarian Arteries: Origin and Course
* Arise from Aorta at L2
* Descend on Posterior Abdominal wall to Pelvic Brim
* Cross over External Iliac Vessels to enter Suspensory Ligament of Ovary
* Enters the Mesovarium to supply the Ovary and sends medial branches to Uterine Tube
298
Undifferentiated Primordial Structures Which Becomes External Genitalia
1. Genital Tubercle
2. Genital Fold
3. Labioscrotal Swelling
299
Lamina Propria
Found beneath the basement membrane in the Uterine Tube
300
Estradiol's Role in Proliferative Phase of Menstrual Cycle
1. Increases thickness of Endometrium
2. Induces growth of Uterine Glands
3. Promotes Development/Elongation of Spiral Arteries
4. Prepares Uterus for Progesterone-induced Endometrial Differentiation (Increases Progesterone Receptors)
301
Original of Vaginal Artery
Arises from initial part of Uterine Artery
302
Contents of the Broad Ligament of the Uterus
Note: not the anatomical parts
1. Uterine Tube
2. Round Ligament of the Uterus
3. Round Ligament of the Ovary
4. Uterine Artery/Vein
5. Terminal Branches of Ovarian Artery/Vein
303
Causes of Luteolysis
1. Decline in LH (Estrogen/Progesterone Feedback)
2. Prostaglandin F2α
3. "Various Paracrine Factors"
304
Hypospadias
Birth defect where urethral opening is on the underside of the penis rather than the tip. Associated with Androgen absence during differentiation and Micropenis
305
Estradiol Secretion by Sertoli Cells
Aromatization of Androgens. Stimulated by FSH (increases Aromatase expression)
306
Sensory Innervation to the Penis
Dorsal Nerve of the Penis (Branch of Pudendal Nerve)
307
Anal Sinuses
Upper Half of Anal Canal
Recess superior to Anal Valve and between Anal Columns
308
Coccygeus: Insertion
Sacrum and Coccyx
309
Bulbospongiosus Muscle
Located in Superficial Perineal Pouch. Covers Bulb of Penis or Bulb of Vestibule (Female)
310
Stimulates Proteolytic Enzymes Secretion by Thecal and Granulosa Cells
LH (release of the Oocyte during ovulation)
311
External Hemorrhoids
Varicosities of tributaries of Inferior Rectal Veins covered by skin. Most painful (somatic sensory)
312
Gives off Prostatic Branch (Artery)
Inferior Vesical Artery
313
Menstrual Cycle Day Breakdown
1. Menses (1-4)
2. Proliferative Phase (5-14)
3. Secretory Phase (15-26)
4. Premenstrual Phase (27-28)
314
AMH (Female)
Involve in Intraovarian Signaling. Mature Prenantral Follicle secretes it to restrain development of other Follicles
315
Piriformis Muscle: Origin
Sacrum
316
Arteries Passing in Between Piriformis and Coccygeus Muscles in Greater Sciatic Foramen
Inferior Gluteal and Internal Pudendal Arteries
317
Formed from Single Layer of Pregranulosa Cells Around Primary Oocyte
Primordial Follicle
318
Corresponding Endometrial Cycle Phase(s) of Follicular Phase
Menstrual and Proliferative Phases
319
Rectovaginal Septum
Separates vagina from rectum. Fused to inferior end of Peritoneum. Limits spread of infection or cancer
320
Sex Steroids Secreted by Granulosa Lutein Cells
1. Progesterone
| 2. Estrogens
321
HPG Axis: Neonatal Period
* Active week after birth
* FSH/LH elevated for first few months
* Gradually declines after CNS exerts inhibitory effect
322
General Causes of Defective Virilization in 46, XY Embryo (with normal Testes)
1. Inborn error of Testosterone Biosynthesis
| 2. Inability to Respond to Androgens
323
Anorectal Junction
Pierces posterior midline part of Pelvic Diaphragm
324
Anterior Half of Perineum
Urogenital Triangle
325
Fate of Cortical Cords in Female Differentiation
Cortical Cords break up into Primordial Follicles in the 3rd month.
326
Main Blood Supply to Perineum
Internal Pudendal Artery
327
Function of IGF-1 Produced by Dominant Follicle
Enhances Granulosa Cell responsiveness to FSH.
328
Epithelium of Mucosal Layer (Vagina)
Stratified Squamous Epithelium (Non-Keratinized)
329
Structures Derived from Urogenital Sinus
* Prostatic Buds (Male)
| * Lower pt. of Vagina (Female)
330
Primary Regulator Granulosa Cell Activity
FSH
331
Regulator of Epididymis Function
Testosterone
332
Prostatic Carcinoma Metastasis Path
Prostatic Venous Plexus > Vesical Venous Plexus > Internal Iliac Vein > Lateral Sacral Vein >...
* Vertebral Column: Internal Vertebral Venous Plexus
* Spinal Cord: Radicular Veins
333
Transverse Rectal Folds
3 semicircular horizontal folds of Rectal Mucosa (2 left, 1 right). Located at each sharp rectal flexure
Hard Stool or Protoscope can tear folds, leading to Rectal Wall infection
334
Benign Prostatic Hyperplasia (BPH)
Median (less commonly, Lateral) lobe bulges into bladder at Internal Urethra Orifice. Dripping of urine into urethra causes urination at night
335
Pelvic Brim Components: Posterior/Medial to Anterior/Medial
1. Sacral Promotory
2. Ala (Sacrum)
3. Linea Terminalis (itself has 3 components)
4. Pubic Symphysis
336
Decapacitation
Epididymis secretions coat Spermatozoa with substances blocking Acrosomal reaction
337
Promotes Acidification of Vaginal Lumen
Estradiol
338
Components of Testosterone Circulation
1. Sex Hormone-Binding Globulin (SHBG) (40-60%)
2. Free Testosterone (2-3%)
3. Albumin (Rest)
339
Alevolar Ventilation in Pregnancy
1. Rises throughout
2. Mainly due to 30-40% increase in Tidal Volume
3. Decrease in Alveolar PCO2
4. Respiratory Alkalosis prevented by Renal Bicarb Excretion
5. Progesterone increases sensitivity of Central Chemoreceptors to CO2
340
All Primordial Follicles Formed by This Time
6 month old infant
341
Types of Estrogen
1. Estradiol (E2)
2. Estrone (E1)
3. Estriol (E3)
342
What stage does the Zona Pellucida form
Forms around Oocyte after Primordial Follicle leaves pool of inactive follicles. Seen in the Primary Follicle
343
5α-Reductase Deficiency
Cannot convert Testosterone to DHT
* Internal Genitalia Male
* External Genitalia Ambiguous
* Further Masculinization will occur at puberty
344
Intrauterine Growth Restriction (IUGR)
Occurs from sustained reduction in placental perfusion
345
Adaptation During Pregnancy: Plasma ADH Levels
Normal (note this is abnormally high given the Osmolality, however. Set point changes)
346
Supplied by Deep Arteries of the Clitoris
Crura and Corpus Cavernosum of the Body
347
Fundiform Ligament of Penis
Supports body of penis. Descends from Linea Alba, splits into two bands that pass on either side of penis.
348
Adaptation During Pregnancy: Systolic Blood Pressure, Diastolic Blood Pressure, and Mean Arterial Pressure
All decrease
SBP falls least due to disproportionate decrease in peripheral resistance.
Blood pressure does increase during 3rd trimester, may return to normal or exceed pre-pregnancy
349
Primary Secretion of Thecal Cells
Androstenedione
350
External Urethral Sphincter: Location
Surrounds urethra within Urogenital Diaphragm
351
Uterine Tube Blockage
Major cause of infertility. Result of adhesions from healed infections that have spread from Vagina/Uterus or Peritoneal Cavity
352
Follicular Cell without 17α-hydroxylase Activity
Granulosa Cells
353
Excessive Androgen After 12 Weeks in 46, XX Embryo
Leads to Clitoral Hypertrophy
354
Which is Posterior? Sacrotuberous and Sacrospinous Ligaments
Sacrotuberous Ligament
355
Layers of Muscular Wall of Ductus Deferens
1. Outer Longitudinal
2. Middle Circular
3. Inner Longitudinal
356
Origin of Superior Vesical Arteries
Umbilical Artery
357
Stimulate Androgen Binding Protein (ABP)
FSH and Testosterone
358
Older Age-Related Changes to Androgen in Males
1. Decline in Total Serum Testosterone
| 2. Increase in SHBG (lowers bioavailability)
359
Round Ligament of the Uterus
Ligament from Uterus through Inguinal Canal to Labia Majora
Remnant of the distal part of the Gubernaculum. Attaches to Uterus inferior to Uterine Tube
360
Layers of the Vagina (Superficial to Deep)
1. Mucosal Layer
2. Muscular Layer
3. Fibrous Layer
361
Pubococcygeus
Part of Levator Ani
* Originates from Body of Pubis
* Inserts on Anococcygeal Body and Coccyx
362
Mesovarium
Two-layered reflection from posterior layer of Broad Ligament of the Uterus, associated with the Ovary
363
Primary Hormonal Influence in Secretory Phase (Menstrual Cycle)
Progesterone
364
Innervated by Pudendal Nerve
1. Skeletal Muscles of Perineum
2. Sensory to Lower 1/2 of Anal Canal
3. Skin of External Genitalia
365
Irradiation (Primary Hypogonadism)
Seminiferous Tubules most sensitive. Leydig cells more resistant
366
Sex Steroids Secreted by Theca Lutein Cells
1. Progesterone
| 2. Androgens
367
Hormones Affecting Erythropoiesis
1. Testosterone (Stimulates Erythropoietin Synthesis)
2. Cortisol
3. GH
4. Prolactin (Enhance Erythropoietin Effect)
5. hPL (Enhance Erythropoietin Effect)
368
Limits Migration of Implanted Embryo through Stroma
Compact Layer formed by Decidual Reaction
Involves secretion of factors that inhibit Hydrolytic Enzymes released by Synctiotrophoblasts
369
Tearing of Anal Valves
Torn by hard stool or protoscope. Anal canal infected and forms a fistula through wall into Ischiorectal Fossa
Can result in Perianal Abscess
370
Cells with Prominent Aromatase Activity (Male)
1. Certain CNS Nuclei
2. Leydig Cells
3. Sertoli Cells
4. Adipose Tissue
371
Fate of Indifferent Gonad Medulla
* Differentiates in Testis
| * Regresses in Ovary
372
Phase where Follicles become FSH-dependent for growth and survival
Larger Antral Follicles become dependent on FSH. Prior to that, FSH just growth promoting
373
Start of Uteroplacental Circulation
Lacunae development by Synctiotrophoblasts as they invade Endometrium
374
Reasons Germ Cells in Ovary Peak at 20 Weeks
1. Decreased Oogonial Mitosis (stops at 7 months)
2. Atresia of Non-Dominant Oogonia
3. Atresia of Maturing Follicles (Pre-Puberty)
375
Primary Regulator of Testosterone Secretion (Males)
Lutenizing Hormone (LH)
376
Formation of the Thecal Layer
Forms from Stroma Cells surrounding Basal Lamina in response to Paracrine Factors from Granulosa Cells
377
Episiotomy
Surgical incision of the Perineum and Inferoposterior Vaginal Wall to enlarge Vaginal Orifice. To decrease excessive tearing of Perineum and uncontrolled jagged tears of the musle. (Birth)
378
Major Blood Supply to Rectum
Superior Rectal Artery
379
Causes of Renin Secretion in Pregnancy
1. Response to Decreased Blood Pressure
2. Uterus Secretes Renin
3. Estrogen/Progesterone stimulate Renin Synthesis
380
Areola
Pigmented area around nipple with sebaceous glands near surface. Pink until first pregnancy, may become more pigmented
381
Parts of a Mature Spermatozoa
1. Head
2. Midpiece
3. Tail
382
Supplies Middle and Inferior Parts of Rectum
Middle Rectal Arteries
383
Rete Testis
Labyrinth of spaces located within Mediastinum/Tunica Albuginea of Testis. Passage from Tubuli Recti to Efferent Ductules
384
Tubuli Recti
Passage for Spermatozoa produced in Seminiferous Tubules to Rete Testes
385
Blood-Testis Barrier
Formed by Tight Junctions between adjacent Sertoli Cells. Limits exchange between Interstitial Fluid and Seminiferous Tubule Lumen
Creates environment for spermatogenesis and defends against auto-antibody attack
386
Function of Androgen Binding Protein (ABP)
Secreted into Seminiferous Tubules to keep Testosterone levels elevated
387
Mesenchymal Layer Separating Genital Ridge from Medulla
Tunica Albuginea (well it becomes that)
388
Divides Anal Canal into Two Halves
Pectinate Line, indicated by Anal Valves
389
Breast Development: Puberty
Response to rise in Estrogen and GH
1. Increase mostly in Stromal and Adipose Tissue
2. Areola/Nipple diameters increase
3. Ducts elongate and branch
4. Ductal Growth/Branching increases due to Estradiol/Progesterone in monthly cycles
390
Initiates Menses
Sudden drop in Estrogen and Progesterone in the Menstrual Phase (High in Secretory Phase)
391
Function of Epididymis Epithelium
1. Tight Epithelium forms Blood-Epididymis Barrier
| 2. Secretes Proteins and Glycoproteins
392
Two Phases of Ejaculatory Response
1. Emission
| 2. Ejaculation
393
Initial Mitotic Division of Fertilized Zygote
Happens while unattached in Fallopian Tube. Does not increase in size because of Zona Pellucida around it
394
External Urethral Sphincter: Innervation
Perineal Branch of Pudendal Nerve
395
Muscle in Lesser Sciatic Forament
Obturator Internus Muscle
396
Mesometrium
Forms the majority of the Broad Ligament of the Uterus.
Lateral to Uterus, inferior to Mesovarium
397
Time of Cyclic Recruitment of Follicles
Late Luteal Phase of PRECEDING Cycle
398
Promotes Transabdominal Movement of Testes to Internal Inguinal Ring in Week 12
Insulin-like Peptide 3 (INSL3)
399
Continuation of Bulb in Penis
Corpus Spongiosum
400
Prostate Gland: Lymphatic Drainage
Internal Iliac Nodes
401
Factors Decreasing Systemic Vascular Tone in Pregnancy
1. Estrogen (endothelial cells have ER, which elicits NO production)
2. Progesterone (smooth muscle relaxer)
3. Decreased Angiotensin II Sensitivity
4. Prostacycline (PI2)
5. Relaxin
402
Capacitation
Process of hyperactivation of Spermatozoa, 5-7 hours after ejaculation.
403
Why is LH required for Spermatogenesis?
* Sertoli Cells don't have LH Receptors. BUT
* LH stimulates Testosterone release from Leydig Cells
* Testosterone activates genes in Sertoli Cells promoting Spermatogenesis
404
Hyperactivation of Spermatozoa
Causes flagellum to beat in whip-like fashion and the head to move laterally. Helps sperm move through Tubular Mucus and Cumulus Oophorus
Intracellular Ca2+ rise (permeability) triggers exocytosis of Acrosome. The Acrosome contains Hydrolytic Enzymes which dissolve the Zona Pellucida
405
Prepuce
Folded double layer of Superficial Penile Fascia and skin that surrounds Glans Penis
406
Ligaments of the Sacroiliac Joint (Anterior to Posterior)
1. Anterior Sacro-Iliac Ligaments
2. Interosseous Ligaments
3. Posterior Sacro-Iliac Ligaments
407
Distal dilated part of Ductus Deferens
Ampulla
408
Syndrome of Complete Androgen Resistance
* Testes capable of secreting Androgens are located in Abdominal Cavity
* Male and Female Internal Genital Tracts Absent
* External Genitalia / Secondary Sex Traits Female
* Pubic Hair Scant/Absent
409
Maternal Response to Endometrium Invasion
Trophoblasts trigger Decidual Reaction
410
Necessary for Syncytiotrophoblast to Synthesize Estrogen
1. Dehydroepiandrosterone (DHEA)
| 2. 16α-hydroxy-dehydroepiandrosterone (16α-OH DHEA)
411
Origin of Primordial Germ Cells
Migrate from Yolk Sac Endoderm in about Week 5
412
Layers of the Urogenital Diaphragm
1. Superior Fascial Layer
2. Deep Perineal Pouch
3. Inferior Fascial Layer / Perineal Membrane
413
Sacral Plexus Nerves Which Remain in True Pelvis
1. Branches to Pelvic Diaphragm
| 2. Pelvic Splanchnic Nerves
414
Adaptation During Pregnancy: Cortisol
1. Increase in Maternal Cortisol (increased ACTH, Estrogen-induced CBG synthesis)
2. Contributes to Insulin Resistance
3. Leads to appearance of Striae (Stretch marks)
415
Location of Testosterone Inactivation
Liver
416
Uterine Tubes: Arterial Supply
Uterine and Ovarian Arteries
417
Referred Pain from Bladder
1. Tip of Penis (S2-S4)
| 2. Hypogastric Region of Anterior Abdominal Wall (L1)
418
Sertoli Cell Secretions
1. Androgen Binding Protein (ABP)
2. Anti-Mullerian Hormone (TGFβ Family)
3. Inhibins (TGFβ Family)
4. Activins (TGFβ Family)
5. Estradiol
419
Tunica Albuginea (Penis)
Fibrous covering directly investing each cavernous body. Fuses in midline of penis to form a septum.
420
Ovarian Dysgenesis
Caused by Germ Cell absence OR only single X Chromosome
Ovaries regress. Associated with Turner Syndrome (45,X)
421
Venous Anastomosis in Rectum
1. Portal: Superior Rectal Vein
| 2. Caval: Middle and Inferior Rectal Veins
422
Distinct Layers of Granulosa Cells
1. Mural Cells
| 2. Cumulus Cells
423
Phases of Ovarian Cycle
1. Follicular Phase
2. Ovulatory Phase
3. Luteal Phase
424
Part of Endometrium Shed During Menstruatioon
Stratum Functionalis -- Upper 2/3
425
Prostatic Sinus
Groove on each side of Urethral Crest, on the Posterior Wall of the Prostatic Urethra
Receives 20-30 Prostatic Ducts
426
Veins in Penis
1. Deep Dorsal Vein of Penis
| 2. Superficial Dorsal Vein of Penis
427
Cholesterol Esters
Found in yellowish liquid droplets inside corpus Luteum.
428
Supplies Anorectal Junction and Anal Canal
Inferior Rectal Arteries
429
Parasympathetic Preganglionic Fibers in Sacral Plexus
Pelvic Splanchnic Nerves
Innervate Terminal Ganglia which go to Hindgut derivatives
430
Connections between Sertoli Cells and Germ Cells
1. Adherens Junctions
| 2. Gap Junctions
431
Granulosa Cell Type Which Becomes Corpus Luteum
Mural Cells
432
Which is Anterior? Sacrotuberous and Sacrospinous Ligaments
Sacrospinous Ligament
433
Peritoneal Exudates
Mass of cell/fluid leaving the Peritoneal tissue during Peritonitis.
Drains into Rectovesical (Male) or Rectouterine (female) pouches when sitting or supine due to being lowest point in peritoneal cavity. Can cause tenderness.
434
Rectovesical Pouch
Males only
Formed by reflection of Peritoneum from Rectum to superior-posterior surface of Bladder
435
Landmark for Beginning of Anal Canal
Coccyx (begins at narrowing of Rectal Ampulla
436
Relaxin
Peptide hormone produced by Corpus Luteum, Decidua (Endometrium), and Placenta
Promotes Decidualization and other growth factors. Contributes to decrease in systemic vascular resistance
437
Exogenous Inhibitors of Ovulation
1. COX-2 Inhibitors
| 2. Progesterone Inhibitors
438
Vascular Endothelial Growth Factor (VEGF)
Secretion by Granulosa-Lutein Cells stimulated by LH
Promotes Angiogenesis around Corpus Luteum
439
Major Type of Estrogen Produced by Placenta
Estriol.
Levels measured during pregnancy
440
Estriol
E3
Weaker estrogen. Derived from metabolism of E1 and E2 in non-pregnant women. Placenta synthesizes large amount
441
Cytotrophoblasts
Differentiate from Trophoblasts.
Inner layer of continuously dividing cells
442
Upper Half of Anal Canal: Lymphatic Drainage
Pararectal Nodes then to Inferior Mesenteric Nodes
443
General/Regional Location of Sacral Plexus
Against Posterior Pelvic Wall
444
Nipple
Circularly-arranged Myoepithelial (Smooth) Muscle; Contains 15-20 Lactiferous Duct openings. Moves milk into duct
445
Arteries Supplying Rectum
1. Superior Rectal Artery (1)
2. Middle Rectal Arteries (2)
3. Inferior Rectal Arteries (2)
446
Rectouterine Pouch
Female only
Formed by reflection of Peritoneum from Rectum to Posterior Vagina/Uterus
447
Median Lobe (Prostate Gland)
Located between Urethra and Ejaculator Ducts
Common site for Benign Prostatic Hyperplasia
448
Sympathetic Innervation to Rectum
Superior and Inferior Hypogastric Plexuses
449
Resumption of Meiosis I in Preovulatory Follicles
Stimulated by LH via Mural Granulosa Cell release of Growth Factors acting on Cumulus Granulosa Cells. Occurs several hours before ovulation.
Cumulus Cells transmit signal to Oocyte which causes a decline in cAMP. Oocyte completes Meiosis I and extrudes a Polar Body
450
Primary Function of Inhibin B
Negative feedback regulation of FSH Secretion
Blocks GnRH stimulated FSH Release (Pituitary)
451
Nerve affected by a diseased Ovary and resulting in medial thigh pain
Obturator Nerve
It passes along the Obturator Internus m. in the Ovarian Fossa
452
Bioavailable Tesosterone
Free + Albumin-Bound Testosterone.
The latter dissociates readily whereas SHBG has a high affinity for Testosterone.
453
Lab Findings in Klinefelter Syndrome
1. Elevated FSH and LH
2. Testerosterone Low to Normal
3. Estradiol Elevated
454
Urethral Crest
Median Ridge on Posterior Wall of the Prostatic Urethra
455
Psychic Stimulus Pathway Initiating Erection
Corticospinal Pathway
456
Adaptation During Pregnancy: Renal Blood Flow
Increase due to Renal Vasodilation
457
3β-HSD
Converts Pregnenolone to Progesterone
LH induces expression in Granulosa-Lutein Cells
458
Name for Bones Surrounding Pelvic Inlet
Pelvic Brim
459
LH Receptor and Intracellular Mechanism
* G-Protein Coupled
| * cAMP signaling pathway
460
Deep Arteries of the Penis
Supplies erectile tissue of Crura and Corpora Cavernosa
461
Major Circulating Estrogen in Pregnant Female
Estriol
462
Principal Actions of hCG in Pregnancy
1. Prevent Luteolysis of Corpus Luteum
| 2. Promote Progesterone Production
463
Prevents Luteolysis During Pregnancy
Human Chorionic Gonadotropin (hCG)
464
Lacunae
Spaces developed by the Synctiotrophoblasts as they invade the Endometrium. Connect with Sinusoids and fill with Maternal Blood.
Finger-like projections will form Vili over time
465
Rectal Prolapse
Abnormal descent of rectum through anal canal. Can occur in young children because sacrum not curved like an adult
Can also occur if not enough support from Puborectalis Muscle (Levator Ani)
466
Location of Cauda Equina
Sacral Canal
467
Mechanism of Estradiol Thickening Endometrium
Estradiol stimulates Stromal Cells to release Growth Factors. Superficial Epithelial and underlying Stromal Cells then proliferate.
468
Head (Mature Spermatozoa)
Mostly the nucleus. Contains the acrosome on the tip.
469
Causes of Primary Hypogonadism (Male)
1. Klinefelter Syndrome (most common)
2. Orchitis
3. Irradiation
470
Stimulate Inhibin B Production
Secreted by Sertoli Cell
1. FSH
2. Testosterone
471
Organize Seminiferous Tubules in Lobules
Septa creating by invaginations of the Tunica Albuginea
472
Adaptation During Pregnancy: Cardiac Output
Increases during first trimesters, remains elevated. Increase is to compensate for fall in systemic vascular resistance
Increases due to Stroke Volume and Heart Rate increases.
473
Estrogen Effect on Bones
Inhibits Bone Resorption
474
Barr Body
Inactivated X chromosome. Pseudoautosomal region escapes inactivate X
475
Adaptation During Pregnancy: Pulmonary Resistance
Decreases due to relaxation of Smooth Muscle in Airways
476
External Anal Sphincter: Innervation
Inferior Rectal Nerve
477
True Pelvis: Posterior Wall
1. Sacrum
2. Coccyx
3. Piriformis Muscle
478
Origin of Primitive Sex Cords
Projections from Genital Ridge epithelium into underling mesenchyme before and during Primordial Germ Cell Migration
479
Adaptation During Pregnancy: Anterior Pituitary
Increases in size by 33%, has little effect on pregnancy post-implantation.
1. Major Change: Hyperplasia of Lactotropes (due to high estrogen)
2. Serum PRL increases
3. ACTH Increases (drops just before birth, increases during delivery)
4. Pituitary GH decreases
5. TSH lower in 1st trimester than 2nd/3rd
6. FSH and LH become very low
480
Adaptation During Pregnancy: GI System
Mostly due to Progesterone. Decrease in:
1. GI Motility
2. Food Absorption
3. LES Tone
4. Gall Bladder function
5. gastric emptying
481
Deep Dorsal Vein of the Penis
Drains blood from Corpora of Penis. Drains into Prostatic Venous Plexus and/or Vesical Venous PLexus
482
Epithelial Lining of Uterine Tube
1. Ciliated Simple Columnar
| 2. Secretory Peg (darker, not ciliated, protrude into Lume)
483
Pudendal Nerve Block
Peripheral nerve block providing local anesthesia over S2-S4 dermatomes to relieve pain during childbirth.
Needle is passed through the Vaginal Wall, toward Ischial Spine and through the Sacrospinous ligament.
484
Efferent Ductules
10-20 Efferent Ductules connect Rete Testis to head of Epididymis. Reabsorbs some extra fluid in the process.
485
Primary Hormone Influencing Follicular Phase
Estradiol
486
HPG Axis: Fetal Development
* Established during First Trimester
* Activity Peak Mid-Gestation
* Declines toward birth due to negative feedback of Placental Estrogens
487
Tail of the Epididymis
Lower, tubular portion of the Epididymis continuous with Ductus Deferens
488
Progestins
Steroid hormone promoting gestation (carrying of embryo/fetus in womb)
1. Progesteron (most potent)
2. 17α-hydroxyprogesterone
489
PRL Action on Milk Production
Acts on Epithelial Cells of Alveoli. Cortisol/Insulin permissive
Induces Transcription of:
1. Milk Protein (Casein)
2. Alpha Lactalbumin (enzymes for lactose synthesis)
3. Enzymes for Lactose/Triglyceride production
490
Differentiated Mesenchymal Cells Resulting from Sertoli Cell Recruitment via Paracrine Factors
1. Peritubular Myoid Cells
2. Endothelial Cells forming Male-Specific Vasculature
3. Leydig Cells
491
Contributes to Preeclampsia / Hypertension
Failure of invasion of Spiral Arteries by Cytotrophoblasts
492
Adaptation During Pregnancy: Plasma Protein Composition
1. Albumin concentration decreases (production increases)
2. Fibrinogen/Clotting factors increase
3. Binding Globulins
493
Piriformis Muscle: Course
Leaves True Pelvis through Greater Sciatic Forament
494
Blastocyst (and components)
Hollow, fluid-filled sphere developed from the Morula entering the Uterus.
Cell Types:
1. Inner Cell Mass (become Fetus)
2. Outer Layer of Trophoblastic Cells (responsible for implantation, formers fetal part of Placenta)
495
Placental Progesterone (when it takes over, source, and secreting cell)
1. Placenta major source after 8th week
2. Secreted by Syncytiotrophoblasts from maternal LDL/VDL
3. 90% goes into Maternal circulation
496
Binding Globulins Stimulated by Estrogen During Pregnancy
1. Thyroxine-Binding Globulin
2. Corticosteroid-Binding Globulin
3. Sex Steroid-Binding Globulin
497
Muscle Immediately Posterior to Sacral Plexus
Piriformis
498
Deep Transverse Perineal Muscle: Innervation
Pudendal Nerve
499
Invasion of Spiral Arteries Post-Implantation
Done by Cytotrophoblasts, causing destruction of the Smooth Muscle Layer and Elastic Fibers. Replaced by Fibrous Tissue.
Creates low resistance vessels, unresponsive to normal vascular tone modulation and enhancing flow into placenta .
500
Median Episiotomy
Midline incision of posterior wall of vagina, Fourchette, and Perineal Body. Less common than Mediolateral due to risk of cutting External Anal Sphincter
501
Floor of the Pelvic Cavity
Pelvic Diaphragm
502
Action(s) of Ischiocavernosus Muscle
Aids in erection by compressing crus of penis
503
Parts of External Anal Sphincter (Superficial to Deep)
1. Subcutaneous Part (slender, surrounds anus)
2. Superficial Part (Anchors anal canal by attaching to Perineal Body/Anococcygeal Body)
3. Deep Part (fuses with Puborectalis muscle)
504
Leavtor Ani: Subdivisions (medial to lateral)
1. Puborectalis
2. Pubococcygeus
3. Iliococcygeus
505
Prostate Gland: Arterial Supply
Branches of Inferior Vesical Artery
506
Structures Differentiating from the Wolffian Ducts
1. Epididymis
2. Ductus Deferens
3. Seminal Vesicles
4. Ejaculatory Ducts
507
Lobes of the Prostate Gland
1. Median Lobe
2. R Lateral Lobe
3. L Lateral Lobe
4. Posterior Lobe
5. Anterior Lobe
508
Syncytiotrophoblasts
Multinucleated structure formed by fusion of Cytotrophoblasts as Endometrium is bound/penetrated. Push through epithelial cells
Releases proteolytic enzymes to digest matrix proteins holding epithelial cells of Endometrium together and matrix proteins of the Stroma
509
Sacrotuberous Ligament: Attachments
1. Sacrum
| 2. Ischial Tuberosity
510
Oxytocin Receptor Mechanism
G protein-coupled. Activates IP3/DAG pathway
511
Continuation of Crura in Penis
Corpora Cavernosa
512
Kallman Syndrome
* Isolated Gonadotropin Deficiency
* Deficient GnRH release by Hypothalamus
* GnRH neurons from Olfactory Placode fail to migrate to Hypothalamus
* Arrested Spermatogenesis in Testes
* Associated with defective smell
513
Puborectalis
Part of Levator Ani
* Originates from Body of Pubis
* Forms important sling around Anorectal Junction
514
Coccygeus relation to Sacrospinous Ligament
Anterior
515
Hormones in Male Genital Duct Differentiation
1. Anti-Mullerian Hormone
| 2. Testosterone for Wolffian Ducts (fetal Leydig Cells)
516
Enhance Solubility of Inactivated/Excretory Metabolites of Testosterone
1. Sulfate
| 2. Glucoronic Acid
517
Signal Responsible for Induction of Ovulation
Massive increase in plasma LH.
Result of positive feedback effect of LARGE amount of Estradiol on Pituitary and Hypothalamus (normally a negative feedback mechanism!)
518
Epithelium of Cervix
* Facing Vagina: Stratified Squamous (non-keratinized)
| * Facing Uterus: Simple Columnar Epithelium
