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Week 7 Flashcards

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1
Q

What are Call-Exner Bodies?

A
  • begin the formation of the antrum
  • liquor folliculi fills the space
    • fluid made by Granulosa cells
    • rich in hylauronate, steriods, growth factors, and gonadotropins
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1
Q

What is the function of sertoli cells?

A
  • primary target of testosterone and androgens
  • forms blood testis barrier
  • phagocytosis excess material
  • secrete ABP and inhibin
  • makes and secretes
    • testicular fluid
    • testicular transferrin
    • plasminogen activator
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2
Q

What are the three phases of spermatogenesis?

A
  • Spermatocytogenesis
    • spermatogonia undergo mitosis
  • Meiosis
    • 1º spermatocyte > 2º spermatocyte > spermatids
  • Spermiogenesis
    • spermatids > spermatozoa
  • Takes 74 days
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2
Q

What is the role of testosterone in the male?

A
  • necessary for
    • spermiogenesis
    • male differentiation in utero - cryptorchidism
  • influences metabolism
  • affects behavior and libido
  • 95% comes from Leydig cells and 5% from adrenal
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3
Q

What is oocyte maturation Inhibitor?

A
  • OMI made by the follicular cell and goes through the gap junction to reach the oocyte
  • OMI prevents oocyte from undergoing spontaneous meitoic maturation
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3
Q

What do theca interna cells do?

A
  • supply the follicular cells with androstenedione to produce estradiol
    • creates theca interna-follicular cell synergism
  • Absorb cholesterol from the blood stream to make the androstenedione
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3
Q

Describe what the umbilical artery supplies?

A
  • first branch of anterior interal iliac
  • forms superior vesical artery
    • supplies superior bladder and distal ureter
  • carries blood from fetus to placenta
    • after birth forms a solid fibrous cord
  • medial umbilical ligament
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5
Q

What does the iliolumbar of posterior internal iliac divide into and supply?

A
  • first branch off the posterior internal illiac artery
  • divides into
    • iliac branch
      • into the iliac fossa to supply iliacus and ilium
    • lumbar branch
      • posterior abdominal wall, psoas major and quadratus lumborum muscles
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6
Q

What are the three glycoproteins that make up the zona pellucida?

A
  • ZP1
  • ZP2
  • ZP3
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6
Q

Where are Leydig (intersitial) cells located and what is there function?

A
  • located in interstitium along with blood vessels and lymphatics
  • function
    • secrete testosterone during fetal period for male sexual differentiation
    • go dormant at birth
    • at puberty, under LH stimulation, secrete testosterone
    • prolactin increases steriodgenesis
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6
Q

What are the layers of the Ductus Deferens?

A
  • Mucosa
    • pseudostratified columnar epithelium with sterocilia
    • lamina propria with elastic fibers
  • Muscularis externa
    • Inner longitudinal, middle circular, outer longitudinal
  • Adventitia
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6
Q

What neuronal innervation stimulates lubrication?

A
  • parasympathetic function
    • stimulate secretion of mucus from urethral glands and bulbourethral glands
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6
Q

What is the innervation of the bladder during urination?

A
  • sympathetic
    • internal urethral sphincter contraction - inhibit bladder contraction
  • parasympathetic
    • bladder contraction IUS relaxation
  • Somatomotor
    • external urethral sphincter contraction (pudendal)
  • sensory
    • viscerosensory - peritoneal surface and subperitoneal bladder
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6
Q

What is the venous drainage in the pelvis?

A
  • extensive venous plexuses forming the pelvic plexus of veins
  • venous drains into internal iliac veins > common iliac veins\
  • deep dorsal vein drains clitoris/erectile tissue join vesical/prostatic venous plexuses
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7
Q

What is the innervation during defecation?

A
  • sympathetic
    • internal anal sphincter contraction which inhibits rectal contractions
  • parasympathetic
    • rectal contraction IAS relaxation
  • somatomotor
    • esternal anal sphincter, puborectalis, levator ani contraction
  • sensory
    • above pectinate line - viscerosensory
    • below pectinate line - somatosensory
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7
Q

AST

A
  • Aspartate aminotransferase
    • aspartate + aKG > OAA + glutamate
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8
Q

What are the parts of the fallopian tube?

A
  • Infundibulum
    • fibmbriae become engorged with blood close to ovulation
  • Ampulla
    • site of fertilization
  • Isthmus
    • mainly muscle to contract towards uterus
  • Intramural segment
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8
Q

What are the areas of collateral circulation in pelvis?

A
  • lumbar (abdominal aorta) and iliolumbar (poster internal iliac)
    • posterior abdominal and pelvic wall and spinal cord
  • median sacral (abdominal aorta) and lateral sacral (posterior of internal iliac)
    • back and spinal cord
  • superior rectal (IMA) and middle rectal (anterior of internal iliac)
  • Inferior gluteal (anterior of internal illiac) and deep artery of thigh
    • gluteal muscles and hip joint
  • right internal iliac and left internal iliac
    • impotence and claudication of buttocks and thighs
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10
Q

What is the role of Cortical Granules in the oocyte?

A
  • contain proteases
    • released at fertilization after Ca2+ mobilization
  • proteases cause the conformational change of ZP2 and remove carbs from ZP3
    • changes in ZP prevent penetration by additional sperm
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10
Q

Describe the supply of the internal pudendal artery

A
  • leaves pelvis thorugh greater sciactic foramen
  • enters ischioanal fossa via the lesser sciatic foramen with the pudendal nerve
  • becomes deep and dorsal branches of clitoris or penis
  • main artery of perineum
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11
Q

What are the follicular phases and what are the hormones produced in each?

A
  • Follicular phase
    • estrogen
  • Luteal phase
    • progestrone and estrogen
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12
Q

Inferior gluteal nerve

A
  • L5 - S2
  • Leave pelvis via greater sciatic foramen
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12
Q

Describe the innervation of periarterial plexuses

A
  • postsynaptic, sympathetic, vasomotor fibers to
    • superior rectal
    • ovarian
    • internal iliac arteries
  • minor route: by which sympathetic fibers enter pelvis
  • main function: vasomotion of arteries they accompany
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14
Q

What is the drainage system of the rectum?

A
  • superior rectal veins > hepatic portal system
  • Middle and inferior rectal veins > caval system
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15
What are the branches off the anterior division of the internal iliac artery?
* umbilical * obturator * inferior vesical/vaginal * middle rectal * uterine * internal pudendal * inferior gluteal
16
What does FSH do in the ovarian cycle?
* stimulates growth and development of secondary follicles * stimulates granulosa cells convert androgens to estrogen * stimulates the synthesis LH receptors on granulosa cells
16
What is the outermost layer of the ovary?
* Germinal epithelium * serosa * cubodial
16
What are the layers of the uterus?
* Endometrium * Stratum functionalis * Stratum basale * Myometrium * deeper layers contain blood vessels * Perimetrium (serosa) * posterior and part of anterior surface * Adventitia
16
Describe glands during the proliferative and secretory phases?
* early proliferative * short, straight, and narrow * midproliferative * longer and straight * late proliferative * grow rapidly and become tortuous * secretory * glycogen accumulates at base of glands * glands look sawtooth
16
What is the neuronal stimulus of the male sexual act?
* From sex organs * sexual stimulations from glans penis or areas adjacent to penis * psychic stimulation from brain * thinking, dreaming * impulses from brain and/or sex organs * integrated in sacral and lumbar spinal cord
16
At what points does the iliacs split?
* common iliac splits into * internal and external iliacs between L5 and S1 * Internal iliac splits ino * anterior and posterior divisions
17
What is adiposogenital syndrome?
* deficiency in GnRH production * abnormalities in feeding center of hypothalamus * overeat \> obesity * markedly under development of gentelia
19
Where do spermatoza become mobile?
* Not mobile until they reach the transition from the caput (head) to corpus (middle) of epididymis * moderate motility in cauda (tail) of epididymis * Do not become fully mobile until ejaculation into the female reproductive tract * acidic vagina makes them less mobile
19
What are the secretory products of sertoli cells?
* FSH stimulates sertoli cells to secrete ABP * Androgen Binding Protein * inhibin to control FSH production
20
What is the role of parasympathetic innervation in the erection?
* parasympathetic releases NO to cause relaxation of SM * helicine arteries straighten out lowering endothelial cushions * increased blood flow to engorge erectile tissue * limited by compression of venous drainage
22
What are the structural features of efferent ductules?
* mix of tall and short columnar cells to make the luminal look sawtooth * psedostratified columnar cells with or without cilia * beat towards epididymis * thin circular SM * responsible for moving sperm to epididymis
22
What are the four main routes autonomic nerves enter pelvic cavity?
* sacral sympathetic trunks (10%) * periarterial plexuses * hypogastric plexuses (90%) * superior and inferior * pelvic splanchnic nerves
24
What is the function of principal cells of the epipdidymis?
* fluid resorption * secrete protein which initiates motility * secrete glycerophosphocoline which inhibits capacitation
24
How does the skeletal muscle eliminate nitrogen?
* using ALT to create alanine from pyruvate * fixes NH4 from muscle protein breakdown * Alanine travels in blood to go to liver * Alanine \> pyruvate \> glucose * releases NH4 to enter urea cycle
25
How is the spermatogenesis regulated by hormones?
* temp: 35 ºC * FSH * promotes synthesis of androgen binding protein (ABG) by sertoli cells to localize testosterone in seminferous tubules * LH * stimulates interstitial cells to produce testosterone * Prolactin * accentuates steroidgenesis of IC * Inhibition: testosterone feedback onto LH and inhibin inhibits FSH
26
What are the layers of the prostate?
* Mucosa * simple or pseudostratified columnar epithelium * think lamina propria * corpora amylacea (calcifications) * Fibromuscular stroma (no muscularis) * Fibroelastic capsule
26
How does estrogen affect spermatogenesis?
* reabsorption of luminal fluid in the head of epididymis * allows the sperm to enter epididymis concentrated rather than dilute * at early follicularphase * converted from testosterone by * Leydig cells * Sertoli cells * Developing germ cells * 2/3 from peripheral conversion (skin, brain, fat, liver)
27
What is orchidectomy and what are the symptoms?
* activity of all accessory sex organs declines * no seminal plasma made * decrease in muscular mass * decreased libido, antisocial patterns of sexual behavior * prevention of male baldness, decrease in kidney and liver weight, erythropoiesis * increase thymus weight
28
What is the role of maturation promoting factor (MPF)?
* just before ovulation, occyte activates itself with MPF to induce complete of meiotic prophase * results in the formation of the first polar body and a secondary oocyte
29
What is hirsutism?
* excessive hairiness in women * caused by * increased levels of androgens * oversensitivity of hair follicles to androgens
31
What are the layers of the vagina?
* Mucosa * parakeratinized epithelium * predominate vascular lamina propria * Muscularis * ICOL * bulbospongiosus muslce at opening * Adventitia * inner elastic layer * outer highly vascular layer
32
What is the purpose of the scrotum?
* allow for 2-3º difference from the body to do spermatogenesis * within the scrotum is the papiniform venous plexus that does countercurrent heat exchange
33
How does growth factor affect spermatogenesis?
* act on germ cells or somatic cells via receptors
35
What are the two cells of the epithelium in the seminiferous tubules?
* Spermatogenic * sertolie cells
37
What is the prestep of the urea cycle?
* NH4 + CO2 + 2ATP + H2O \> carbamoyl phosphate * Enzyme * carbamoyl phosphate synthetase (CPS1) * irreversible reaction
38
What is the origin of illiococcygeus muscle?
* arises from posterior tendinous arch and at ischial spine * together with pubucoccygeus forms a ligament between anal aperatureand coccyx * **anococcygeal raphe/ligament** * often thin and poorly developed
39
What is the role of estogens in the female?
* maintains female reproductive tract * rebuilds uterus after menses * increases inhibitor of FSH/LH * at low levels * high levels stimulates the surge in LH levels
41
ALT
* Alanine aminotransferase * alanine + aKG \> pyruvate + glutamate
42
Function of aminotransferase
* transfer NH3 group from AA to Glutamate * alphaKG \> Glutamate * requires PLP (Vit B6)
44
Describe the supply lateral sacral arteries
* usually two arteries on each side arise from a common trunk * give off spinal braches to supply * sacral meaninges enclosing the roots of sacral nerves * erector spinae muscles and skin covering the sacrum
46
Inferior hypogastric plexus
* right and left hypogastric nerves after entering pelvis * descend lateral to rectum * converge with pelvic splanchnics and form right and left inferior hypogastric plexuses * contain postganglionic sympathetic and postganglionic parasympathetic fibers
47
What is the function of ciliated cells?
* have cilia * increase in height during estrogenic phase of menstrual cycle and reach max height at ovulation * decrease in height when progesterone levels are elevated
48
Superior hypogastric plexus
* continuation of aortic plexus, branches from L3,4 and lumbar splanchnics
49
What is the role of LH in the ovary?
* triggers primary oocyte to complete meiosis I and enter meiosis II * Surge initiates ovulation * effects the transformation of remaining granulosa and theca internal cells to luteal cells * stimulates follicular luteal cells to secrete progesterone
51
What are the stages of follicular development?
* Primordial follicle * Primary follicle * unilaminar * multilaminar * Secondary Follicles * Mature or Graafian Follicles
51
Pudendal nerve
* S2-S4 * main nerve of perineum and innervates * external genitalia * external urethral sphincter * external anal sphincter * skin around anus and perineum * leaves pelvis via greater sciatic foramen * enters perinem via lesser sciatic foramen
53
What does Lactobacillus acidophilus do in the vagina
* natural bacteria of vagina * produces lactic acid to breakdown glycogen produced by the stratified squamous epithelium * makes the vagina acidic to prevent proliferation of bacteria
55
What occurs to the follicular cells once the secondary oocyte leaves?
* basement membrane breaks down * follicular cell layer folds to become corpus luteum storing lipids * blood vessels invade folicular cell layer and antral cavity fills with CT and blood vessels = lutenizing * **corpus hemorrhagium**
56
Obturator nerve
* L2-L4 * passes through lesser pelvis passing through oberturator membrane * innervates medial thigh
57
What occurs during sperm capacitation?
* make sperm capable of fertilizing egg * occurs naturally in female tract * takes 1-10 hours * process * washs off inhibitory factors that suppress sperm activity * removes lipid/cholesterol vesicles to expose acrosome so acrosomal enzymes can be released * sperm membrane becomes more permeable and Ca2+ enters sperm, triggers hypermotility in order to penetrate ZP * Washing sperm wit human tubular fluid (HTF) to capacitate sperm
58
What muslces make up the pelvic floor?
* pelvic diaphragm * coccygeus * levator ani * puburectalis * iliococcygeus * pubococcygeus * perineal membrane (inferior fascia of UG diaphragm) * muscles of deep perineal pouch
59
What are the morphological phases of spermiogenesis?
* Golgi phase * Cap phase or acrosomal phase * formation acrosomal cap * hylauriondase, neuraminidase, acid phosphatase, proteases * maturation phase * nucleus flattened, addition of mito, elongation, loss of excess cytoplasm
59
Describe the supply by the uterine artery?
* may arise from umbilical artery * passes over the ureter * supplies * vagina * cervix * body and fundus of uterus * anastomoses with ovarian artery to supply ovary and uterine tube
61
What muscles insert to the perineal body?
* bulbospongiosus muscle * superficial transverse perineal muscle * external anal spincter muscle * fibers from * deep transverse perineal muscle * external urethral sphincter muscle
62
What are the properties of semen?
* pH of 7.2 - 8.0 * milky appearance * coagulum (clotting enzyme) * dissolves in 15-30 min due to fibrinolysin derived from profibrinolysin
63
Describe the supply of the superior gluteal artery
* largest branch of internal iliac artery * leaves pelvis through greater sciatic foramen * supplies muscles and skin of gluteal region * branches to adjacent muscles and bones of pelvic wall
65
What are interstitial glands?
* clumps of cells in the ovary medulla that appear just before puberty * secreting pulse of estrogen * contribute to the maturation of secondary sexual characteristics
66
What is in the secretory product from the seminal vesicles?
* pale yellow because of lipochrome pigment * rich in fructose and prostaglandins (aid fertilization) * sperm nutrition source * 70% of ejaculate * empty its contents into ejeaculatory duct
67
What is the target of FSH and what are its actions?
* Sertoli cells * growth, differentiation and maintenace * releases paracrine factors to spermatogonia * Increases LH receptors on Leydig cells * spermatogenesis
68
What affects the functional layer of the endometrium?
* changes in blood levels of estrogens and progesterone * the blood supply from spiral arteries * layer is partially or totally lost after menstration
69
Where is sperm stored?
* most of it is stored in the ductus deferens and can remain there for about a month * motility suppressed in ductus deferens
71
What is cryptorchidism?
* 1-3 months before birth * if not usually happens within months * if it doesnt descend in a year, requires surgery * descent through inguinal canal into scrotum * testosterone from fetal leydig cells triggers action
72
What is luteolysis and when does it occur?
* Regression of the corpus luteum because of no HCG signal * reduction in blood flow * T cells come to produce interferon-gamma that attracts macrophages * marcophages make TNF-alpha to cause apoptosis * progestrone, estrogen, and inhibin levels all decrease * FSH levels gradually increase
73
Where are gap junctions used follicular developement and where are they located?
* Allow communication between * adajcent follicular cells of corona radiata * follicular cells of corona radiata and oocyte
75
Coccygeal plexus
* lies on pelvic surface of coccygeus * innervates * coccygeus * part of levator ani * anococcygeal nerves arise from this plexus
76
What is male climacteric (andropause)?
* start in 40s, testosterone levels decline * symptoms - similar to menopause * hot flashes * suffocuation * psychic disorders
77
What are the layers of the seminferous tubules?
* Epithelium * Basement membrane * Peritubular CT sheath * Blood vessels, lymphatics, myoeptihelial cells tubules are a solid core until puberty
78
What is in the secretion of the prostate gland?
* Whitish fluid rich in * acid phosphatase * citric acid * citrate ion * clotting enzyme * Ca2+ * contributes 25% of ejaculate * pH of 6.5 * fibrinolysiin helps liquefy semen
79
What is the function of peg cells?
* provide nutrients to egg during migration * cyto cleared out because of their high glycogen levels * Help with capacitation * shorter during progestone stage
80
What occurs doing acrosome reaction?
* content of acrosome * hyaluronidase - dissolves CT among multiple layers of granulosa cells * proteolytic enzymes - dissolve ZP * Derived from Golgi apparatus during spermiogenesis * essential for sperm to fertilize eggs
81
What are the cells of the epididymis?
* pseudostratified columnar epithelium with stereocilia * Basal cells (stem) * Principal cells * layers of circular SM Storage site
83
Sciatic nerve
L4 - S3
84
Describe innervation of pelvic splanchnics
* originate from anterior rami of S2-S4 and convery presynaptic parasympathetic fibers * join with hypogastric nerves to form inferior hypogastric plexus * parasympathetic innervation of pelvic viscera and descending and sigmoid colon
85
What is the innervation involved with emission and ejaculation?
* emission * sympathetic reponse to move semen to prostatic urethra * sympathetic impulses from T12-T2 \> hypogastric and pelvic nerve sympathetic nerve plexuses \> gential organs \> emission * ejaculation * somatomotor response * firing of bulbourethral, prostate, seminiferous tubules/epididymis, seminal vesicles * resolution: 1-2 min after ejaculation
86
Describe the supply of obturator artery?
* variable origin but usually second branch * presence of an accessory obturator artery arising from inferior epigastric artery * runs along obturator fascia on lateral wall of pelvis * leaves the pelvis through obturator canal * supplies adductor region of the thigh
87
What is the target of LH in males and what are its actions?
* Leydig cells * growth and differentiation * increase testosterone production * down regulation of LH receptors
88
At what stage is the zona pellucida is assembled?
* produced by the primary oocyte at the unilayered primary follicle site
88
Area supplied by inferior vesical artery
* equivalent to vaginal artery * supplies vagina, adjacent regions of bladder and rectum * anastomoses with vaginal branch of uterine artery and superior vesical artery * supples branches to * bladder * distal ureter * seminal vesicles (males)
90
What is the origin/insertion and functions of coccygeus?
* origin and insertion * ischial spine * sacrospinous ligament to coccyx and inferior sacrum * Functions * supports pelvic viscera * pulls coccyx foward after defecation
91
What are the features of the erectile tissue?
* helicane arteries are filled with blood and endotheial cushions deflate to allow the arteries to fill up * SM puckers up the endothelium to make up the cushions
92
What are the secretions from the bulbourethral glands?
* secrete pre-ejaculate to help de-acidify the urethra * looks very mucosey, acts like a lubricant
93
When is a male considered infertile?
* low sperm count * * spermatogenic defects: genetic factors * abnormal sperm motility * structural * tail deformation * metabolic * low energy supply, ion signaling
94
What are the two components of the cervix?
* endocervical canal * mucos secreting columnar epithelium * ectocervix
95
Describe supply of inferior gluteal artery
* pass posteriorly between sacral nerves * leaves pelvis through greater sciatic foramen * supplies muscle and skin of buttock and posterior thigh * anatomoses with a network of vessels around hip joint
96
Describe supply of middle rectal artery?
* supplies inferior rectum * anastomoses with superior and inferior rectal arteries * may arise from * internal iliac artery * inferior vesical artery * internal pudendal artery
97
Lumbosacral trunk
* L4 joins with L5 (above pelvic brim) an then with sacral plexus (s1 just below pelvic brim)
98
What occurs to the functional layer during premestrual or ischemic stage?
* Periodic contractions of spiral arteries because of * lower levels of progesterone deprives the functional layer of oxygen * breakdown of spiral arery floods lamina propria with blood * functional layer consisting of glands and decidual like cells detaches and sheds = menses
99
What is the pelvic pain line?
* refers to orgnas aove (or in contact with) or below the peritoneum and whether pain will be felt consciously * visceral afferent innervation will follow * above line - pain will be conducted by sympathetic fibers to reach thoracic/lumbar spinal ganglia * below line - pain conducted by parasympathetic ribers to reach spianl sensory ganglia of s2-s4
101
Superior gluteal nerve
L4 - S1
102
What are the layers of the uterine tube?
* Mucosa * ciliated cells * peg cells * Muscularis * ICOL * Serosa
104
What are the sites of testosterone negative feedback?
* pituitary gland * decreasing LH pulse amplitude * hypothalamus * GnRH pulse generator to decrease pulse frequency
105
What is dihydro-testosterone?
* ~7% of testosterone is reduced to dihydro-testosterone by 5alpha-reductase * higher affinity than testosterone for androgen receptors * defiency * under developed male genitalia and prostate
107
Describe the innervation the sacral sympathetic trunk provides
* continusation of sympathetic trunks to innervate the lower limbs * main function: postsynaptic fibers to sacral plexus * send gray communicating rami to anterior ramus of sacral and cocygeal nerves * sends small branches to inferior hypogastric plexus
108
What are the layers of the testis?
* Tunica vaginalis * parietal/visceral layers * Tunica albuginea * Tunica vasculosa * semiferous tubules
109
How is the secondary oocyte released?
* Surge of LH * induces fibroblasts to release proteases that degrade the collagen fibers of the tunica albuginea and theca externa * rapid growth of new blood vessels \> follicle swelling \> follicle rupture
110
What is the origin of puborectalis of levator ani?
* arises from pubis (r/l pubic bodies) * U-shaped sling
111
What is the origin of th pubococcygeus?
* arises from posterior aspect of pubic body and anterior tendinous arch * attaches to coccyx
113
What are the layers of the seminal vesicles?
* Mucosa * pseudostratified columnar epithelium that height varies with testosterone levels * lamina propria with elastic fibers * Muscularis externa * ICOL * Adventitia
114
What is the clinical significance of the transformation zone of the cervix?
* at puberty the cervix extends into the acidic region of the vagina columnar epithelium undergoes metaplasa to become stratified squamous epithelium * 95% of cervical intraepithelial neoplasias originate in the zone
115
What are the branches off the posterior division of the internal iliac artery?
* illolumbar * lateral sacral * superior gluteal
116
What are the structural features of the sertoli cells?
* all sertoli cells are connected to other sertoli cells and developing spermatogonia * form unique types of junctional complexes * rest on basement membrane and reach lumen * has FSH receptors

Block 3 (8 decks)

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