Repro - Anatomy & Physiology

ekadar's version from 2016-03-13 07:40

Female anatomy

Question Answer
Venous drainage of left ovary/testis→ left gonadal vein → left renal vein → IVC
Venous drainage of the right ovary/testis→ right gonadal vein → IVC
Lymphatic drainage of ovaries/testesparaaortic lymph nodes
Lymphatic drainage of distal 1/3 vagina/vulva/scrotumsuperficial inguinal nodes
Lymphatic drainage of proximal 2/3 vagina/uterusobturator, external iliac, and hypogastric nodes
Suspensory ligament of the ovariescontains what?Contains ovarian vessels, nerves and arteries
Ureters are at risk during what procedure?during ligation of ovarian vessels in oophorectomy (suspensory ligament) or ligation of uterine vessels in hysterectomy (cardinal ligament)
Cardinal ligament contains what?Contains the uterine vessels
Round ligament of the uterus connects what and contains what?Connects uterine fundus to labia majora
contains the artery of sampson
Broad ligament connects what and contains what?Connects the uterus, fallopian tubes, and ovaries to pelvic side wall
Contains ovaries, fallopian tubes, and round ligaments of uterus
The round ligament of the uterus is a derivative of what?Gubernaculum
Components of the broad ligamentMesosalpinx, mesometrium, and mesovarium
Histology of the vaginastratified squamous epithelium, nonkeratinized
Histology of the ectocervixstratified squamous epithelium
Histology of the endocervixsimple columnar epithelium
Histology of the uterussimple columnar epithelium, pseudostratified tubular glands
Histology of the fallopian tubesimple columnar epithelium, ciliated
Histology of the ovarysimple cuboidal epithelium
Histology of the transformation zonesquamocolumnar junction. metaplastic cells transform from columnar to squamous

Male anatomy

Question Answer
Varicocele is more common on the R or L?Left
Because left spermatic (gonadal) vein enters the left renal vein at a 90° angle → less continuous flow → more pressure
Pathway of sperm travelSEVEN UP:
Seminiferous tubules
Vas deferens
Ejaculatory ducts
Nerve that is responsible for erectionpelvic nerve (parasympathetic)
The two chemical mediators of erectionNO → ↑ cGMP → smooth muscle relaxation → vasodilation → proerectile
NE → ↑ influx of [Ca] → smooth muscle contraction → vasoconstriction → antierectile
Nerve for emissionHypogastric nerve (sympathetic nervous system)
Nerve for ejaculationPudendal nerve (visceral and somatic nerves)
Point and ShootErection is parasympathetic (via pelvic nerve) and Emission is Sympathetic (via hypogastric nerve)
SpermatogoniaLine seminiferous tubules
Maintain germ pool and produce 1° spermatocytes
Sertoli cells locationLine seminiferous tubules
Sertoli cell function (7)Secrete inhibin → inhibit FSH
Secrete androgen-binding protein → maintain local levels of testosterone
Tight junctions between adjacent sertoli cells to for blood-testis barrier → isolates gametes from autoimmune attack
Support and nourish developing spermatozoa
Regulate spermatogenesis
Produce anti-mullerian hormone
Temperature sensitive: ↑ temp → ↓ sperm production and ↓ inhibin
Conditions that cause ↑ temp → ↓ sperm productionVaricocele
Leydig cells
Located in the interstitium
Secrete testosterone
Unaffected by temperature
injury from pelvic fractureposterior urethra
damage due to perineal straddle injuryanterior urethra
injury to cavernous nerves during prostate surgeryerectile dysfunction
Sildefanilincreases cGMP aka erection

Male physiology

Question Answer
SpermatogoniumDiploid: 2N, 2C, 46 single chromosomes
still on blood side of blood-testis barrier
1° spermatocyteDiploid: 2N, 4C, 46 sister chromatid pairs
(underwent replication as it crossed blood-testes barrier)
2° spermatocyteHaploid: 1N, 2C,now two cells with 23 sister chromatids each
X's have been separated from the Y's
product of Meiosis 1
SpermatidHaploid: 1N, 1C, 24 single chromatids across 4 cells
product of meiosis 2
Mature spermatozoon1N
acquired acrosome (head), tail, etc.
LH in spermatogenesisStimulates synthesis of testosterone in leydig cells
FSH in spermatogenesisStimulates Sertoli cells to produce ABP, inhibin
Inhibin fninhibit anterior pituitary
The 3 androgensTestosterone, dihydrotestosterone (DHT), androstenedione
Which androgens come from the testis?DHT and testosterone
Which androgens come from the adrenal glands?Androstenedione
Relative potency of the androgensDHT > testosterone > androstenedione
Which androgen causes differentiation of epididymis, vas, SVs (internal genitalia except prostate)Testosterone
Which androgen causes growth spurt of penis, seminal vesicles, sperm, muscle, RBCs?testosterone
Which androgen causes deepening of voice?testosterone
Which androgen causes closing of epiphyseal plates?testosterone via estrogen converted from testosterone
Which androgen causes libido?testosterone
Which androgen causes differentiation of penis, scrotum, prostate?DHT (early)
Which androgen causes prostate growth?DHT (late)
Which androgen causes balding?DHT (late)
Which androgen causes sebaceous gland activityDHT (late)
Androgens to estrogensTestosterone and androstenedione → estrogen in adipose tissue and Leydig cells
Enzyme: aromatase
Testosterone to DHTvia the enzyme 5α-reductase - inhibited by finasteride
Exogenous testosterone→ inhibition of hypothalamic-pituitary-gonadal axis → ↓ intratesticular testosterone → ↓ testicular size → azoospermia

Female physiology

Question Answer
Sources of estrogenOvary - 17β-estradiol (Granulosa cells)
placenta - estriol
adipose tissue - estrone via aromatization
Relative potency of estrogensEstradiol > estrone > estriol
Estrogen influences the development and growth of?Development of: genitalia, breast, female fat distribution
Growht of: follicle, endometrial proliferatoin, ↑ myometrial excitability
Estrogen influences LH/estrogen/progesterone/prolactin how?upregulation of estrogen, LH, and progesterone receptors
Feedback inhibition of FSH and LH, then LH surge
Stimulation of prolactin secretion (but blocks its action at breast)
Changes in estradiol, estrone, and estriol in pregnancy50-fold ↑ in estradiol and estrone
1000-fold ↑ in estriol (indicator of fetal well-being)
Estrogen receptors are where?in the cytoplasm, then transferred to the nucleus when bound by estrogen
Theca cellConversion of cholesterol to androstenedione
Pulsatile GnRH → LH → Desmolase → the conversion to Androstenedione
Granulosa cellConversion of androstenedione to estrogen
Pulsatile GnRH → FSH → Aromatase → conversion to estrogen
Sources of progesteroneCorpus luteum
adrenal cortex
Progesterone causesProgestation
Others: thick cervical mucus to prevent sperm entry, ↑ body temp, ↓ estrogen receptor expressivity

Menstrual cycle

Question Answer
Proliferative phaseaka: follicular phase
Days 1-14 (can vary in length)
Secretory phaseaka luteal phase
Days 14-28 (stay constant)
Endometrial growth/maintanence influenced byesrogen → growth
progesterone → maintanence
when progesterone levels fallmenstruation
when is the progesterone peakright after the LH surge
Ovulation↑ estrogen → ↑ GnRH receptors on anterior pituitary → Estrogen surge → LH release → ovulation (rupture of follicle)
Mittelschmerzblood from ruptured follicle or follicular enlargement causes peritoneal irritation that can mimic appendicitis
Arrest of oogenesis from birth to puberty1° oocyte begin meiosis 1 (in prophase) during fetal life
complete Meiosis 1 at ovulation
Arrest of oogenesis between ovulation and fertilization2° oocyte is arrested in metaphase 2 (in metaphase) until fertilization (an egg met a sperm)
If fertalization does not occur within 1 day, the 2° oocyte degernates
OogoniumDiploid: 2N, 2C, 46 single chromosomes
1° oocyteDiploid: 2N, 4C, 46 sister chromatids
Product of replication (interphase)
2° oocyteHaploid: 1N, 2C, 23 sister chromatids in one 2° oocyte + 1 polar body
Product of Meiosis 1 upon ovulation
OvumHaploid: 1N, 1C, 23 single chromatids in one cell + 3 polar bodies
Product of Meiosis 2 upon fertilization
Where does fertilization usually occur?upper end of fallopian tube (ampulla)
Implantation occurs when?6 days after fertilization
hCGsecreted by trohpoblast which is detectable in blood 1 week after conception
Detectable in home test in urine 2 weeks after conception
Lactationthe ↓ in progesterone disinhibits (allows) lactation - after labor
Suckling is required to maintain milk production since ↑ nerve stimulation ↑ oxytocin and prolactin
Prolactininduces and maintains lactation and ↓ reproductive function
Oxytocinmilk letdown and uterine contractions
Source of hCGSyncytiotrohpoblast of placenta
hCG functionMaintains the corpus luteum (and thus progesterone) for the 1st trimester by acting like LH - otherwise no luteal cell stimulation & abortion results
2nd/3rd trimester - the placenta makes its own estriol and progesterone so the corpus luteum degenerates
hCG in pathologic stateshydatidiform moles, choriocarcinoma
what hormone level is specific for menopausevery high FSH, high LH and high GNRH because loss of negative feedback on FSH due to decreased estrogen