eesohbel's version from 2015-06-18 02:01

Genital Embryology

Question Answer
Which system turns into female?Mullerian aka PARAmesonephric duct
What female structures are derived from Mullerian ducts?Fallopian tubes, Uterus, Upper vagina
The lower vagina is derived from [?]Sinovaginal bulbs
Inhibition of the Paramesonephric ductsMullerian inhibitory factor (MIF)
MIF is secreted by [?]Sertoli cells
Testosterone is secreted by [?]Leydig cells
What does MIF do?Degeneration of Paramesonephric ducts
Which system turns into male?Mesonephric aka Wolffian
What male structures are derived from Mesonephric ducts?Seminal vesicles, Epididymis, Ejaculatory duct, Duct deferens [SEED]
What factors are necessary for the Wolffian duct to form?SRY (testes determining factor), MIF, DHT
What gene drives male development?SRY on the Y chromosome
SRY gene makes [?] for testicular developmentTestis determining factor
What enzyme is needed for male genitalia to develop?5-alpha-reductase: DHT
What keeps the mesonephric ducts alive?Testosterone
What blocks the urogenital sinus development?DHT blocks urogenital sinus from turning into lower vagina
Sertoli cells make [?]MIF, ABP (Androgen Binding Protein: maintains testosterone), Inhibin (feedback to FSH)
Leydig cells make [?]Testosterone
Blood-testes barrier is made ofSertoli cells
FSH stimulatesSertoli: make ABP and spermatogenesis
LH StimulatesLeydig cells: make testosterone!


Question Answer
dizyogtic twinsdichorionic diamniotic
0-4 days monozygotic twinsdichorionic diamniotic
4-8 days monozygotic twinsmonochorionic diaamniotic
8-12 days monozygotic twinsmonochorionic monoamniotic
Greater than 13 daysconjoined

Uterine abnormalities

Question Answer
septate uterusdecreases fertility
bicornuate uterusincomplete fusion of mullerian ducts. increased risk of complicated pregnancy
uterus didelphyscompete failure of fusion. double uterus, vagina and cervix. Pregnancy possible

Urachus and Viteline duct

Question Answer
patent urachusurine discharge from umbilicus. partial failure of urachus to obliterate.
vitelline (omphalo-mestenteric) fistulameconium discharge from umbilicus
Meckel diverticulumpartial close of vitelline duct

Female/Male structures matching

Question Answer
Glans penisglans clitoris
corpus cavernosumvestibular bulbs
bulbourethral glands greater vestibular glands
prostate gland urethral and paraurethral glands
ventral shaft of penislabia minora
scrotum labia majora
infundibulopelvic ligament (suspensory ligament)ovaries to lateral pelvic wall. carries all the ovarian vessels, nerves and arteries
cardinal ligament cervix to side wall of pelvis
round ligament of the uterus uterine fundus to labia majora
broad ligament uterus, fallopian tubes and ovaries to pelvic side wall
ovarian ligament medial pole of overy to lateral uterus
In the female the urethral folds do not fuse and form the labia minorain the male the urethral folds fuse to form the ventral aspect of the penis
What would happen if the urethral folds failed to fuse in a malehypospadias. "underside"
episadiasabnormal opening on the "top side" of the penis. bladder extrosphy

Male Sexual Response

Question Answer
Erectionmediated by parasympathetic fibers via the pelvic nerve
Emissionmediated by sympathetic fibers via the hypogastric nerve
Ejaculationmediated by visceral and somatic nerve (ie pudenal)
Point and ShootErection (PNS) and Emission (Sympathetic)

Innervation to the Dick

Question Answer
ErectionParasympathetics (Pelvic nerve Points): mediated by NO to relax and vasodilate the penis
How does sildafenil work?PDE-5 inhibitor: Inhibits PDE-5 from breaking down cGMP, mediator for NO
Erectile dysfunction is caused by damage to [?]Cavernous nerves (pelvic nerve) carrying PS fibers
EmissionSympathetic: Hypogastric nerve
EjaculationSomatic Pudendal nerve
MC damaged nerve during childbirth or bicycling?Pudendal nerve
What does the pudendal nerve do?Sensation and motor to:
1. Perineal muscles
2. External anal sphincter
3. External urethral sphincter
Main artery of the pelvis?Internal iliac
Main nerve of the pelvis?Pudendal!
Where does testicular cancer first metastasize?Para-aortic nodes
Lymphatic drainage of the testes or ovaries?Para-aortic nodes
Lymphatic drainage of the scrotum or vagina/vulva?Superficial inguinal nodes
Lymphatic drainage of the prostate or cervix/uterus?External and internal Iliac nodes
Mechanism of erectile dysfunctiondamage to pelvic nerve either in spinal cord or after it leaves the spinal cord

Testicular tumors

Question Answer
Fried egg appearance seminoma
most common testicular tumor seminoma
embryonal painful tumor
Leydig testosterone
Sertoli estrogen
testicular lymphoma older men
mc in young children yolk sac
tubular appearance embryonal
Reinke crystalsleydig cells
elevated AFPyolk sac and teratomas
elevated HCGseminoma, choriocarcinoma, embryonal carcinoma
endodermal sinus structures (schiller duvall bodies)Yolk sac
mc cause testicular cancer in males over 60testicular lymphoma. diffuse large B-cell lymphoma is mc type.

Ovarian neoplasms

Question Answer
sex cord tumorsfibroma, sertoli leydig, granulosa theca
Meig's syndromeFibroma. Triad of ovarian fibroma, ascites and hydrothorax (PE). Pulling sensation in groin
sertoli-leydighirsutism and virilization
granulosa-thecaestrogen producing tumors. malignant.
call exnergranulosa theca
germ cell tumorscystic teratoma, dysgerminoma, endometrial sinus, choriocarcinoma
struma ovarii (mature cystic teratoma)hyperthyrodism
fried egg appearancedysgerminoma
Schuller Devall bodiesendometrial sinus
does not respond to chemotherapychoriocarcinoma
fetal tissuecystic teratoma (aggressive). immature teratomas in women are aggressive
yolk sacendometrial sinus
bladder like epitheliummBrenner tumor
Surface epithelium tumorsendometrioid, brenner's cystadenoma, cystadenocarcinomas, cystadenoma, mucinous cystadenocarcinomas
serous cystadenocarcinomabilateral
psammona bodiescystadenocarcinomas

Female histo

Question Answer
ectocervixstratified squamous epithelium
transformation zonesquamocolumnar junction (metaplastic cells transform from columnar to squamous)
endocervixsimple columnar epithelium, mucus-secreting

tanner stages

Question Answer
IIpubic hair
IIIpubic hair darkens; penis size and breast enlarge
IVpenis width, raised areolae
Vadult areolae are no longer raised


Question Answer
MC incontinenceStress incontinence: weakened pelvic floor
After childbirthStress: Increased abdominal pressure against weak pelvic floor
Treatment of stress incontenanceexercise, alpha agonists, surgery
Suddenly need to pee!Urge incontinence
Cause of urge incontinenceOveractive detrusor
Treatment of urge incontinence?Antimuscarinics: Oxybutynin, Darifenacin
Continuous leakage of urineOverflow incontinence: overdistention of bladder
Treatment for overflow incontinencecholinergic agonists, alpha adrenergic antagonists
functional incontinencecaused by an increase in urinary volume


Question Answer
MC Congenital hernia?Indirect inguinal hernia: Failure of processus vaginalis to close
Path of an indirect inguinal hernia?Internal (deep) inguinal ring >> external (superficial) inguinal ring >> scrotum
Failure of processus vaginalis can result in [?]Indirect inguinal hernia and hydrocele
Which layers cover an indirect inguinal hernia?All 3 layers of spermatic fascia
Indirect hernias lie [?] to inferior epigastric arteryLateral
Direct hernias lie [?] to inferior epigastric arteryMedial
Acquired hernia?Direct inguinal hernia: usually heavy lifting
Path of direct inguinal hernia?Hesselbach's (inguinal) triangle >> Abdominal wall >> External Inguinal ring
Which layers cover direct inguinal hernia?External spermatic fascia only
Borders of hesselbach's triangle?Inguinal ligament
Inferior epigastric vessel
Lateral rectus abdominus
MC groin hernias in women?Femoral hernia [Fem-Fem]
Path of femoral hernia?Protrudes below inguinal ligament through Femoral canal
Hernia most susceptible to complications?Femoral
Incarcerationcontents of hernia get irreducibly trapped... obstructed flow
StrangulationNecrosis of herniated contents

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