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65 Cards in this Set
- Front
- Back
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What is the "seam" of the scrotum? What seperates the testes in the scrotum? In what structure would you find the cremaster muscle? |
- raphe - scrotal septum - spermatic cord |
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What factors maintain the need for the testes to be 2-3 degrees below body temperature (2)? |
- their location outside of the pelvic cavity - contraction relaxation of the dartos and cremaster muscles |
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Where do the testes begin in foetal development? Where route do they take as they travel to the scrotum? When do they start moving? |
- near the kidneys - through the inguinal canal - 7-8 months into foetal development |
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Which structure produces the 200-300 internal lobules of the testes? What are the main structures you find within these lobules? What functions occurs within these structures? |
- tunica albuginea - seminiferous tubules (2-3) - spermatogenesis |
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What 2 cell types can be found in the seminiferous tubules? |
- sertoli cells and spermatogenic cells |
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In order of least to most differentiated, what are the 3 types of spermatogenic cell found in the seminiferous tubules? |
- spermatogonia - spermatocytes - spermatids |
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Describe what the blood-testis barrier is made up of? What is the purpose of the blood-testis barrier? |
- sertoli cells joined by tight junctions - prevents an immune response being launched against the antigenic germ cells |
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What are the 6 funcitons of Sertoli cells? |
- nourishgerm cells - phagocytosis - regulate movement of spermatogenic cells - release mature germ cells (spermatozoa) into the lumen - hormonesecretion (inhibin) - hormone regulation (FSH and testosterone) |
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What cell types would you find inbetween seminiferous tubules? What is their function? |
- Leydig (interstitial) cells - secrete testosterone |
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What are the four regions of a sperm? |
- head - mid connecting piece - tail - end piece |
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In order, list the different ducts that semen flows through - including the urethra (11) |
- seminiferous tubules - straight tubules - rete testis - efferent ducts - epididymis - ductus (vas) deferens - spermatic cord - ejaculatory ducts - prostatic urethra - membranous urethra - spongy urethra |
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What causes semen to flow from the seminiferous tubules to the straight tubules |
- sertoli cells secrete fluid - increases pressure in the seminiferous tubules |
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What tissue type lines the epididymis? It is encircled by what type of muscle? |
- pseudostratified columnar - smooth muscle |
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What is present on the surface of pseudostratified columnar cells in the epididymis? Why is this term misleading and what is their function? |
- stereocilia - they act more like microvili to absorb degenerated sperm |
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What are the 3 functions of the epididymis? |
(1) site of spermmaturation (develop motility and ability to fertilise) (2) passagefor the release of sperm (3) site of sperm storage andreabsorption |
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Describe the muscle layers of the ductus (vas) deferens What tissue type lines the vas deferens? |
- inner and outer: longitudinal - middle: circular - pseudostratified columnar |
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Describe the route that the vas deferens take in the pelvic cavity? Describe the 2 main functions of the vas deferens |
- from testis to bladder and back down to the prostate - peristaltic conduit for sperm and site of storage and reabsorption |
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List the 6 structures found in the spermatic cord |
-ductus/vas deferens -testicular artery -pampiniform plexus: venous network that drains the testes andtransports testosterone -lymphatic vessels -autonomic nerves -cremaster muscle |
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Describe how the tissue type of the mucosa changes throughout the different sections of the urethra? |
- prostatic urethra: transitonal epithelium (continuos with bladder) becoming stratified of pseudostratified columnar distally - membranous and spony urethra: stratified or pseudostratified columnar. Becomes non-keratinised stratified squamous near the external urethral orifice - |
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Describe the different muscle types found in the sections of the urethra |
- prostatic: smooth - membranous: skeletal - spongy: smooth |
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What is secreted by seminal vesicles? What is its functions? |
- alkaline fluid - neutralises acidic environmentin the urethra and female reproductive tract, protecting the sperm |
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What are the 3 main components in secretions from seminal vesicle, and what is their function? |
-fructose: ATP production for sperm -prostaglandins: enhances sperm motility and viability, and stimulatesmooth muscle contractions in the female) -clotting proteins: coagulates sperm |
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Describe how the prostate changes in size throughout life? |
-Slow increase in size till puberty; rapid expansion from then until30; further enlargements from >45 years. |
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What are the 4 main components in secretions from the prostate, and what is their function? |
-citric acid: ATP production in Krebs for sperm -proteolytic enzymes (e.g. protein-specific antigen, pepsinogen,lysosymes, amylase): break down clotting proteins form seminalvescicles -acid phosphatase: tumour suppressor? Liquification of sperm? -seminal plasmin: antibacterial |
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What is secreted from the bulbourethral glands and what is its function? |
-secrete alkaline fluid during arousal to neutralise acidity in themale and female tracts – protects sperm -secrete mucous at the end of the penis and urethra – preventsdamage to sperm during ejaculation |
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What are the 3 main regions of the penis? |
- body, glans penis and root |
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What are the 3 cylindrical masses of tissue found in the penis and what surrounds them? |
- corpora cavernosa (2) - corpus spongiosum - tunica albuginea |
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What 2 ligaments support the penis? |
- fundiform ligament and suspensory ligament |
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What are the 3 phases of spermatogenesis? |
- mitotic proliferation - meiotic differentiation - differentiation |
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Describe the process of spermatogenesis (essay answer) |
- spermatogonia (immature) - found near the base of the seminiferoustubules - undergo successive mitotic cell divisions to increasethe cell number and then differentiate into spermatocytes. At thisstage they are diploid (2n). There are 2 types of spermatogonia, A and B. A types can be pale or dark; when they undergo mitosis, pale A types mature into type B spermatogonia, which in turn mature into primary spermatocytes. Dark A types stay in the basal compartment and continue to undergo more mitosis. - spermatocytes undergo 2 rounds of meiosis, produducing spermatids. - spermatids undergo differentiation, producing spermatozoa. During this tage, the a tail is added, as it the mid piece containing lots of mitochondria. The cytoplasm also undergoes remodelling (condenses), producing a residual a body and causing the DNA to be compacted. |
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What ultimately regulates spermatogenesis? |
Hypothalamic-Pituitary-Gonadal axis |
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Draw a diagram illustrating regulation of spermatogenesis |
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What cells do FSH and LH act on and what is the result? |
FSH: Sertolic cells - supports spermatogenesis LH: Leydig cells - produce testosterone |
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Describe the process of fertilisation (essay answer (9)) |
(1) after ovulation, the fimbriae slide over the surface of theovary,picking up the oocyte and depositing it into the uterine tube.Cilia and smooth muslce contractions then propel the secondary oocytetowards the uterus (2) on reaching the ovum, the sperm binds to the zona pellucida via ZP3, inducing a signal cascade (3) binding induces the acrosome reaction: there is an increase in Ca2+ in the sperm, causing the plasma membrane and acrosome to fuse. This results in exocytosis of the acrosomal contents and the release of hydrolytic enzymes - needed to penetrate the corona radiata and zona pellucida (4) acrosomal enzymes and an increase in sperm motility allow the sperm to penetrate the zona pellucida (5) cell membrane of the sperm and oocyte fuse. The sperm then becomes enveloped in microvilli and the cytoplasmic portions of the sperm enter the cell; the sperm cell plasma membrane is then left behind (like a snae crawling out of its skin) (6) Cortical reaction: as the sperm penetrates the oocytes membrane, ittriggers the production of inositol 1,45,-triphosphate (IP3). Thisleads to an increase in Ca2+ which causes 2 major events: (1) inducesmeiosis II in the oocyte, and (2) the cortical reaction. In thecortical reaction, granules underneath the oocyte membrane undergoexocytosis. As they do this they release enzymes which act on theglycoproteins in the zona pellucida, which causes them to harden.This prevents polyspermy. If polyspermy does occur, they will notdevelop past the early cleavage stage. (7) Quickrecap: previously, the oocyte had been arrested in prophase ofmeiosis I since foetal development. It completed meiosis I justbefore ovualtion, following the surge of LH – producing the firstpolar body and a haploid secondary oocyte. In between then and fertilisation, the oocyte began meiosis II, and is now arrested inmetaphase. Due to the rise in Ca2+ within the oocyte (step 5), it isnow triggered to complete meiosis II – producing its second polarbody and the ovum. The chromosomes of the ovum then decondense toform the female pronucleus (haploid). (8) thesperm nucleus also decondenses, forming the male pronucleus(haploid), and the cytoplasmic portion of the tail degenerates. (9) themale and female pro nuclei fuse forming a diploid zygote. Thecombination of the 2 sets of chromosomes marks the end offertilisation and the beginning of embryonic development.
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Describe the blocks to polyspermy |
- fast block: occurs when the sperm head comes into contact with the viteline and plasma membranes. Causes massive depolarisation of hte ovum due to a influx of Na+. The positve change in membrane potential prevents sperm from fusing, as the have positively charged molecules in their head. - slow block to polyspermy: Asthe sperm penetrates the oocytes membrane, it triggers the productionof inositol 1,45,-triphosphate (IP3). This leads to an increase inCa2+ which causes 2 major events: (1) induces meiosis II in theoocyte, and (2) the cortical reaction. In the cortical reaction,granules underneath the oocyte membrane undergo exocytosis. As theydo this they release enzymes which act on the glycoproteins in thezona pellucida, which causes them to harden. This preventspolyspermy. If polyspermy does occur, they will not develop past theearly cleavage stage |
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What are the 3 most important factors regarding fertility. |
- sperm - ovum - fallopian tubes |
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List 4 things you should consider when taking a history of a female concerned about fertility |
- age - previous pregnancies - information on periods - family history |
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List 5 things you should consider when taking a history of a male concerned about fertility |
- age - occupation - and previous children - injuries - family history |
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List 7 lifestyle factors which can affect fertility |
- smoking - alcohol - recreational drugs - STIs - occupation - disease - prescription drugs |
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List 7 drugs associated with infertility |
- alcohol - nicotine - asprin - alcohol - caffeine - calcium channel blockers - antipsychotics |
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List 4 primary care assessment/tests for infertility |
- rubella status - chlamydia/gonorrhoea - BMI - cervical smear |
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List 4 tests you might perform if you suspect and ovulatory disorder |
- progesterone levels - ultrasound to look for antral follicles - blood tests for anti-Mullerian hormone and baseline hormones (FSH, LH, prolactin, sex hormone-binding globulne and testosterone) - BMI |
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Describe how anovulation is clinically classified and the features of each |
- group 1(hypothalamic-pituitary-ovarian failure): generally due to lifestyle factors, such as BMI (high/low), extreme fitness etc. - group 2 (hypothalamic-pituitary-ovarian dysfunction with high prolactin levels): associated with PCOS and obesity - group 3 (complete ovarian failure): e.g. Turner's syndrome or Premature Ovarian Failure |
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Give an example of how you would treat someone with type 1, 2 and 3 anovulation |
- group 1: lifestyle modifications, pulsatile GnRH and/or gonadotropins with LH - group 2: lose/gain weight, anti-oestrogens (e.g. clomiphene citrate (CC),letrozole, metformin, gonadotrophins) - group 3: oocyte donation |
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What are the 2 most important factors of semen quality? List 2 other factors |
- count (>15 million/ml and motility (overall motility(progressive and non-progressive) >40%, or >32% progressive(progressive means they are swimming from one place to another, notjust swimming in circles or twitching) - viability (live sperm: >58%), morphology (>4% normal) |
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Describe what fertility options would be available for a couple where the man has poor sperm quality |
- check FSH levels –hormone which promotes function of the Sertoli cells (supportive,metabolic function). - IUI: spermsinserted into the woman's uterus (possibly a donor) - Intra-cytoplasmicSperm Injection (ICSI): embryologistselects a single sperm to be injected directly into an egg, insteadof fertilisation taking place in a dish where many sperm are placednear an egg.
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What 3 loci on the Y chromosome are associated with infertility? Which is most common? |
-Azoospermiafactor (AZF) a, b and c (male Sex-Determining Region (SRY) -AZFc |
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What is the most common cause of infertility associated with uterine tubes? What is the gold standard for assessing fallopian tubes? Give two example of less invasive tests for assessing fallopian tubes |
- PelvicInflammatory Disease (PID), such as from chlamydia - laparoscopy and dye test - Hystrocontrast Sonography (HyCoSy) - uses ultrasound guidance and dye- and Hystro Salpingo Gram (HSG) - uses X-ray guidanceand dye |
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What is the most likely treatment for someone who has blocked uterine tubes? What actioin might you take if a woman has pus, fluid or blood in her fallopian tubes and why? |
- IVF - clipping or salipingoectomy (removal of fallopian tubes): to prevent fluids washing away an implanted emryo |
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Describe endometriosis |
- essentially,endometriosis is retrograde menstruation, causing the womb lining toembed its self on other organs. - “Where tissues normally foundlining the womb are found elsewhere in the body e.g. ovaries andfallopian tubes, outside the womb, lining of the abdomen, and bowelor bladder” |
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Briefly describe the process of IVF (essay answer) |
- hormones are injected to induce menstruation - ultrasound in the perfomed to look for (antral) follicles - FSH is the administered to cause primary follicles to develop into secondary follicles - LH is administered to loosen the egg from the follicle cells - eggs are collected from the ovary - sperm is collected, washed and concentrated - sperm and egg are combined for fertilisatiojn to occur - embryos are selected and then incerte in tothe uterus/oviduct - pregnancy/hCG test is perfomed |
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Summarise Intra Cytoplasmic Sperm Injection |
- single sperm is micro injected into an egg - fertilised ovum is then inserted into the uterus |
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Summarise Intra Uterine Insemination |
- sperm is collected, washed, concentrated and then inserted directly into the uterus |
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Outline the type of people who would qualify for fertility treatment through the NHS |
- same sex couples - people with certain medical conditions e.g. cancers, heart problems (may involve surrogacy) - transgender people - people who may transfer genetic disorders: Pre-Implantation Genetic Disorders - people who have consistent implantation failure |
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What are the 2 types of surrogacy |
- host(gametes from the intended parents) - straight (surrogates egg) |
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At birth, who would be the legal parents in the case of surrogacy |
- mother: surrogate - father (other): if the surrogate is married or in civlil partnership, they would be the legal parent. If they are not, it could be the genetic father |
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What legal order must be completed in order for genetic parents to be considered the legal parents? When must this be done? |
- parental order - before 6 months |
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List the ethical problems surrounding surrogacy (6) |
- do people have a rightto have children - 2 main ethicalconsiderations: exploitation of woman and children be used ascommodities - health risks to thesurrogate mother - the demands and risksplaced on the surrogate could be considered synonymous with work, andyet is unpaid. This, in itself, can be considered exploitative - the risk of surrogacybecoming commercialised - compassionate familialsurrogacy: when a person feels compelled to be a surrogate to afamily member despite the risk to her own health - there is an argumentthat people should adopt if they cannot conceive, rather thanbringing more people into the world. |
