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Female and Male Reproductive
Scrotum
what is it?/what does it do
|
pouch of skin with a thickened fat layer
Function:to protect and maintain the testes at 3 degrees below body temp. |
Dartos and Cremaster |
Pulls testicles toward the body to keep warm when cold
pulls testicles upward to keep warm when cold |
Testes |
produced in the pelvic cavity and begin to descend around the 28th week of pregnancy. |
After the testes descend what layer of tissue proceeds it? |
tunica vaginalis plus cavity formed-processus vaginalis |
Cryptorchidism |
"hidden testis"
Etiology:unknown but may be related to hormone deficiency
Problems:left untreated=infertility/sterility
Treatment:orchiopexy if testes do not descend in first 3 months after birth |
Hydrocele |
fluid found anywhere along the processes vaginalis
Etiology: PV didn't close properly
Problems: increased size causes pain and obstruction of blood flow
Treatment:drain fluid,if reacccumulates surgery
|
Testicular Torsion |
Twisting of the spermatic chord which causes pain,impairment of blood flow and swelling
-mostly in newborns or young boys but adults can get it if it unattached from the wall
Problems:24 hours or more the survival of the testicle is doubtful
Treatment:surgery to open scrotum,untwist, and secure testicle to scrotal wall |
Testicular Cancer |
rare, but MOST COMMON TUMOR of men 20-34
Problems:pain,infertility,spread to other organs
Treatment:if tumor is associated with seminiferous tubules then 1. removal of testis and spermatic cord
2.spread of cancer=removal of lymph nodes
3.radiation/chemo
4.combination of these |
Carboplatin |
chemo-theraputic drug used after removal of testicles and proved that 95% of men were cancer free and 72% had no reoccurrence in other testicle |
Spermatogenesis |
sequence of events leading to sperm |
1.seminiferous tubules |
-found in each testis and are comprised of sustentacular cells which protect developing sperm immune cells. Interstitial cells produce testosterone |
2.Hormonal Regulation |
beginning at puberty two hormones are released
1.ISCH-simulates interstitial cells to release testosterone
2.FSH-stimulates sustentacular cells to produce ABP
ABP-allows sperm to bind the testosterone and begin production |
Epididymis |
coiled tube attached to the testicle responsible for storing immature sperm
|
Epididymitis |
inflammation of the epididymis caused by the gonorrhea bacteria |
Gonorrhea |
most common sexually transmitted disease in US
pain in urination,discharge and pus
treatment:antibiotic Cipro |
Ductus (vans) Deferens |
long tubular structure that extends from the epididymis to the prostate.
-stores the mature sperm |
Vasectomy |
voluntary sterilization of the male.
Small section of each vas deferens is surgically removed and the ends are clipped back.
-interferes with sperm transport so it never leaves the body and it is reabsorbed into the body to continue spermatogenesis
1.bilateral-both ends cut off
2.single
3.reversal-longer you wait,harder it is to get pregnant |
Seminal Vesicles |
1/2 of 5 glands
secrete a fructose fluid that acts as an energy source through their voyage |
Ejaculatory Ducts |
continue the duct and are found inside the prostate |
Prostate |
3 of 5 glands
secretes an acidic fluid flowing into the prostatic urethra
fluid helps liquify and kill bacteria |
What is the duct process? |
1.epididymis
2.vas deferens
3.seminal vesicles
4.ejaculatory ducts
5.prostate
6.urethra
7.bulbourethral glands
8.penis |
Benign Prostatic Hypertrophy |
non cancerous,enlargement of the prostate
Symptoms:enlarged prostate,prostatic urethra constricted, urination is painful and difficult
Detection: digital rectum exam,transrectal ultrasonography
Treatment:overgrowth is removed by TURP and extra prostate tissue is removed |
Prostatic Cancer |
*2nd leading cause of DEATH from cancer in men
Symptoms: similar to BPH, as cancer grows it invades surrounding nerves and becomes extremely painful
Detection: BIOPSY is best option. DRE or blood tests can be done
Treatment:depends on stage of cancer
1.radiation
2.prostatectomy
3.hormone therapy to block testosterone
4.antiangiogenesis drugs
5.IRESSA
6.Proton therapy-permanently damage the DNA and can regulate size&depth of beam |
Urethra |
3 sections:1.prostatic
2.membraneous
3.penile |
Bulbourethral Glands |
5 of 5 glands:serete a small amount of liquid into the penile during sexual arousal. it lubricates the head of the penis and neutralizes acid from urine present
(Precum) |
Penis |
3 columns of erectile tissue that become engorged with blood during sexual arousal causing an erection |
Male pseudohermaphroditism |
condition is caused by inadequate amounts of testosterone or by delayed development of the reproductive organs.
results in external genitalia that looks female |
hypospadias |
urethral opening is on the UNDERSIDE of the penis.cause could be from testosterone imbalances or mother's steroid use in early pregnancy/diet
Treatment:surgery to close off old and make new opening |
Epispadias |
urethra open on TOP of the penis
abdominal wall below navel doesn't form and the urniary bladder is exposed
tissue grafting is required |
Infertility |
inability for the male to produce viable sperm or inability for sperm to fertilize egg
*treatable through hormone therapy,proper nutrition or microsurgery |
Sterility |
permanent inability to make or fertilize sperm
cause:genetic problem or degeneration of the seminiferous tubules caused by infection |
Erectile Disorder |
inability for male to get or maintain an erection
caused by physical or psychological problems
Physical:blood vessel disorder, nerve damage from diabetes, spinal cord injuries
Psych:anxiety, depression,emotional stress. relationship issues
therapy can fix it |
Ovaries |
held in place by their attachment to the uterus and the pelvic wall.The ovary contains several hundred thousand oogonia cells that last a females entire lifetime.The oogonia is surrounded by granulosa cells that increase in size to become primary oocytes |
Oogenesis |
sequence of events leading to the development of the egg cell.
FSH-increases the number of granulosa cells
LH-causes the primary oocyte to divide into a secondary oocyte and a polar body causing ovulation
Corpus Luteum-produces estrogen and progesterone which prepare the uterus for implantation |
Birth control |
contain mestranol that tricks the brain to stop sending LH and FSH causing the egg to no ovulate |
Morning-After Pill |
pills with a higher dosage of estrogen and progesterone that are taking within 72 hours after intercourse.
these delay ovulation, change the lining of the uterus that prevent fertilization, and impure tubal transport of egg or sperm |
RU-486 Abortion Pill |
anti-progesterone that binds to the cells of the uterus and blocks the binding of progesterone. This causes menstruation,taking the embryo with it. |
Ovarian Cysts |
sacs of fluid on the ovary.
Symptoms:produce no symptoms unless it grows too large, then it can be painful.
If ruptures and ovarian vessel may tear resulting in a hemorrhage.
Treatment: cysts rupture on their own but a large cyst can block blood flow and needs to be surgically removed |
Ovarian Cancer |
4th most common female cancer. 60-80 years
Symptoms:abdominal swelling, and pain, nonmenstruation bleeding,weight loss,problems with urination and constipation.
Detection & Treatment:
1.transvaginal sonography-detects in early stages
2.MRI-visualizes soft tissue
3.blood test CA125-35% predictive value
4.Proteomic Fingerprinting-detection of multiple proteins at an elevated level predicts the risk of cancer
|
What is different of ovarian cancer than other cancers? |
because it has no early symptoms and with no effective screening techniques, the disease is already very progressed by the time treatment begins. |
Uterine tubes-Oviducts-Fallopian tubes |
Four parts to the oviduct
1.infundibulum-long fingerlike projections called fimbriae
2.ampulla-longest part,95% of fertilization takes place here
3.isthmus-narrowed portion
4.interstitial segment |
Tubular Pregnancy |
the egg is fertilized in the oviduct and attaches to the wall.
ectopic pregnancy-anywhere but normal
Symptoms:abdominal pain or discomfort
Problems:enlargement,rupture, hemorrhage of the uterine tube
Treatment:removal of the oviduct
-eggs may be moved and transplanted to the uterus |
Salpingitis |
inflammation of the oviducts.
Cause: untreated std's, streptococcal or staphylococcal bacteria
Symptoms: pus producing infection, tubes swell shut
treated with antibiotics
When inflammation subsides the walls of the tube may adhere to another and block off the tubes. infertility or sterility can result |
Tubal ligation |
voluntary sterilization which involves the removal of each oviduct and tying off the ends.
Surgery-laparoscopy-small instruments inserted through the abdomen |
Uterus |
3 Sections:
Fundus-dome
Body
Cervix
Wall is 3 layers:
Perimetrium-outside
Myometrium-middle
Endometrium-inside layer consisting of a thin deep layer-Basilar and thick-Functional which is the layer that sheds each month causing menstruation |
Menstrual Disorders: Amenorrhea |
absence of menstruation
Normal:time period before puberty,following menopause, and during pregnancy
Primary:failure to have menstruation when the age of puberty is reached. Accompanied by failure of secondary sex characteristics(Athletes)
Secondary: the stopping of menstruation in women who previously had a normal period. Caused by hormonal disturbances,psychological factors(depression,stress) |
Dysmenorrhea |
painful or difficult periods along with painful cramps.
Prostaglandins promote contraction of the uterus during a period but in the excess they will cause stronger pains. |
Abnormal Uterine Bleeding |
menorrhagia during the menstrual period and spotting between periods.
Hypomenorrhea-deficient amount of menstrual flow
Oligomenorrhea-infrequent menstruation
Polymenorrhea-increased frequency of menstruation
caused by hormonal irregularities,emotional factors, various diseases/ physical conditions |
Uterine Prolapse |
descent of the uterus into the vagina
occurs in women at any age but have had multiple births or no birth and defects in the supporting strength
Treatment:surgery to tighten or for aged women who are at risk a pessary can be put in to support and hold in place |
Pelvic Inflammatory Disease |
infection of the oviducts and the ovaries. inflammation of the uterus.
Cause:cervical mucus secretions provide a bacterostatic barrier by preventing bacteria from going in. conditions or surgeries that ruin the cervical mucus can cause this infection.
Symptoms:abdominal tenderness and pain in cervix, feve, pus drainage
Treatment: pelvic wash is inserted through a tube and antibiotic goes directly into the vagina.If the infection is worse they remove ovaries,oviducts and uterus |
Uterine Tumors-Leiomyomas |
Symptoms:if small, tumors cause no problems. If large they can reach weights up to 30 pounds and can result in constriction of blood flow and sever pain
Treatment:drugs or removal of the uterus
fibroid embolization:plastic pellets inserted into the vessel that feeds the fibroid, cuts off blood blow to tumor to kill it
Laser ablation-destroys tumor with a laser needle |
Endometriosis |
endometrial tissue within the pelvic cavity.
Cause:endometrial tissue flows backward into the oviducts into the pelvis during a period. Also metaplasia which is when the cells were supposed to go down to the uterus but never did.
Symptoms:dysmenorrhea and can cause an inflammatory reaction
Treatment:medications that block FSH and LH are used. If worsening surgical removal of the endometrial implants is possible but can led to removal of ovaries,and oviducts |
Uterine Cancers-Cervical Cancer |
most common malignancy of a female's reproductive organs.
1.2nd most frequent cancer in women
Cause: HPV
Symptoms:abnormal bleeding and persistent vaginal discharge
treatment:early detection is key. Pap smears examine the cells for cancer.laser or cryocautery is appropriate but if too invasive hysterectomy is required with radiation/chemo |
Vagina |
produces an acidic fluid which helps increase resistance to infection. |
Vaginitis |
inflammation of the vagina
1. Candidiasis-yeast infection.itching,burning,white discharge. Anti fungal medications are used
2. Trichomoniasis-infection by parasite by sexual contact.foul-smelling discharge,itching,burning, soreness. Topical anti parasitic meds are used and both partners have to be treated
3.Bacterial Vaginitis-bacteria occur in vagin causing this infection. itching,burning, and foul smelling discharge. oral and topical antibiotics are used |
Vulva |
Mons Pubis-fatty,hair covered pad that protects clitoris
Labia majors-two large hair covered folds
Labia minors-two thin hairless skin folds between the labia major
Vestibule-space between the labia minor which contains the openings of the vagina
Vestibular glands-secrete mucus near the vaginal opening that provides lubrication during intercourse
Clitoris-body of erectile tissue. becomes engorged with blood during sexual arousal and highly sensitive to stimulation |
Cancer of the vulva |
occurs at any age but mostly in mid-60's. unknown cause.
Symptoms: presence of whitish, plaque like lesions
treatment:partial or complete removal of the vulva |
Female Pseudohermaphroditism |
causes an increase production of testosterone from the mother's adrenal gland and causes a clitoral enlargement and labial fusion looking like a male
surgery is only option |
Breasts/Mammary Glands |
15-20 alveolar glands. the ducts from the alveolar glands enlarge into ampullae and then back into the ducts. the nipple has erectile tissue
After birth prolactin and oxytocin are released to tell the nipple to stimulate the milk |
Benign Breast Disorders |
1.Fibrocystic breast disease-fluid filled growths surrounded by fibrous tissue fluctuate in size, pain and tenderness with fluctuation of estrogen. cysts are firm, regular shaped and can be moved about
Treatment: aspiration of the cyst |
Benign Neoplasms |
non cancerous growths that occur at any time in life.
differ from cysts because they are solid not fluid-filled
nontender,encapsulated,freely moveable
-biopsied to make sure they aren't cancerous |
Breast Cancer |
most common form of cancer in women 25-75 and is the leading cause of death in women 40-50
Cause:unknown but women are most susceptible if over 35,family history,not given birth,40 years of menstrual activity
Symptoms:hard,painless lump with rough outer edges in upper outer quadrant.nipple retraction,dimpling of skin,changes in the breast,swollen lymph nodes in armpit,bloody discharge of nipple
Detection: self exam,mammography, MRI
*Dr. Malkas is using proteomic to identify a protein linked to the development of malignancy.
Confirmation:biopsy of tumor
Treatment:
1.surgical-lumpectomy-removal of a lump and tissue surrounding. radiation or chemo following
2.Modified radial Mastectomy:for larger tumors total removal of the breast may be required. radiation following
3.Sentinental Node Biopsy:allows the surgeon to remove a few nodes to be looked at during surgery to see if other nodes need to be removed
4. Hormone Therapy:uses SERMs to block the attachment of estrogen to the tumor cells
5.Aromatase Inhibitors: used in postmenopausal women to block conversion of hormones produced by the adrenal gland into estrogen
6.Immune Therapy:Herceptin blocks the effects of HER2 and prevents reoccurrence
7.Chemo: interferes with rapid cell division but causes nausea,hair loss,fuzzy thinkning,damage to nerves, and the tissue surrounding the heart
8.Radiation:direct a beam to the tumor to kill the cancer cells
Partial Breast Radiation:radiation seeds are placed around the tumor and kill stray cells while going about your daily routine
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