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46 Cards in this Set

  • Front
  • Back

Embryonic development of inguinal canal

Gubernaculum descends through ant. ab. wall from inferior pole of gonad

Attaches to labioscrotal swelling

Peritoneal herniation (processus vaginalis) occurs along path of gubernaculum

In male, testis descends along gubernaculum, ventral to processus vaginalis

Contents of inguinal canal

Ilioinguinal nerve

Males - vas deferens, gonadal vessels and gonadal nerve

Females - round ligament of uterus

Course of pudendal nerve

+branches x3

Passes out of greater sacral foramen

Back into perineum via lesser sacral foramen

Inferior rectal nerve

Posterior scrotal/labial nerve

Dorsal nerve of clitoris/penis

Ovarian and uterine ligaments

Broad ligament - peritoneal fold covering uterus and ovaries anteriorly

Round ligament of uterus - from uterus to labium majorum via inguinal canal

Ovarian ligament - from ovary to lateral margin of uterus

Suspensory ligament of ovary -from ovary to lateral pelvic wall, with ovarian neurovasculature

Normal orientation of uterus

Anteversion (right angle to vagina)

Anteflexion (Pointed inferiorly at anterior extent)

Blood supply of:




Uterus+vagina: uterine artery (from internal iliac artery)

Ovary: ovarian artery (from abdominal aorta distal to renal arteries)

Sections of oviduct

lateral to medial, x4

Fimbria - communicates with ovary




Epithelium of:

Uterus and endocervix

Ectocervix and vagina

Uterus and endocervix - Simple columnar

Ectocervix and vagina - Stratified squamous

Temperature regulation of testis

Cremaster (over testis) and dartos (in scrotum) contract in response to cold etc. to hoist testes

Pampiniform venous plexus acts as a countercurrent hear exchanger to cool blood in gonadal arteries

Tributaries of male spongey urethra (+what supplied)

Bladder - urine

Vas deferens - spermatozoa

Seminal vesicle (vas deferens outcrop posterior to bladder) - sugars and prostaglandins

Prostate - hydrolytic enzymes

Erectile tissue of penis

2x (dorsal) corpora cavernosa

1x (ventral) corpus spondiosum, surrounding penile urethra

Mechanism of male erection and ejactulation

Parasympathetic activation

Internal pudendal arteries dilate

Pudendal veins compressed against fascia

Ischiocavernosus and bulbospongiosus compress bulb of penis

Sympathetic activation

Contraction of smooth muscle of epididymis, vas deferens etc.

1' oocyte

2' oocyte


1' oocytes - arrested in meiosis i at birth, in primary follicle

2' oocyte - recruited in follicular phase of menstrual cycle, meiosis i complete, meiosis ii arrested

ovum - haploid, following meiosis ii

Spermatogenesis vs. spermiogenesis

Spermatogenesis - production of spermatids in seminiferous tubule

Spermiogenesis - development of spermatids into motile spermatozoa, in epididymis


Oestrone - produced in adipose tissue. Triggers menarche

Oestradiol - most important and potent oestrogen, converted from testosterone by aromatase in granulosa cells

Oestriol - metabolite of other oestrogens


DHEA - weak androgen produced in adrenal medulla and Leydig cells

Testosterone - produced in Leydig cells (Theca cells in women)

DHT - Sertoli cell metabolite (by 5-α reductase) of testosterone twice as potent. Bound to ABP and carried to seminiferous tubule.

FSH and LH actions in males

FSH activates ABP production by Sertoli cells

LH induces Leydig cell testosterone production

Capacitation and fertilisation

Spermatozoa reach the ovum by chemotaxis

Capacitation occurs, exposing the acrosome and intensifying sperm motility behaviour

Membrane, ECM of zona pellucida hydrolysed

Acrosome reaction leads to Ca2+ influx into ovum, causing degranulation of factors preventing polyspermy. 2' oocyte completes meiosis ii.

Sperm contents exocytosed into peri-vitelline space and taken into fertilisation cone.

Pre-implantation conceptus stages

Zygote (fertilised ovum)

Morula (16-32 cells, polarised)

Blastocyst (32-64 cells, differentiation of inner cell mass and trophoblast, cavity formation)

Pearl index

For contraceptive efficacy evaluation

Unintended pregnancies per 100 woman-years of use

CoCP mechanism



Inhibits LH/FSH release, preventing follicular development and ovulation

Increased risk of VTE, CV events, temporary breast cancer risk

POCP mechanism

indicated eg. in breast cancer, breastfeeding

Alters cervical mucus to prevent sperm penetration and implantation, often prevents ovulation

Intrauterine contraceptive devices

Copper - induces inflammatory response which reduces sperm and ova viability

Hormonal - slow release of levonorgestrel, acts similarly to the POCP (alters cervical mucus to prevent penetration, implantation, and often ovulation)

Emergency contraceptive methods


Levonorgestrel (<72 hours)

Ulipristal acetate - progesterone receptor modulator (<120 hours)

Copper IUD, prevents implantation

Stem cell classes

Pluripotent - can differentiate into any cell from any of the three germ layers. eg. embryonic

Multipotent - can give rise to several specialised cells or tissues.

Oligopotent - can give rise to a few specialised cells or tissues

Unipotent - can produce only one cell type, but is capable of self-renewal

Cavities in developing placenta

Primary yolk sac - First formed, lined with hypoblast

Amniotic cavity - Forms at implantation pole, surrounded by ectoderm

Chorionic cavity - forms within layer of extraembryonic mesoderm, surrounds yolk sac, amniotic cavity, and embryo

Features of maternal and foetal surfaces of placenta at term

Foetal: smooth, amnion-covered

Maternal: grey, divided into ~15 cotyledons, each supplying one main stem villus

Umbilical cord contents

+gas transfer in mature placenta

2 umbilical arteries

1 umbilical vein

Maternal spiral arteries open directly into intervillous spaces

Foetal capillary networks, covered by a thin layer of syncytium, exchange gas with maternal blood in which they are bathed

Week 2 events in embryonic development

Trophoblast -> cytotrophoblast, syncytiotrophoblast

Inner cell mass -> dorsal epiblast, ventral hypoblast (lines yolk sac)

Amniotic cavity and 1' yolk sac develop


Week 4

Neural plate forms from ectoderm over notochord

Neural plate folds, forming neural tube (embedded within mesoderm)

Endoderm-derived neural crests develop adjacent to neural tube

Neuropores close at rostral and caudal ends

End-tissues from components of neurulation:

Neural tube


Rostral neural crest cells

Caudal neural crest cells

Neural tube: brain and spinal cord

Lumen of neural tube: ventricular system

Rostral neural crest cells: cranial bones, pia and arachnoid mater, cranial nerves

Caudal neural crest cells: spinal ganglia, Schwann cells

Development of septa in embryonic heart

Endocardial cushions give rise to AV septum

Incomplete IA septum develops from atrial roof from septum primum

Second IA structure develops from septum secondum, forming valved foramen ovale

IV septum develops from base of common ventricle

Helical septum develops from walls of ventricular outflow tract (aorta, pul. trunk)

Shunt functions in foetal circulation

Foramen ovale channels oxygenated blood from the inferior vena cava into the left atrium to supply the major aortic arch branches

Deoxygenated blood from the SVC passes to the right ventricle, and is shunted via ductus arteriosus into the aortic arch distal to the carotid artery branches

Neonatal fontanelles


Posterior (anterior to occipital, in midline)

Sphenoid (pterion)

Mastoid (between occipital and temporal)

Milk constituents

x4 nutrients

x3 immune

Triacylglycerides, Proteins, Lactose, Trace elements, IgA, lysozyme, Complement

Colostrum special characteristics

More IgA and protein

Less lactose




early/late neonatal death

Miscarriage: pregnancy loss <24 weeks

stillbirth: born >24 weeks dead

Early neonatal death: death <1/52

Late neonatal death: death 8-28 days

Events in puberty

Adrenarche - increased production of adrenal steroids

Gonadarche - enlargement of testes/ovaries

Thelarche - onset of pubertal breast tissue growth

Pubarche - first appearance of pubic hair growth

Menarche - first menstruation. Mean age ~13 (8-16 may be normal)

Factors underlying menarche

Attainment of ~17% body fat, and consequent secretion of sufficient levels of adipose oestrone to trigger gonadarche.

Establishment of the HPG axis and secretion of ovarian oestrogens, stimulating uterine and endometrial growth

Pregnancy test mechanism

when effective

detection of β subunit of hCG

Most tests effective from a few days after implantation

Calculation of due date


+ investigation

From date of last menstrual period

Add 7 to date

Subtract 3 from month

Add a year if necessary

foetal crown rump length at USS 11-14 weeks

Intrauterine insemination

+use x2

The male partner provides a semen sample, fast-moving sperm are ‘washed’ (by centrifugation, to remove prostaglandins which can induce cervical cramping), and this is introduced into the uterine cavity.

Technique used in eg. IVF, ICSI. Used standalone for mild male factor infertility, endometriosis.

In vitro fertilisation

+2 indications

GnRH agonists suppress spontaneous ovulation (by upsetting the HPG axis) and then human menopausal gonadotrophin (containing FSH and LH) elicit ovulation.

Oocytes then harvested, fertilised in vitro, and transferred to uterine cavity.

- Indicated for tubal infertility, pre-implantation genetic screening w/ history of disorders

Intracytoplasmic sperm injection

A single sperm is directly injected into the egg which has been aspirated from the ovary. The fertilised egg is transferred to the uterine cavity.

Used in severe male factor infertility (very low sperm count, tetarozoospermia)

Physical milestones at 3, 6, 12, 18 months

3: head up prone

6: sits unsupported

12: stands

18: walks decently

Law of Laplace


Surfactant reduces tension T in alveolar wall by forcing water to spread more uniformly