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46 Cards in this Set
- Front
- Back
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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 |
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Contents of inguinal canal |
Ilioinguinal nerve Males - vas deferens, gonadal vessels and gonadal nerve Females - round ligament of uterus |
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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 |
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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 |
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Normal orientation of uterus |
Anteversion (right angle to vagina) Anteflexion (Pointed inferiorly at anterior extent) |
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Blood supply of: Uterus Vagina Ovary |
Uterus+vagina: uterine artery (from internal iliac artery) Ovary: ovarian artery (from abdominal aorta distal to renal arteries) |
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Sections of oviduct lateral to medial, x4 |
Fimbria - communicates with ovary Infundibulum Ampulla Isthmus |
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Epithelium of: Uterus and endocervix Ectocervix and vagina |
Uterus and endocervix - Simple columnar Ectocervix and vagina - Stratified squamous |
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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 |
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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 |
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Erectile tissue of penis |
2x (dorsal) corpora cavernosa 1x (ventral) corpus spondiosum, surrounding penile urethra |
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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. |
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1' oocyte 2' oocyte ovum |
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 |
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Spermatogenesis vs. spermiogenesis |
Spermatogenesis - production of spermatids in seminiferous tubule Spermiogenesis - development of spermatids into motile spermatozoa, in epididymis |
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Oestrogens |
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 |
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Androgens |
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. |
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FSH and LH actions in males |
FSH activates ABP production by Sertoli cells LH induces Leydig cell testosterone production |
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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. |
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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) |
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Pearl index |
For contraceptive efficacy evaluation Unintended pregnancies per 100 woman-years of use |
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CoCP mechanism +risks |
Oestrogen+progesterone Inhibits LH/FSH release, preventing follicular development and ovulation Increased risk of VTE, CV events, temporary breast cancer risk |
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POCP mechanism |
indicated eg. in breast cancer, breastfeeding
Alters cervical mucus to prevent sperm penetration and implantation, often prevents ovulation |
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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) |
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Emergency contraceptive methods x3 |
Levonorgestrel (<72 hours) Ulipristal acetate - progesterone receptor modulator (<120 hours) Copper IUD, prevents implantation |
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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 |
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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 |
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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 |
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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 |
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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 |
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Neurulation |
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 |
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End-tissues from components of neurulation: Neural tube Lumen 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 |
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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) |
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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 |
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Neonatal fontanelles |
Anterior Posterior (anterior to occipital, in midline) Sphenoid (pterion) Mastoid (between occipital and temporal) |
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Milk constituents
x4 nutrients x3 immune |
Triacylglycerides, Proteins, Lactose, Trace elements, IgA, lysozyme, Complement |
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Colostrum special characteristics |
More IgA and protein Less lactose |
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Definitions:
miscarriage stillbirth 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 |
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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) |
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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 |
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Pregnancy test mechanism when effective |
detection of β subunit of hCG Most tests effective from a few days after implantation |
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Calculation of due date approximation + 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 |
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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. |
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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 |
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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) |
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Physical milestones at 3, 6, 12, 18 months |
3: head up prone 6: sits unsupported 12: stands 18: walks decently |
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Law of Laplace |
P=2T/r Surfactant reduces tension T in alveolar wall by forcing water to spread more uniformly |
