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Reproductive system questionsPurpose of male reproductive organso Produce, maintain, transport sperm + semen o Discharge sperm within female reproductive tract during sex o Produce + secret male sex hormones needed to maintain male reproductive systemTestosteronePrimary male sex hormoneTesteso Two t...

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Reproductive system questions

Purpose of male reproductive organs

o Produce, maintain, transport sperm + semen o Discharge sperm within female reproductive tract during sex o Produce + secret male sex hormones needed to maintain male reproductive system Primary male sex hormone

Testosterone

Testes

Sperm production

Epididymis

Vas deferens

o Two testes o Inside scrotum + secured either end by spermatic cord o Makes testosterone o Contain seminiferous tubules = produces sperm o Made in seminiferous tubules o Made from sperm cells surrounding the lumen of seminiferous tubules o Sperm cells then released into ducts o Bring immature sperm cells to maturity ready for fertilisation o Long coiled tube at the back of each testicle o Sperm enter head + moved along by contraction of smooth muscles lining epididymal tubes into vas deference o Long muscular tube running from epididymis > pelvis cavity > behind bladder o Connects epididymis to urethra o Transports mature sperm to urethra in preparation for ejaculation o Part of spermatic cord Sperm maturation

Function of the epididymis

Function of the van deferens

Sperm transport o Epididymis > urethra

Where is sperm produced?

In the cell wall of seminiferous tubules located in the testes

Walnut sized gland located below the bladder Prostrate

Testes pathologies

o Epididymal cyst o Infection (epididymo-orchitis) o Hydrocele o Varicocele o Torsion o tumour Epididymal cyst

Most common testicular pathology?

most common testicular pathology GP detects lump Usually in epididymal head No treatment needed – unless large + causing discomfort o Venus network of 10 veins that drain the testes + epididymis o Includes vas deferens, testicular artery, pampiniform

o o o o

Epididymal cyst

Spermatic cord

5% What % volume of semen does sperm make up?

What 3 accessory glands produce semen?

Seminal vesicles

o Seminal vesicles o Prostate o bulbourethral glands o Pouch like glands attached to vas deferens near base of bladder o Makes semen (seminal vesicle fluid) 70%

What % volume of semen does seminal vesical make up?

Why is seminal vesicle fluid alkaline?

Neutralises acidity of male urethra + vagina = survival of spermatozoa

Energy for spermatozoa motility Why does seminal vesicle fluid contain fructose?

Why does seminal vesicle fluid contain prostaglandins?

Why does seminal vesicle fluid contain clotting fluid?

Supresses female immune response to foreign semen

Keep semen in female reproductive tract post ejaculation

Mature motile male sex cells spermatozoa

Cells/ gametes capable of motion motile

penis

o Male sex organ (copulation) o When sexually aroused blood vessels vasodilate = corpora carernosa + corpus spongiosum fill with blood o = erect / stiffness = penetration into vagina + deposit semen into female reproductive tract Sexual intercourse

copulation

Columns of erectile tissue in the penis Corpora carernosa

Most common forms of male reproductive system imaging

Other forms of less common forms male

o US testes o MRI prostate

o MRI testes o MRI penis

reproductive system imaging

Prostate pathologies

Prostatitis signs and symptoms

Benign prostatic hypoplasia (BPH) Signs and symptoms

Prostate cancer signs and symptoms

o o o o o o o

US penis US prostate (transrectal) PET prostate CT prostate Prostatitis (inflammation of prostate) Benign prostatic hypoplasia (BPH) Prostate cancer

o Swelling/ inflammation of prostate gland o Trouble/ pain urinating o Pain around penis, testicles, anus, lower abdomen o Pain pooing, weeing ejaculating o Difficulty weeing - blood in urine o Feeling unwell, aches, high temp o Prostate gland enlargment o Trouble/ pain urinating o Nocturia (increased urination at night) o Inability to completely empty bladder o Hesitancy (difficulty in starting to urinate) o Trouble/ pain urinating o Nocturia (increased urination at night) o Inability to completely empty bladder o Hesitancy (difficulty in starting to urinate) o Blood in urine or semen o Transport semen + urine out of body

Urethra

Synthesis of sperm cells spermatogenesis

Prostate gland

Bulbourethral glands

Ejaculatory ducts

Scrotum

The glans

Right iliac fossa RIF

Left iliac fossa LIF

Post-menopausal bleeding PMB

Intermenstrual bleeding IMB

Polycystic ovarian syndrome PCOS

Last menstrual period LMP

TAH + BSO

Total abdominal hysterectomy and bilateral salpingo-oophorectomy - removal of the uterus, cervix and both fallopian tubes and ovaries Pelvic inflammatory disease

PID

Purpose of female reproductive organs

FSH

o Produces eggs o Produces hormones o Maintains fertilised egg until it develops into foetus until ready for delivery Follicle stimulating hormone

LH

Luteinizing hormone

Oestrogen

Progesterone

Inhibin

Relaxin

Why is it important to know what stage a woman is in in her cycle

Ovarian pathologies

Uterine pathologies

o Secreted by corpus luteum o Inhibits secretion of FSH + LH

o Secreted by corpus luteum during pregnancy o Relaxes symphysis pubis + dilates uterine cervix for delivery Women’s anatomy/ uterus looks different at different times of the month depending on the stage of the cycle o o o o o o o o o o

Cyst Haemorrhagic cyst Endometrioma PCOS tumour polyp endometrial cancer benign endometrial hyperplasia fibroids cervical tumour

Tubal pathologies

o hydrosalpinx o tubal blockage o ectopic pregnancy

name of the uterine cavity that sheds every month during menstruation

Endometrium

endometrium will be thickest in which phase of the menstrual cycle?

luteal phase

Menstrual cycle order

o Menstruation o LH and oestrogen surge o Ovulation o Corpus luteal development 12 days

How long does it take on average of sperm to travel through the epididymis?

What are the ducts called in the breast that deliver breast milk to the skin surface?

lactiferous ducts

How many sections is the breast divided into 4 for imaging purposes?

Does a trans-abdominal ultrasound require a Full bladder full bladder or an empty bladder?

Does a trans-vaginal ultrasound require a full bladder or an empty bladder?

Empty bladder

Endometriosis is always seen on an ultrasound scan

False

An Hysterosalpingogram (HSG) should be performed between days 14-28 of the menstrual cycle

False

PSA

Prostate specific antigen

What is the only definitive way to tell if a tissue is malignant?

Biopsy and histology

Which days of the menstrual cycle would you expect the endometrium to be thinnest?

6-12

What are two other types of investigation that can look for gynaecological pathologies (other than diagnostic imaging)? Mammography is more useful in younger patients, because of their denser breast tissue.

o hysteroscopy o Colposcopy

true

What are three advantages of US over MRI in assessing gynaecological pathology?

o Cheaper o More widely available o Better tolerated by patients

structures through which sperm pass during ejaculation

o Vas deferens (in which secretions from the seminal vesicles are added) o Prostatic urethra (in which secretions from the prostate gland area added) o Membranous urethra (in which secretions from the prostate gland area added) o Penile (spongy) urethra

Epididymal cyst pathway

o o o o

Testicular cancer pathway

o o o o o o

GP - testicular lump GP requests US US shows epididymal cyst GP has consultation with patient + discharges GP – testicular lump or pain GP requests US US shows likely testicular cancer Patient sees urologist Blood test for tumour markers, CXR, CT scan for staging Surgery booked

Testicular torsion pathway

Prostate cancer pathway

o Patient has radical orchidectomy o Post operation adjuvant chemotherapy o A&E – acute testicular pain o Triage nurse o Urology registrar – examines o US – differentiate between torsion + infection o Patient goes to theatre immediately o Fixation of testicle or removal or tissue already necrotic o GP – LUTS o GP – PSA blood test = raised + renal tract US = normal o GP – MRI = PIRADS 5 lesion o Biopsy of lesion under US guidance = positive for prostate cancer o CT for staging o Depending on histology – surgery or radiotherapy o Continuous monitoring of PSA levels to see response to treatment 3

Nocturia

Frequent/ urgent need to urinate

Hesitancy

Difficulty starting to urinate

Prostate cancer risk factors

dysuria

Prostatitis risk factors

o Age – over 50s o Ethnic group – African-Caribbean o Family history o Obesity o Diet – high calcium Pain/ burning sensation when urinating

o Bacterial infection in urine form bladder or urethra leak into prostate – antibiotics o Nerve damage (surgery/ trauma) o Young/ middle aged

Benign prostatic hypoplasia risk factors

Epididymal cyst signs and symptoms

Testicular infection/ epididymo-orchitis

hydrocele

varicocele

Testicular torsion

Testicular tumour

o o o o o o o

Urinary catheter HIV/AIDS Had prostatitis previously Age – increasing chance with age Family history Diabetes and heart disease obesity...