Reproductive System, Charleigh Ochoa P. 1

Major Functions

Male

Female

Anatomy of Male Reproductive Structures

Anatomy of Female Reproductive Structures

Events of Female Hormonal Cycles

Disorders

Female Hormones

Male Hormones

Both

Form gametes

Bring gametes together

Combine genetic information through fertilization

Support development of fetus and birth of baby

Spermatogenesis

Oogenesis

Testes

Ovaries

Testosterone

Estrogens

Progesterone

Gonadotropin-releasing Hormone (GnRH)

Follicle-stimulating Hormone (FSH)

Luteinizing Hormone (LH)

Gonadotropin-releasing Hormone (GnRH)

Luteinizing Hormone (LH)

Follicle-stimulating Hormone (FSH)

Inhibin

Inhibin

sperm-producing gonads

lie within the scrotum

Ejaculatory Duct

Ductus (Vas) Deferens

Urethra

Epididymis

Prostate

Seminal glands

Scrotum

sac of skin and superficial fascia

hangs outside abdominopelvic cavity at root of penis

contains paired testes at 3º C lower than core body temp

lower temp is necessary for sperm production

divided into two compartments, one for each testis

each is surrounded by two tunics

Tunica albuginea

Tunica vaginalis

outer layer formed from peritoneum

inner layer forms fibrous capsule

divided into ~250 lobules, each containing 1-4 seminiferous tubules

site of sperm production

sperm is conveyed from STs to rete testis to efferent ductules to epididymis

Spermatic cord encloses nerve fibers, blood vessels, and lymphatics that supply testes

Testicular Cancer

Rare, but most common cancer in men age 15-35

Symptoms

painless, solid mass in testis

Treatment

90% cured by surgical removal of testis and often radiation or chemotherapy

area in which sperm mature

Penis

highly coiled

pass slowly through at rate that takes ~20 days to gain ability to swim

can be stored for several months

contracts during ejaculation, expelling sperm into ductus deferens

passes through inguinal canal to pelvic cavity

joins duct of seminal vesicle to form ejaculatory duct

smooth muscle in walls propels sperm from epididymis to urethra

conveys both urine and semen (at different times)

male copulatory organ

consists of:

root and shaft that ends in glans penis

prepuce or foreskin

60% of US males are circumcised, foreskin surgically removed

internally, made up of spongy urethra and 3 cylindrical bodies of erectile tissue, spongy network of connective tissue and smooth muscle with vascular spaces

Corpora cavernosum

Corpus spongiosum

surrounds urethra and expands to form glans and bulb of penis

paired dorsal erectile bodies

Erection

erectile tissue fills with blood, causing penis to enlarge and become rigid

contains smooth muscle that contracts during ejaculation

produces viscous alkaline seminal fluid

fructose, citric acid, coagulating enzyme (vesiculase), and prostaglandins

comprises 70% volume of semen

duct joins ductus deferens to form ejaculatory duct

encircles urethra inferior to bladder

consists of smooth muscle that contracts during ejaculation

secretes milky, slightly acidic fluid

contains citrate, enzymes, and prostate-specific antigen (PSA)

plays a role in sperm activation

enters prostatic urethra during ejaculation

makes up 1/3 of semen volume

Bulbo-urethral glands (Cowper's gland)

produce thick, clear mucus during sexual arousal

lubricate glans penis

neutralizes traces of acidic urine in urethra

Prostatitis

common reason for man to consult urologist

Prostate Cancer

Third most common cause of cancer death in males that affects 1 in 6 men in US

Digital exam screening, PSA levels can be checked by having high rate of false positives

Treated with surgery and sometimes radiation

Metastatic prostate cancer treated with drugs that block testosterone synthesis or action

Semen

milky-white mixture of sperm and accessory gland secretions

2-5 ml semen are ejaculated containing 20-150 million sperm/ml

contains fructose for ATP production, protects and activates sperm, and facilitates sperm movement

alkaline fluid neutralizes acidity of male urethra and female vagina and enhances motility

synthesized from cholesterol, transformed at some target cells

prompts spermatogenesis and targets all accessory organs

has multiple anabolic effects throughout body

process of forming male gametes in seminiferous tubules

begins at puberty ~14 years old

adult makes ~90 million sperm daily

Secondary sex characteristics

larynx enlargement causes deepening of voice

skin thickens and becomes oily

bones grow, increase in density

skeletal muscles increase in size and mass

enhanced growth of hair on chest or other areas

boosts basal metabolic rate

Appearance of pubic, axillary, and facial hair

basis of sex drive (libido)

female gonads

secrete female sex hormones

produce female gametes (ova)

progesterone

estrogen (estradiol, estrone, estriol)

located in pelvic cavity

including duct system

uterine tubes

uterus

vagina

paired structures flank the uterus, are almond shaped and about twice as large

each ovary is held in place by several ligaments

ovarian ligament: anchors ovary medially to uterus

suspensory ligament: anchors ovary laterally to pelvic wall

along with mesovarium, are part of broad ligament that supports uterine tubes, uterus, and vagina

Ovarian Follicles

tiny saclike structures embedded in cortex

contain immature egg (oocyte) encased by one or more layers of very different cells

each month a ripened follicle ejects oocyte in event called ovulation

Duct System

uterine tube system does not have direct contact with ovaries

ovulated oocyte is released into peritoneal cavity, where some oocytes never make it to tube system

Uterine Tube System

Uterus

Vagina

The Uterine Tubes

fallopian tubes or oviducts

receive ovulated oocyte and are usual site of fertilization

each tube ~10cm (4 in) long and extends from area of ovary to superior region of uterus

Infundibulum

funnel-shaped opening into the peritoneal cavity

margin contains ciliated projections call fimbriae that drape over ovary

usual site of fertilization

during ovulation, uterine tube captures oocyte

oocyte is carried along toward uterus by smooth muscle peristalsis and ciliary action

thin-walled tube 8-10cm (3-4in) in length

hollow, thick-walled, muscular organ

functions to receive, retain, and nourish fertilized ovum

Regions

Body

Fundus

Isthmus

Cervix

Cervical canal

major portion

rounded superior region

narrowed inferior region

narrow neck, or outlet; projects into vagina

communicates with:

vagina via external os

uterine body via internal os

Cervical Cancer

affects 450,000 women worldwide each year, killing half

Most common between ages 30 and 50

Risks

frequent cervical inflammation; STIs, including HPV; or multiple pregnancies

Treatment

Gardasil:three-dose vaccine; protects against HPV

Papanicolau (Pap) smear

recommended for 11 and 12 year old girls

for detection:

recommended every 3 years for ages 21-30

every 5 years for ages 30-65, but include HPV testing

Discontinue at 65, after hysterectomy, or with sexual activity

Uterine Wall

Myometrium

Endometrium

Perimetrium

outermost serous layer (visceral peritoneum)

bulky middle layer consisting of interlacing layers of smooth muscle

contracts rhythmically during child-birth

mucosal lining

simple columnar epithelium on top of a thick lamina propia

fertilized egg burrows into endometrium and resides there during development

functions as birth canal, passageway for menstrual flow, and organ of copulation

vaginal secretions are acidic in adult females

mucosa near vaginal orifice forms incomplete partition called hymen that ruptures with intercourse

External Genitalia

Labia majora

Labia minora

Mons pubis

Vestibule

Clitoris

Perineum

fatty area overlying pubic symphysis

hair-covered, fatty skin folds

skin folds lying within labia majora

recess within labia minora

anterior to vestibule

diamond-shaped region between pubic arch and coccyx

counterpart of scrotum

counterpart of penis, body of clitoris has erectile tissue

Breast Cancer

Invasive breast cancer is most common malignancy and second most common cause of cancer death in women

13% of women will develop

Usually arises from epithelial cells of smallest ducts that eventually metastasize

Risk factors

early onset of menstruation and late menopause

no pregnancies or first pregnancy late in life

no or short periods of breast feeding

family history of breast cancer

10% due to hereditary defects, including mutations to genes BRCA1 and BRCA2

70% of women with breast cancer have no known risk factors

Greater risk of ovarian cancer as well

50% to 80% of women with these genes develop breast cancer

Diagnosis

Early detection via self-examination and mammography, a type of x-ray examination

Recommended screening every year fro age 40+

Treatment

Depends upon characteristics of lesion

radiation, chemotherapy, or surgery followed by radiation or chemotherapy

drugs for estrogen-responsive cancers

Lumpectomy: less invasive and excises cancerous lump

production of female gamete

begins in fetal period

Primary oocytes that undergo meiosis I to produce

Secondary oocytes that undergo meiosis II to produce

Oogonia (diploid stem cells) divide by mitosis to produce

Ova

At birth, female presumed to have lifetime supply of primary oocytes

Primordial follicle

Secondary follicle

Vesicular (antral) follicles (tertiary follicles)

single layer of squamous pre-granulosa cells surrounding primary oocyte

have multiple layers of granulosa cells surrounding primary oocyte

have a fluid-filled cavity called an antrum

before ovulation primary oocyte inside vesicular follicle resumes meiosis and becomes secondary oocyte

begins during fetal period and takes years

first to develop in fetus

Ovulation

each month after puberty, a select few primary oocytes are activated

caused by high hormonal levels, especially FSH

One from this group is "selected" each month to become dominant follicle

Follicle Development

Follicles and oocytes may take nearly a year to mature before ovulation can occur

Maturation phase

Phase 1

Phase 2

gonadotropin-independent pre-antral phase involves intrafollicular paracrines

antral phase stimulated by FSH and LH

Dominant follicle is selected

Primary oocyte resumes meiosis I

Stages of Development

primordial follicle becomes primary follicle

oocyte secretes glycoprotein-rich substances that forms zona pellucida that encapsulates oocyte

Secondary follicle becomes vesicular (antral) follicle

Primary follicle becomes secondary follicle

Antrum: large cavity that is formed when all fluid coalesces

distinguishes vesicular follicle from previous follicles

Antrum continues to expand with fluid isolating oocyte

isolated oocyte with its surrounding granulosa cells called corona radiata

After oocyte & corona radiata are ejected, ruptured follicle transforms into glandular structure called corpus luteum

Ovarian Cycle

monthly series of events associated with maturation of egg

Follicular phase: period of vesicular follicle growth (days 1-14)

Luteal phase: period of corpus luteum activity (days 14-28)

two consecutive phases, with ovulation ocurring midcycle between pahses

several vesicular follicles become sensitive to FSH and are stimulated to grow

FSH levels drop around middle of phase

dominant follicle outcompetes other follicles and is only one to continue on

Ovulation

in-between follicular and luteal phase

ballooning ovary wall ruptures, expelling secondary oocyte with its corona radiata into peritoneal cavity

after ovulation, ruptured follicle collapses, and sntrum fills with clotted blood

remaining cells form corpus luteum

secretes progesterone and some estrogen

Hormonal interaction during Ovarian Cycle

Negative feedback inhibits gonadotropin release

Positive feedback stimulates gonadotropin release

FSH and LH stimulate follicles to grow, mature, and secrete sex hormones

LH surge triggers ovulation and formation of the corpus luteum

GnRH stimulates FSH and LH secretion

Negative feedback inhibits LH and FSH release

The Uterine (Menstrual) Cycle

cyclic series of changes in endometrium that occur in response to fluctuating ovarian hormone levels

Three phases

Days 6-14: proliferative (preovulatory) phase

Days 15-28: secretory (postovulatory) phase

Days 1-5: menstrual phase

gonadotropin levels begin to rise

stratum functionalis detaches from uterine wall and is shed

Ovarian hormones at lowest

By day 5, growing ovarian follicles start to produce more estrogen

menstrual flow of blood and tissue lasts 3-5 days

estrogen also increases synthesis of progesterone receptors in endometrium

thins out normally thick, sticky cervical mucus to facilitate sperm passage

rising estrogen levels prompt generation of new stratum functionalis layer

ovulation occurs at end of proliferative phase on day 14

as layer thickens, glands enlarge, and spiral arteries increase in number

endometrium prepares for embryo to implant

If fertilization does not occur

phase that is most consistent in duration

endometrial cells die; and glands regress

blood vessels fragment, and functional layer sloughs off and uterine cycle starts all over again on first day of menstruation

corpus luteum degenerates toward end of secretory phase; progesterone levels fall

Effects of Estrogens and Progesterones

Estrogens

Progesterones

support rapid short-lived growth spurts at puberty

Induce secondary sex charcateristics

exert anabolic effect on female reproductive tract

Estrogen also has metabolic effects

promote oogenesis and follicle growth in ovary

works with estrogen to establish and regulate uterine cycle

promotes changes in cervical mucus

effects of placental progesterone during pregnancy

growth of breasts

increased deposits of subcutaneous fats

widening and lightening of pelvis

maintains low total blood cholesterol and high HDL levels

facilitates calcium uptake

inhibits uterine motility

helps prepare breasts for lactation

Sexually Transmitted Infections

Viral STIs

Trichomoniasis

Gonorrhea

Chlamydia

Syphilis

HPV

Genital herpes

most common bacterial STI in US

can be contracted from birth canal by newborns

responsible for 25-50% of all diagnosed cases of PID

Symptoms

Treatment

Antibiotics

urethritis

painful intercourse

irregular menses

abdominal, rectal, or testicular pain

penile and vaginal discharges

can lead to sterility

parasitic infection that is more common in women than men

easily and inexpensively treated

Symptoms

70% of women have no symptoms

30% have yellow-green vaginal discharge with strong odor

Bacterial infection of mucosae of reproductive and urinary tracts

most infections are asymptomatic

Symptoms

Females

Males

urethritis, painful urination, discharge of pus. from penis

abdominal discomfort, vaginal discharge, or abnormal uterine bleeding, and possible urethral symptoms

untreated can cause urethral constriction and inflammation of duct system

untreated can lead to pelvic inflammatory disease and sterility

Treatment

antibiotics, two antibiotic treatments required

bacterial infection transmitted sexually or congenitally

infected fetuses can be stillborn or dies shortly after birth

Infection is asymptomatic for 2-3 weeks and then painless chancre appears at site of infection

disappears within a few weeks

If untreated, secondary signs appear weeks later

Pink skin rash, fever, and joint pain can develop

appear for 3-12 weeks, then disappear

Can enter latent period, which may or may not progress to tertiary syphilis

Treatment

Penicillin

group of ~40 or more viruses is most common in US

over 50% of adults are infected during lifetime

cause of genital warts

can cause multiple cancers

Vaccination can guard against most common cancer-causing strains

recommended for boys and girls before becoming sexually active

One of most difficult human pathogens to control because most do not know they are infected

only 15% display signs of infection

Characterized by latent periods and flare ups with vesicle formation

Treatment

antiviral drugs can reduce duration and intensity of flare-ups

Puberty

period when reproductive organs grow to adult size and become functional

occurs in response to rising levels of gonadal hormones

secondary sex characteristics also appear

earliest time reproduction is possible

Menopause

has occurred when menses have ceased for an entire year

no male equivalent

declining estrogen levels

atrophy of reproductive organs and breasts

gradual thinning of skin and bone loss

hot flashes

increased total blood cholesterol and falling HDL

irritability and depression in some

Treatment

estrogen-progesterone preparations