Which is not part of the spermatic cord's contents?
Cremasteric Artery
Ductus Deferens
Artery of the Ductus Deferens
Pampiniform Plexus
Lymphatic Vessels
Genitofemoral Nerve (Genital Branch)
Testicular Artery
Parasympathetic Nerve fibers
Sympathetic nerve fibers
Cremasteric Muscle
What is true regarding descent of the gonads?
Originally from level T10
Pulled down by ligamentous cord gubernaculum
Bring along blood supply, nerves, and lymphatics
In women Gubernaculum becomes the round ligament of the uterus
In women gubernaculum becomes ligament of ovary proper
In men, the gubernaculum disintegrates
In men, part of the gubernaculum becomes the scrotal ligament that "anchors" the scrotum in place outside the body
Originally from Level L4
Descent happens early--middle pregnancy
Descent happens in late pregnancy/early birth
What is of clinical importance of varicocele?
sometime chronic pain
acute pain
"Bag of worms" appearance
testicular blood supply is blocked
testicular veins widen due to dysfunctioning
can affect fertility/potency
irreversible damage
may have swelling
extreme pain
usually unpainful
What is the clinical importance of hydrocele?
"transilluminate" test
painful swelling
painless swelling
excess fluid accumulate around testis
fluid escapes tunica albuginea
fluid escapes tunica vaginalis
Which are layers of the scrotum
Skin
Dartos Fascia
External Spermatic Fascia
Cremaster fascia
Dartos Muscle
Internal Spermatic Fascia
Tunica Albuginea
Tunica Vaginalis
Corpus Cavernosum
Ischiocavernous muscle
What does the Cloaca give rise to?
Genital tubercle
Urethral folds
Anal Fold
Genital Swelling
External Genitalia
Uterus
Bladder
Prostate
What are the symptoms characteristic of Hypospadias?
multiple urethral openings on ventral side
multiple urethral openings on dorsal side
abnormal urination
apyrexial
high fevers
normal vital signs
highly visible swelling
What is sensitivity?
How likely to give true positives
How likely not to give false negatives
How likely not to give false positives
How likely to give false negatives
What is the probability of correctly identifying a non-diseased person?
Sensitivity
Specifity
Likelihood
Positive predictive values tell us how likely we are to get the disease
Negative predictive value is how likely patient does not have the condition
What are the defining characteristics of Polycystic Ovary Syndrome? (POS)
Hyperandrogenism (high testosterone) and anovulation
Dysmennorea
Painful abdomen
Increased surge of estrogens
Diagnosis requirements of PCOS?
oligo-ovulation or anovulation
12< cysts on ovaries
symptoms like hirsutism, alopecia, and acne
20< cysts on ovaries
polyovulation
dyspareunia
PCOS can lead to ______________.
Hyperprolactemia
Cushing's Syndrome
Thyroid Disorder (Hypothyroidism)
Androgen-secreting ovarian or adrenal tumors
Addison's Disease
Diabetes II
Heart Disease
What is endometriosis?
growth of endometrial tissue elsewhere than the uterine cavity
inflammation of the endometrium
excessive proliferation of the endometrium
Tumor of the endometrium
Important clinical factors of endometriosis?
cyclic or chronic pelvic pain
infertility
dysmennorea
menorrhagia
discolored discharge
endometrial tissue most commonly in pouch Douglas, pelvic cavity, uterosacral ligaments, and bladder
endometrial tissue most commonly in vagina, cervix, and rectum
diagnosis using ultrasound (see lesions, cysts, and peritoneal deposits)
diagnosis using laporoscopy (see lesions, cysts, and peritoneal deposits)
Management of endometritis?
asymptomatic: only analgesia if needed
goal: promotion of ovulation pills promoting LH
goal: suppression of ovarian function Combined pill or GnRH agonists
Give pills to manage stress
Surgical removal of endometrial lining of the womb (Laparoscopic endometrial ablation)
Surgical alteration of endometrial womb thickness (laparoscopic endometrial retroversion)
Only can give analgesics because cannot cure
If post-menopausal bleeding at least 1 year after last period, endometrial carcinoma until proven otherwise.
Beta HCG isn't reliable for vaginal bleeds to rule out pregnancy/ectopic pregnancyy
What is PID (Pelvic Inflammatory Disease)
any infection of the womb
autoimmune disease of the pelvic bones
any infection of the womb and fallopian tubes
What most commonly causes PID (3 answers)?
STI ex: chlamydia
Post parturition
contraceptive device insertion ex: coil
sexual activity
hereditary; autosommal recessive
Most noteworthy symptoms of PID?
pelvic pain/lower abdominal pain
fever
vaginal discharge
post-sex vaginal bleeding
vomiting
red appearance of tummy and hips
inability to walk at all
Which test is NOT done when investigating PID?
blood test
urine test
swabs and culture
pregnancy test
ultrasound
X-ray fluroscopy
Management of PID?
2 different types of Antibiotics broad-spectrum (IV if high fever or peritonitis)
Avoid intercourse until full healing
Remove IUD/ inserted contraceptive devices if severe
Refer to GUM clinic if STD
Specific antibiotics if cause known
Surgical alteration
Radiation/ chemotherapy
Phototherapy
Because PID can cause scarring of fallopian tubes and uterus, it can lead to...
reoccurent PID
ectopic pregnancies (higher risk)
decreased fertility
peritonitis
hypoxia of uterine tissue
widespread septicemia
What hormone(s) increases after menopause?
LH
FSH
LH and FSH
LH and estrogen
estrogen
estrogen and FSH
What is 2nd trimester?
wk 0-12
wk 13-24
25-36/38
wk-30-38
wk 20-40
What pills can induce abortion?
Mifepristone and Misoprotol
Mifepristone
Misoprostol
Misonefer
Misonefer and Mysterin
Metaformin
A skeletal muscle can be innervated by nerves from more than one single spinal cord level
is how the body knows the relative position of our muscles. Specifically, the and This is how we know what our feet are doing or where they are even if they're not visible.
What are examples of proprioception?
golgi tendon bodies
muscle spindles
joints sensors
skin sensors
myotomes
dermatomes
deep tendon reflex
force you to relax to prevent muscle overexertion. They also help with movement.
During low intensity exercise, most of our energy comes from . Once exercise hits % max intensity, most our energy comes from .
