what is testosterone produced by in response to stimulation by LH from the anterior pituitary?
leydig cells
what stimulates testicular germ cells to mature into functional sperm?
FSH
what is the penis composed of?
shaft and glans
what is the opening of the penis?
external urethral meatus
what is a retractable collar of skin that folds over the glans?
preupuce
how many dorsal corpus cavernosums does the penis have? what about corpus spongiosum?
2 1
what keeps the testicular temperature about 5 degrees F below body temperature? which is necessary for proper sperm development?
scrotum
what is the smooth serosal sac with a small amount of fluid that allows free movement of the testicle?
tunica vaginalis
in males, a gonad is composed of:
seminiferous tubules (90%) where sperm are rpoducedinterstitial tissue (10%) that produces testosteron
what are seminiferous tubules lined by?
spermatogonia
what specialized cells regulate sperm production?
sertoli cells
where are sperm stored and mature?
epididymis
what does fluid from the seminal vesicles contain?
vesiculase that cauess semen to clot after ejaculation
what is formed by mature sperm form the epididymis iwth fluids from the seminal vesicles and prostate?
semen
what is the ejection of semen mediated by in response to stimulation?
symapthetic nervous systemmuscular contractions
what is erectile dysfunction caused by?
either slow arterial inflow or fast venous drainage to the corpus cavernosumcan be due to atherosclerosis, nerve damage, hormonal disturbances, medications
infertility is the inability to contribute to conception, inability of a couple to conceive after ____ of unprotected regular intercourse
1 year
is infertility mainly caused by male or female reproductive system dysfunction?
neither. 50:50 split
what does impaired spermatogenesis result in?
low sperm count
what is azoospermia?
presence of no sperm at all in the semen
what are the 3 primary causes of azoospermia?
1. testicular azoospermia2. post-testicular or obstructive azoospermia3. prestesticular azoospermia
what describes azoospermia due to testicular injury or trauma, infection, illness, cancer
testicular azoospermia
what describes azoospermia due to testicles producing sperm but they can't be released due to blockage or surgery like a vasectomy?
ost-testicular or obstructive azoospermia
what describes azoospermia due to healthy testicles with hormone imbalance that results in impairment of stimulatory signals?
prestesticular azoospermia
what are the 3 things imapired sperm/semen emission can be due to?
1. retrograde ejaculation into the bladder2. failure of emission3. anorgasmia
true or false? autoimmune antisperm antibodes and sperm with impaired motility can cause infertility?
true
what does the diagnosis of infertility require?
semen analysis
what is an antiestrogen that can be used to increase sperm count?
clomiphene
what is a birth defect in boys in which the opening of the urethra is not located at the tip of the penis?
hypospadias
what is an opening of the penis on the dorsum?
epispadias
what is a condition of the penis that occurs in some adults and children who are not circumcised from the inabliiy to retract the foreskin over the glans?
phimosis
what results fro the adhesions between the epithelial layers of the inner prepuce and glans before puberty?
physiologic phimosis
what promotes poor hygiene, infection inflammation, and scarring which may males to squamous carinoma?
pathological phimosis
what is the most acute complication of pathological phimosis?
paraphimosis
what is paramiphosis?
occurs when a forcible retracted prepuce becomes trapped which produces glans congestion, edema, pain, and urinary obstruction
what is balanitis?
inflammation of the glans, usually uncircumcised men
balanitis is most often caused by ____
fungal infection, but can also be caused by bacterial infection or STI
what is an inflammatory disease with white, sclerotic patch at the tip of the glans which can constrict the urethral opening?
balanitis xerotica obliterans
what is condyloma acuminatum?
sexually transmitted cauliflower like growth caused by HPV
describe bowen disease
squamous carcinoma in situ which remains contained to the BM (grey/red plaque on glans)
what is the most common invasive malignancy which usually forms on or under the foreskin?
squamous carcinoma
what is peyronie disease?
noncancerous condition resulting from fibrous scar tissue of the corpus cavernosum which distorts the erect penis = pain
what is peyronie's disease caused by?
repeated penile injury, usually during sex or physical activity
what is a prolonged erection of more than 4 hours of the penis usually due to impaired venous outflow from inflammation or drug therapy?
priapism - ischemic is medical emergency
what is the most common cause of urethritis (inflammation of urethra)
usually STI
what is a fungal infection that causes a red itchy rash in moist areas with inflammation of the scrotum or inguinal skin?
tinea cruris
what is varicocele?
when veins become enlarged inside the scrotum
what is the accumulation of fluid in the sac of the tunica vaginalis that surrounds the testis?
hydrocele
what is cryptochidism?
failure of one or both testes to descent from abdomen into scrotum **increases risk of malignancy
what is orchitis?
swelling from inflammation of testes which can be caused by mumps
what are the main causes of epididymitis?
men < 35: STImed > 35: urinary pathogen
what are cysts of the epididymis that contain sperm which happens when sperm builds up somewhere in the epididymis?
spermatocele
what is the rotation of the testicles which results in twisting of the spermatic cord?
testicular torsion **only interrupts venous drainage NOT arterial flow
what does testicular torsion require immediately?
surgery and orchipexy of both testiclesorchipexy: surgery to move/fix testicle in the scrotumEMERGENCY
what should be suspected in any male with painless enlargement of the testis?
testicular neoplasms
what are the 2 major groups of testicular neoplasms?
1. tumors of germ cells (95% and usually malignant)2. tumors of sex chord/stroma cells (5% usually benign)
germ cells are ___ so a wide variety of tumors can arise at any stage of development
totipotent ** makes it unique
a benign ___ is composed of differentiated tissues such as hair, skin, brain, or thyroid tissue
teratoma
what type of germ cell tumor retains features of primitive spermatocytes and are the most common?
seminomagrow slowly (limited by immune system) and metastasize later than other germ cell malignancies
what does the diagnosis of germ cell tumors require?
removal of entire testis for exam
leydig cell tumors (sex chord/stromal tumor) arise in __
testicular stroma
sertoli cell tumors (sex chord/stromal tumor) arise in __
seminiferous tubules
what encircles the urethra at the neck of the bladder?
prostate
what are the 4 zones of the prostate gland?
peripheral, central, transitional, anterior
what is the prostate's primary function?
to produce seminal fluid which nourishes and transports sperm
the majority of testicular neoplasms are?
MALIGNANT
what does the normal function of the prostate gland depend on?
androgens, mainly testosterone
what type of antigens does the prostate gland contain?
prostate specific antigen (PSA) which dissolves clotted semen and allows it to migrate up toward the female genital tract
what is acute bacterial prostatitis usually caused by?
e.coli or other fecal bacteriapresents with fever
what is a routine procedure used to examine the lower rectum and other internal organs?
digital rectal exam (DRE)
what makes cancers of the prostate gland palpable?
because it usually develops in the posterior and peripheral parts
true or false? chronic bacterial prostatitis may be nearly asymptomatic or present with low back pain and there is fever
false. NO FEVER
how is nonbacterial prostatitis (also known as chronic pelvic pain syndrome) different from chronic bacterial prostatitis?
it is similar but urine cultures are negative. this is the most common form of prostatitis *antibiotics usually not effective
true or false? only a small population of men develop (benign prostatic hyperplasia) with advancing age
FALSE. nearly all men develop BPH with advancing age. can enlarge 3-5x and protrude into bladder
what can benign prostatic hyperplasia (BPH) cause>
obstruction = prevent complete emptying of bladderpromotes stasis = infection
what is the most common malignancy, more frequent than breast or lung cancer?
prostatic carcinoma/adenocarcinoma
protastatic carcinoma/adenocarcinoma are usually __-dependent
androgen dependent
what is defined by neoplastic growth of epithelial cells within preexisting benign prostatic acini or ducts?
prostatic intraepithelial neoplasia (PIN): atypical cells contain some molecular changes in carcinoma
high grade prostatic intraepithelial neoplasia (PIN) is considered as?
carcinoma in situ
true or false? adenocarcinoma is no more likely to develop in a patient with PIN than a patient without PIN
true
prostatic carcinomas are usually asymptomatic and are discovered by ___
increased levels in PSA- it is prostate specific but not sensitive or specific for prostate cancer
what scale is used to grade prostatic carcinomas?
gleason scale1: well differentiated 5: poorly differentiatedhigher score = more advanced and deadly
what system stages prostatic carcinoma?
TNPT1: best prognosisT4: worst prognosis
lymph node involvement, distant metastases, high PSA, and high gleason score is associated with what kind of outcome
poor outcome
ale infertility can be caused by what 3 things?
impaired spermatogesis, azoospermia, impaired semen emission
testicular torsion is caused by rotation of the testicles which results in ___ and is ____
twisting of the spermatic cord and hypoxia; and is an acute medical emergency