b. Female B1. Corpus luteum [KIEV] B2. Ovary [KIEV B3. Fallopian tube [ DENNIS] B4. Uterus [DENNIS] B5. Vagina [DENNIS]
2. Trace A. Menstrual Cycle [JESS, PALTEP, CLAR] B. Spermatogenesis [KIEV, DENNIS]
EXP 19B Discuss the value of the above tests in assessing the systems wellbeing. A. Pregnancy Test ===[PALTEP] B. Seminal Fl. Analysis 1. Physical Exam [ JESS, CLARISSE] 2. Microscopic Exam a. Motility [ DENNIS] b. Morphology [KIEV]
B3. Fallopian tube [ DENNIS] Two uterine tubes, also called fallopian (fa-lo_pe-an) tubes, or oviducts (o_vi-du kts), are present. There is a uterine tube on each side of the uterus associated with an ovary (see figure 28.10). Each tube is located along the superior margin of the broad ligament. The part of the broad ligament most directly associated with the uterine tube is called the mesosalpinx (mez_o-sal_pinks; mesothelium of the trumpet-shaped uterine tube). The uterine tube opens directly into the peritoneal cavity to receive the oocyte from the ovary. It expands to form the infundibulum (in-fun-dib_u-lum; funnel), and long, thin processes called fimbriae (fim_bre-e; fringe) surround the opening of the infundibulum. The inner surfaces of the fimbriae consist of a ciliated mucous membrane. B4. Uterus [DENNIS] Uterus The uterus (u_ter-u s) is the size and shape of a medium-sized pear and is about 7.5 cm long and 5 cm wide (see figures 28.9 and 28.10). Its slightly flattened anteroposteriorly and is oriented in the pelvic cavity with the larger, rounded part, the fundus (fun_du s; bottom of a rounded flask), directed superiorly and the narrower part, the cervix (ser_viks; neck), directed inferiorly. The main part of the uterus, the body, is between the fundus and the cervix. A slight constriction called the isthmus marks the junction of the cervix and body. Internally, the uterine cavity continues as the cervical canal, which opens through the ostium into the vagina. Inguinal canals to the labia majora of the external genitalia, and the uterosacral ligaments attach the lateral wall of the uterus to the sacrum. Normally, the uterus is anteverted, meaning that the body of the uterus is tipped slightly anteriorly. In some women, the uterus is retroverted, or tipped posteriorly. In addition to the ligaments, skeletal muscles of the pelvic floor provide much support inferiorly to the uterus. If these muscles are weakened (e.g., in childbirth), the uterus can extend inferiorly into the vagina, a condition called a prolapsed uterus.
B5. Vagina [DENNIS] Vagina The vagina (va-j_na) is a tube about 10 cm long that extends from the uterus to the outside of the body (see figure 28.10). The vagina is the female organ of copulation, functioning to receive the penis during intercourse, and it allows menstrual flow and childbirth. Longitudinal ridges called columns extend the length of the anterior and posterior vaginal walls, and several transverse ridges called rugae (roo_ge) extend between the anterior and posterior columns. The superior, domed part of the vagina, the fornix (for_niks; domed), is attached to the sides of the cervix so that a part of the cervix extends into the vagina. The wall of the vagina consists of an outer muscular layer and an inner mucous membrane. The muscular layer is smooth muscle that allows the vagina to increase in size to accommodate the penis during intercourse and to stretch greatly during childbirth. The mucous membrane is moist stratified squamous epithelium that forms a protective surface layer. The vaginal mucous membrane releases most of the lubricating secretions produced by the female during intercourse.
A. Spermatogenesis [KIEV, DENNIS]
Sperm Motility The presence of sperm capable of forward, progressive movement is critical for fertility, because once presented to the cervix, the sperm must propel themselves through the cervical mucosa to the uterus, fallopian tubes, and ovum. Traditionally, clinical laboratory reporting of sperm motility has been a subjective evaluation performed by examining an undiluted specimen and determining the percentage of motile sperm and the quality of the motility. Assessment of sperm motility should be performed on well mixed, liquefied semen within 1 hour of specimen collection. The practice of examining sperm motility at timed intervals over an extended period has been shown to serve no useful purpose.5 To provide continuity in reporting, laboratories should place a consistent amount of semen under the same size coverslip, such as 10 _L under a 22 _ 22 mm coverslip. The percentage of sperm showing actual forward movement can then be estimated after evaluating approximately 20 high-power fields. Motility is evaluated by both speed and direction. Grading can be done using a scale of 0 to 4, with 4 indicating rapid, straight- line movement and 0 indicating no movement (Table 113). A minimum motility of 50% with a rating of 2.0 after 1 hour is considered normal.1 The WHO uses a rating scale of a, b, c, d (see Table 113). Interpretation states that within 1 hour, 50% or more sperm should be motile in categories a, b, and c, or 25% or more should show progressive motility (a and b).4 The presence of a high percentage of immobile sperm and clumps of sperm requires further evaluation to determine sperm viability or the presence of sperm agglutinins. In recent years, instrumentation capable of performing computer-assisted semen analysis (CASA) has been developed. CASA provides objective determination of both sperm velocity and trajectory (direction of motion). Sperm concentration and morphology are also included in the analysis. Currently, CASA instrumentation is found primarily in laboratories that specialize in andrology and perform a high volume of semen analysis.