Universitat Internacional de Catalunya
Body Structure and Function: Reproductive System
Other languages of instruction: Catalan
Teaching staff
Students may ask lecturers questions at the end of each class. For enquiries outside of class time, students must make an appointment by email:
Anatomy: Dr. Marta Girvent (by appointment, mgirvent@uic.es)
Histology: Dr. Analía Elguezábal (by appointment, aelguezabal@uic.es)
Physiology: Dr. Maria Laura Gómez (by appointment, pmezquita@uic.es) Coordinator
Dr. Edurne Mazarico (by appointment )
Introduction
The human reproductive function allows the perpetuation of the species and the establishment of the conditions necessary for the survival of the offspring during the first stage of life. This course covers the anatomy and physiology of the reproductive system in both sexes, the maternal changes as a result of pregnancy, the development of the embryo and fetus during pregnancy, the conditions that lead to labor and delivery and the mechanisms involved in breastfeeding.
Pre-course requirements
None
Objectives
Students will learn :
1. The gross structure and the steps involved in the development of the gonads and sex organs in male and females, as well as the ability to identify them on the cadaver.
2. The microscopic structure of the tissues that make up the reproductive system in both sexes, and the ability to identify them under the microscope.
3. The advantages derived from sexual reproduction throughout the evolution of species and the mechanisms that result in sex determination and sex differentiation.
4. The mechanisms for obtaining mature germ cells in both sexes and the hormonal regulation involved in these processes.
5. The neuroendocrine control mechanisms required to deliver germ cells, as well as to accomplish internal fertilization.
6. The hormones responsible for interactive behaviour between members of the opposite sex in order to achieve internal fertilization.
7. The role of sex hormones in prenatal differentiation and acquisition of sexual characteristics after puberty. The changes in fertility throughout life.
8. The timing of pregnancy within the ovarian cycle and the methods available to increase its likelihood or to prevent its occurrence.
9. The stages of pregnancy and the contribution of the placenta to its progression. The physiological adaptations of the mother as a result of pregnancy.
10. The factors that lead to labor and trigger its initiation. The stages of labor and delivery and the mechanisms that control their progression.
11. The induction and maintenance of breastfeeding. The advantages of breastfeeding the newborn.
Competences/Learning outcomes of the degree programme
- 07 - Understand and recognise normal structure and function of the human body at the molecular, cellular, tissue, and organ and systemetic levels, at different stages of life and in both sexes.
- 09 - Understand and recognize the effects, mechanisms and manifestations of disease on the structure and function of the human body.
- 10 - To understand and recognise the agents and risk factors which determine health status, and learn how they determine the symptoms and natural development of acute or chronic diseases in individuals and populations.
- 11 - Understand and recognize the effects of growth, development and aging on the individual and their social environment.
Learning outcomes of the subject
Anatomy
The student will be able to:
1. Identify the location of the testes and surrounding layers.
2. Describe the structures involved in testicular descent and its final location. Understanding the consequences of the lack of descent and testicular torsion .
3. Identify the anatomical regions that make up the route of the sperm and semen. Describe the anatomical components of the penis, including its vasculature .
4.Identify anatomical features and the location of the prostate , seminal vesicles and bulbourethral glands.
5. Identify the location of the ovaries, ligaments, and vascularization .
6. Identify the location of the uterus, its anatomical regions and layers that compose it. Describe your ligaments and the elements they contain. Establish neighborhood relations.
7. Identify the structures of the female external genitalia.
8. Describe the anatomical structure of the breast and lymphatic circulation distribution.
9. Describe the arrangement of the muscles that form the pelvic floor in women.
Histology
The student will be able to:
1. Recognize testis section and identify the components responsible for gametogenesis and endocrine function .
2. Describe the structural changes experienced by germ cells during spermatogenesis and spermiogenesis .
3. Recognize the organization and histological sections : epididymis, vas deferens, seminal vesicles, prostate and penis.
4. Recognize the ovarian section and identify its various components.
5. Describe the changes that occur in the maturation of ovarian follicles, knowing how to recognize the origin and destination of mature follicles.
6. Recognize the organization and histological sections : fallopian tubes, uterus and vagina, appreciating the adaptation of its structures to the functions they perform.
7. Recognize the histological changes experienced by the endometrium throughout the cycle , identifying in histological sections.
8. Describe the structure of the breast and the changes it undergoes during pregnancy and lactation.
Physiology
The student will know :
Sex determination and differentiation
1. What is, what occurs and when sex determination occurs in the gonads.
2. How true differentiation of internal and external reproductive structures during the prenatal period. What are the hormones responsible.
3. What is the coding system of sex chromosome in humans.
4. What is the significance of the Barr body and its importance for fertility.
5. What is the genotype, phenotype and fertility associated with Turner and Klinefelter syndromes.
6. How true differentiation sexual characteristics in both sexes during puberty. What are the hormones responsible.
7. Determining which plan / sexual differentiation occurs by default in the absence of androgens.
8. What is the phenotype resulting from complete androgen insensitivity.
9. What is the phenotype resulting from a deficiency of testosterone and MIF in the prenatal period.
Testicular Function
1. What are the functions of the testicle.
2. What are the functions of Sertoli cells, Leydig, germ and other cells of the testis, and how they relate to each other.
3. What is the function of the blood-testis barrier and what structures it up.
4. What is spermatogenesis and the conditions required to develop normally.
5. What are the mitotic and meiotic cells in spermatogenesis.
6. What is the duration of spermatogenesis and what are the differences between pre-and post-pubertal stage.
7. What are the two essential differences between spermatogenesis and oogenesis.
8. What is spermatogenesis and which involves cessation of transcription.
9. How to control the hypothalamic -pituitary testicular functions .
10. What is the feedback exerted by testicular hormones on the hypothalamic- pituitary axis.
11. Where and when mature sperm become mobile.
12. How semen originates and what are the parameters that affect its ability to fertilization.
13. What is the composition of semen after a vasectomy and what is the fate of sperm in these circumstances.
Ovarian function
1. What are the functions of the ovary.
2. What is the timing of follicle maturation in relation to the stages of oogenesis.
3. At what stage of oogenesis is the egg at the time of ovulation and fertilization.
4. When mitosis ceases in oogenesis . At what stage is resumed oogenesis in the ovarian cycle .
5. How to reduce the population of follicles from embryogenesis and what are the implications in relation to menopause .
6. What are the components of the follicle, the corpus luteum, and their respective functions.
7. What factors induce the selection of the dominant follicle and ovulation.
8. What are the functions of the uterus and what the region undergoing cyclical changes.
9. What changes experienced by the uterus during the follicular and luteal phases, and what are the hormones responsible for these changes.
10. How to control the hypothalamus and pituitary ovarian functions .
11. What is the feedback that exert estrogen and progesterone on the hypothalamic- pituitary axis .
12. Why pregnancy presents with absence of menstrual cycle.
13. What is the influence of stress, emotions, nutritional status etc . on the ovarian cycle.
14. How to vary the levels of FSH, LH, estrogen and progesterone throughout the ovarian cycle.
15. How influence gonadotropins in ovarian hormone production , and vice versa.
16. How triggers ovulation. How to induce ovulation for in vitro fertilization.
17. What is the average length of the ovarian cycle , when ovulation occurs and what is the ideal time to get pregnant.
18. How triggers menstruation and in what circumstances is absent.
Sex hormones
1. Which is the precursor molecule and the sequence of synthesis of sex hormones.
2. How are transported and how sex hormones act on the cell.
3. Where are broken and how sex hormones are removed.
4. What are the general actions of androgens.
5. What are the actions of testosterone and derivatives in the prenatal period and in the adult .
6. What are the general actions and the benefits to women of estrogen.
7. Where they occur and what are the actions of androgens in women.
8. Where they occur and what are the actions of estrogen in men.
9. How estrogen and progesterone influence on the reproductive organs in women.
10.What is the importance and effects of progesterone in relation to pregnancy.
11. What hormones induce changes on the breast at puberty , menstrual cycle and pregnancy.
12. What is the characteristic pattern of hormone production in the hypothalamus -pituitary axis.
13. What is the functional level of the hypothalamic -pituitary before birth.
14. How to vary the function of the hypothalamic -pituitary at puberty .
15. How hormone production varies by the gonads at puberty .
16. What is the difference between primary hypogonadism and hypogonadotropic hypogonadism.
17. What are the changes associated with puberty and timing in both sexes.
18. When is the peak of growth, how long and what should be.
19. How androgen production varies throughout life in man.
20. How varying the ovarian hormone production over the life of the woman.
21. What are the hypotheses to explain the onset of puberty.
22. When and why menopause occurs . What is and what are its consequences.
23. What does andropause and what are its consequences.
Sexual Response
- What are the stages of sexual response, triggers and physiological changes associated with each phase.
- What is the action of the sympathetic and parasympathetic control of sexual response.
- What is the influence of the mechanoreceptors and cerebral cortex.
- What is the action of NO, cGMP and cGMP fosfodiestersa.
- What hormones induce bonding interactive behaviors in relation to procreation.
- How does oxytocin in childbirth, breastfeeding and bonding between mother and newborn.
Fertilization and implantation. The placenta.
1. Where to acquire sperm mobility and where fertilization usually occurs.
2. What is the training , where it happens and what are the triggers.
3. What is the acrosome reaction and what is its importance for fertilization.
4. What events occur from fertilization to embryo implantation in the uterus .
5. How much time elapses from pregnancy until implantation.
6. What is the structure of the blastocyst and which component is involved in the implementation.
7. What is the decidualization and what functions performed.
8. What is the structure and function of the placenta and which products are exchanged through it.
9. What hormones produced by the placenta , what is its function and how they vary throughout the pregnancy.
10. How and when can be performed pregnancy diagnosis.
11. How maintaining corpus luteum function during the first weeks of pregnancy.
12. From what month pregnancy can proceed without the participation of the ovary.
13. What is the fetoplacental unit , what it does and what stage of pregnancy is critical.
Embryonic and fetal development . Maternal adaptations to pregnancy.
1. How to calculate gestational period.
2. What are the main events of embryonic and fetal development, by quarters.
3. What is the importance of folic acid in relation to neural tube.
4. What is the contribution of signaling factors and the endothelium in the developing embryo.
5. What is the fetal circulation circuit with its three leads.
6. How contributes to lung development early fetal viability.
7. What functions performed fetal liver and what is their functional status after birth.
8. What is the volume , composition , and function exchange mechanism of amniotic fluid.
9. How vary estrogen , progesterone, hPL , CRH , PTH and thyroid hormone during pregnancy.
10. Why it happens and what is the evolutionary significance of insulin resistance during pregnancy.
11. What are the cardiovascular adaptations experienced by mothers during pregnancy and what are the causes.
12. What changes pregnancy supposed to respiratory function , renal, liver and endocrine pancreas of the mother.
Childbirth and breastfeeding.
1. When and how birth happens and what changes precede it.
2. At what week of pregnancy is considered premature newborn postmature.
3. What is the role of estrogen and CRH in causing birth and what is the contribution of fetus in it.
4. What is the role of prostaglandins and oxytocin in the pre and during delivery.
5. What are the stages of labor and what the phenomenon of positive feedback.
6. How to contribute fetal size , stress and protein SP -A to the onset of labor.
7. How long and what happens during dilation , the expulsive phase and delivery of the placenta .
8. What is the incidence , duration and symptoms of postpartum depression . What are the assumptions about their origin.
9. When and how breastfeeding is established . What are the advantages of breastfeeding.
10. What you experience breast changes during pregnancy.
11. What are the functions of prolactin during pregnancy and after delivery.
12. Why lactogenesis and lactation are blocked during pregnancy.
13. Why breastfeeding is usually associated with anovulatory period.
14. What is the mechanism that controls lactation neurocrino.
15. What minimum period recommended for breastfeeding as exclusive feeding method.
Syllabus
1. Gross Anatomy
1.1 Male reproductive system : testis and scrotum. Spermatic ducts , prostate, penis.
1.2 Female reproductive system : ovaries , fallopian tubes and uterus , vagina. Mama.
1.3 Muscles of the perineum.
1.4 Muscles of the pelvic diaphragm and pelvic fascia.
2. Microscopic Anatomy
2.1 Male reproductive system ( I). Testis and epididymis.
2.2 Male reproductive system ( II ). Excretory ducts , prostate and penis.
2.3 Female reproductive system ( I). Vagina and uterus.
2.4 Female reproductive system ( II ). Ovarian and breast cancer.
2.5 Pregnancy : breast and placenta.
REPRODUCTIVE PHYSIOLOGY
1. Sexual reproduction. Sex determination and differentiation.
1.1 Sex determination.
1.2 Male and female sexual differentiation : factors involved.
2. Testicular and ovarian function.
2.1 Testicular Function : espermatogéneis. Regulation.
2.2 ovarian function : oogenesis. Ovarian cycle regulation. Uterine cycle.
2.3 Birth Control. Infertility. 3. Role of sex hormones. 3.1 Types of steroid hormones. Mechanisms of action.
3.2 Androgens: types and actions. Adrenocortical Steroids.
3.3 Estrogen and Progesterone : actions on reproductive organs and players.
3.4 Timeline of sexual development 4. Sexual Response. Fertilization and implantation. 4.1 Stages of sexual response.
4.2 Neurological Bases of sexual behavior.
5. Pregnancy , childbirth and breastfeeding.
5.1 Fertilization and implantation.
5.2 Functions of the placenta. Key aspects in embrionary and fetal development.
5.3 Maternal changes associated with pregnancy.
5.4 Labor and delivery.
5.5 Lactation.
Teaching and learning activities
In person
Lectures.
Case discussion seminars.
Anatomy and histology labs.
Evaluation systems and criteria
In person
• Continuous evaluation: 40% of the grade
- MC, Class attendance and participation: 10%
- Anatomical dissection exam: 10% (1)
- Histology examination: 10% (1)
- Physiology exam: 10% (1)
(1) Non-recoverable
• Final Exam: 60% of the grade
The content of the entire course will be evaluated.
Must achieve a minimum score of 50% to pass the course.
Bibliography and resources
G. J. Tortora, B. H. Derrickson. Principles of Anatomy and Physiology, 13th ed. Wiley (2011)
A. Stevens, J. Lowe. Human Histology, 3rd ed. Mosby (2004).
A.L. Kierszenbaum, L.L.Tres. Histology and Cell Biology: An Introduction to Pathology, 3rd ed. Elsevier (2011).
E.N. Marieb. Human Anatomy and Physiology, 7th ed. Pearson Int. Ed. (2007).
Mezquita. Fisiología médica, 1a ed. Panamericana (2011).
W.F.Boron. Medical Physiology, 2nd ed. Sauders (2008).
L.S. Costanzo. Physiology, 5th ed. Elsevier (2013).