「基礎醫學-解剖學」 生殖系統

男性生殖系統

睪丸

精子發生過程的位置是男性生殖系統的數個結構。最開始的階段發生在睪丸,一直到附睪結束。附睪是發展中的精子成熟和儲存直到射精的地方。

曲細精管

曲細精管,又稱生精小管,位於睪丸。主要功能為產生精子

精子

主要在睪丸中生成,並且在附睾(epididymis)中進一步成熟和儲存,不是主要儲存在儲精囊(seminal vesicle)中。儲精囊(seminal vesicle)主要分泌精液的成分,與精子的生成和儲存無直接關聯。

人類精子最適生存溫度略低於體溫,大約在 34-36℃ 之間。

人類的精子和卵子是生殖細胞,它們各自擁有23個染色體,總共46個染色體。這是因為在有性生殖中,精子和卵子各自提供一半的染色體數量,當它們結合時,就會形成一個具有完整染色體數量的受精卵,即46個染色體。
인간의 정자와 난자는 생식세포로, 각각 23개의 염색체를 가지고 있으며 총 46개의 염색체가 있습니다. 이것은 유성생식에서 정자와 난자가 각각 반씩의 염색체를 제공하며 결합할 때 완전한 염색체 수인 46개의 염색체를 가진 수정란이 형성되기 때문입니다.

濾泡刺激激素(Follicle-Stimulating Hormone,簡稱FSH)是由腦下垂體前葉分泌的一種激素。
在男性和女性的生殖系統中都扮演著重要角色。
在男性的生殖系統中,FSH的主要作用是刺激睪丸內的精子生成。
FSH通過刺激睪丸內的精子母細胞(稱為精原細胞)進行分裂和成熟,從而促進精子的生成。
폴리클 자극 호르몬(Follicle-Stimulating Hormone, FSH)은 뇌하수체 앞엽에서 분비되는 호르몬입니다. 남성과 여성의 생식계에서 중요한 역할을 합니다. 남성의 생식계에서 FSH의 주요 작용은 고환 내 정자 생성을 자극하는 것입니다. FSH는 고환 내에서 정자 전구세포(정자의 어머니 세포로 불리는)를 분열 및 성숙시켜 정자 생성을 촉진합니다

精囊

精囊的功能主要是分泌呈弱嗜鹼性的淡黃色黏稠液體,占精液的70%,有營養和稀釋精子的功能。 其主要成分有果糖(ructose)、多種氨基酸、纖維蛋白原、前列腺素和枸櫞酸(citri,acid),其中果糖有營養精子和促進增強精子活動的主要物質。
精囊:又稱儲精囊,位於膀胱底部的後側,輸精管壺腹部的外側,左右各一,主要功能是在提供及儲存精液,但並不儲存精子

輸精管

附睾下端向上,從陰囊上升,穿過腹股溝管進入盆腔內,其末端與精囊腺的排泄管匯合成射精管,開口於尿道的前列腺部

前列腺

恥骨聯合的後面,膀胱的下方

鼠蹊部疝氣(inguinal hernia)

嚴重時,擠入鼠蹊管(inguinal canal)的腸子,最容易直接壓迫到精索(spermatic cord)

女性內外生殖器官

血液供應主要來自:卵巢動脈、子宮動脈、陰道動脈及陰部內動脈。

子宮

子宮頸部(cervix)

子宮頸部(cervix)直接與陰道(vagina)相接,可以藉由陰道擴張器(vaginal dilator)直接觀察檢測

子宮肌膜(英語:myometrium)

也稱子宮肌層,是子宮壁的中間層,包括主要的子宮平滑肌細胞(uterine smooth muscle,也稱子宮肌,uterine myocytes),也包括一些間質及血管組織。 它主要的功能是進行子宮收縮。

子宮圓韌帶(round ligament)

支持子宮的韌帶中,子宮圓韌帶(round ligament)是位於子宮兩側的兩條韌帶,起於子宮側壁上部,輸卵管附著部稍下方,向下經過腹股溝管,經過鼠蹊管(inguinal canal)連結到大陰唇(labia majora)上部,作用是幫助子宮維持前傾。
Among the ligaments that support the uterus, the round ligament is a pair of ligaments located on either side of the uterus. It originates from the upper part of the lateral wall of the uterus, slightly below the attachment of the fallopian tube, and extends downward through the inguinal canal, connecting to the upper part of the labia majora. The round ligament helps to keep the uterus in a forward position.

在懷孕期間,子宮圓韌帶會隨著子宮的增大而變長、增粗。在分娩時,子宮圓韌帶可以幫助胎兒通過產道。
During pregnancy, the round ligament lengthens and thickens as the uterus grows. During childbirth, the round ligament can help the baby pass through the birth canal.

子宮內膜

月經週期功能層會脫落剩下1mm基底層:子宮內膜整個緻密層和大部分的海綿層會成為月經。殘留的海綿層和基底層保留下來在下一次子宮內膜的增生期中進行再生。

卵巢

卵巢中的濾泡由卵母細胞和圍卵細胞組成。
The follicles in the ovaries are composed of oocytes and granulosa cells.
圍卵細胞又分為兩層,外層為顆粒細胞,內層為內鞘膜細胞。
The granulosa cells are further divided into two layers: the outer theca cells and the inner theca interna cells.

雄性素主要由卵巢和腎上腺分泌,由內鞘膜細胞合成雄性素的能力。
Androgens are primarily produced by the ovaries and adrenal glands, and the theca interna cells have the ability to synthesize androgens.
促卵泡激素 (FSH):FSH可以促進內鞘膜細胞合成雄性素。
Follicle-stimulating hormone (FSH) can promote the synthesis of androgens by the theca interna cells.
黃體生成素 (LH):LH可以抑制內鞘膜細胞合成雄性素。
Luteinizing hormone (LH) can inhibit the synthesis of androgens by the theca interna cells.
多囊卵巢綜合症 (PCOS):PCOS 患者的內鞘膜細胞可能會過度合成雄性素。
Polycystic ovary syndrome (PCOS) patients may have theca interna cells that overproduce androgens.

內鞘膜細胞合成的雄性素有下列作用:
The androgens synthesized by the theca interna cells have the following effects:
促進卵泡發育、調節排卵、維持女性生殖系統的健康
Promote follicular development, regulate ovulation, and maintain the health of the female reproductive system.

顆粒細胞(granulosa cells)參與雌激素(estrogen)的合成,濾泡內含23條染色體的卵母細胞(oocyte)和單一大濾泡腔(antrum)。
Granulosa cells are involved in the synthesis of estrogen. The follicle contains an oocyte with 23 chromosomes and a single large antrum.

卵母細胞

此為雌性生殖細胞,卵母細胞是未經減數分裂的生殖細胞,含有23條染色體。次級卵母細胞是卵母細胞經過減數分裂第一次分裂後的產物,含有23條染色體和一個極體。

遺傳性疾病

唐氏症

唐氏症是一種最常見的體染色體異常疾病,第 21 對染色體數目多了 1 條,導致染色體總數為 47 條。這種染色體異常可以發生在卵子或精子形成過程中,也可以發生在受精後的早期胚胎發育過程中。
Down syndrome is the most common autosomal chromosomal disorder. It is caused by an extra copy of chromosome 21, resulting in a total of 47 chromosomes. This chromosomal abnormality can occur during the formation of eggs or sperm, or in the early stages of embryonic development after fertilization.
研究表明,唐氏症的發生率和母親年齡呈正相關,即母親年齡越大,生下唐氏症寶寶的風險越高。這是因為隨著母親年齡的增長,卵子染色體的異常率也會增加。
而父親年齡對唐氏症發生率的影響較小,只有在父親年齡超過 55 歲時,才會略有增加。
Studies have shown that the incidence of Down syndrome is positively correlated with maternal age, meaning that the risk of having a child with Down syndrome increases as the mother's age increases. This is because the risk of chromosomal abnormalities in eggs increases with increasing maternal age.
The paternal age has a smaller impact on the incidence of Down syndrome. Only when the father's age is over 55 years old will the risk increase slightly.

唐氏症的發生率約為 1/1000。
The incidence of Down syndrome is about 1 in 1,000.
唐氏症患者通常有智力障礙、身體發育遲緩、面部特徵異常等症狀。
People with Down syndrome typically have intellectual disabilities, delayed physical development, and abnormal facial features.
唐氏症患者的平均壽命約為 60 歲。
The average life expectancy of people with Down syndrome is about 60 years old.
目前,唐氏症尚無治癒方法,但可以通過早期診斷和干預,改善患者的智力和生活水平。
There is currently no cure for Down syndrome, but early diagnosis and intervention can improve the intellectual and quality of life of people with Down syndrome.

唐氏症可以用 FISH(fluorescence in situ hybridization)輔助診斷。
Down syndrome can be diagnosed with the help of FISH (fluorescence in situ hybridization).
FISH 技術是一種分子生物學技術,可以用來檢測細胞中的特定染色體或基因。
FISH is a molecular biology technique that can be used to detect specific chromosomes or genes in cells. In the diagnosis of Down syndrome, FISH can be used to detect the number of chromosome 21.
產前診斷:可以用於孕婦的羊水穿刺或絨毛膜取樣檢查中,檢測胎兒是否患有唐氏症。
Prenatal diagnosis: FISH can be used in amniocentesis or chorionic villus sampling tests for pregnant women to detect whether the fetus has Down syndrome.
新生兒篩查:可以用於新生兒血液中,檢測是否存在唐氏症的先天性染色體異常。
Newborn screening: FISH can be used in the blood of newborns to detect congenital chromosomal abnormalities, such as Down syndrome.

科林菲特氏症(Klinefelter's syndrome)

患者有一個額外的X染色體,因此他們的核型為47,XXY,患者的白血球細胞核旁最多可以看到1個巴氏體(Barr body),所以巴氏體的存在與否也是診斷科林菲特氏症的指標,巴氏體是由X染色體的非活性部分形成的,男性通常只有一個X染色體,所以較會影響男性。

科林菲特氏症的症狀可能有性腺發育不全、不孕、身材高大、四肢細長、肌肉無力、乳房發育、學習障礙、社交障礙,科林菲特氏症無法治癒,但可使用激素治療改善症狀。

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