2011人类生殖与优生1.ppt

孩子是你心中的太阳!也是你的幸福与烦恼!,医学院开设医学特色选修课,人类生殖与优生王晓梅老师食品营养与食品安全吴序栎老师中药保健常识余惠旻老师病原与健康罗新萍老师皮肤学与皮肤美容学蔡飒老师人体免疫与健康陈思老师药物与家庭用药王晓冬老师生物安全与人类生活王玉树老师,人类生殖与优生,主讲教师：王晓梅联系电话：86671908(704办公室)E-mail:xmwang内线号：614361医学院,课程安排,考核形式：开卷考试考试成绩：考勤（30%）+期末考试（70%）主讲教师：王晓梅：34学时考试：2学时,主要参考教材:HumanReproductiveBiologyRichardE.Jones2007人类遗传与优生丁显平人民军医出版社生殖健康王临虹中国协和医科大学出版社人类生殖史小林科学出版社生殖医学王心如人民卫生出版社受精生物学陈大元科学出版社人类生殖与生殖工程卢光绣河南科技出版社,主要内容,男女生殖系统及生殖内分泌生殖细胞的发生与受精机制性别分化与早期胚胎发育人类遗传疾病与优生生殖健康与性传播性疾病环境因素与优生不孕与避孕生殖工程人类性取向异性恋与同性恋,生殖(Reproduction)：生物体均能产生与自己相似并能独立生活的下一代机体，以保证该生物种族的绵延，这种现象叫生殖。高等动物包括人在内一般通过雌雄配子（精子与卵子）彼此结合，分化发育，形成新一代个体。,生殖生物学发展史,公元前460-377古希腊Hippocrrates最早对鸡胚发育进行仔细观察；公元前384-322Aristotle观察鱼等无脊椎动物，提出胚胎是逐渐形成的。17、18世纪，Malpighi提出“先成论”，胚胎从未受精的精卵中发育而来。1759年德国的Woff提出“后成论”，他发现一切器官都是由简单到复杂逐步形成的。二十世纪五十年代，张明觉与Auatin首次发现精子获能才能受精。,ReproductiveandHormonalFunctionsoftheMale,OBJECTIVES,RecognizethepartsofmalereproductivesystemKeepinmindthepertinentmedicaltermsExplainbrieflytheprocessesrelatedtospermatogenesisandhormonalregulationIntroducesomediseasesrelatedtoeachpartEvaluatethevalueofthespermatozoaroutineanalysis,THEMALEREPRODUCTIVESYSTEM,THEPENIS(externalanatomy),ErectileorganMalecopulatory(copulate)organExitpointforurineandsemenAdd:Prepuce,Smegma,TysonsGlands,(opening),(balan/o),Basepart,BALANITIS,Penis阴茎Consistsoftheroot,bodyandglanspenisContainsTwocavernousbodyofpenis阴茎海绵体Acavernousbodyofurethra尿道海绵体SkinthinandloosePrepuceofpenis阴茎包皮Frenulumofprepuce包皮系带,Nobonycomponent.,corpus,TheMechanismofErection,ERECTILEDYSFUNCTION(IMPOTENCE),Causes:atherosclerosis,neurologic,DM,hormonaldeficiency,sideeffectsofdrugs,psychological,obesity,smoking,SCROTUM,Scrotum阴囊PouchofthinskinlyingbelowtherootofthepenisDividedintotwohavesbyseptumofscrotum,containstestesandtheirductsDeeptoskinisdartoscoat肉膜,aconnectivetissuelayerthatcontainsmanysmoothmusclefiberswhichcontractsinresponsetocold,pullingthetestesclosertothebodyandwrinklingtheskin,TESTICLES(TESTES),Normallylocated,Abnormallylocated,Anatomyofthetestis,RETETESTIS,epididymorchitis,SPERMATOGENESIS,REPRODUCTIVETUBULES,SITEOFMATURATION,PASSAGEWAYVASECTOMY(CUT),EJACULATORYDUCT,URETHRA,URETHRALMEATUS,PROSTATE,ORGASM,EJACULATION,Genitalducts,Epididymis附睾Comma-shaped,withhead,bodyandtailofepididymisLocatedonsuperiorextremityandposterolateralaspectoftestisContainstortuouscanalthatextendsfromtestistoductus(vas)deferensinspermaticcordFunctionthesiteofaccumulationandstorageaswellasthematurationofsperm,Vasdeferens输精管MusculartubethattransportsspermfromepididymistoejaculatoryductFourparts:Testicularpart睾丸部extendsfromthetailofepididymistothesuperiorextremityoftestisSpermaticpart精索部extendsfromsuperiorextremityoftestistothesuperficialinguinalring,theplacewherethevasectomyisperformedInguinalpart腹股沟部extendsfromsuperficialtodeepinguinalringsPelvicpart盆部crossestheobturatorneurovascularbundleandtheuretertoreachthebaseofbladder,terminalpartdilates,formingampullaductusdeferentis,Spermaticcord精索ExtendsfromthesuperiorextremityoftestistothedeepinguinalringSpermaticcordcomprises:VasdeferensTesticularanddeferentialarteriesPampiniformplexus蔓状静脉丛NervesandlymphaticsVestigeofvaginaprocessThesestructuresareboundtogetherbyconnectivetissueandenclosedbytheinternalspermaticfascia,cremasterandexternalspermaticfascia,SPERMATICCORD,tubularstructuresinthemalereproductivesystemthatsupportthetestesinthescrotum.containsanetworkofarteries,veins,nerves,andthefirstsectionoftheductusdeferens,Ejaculatoryduct射精管FormedbyunionofdistalportionofVasdeferensandductofseminalvesiclePassesthroughtheupperpartofprostateandopensintotheprostaticpartofurethra,ACCESSORYGLANDS,SEMINALVESICLEmucus,aminoacids,FRUCTOSE,prostaglandins,PROSTATEGLANDAlkalinesecretion(protective),BULBOURETHRALGLAND(COWPERSGLAND)Mucoussecretion(lubricant),Accessoryglands,Seminalvesicle精囊Pairedsacculated,coiledglandsSecretepartofseminalfluidLocatedonposteriorsurfaceofbladder,lateraltoampullaVasdeferentis,Prostate前列腺Liesbehindpubicsymphysis,betweenneckofbladderandurogenitaldiaphragmShapeChestnut-shapedorganContainsfivelobesAnteriorlobeMiddlelobePosteriorlobeRightandleftlobesEnclosedbyathininnerfibrouscapsule(truecapsule)andastrongouterenvelopeofpelvicfascia,Bulbourethralgland尿道球腺twosmallpea-shapedglands,locatedinthedeeptransversemuscleofperineum,DiseaseConditions,HYDROCELE/HYDROCELE/(HIDRO-SEL)ACIRCUMSCRIBEDCOLLECTIONOFFLUID,ESPECIALLYINTHETUNICAVAGINALISOFTHETESTISORALONGTHESPERMATICCORD.,Collectionoffluidinthetunicavaginalisorspermaticcord,HORMONALINTERACTION:HYPOTHALAMUSPITUITARYTESTESAXIS,FUNCTIONSOFTESTOSTERONE,SEMINALFLUID,Spermcells+glandularsecretionsInfertilityproblems:SEMENANALYSIS,SEMINALFLUID,volumeofejaculate2.0mlormorepH7.2-8.0spermconcentration20millionpermlspermatozoaormoretotalspermcount40millionpermlspermatozoaperejaculateormoreMotility50%ormorewithforwardprogressionMorphology30%ormorewithnormalformsVitality75%ormorelive,i.e.,excludingdyewhitebloodcellsfewerthan1millionperml,NORMOZOOSPERMIAnormalresultsOLIGOZOOSPERMIA20millionpermlAsthenozoospermia50%spermatozoawithforwardprogressionTERATOZOOSPERMIA30%spermatozoawithnormalmorphologyAzoospermianospermatozoaintheejaculateASPERMIAnoejaculate,Haveagreatday!,男性生殖功能与调节,男性生殖器官：睾丸曲细精管生精细胞支持细胞间质细胞附性器官：附睾、输精管、前列腺、精囊腺、尿道球腺、阴茎等,一、睾丸的生精功能,1.精子（sperm）的生成过程曲细精管是雄性生殖细胞(精子)发生和发育成熟的场所精原细胞初级精母细胞次级精母细胞精子细胞精子,2.支持细胞的功能,为各级生精细胞提供营养、支持和保护作用形成血-睾屏障分泌雄激素结合蛋白(ABP)、抑制素、促性腺激素释放激素精液：精子与副睾、精囊、前列腺和尿道球腺的分泌液,3.影响精子生成的因素,年龄温度其它因素：疾病、接触放射性及有毒化学物质、吸烟、酗酒,(二)睾丸的内分泌功能1.雄激素,合成部位：间质细胞睾酮的生理作用1)胚胎时期，中肾小管及中肾管发育为男性的外生殖器2)促进精子生成3)促进副性器官及副性征的发育；维持正常的性欲，调节性行为4)对代谢的影响：促进蛋白质合成、刺激红细胞生成、钠水潴