Chapter 23: Structure and Function of the Reproductive Systems

MULTIPLE CHOICE
1. The initial reproductive structures of the male and female embryos appear the same until

which week of gestation?

a. Third
b. Eighth

c. Twentieth
d. Thirtieth

ANS: B

Between 6 and 7 weeks gestation, the male embryo differentiates under the influence of
testes-determining factor (TDF). In the absence of testosterone, a loss of the wolffian system
occurs and the two gonads develop into ovaries at 6 to 8 weeks gestation.
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2. The absence of which major hormone is a determinant of sexual differentiation (wolffian

system) in utero?
a. Estrogen
b. Progesterone

c. Growth hormone
d. Testosterone

ANS: D

In the absence of testosterone, a loss of the wolffian system occurs and the two gonads
develop into ovaries at 6 to 8 weeks gestation. Between 6 and 7 weeks gestation, the male
embryo differentiates under the influence of TDF. The presence of estrogen is a determinating
factor. None of the other options function as a major determinant to sexual differentiation in
utero.
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REF: Page 769

3. Which gland produces the associated hormones that are found in high levels in a female fetus?
a. Posterior pituitary excretes gonadotropin-releasing hormone (GnRH) and

luteinizing hormone (LH).

b. Hypothalamus excretes luteinizing hormone (LH) and gonadotropin-releasing

hormone (GnRH).
c. Anterior pituitaryfollicle-stimulating hormone (FSH) and luteinizing hormone
(LH).
d. Hypothalamus excretes gonadotropin-releasing hormone (GnRH) and folliclestimulating hormone (FSH).
ANS: C

In the female fetus, the anterior pituitary excretes high levels of two gonadotropinsFSH and
LH. The other sequences are not correct.
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REF: Pages 769-770

4. Which hormone is linked to an increase in appetite during puberty?

a. Inhibin
c. Activin
b. Leptin
d. Follistatin
ANS: B

Sensitivity to leptin, which regulates appetite and energy metabolism, increases during
puberty; in theory, the adolescent consumes more calories to meet the caloric needs of the
pubertal growth spurt. The percent of body fat and leptin levels in girls continue to increase,
whereas muscle mass increases in boys. No apparent link exists between increased appetite
during puberty and any of the other options.
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REF: Page 778

5. The Skene glands are located on either side of which structure?

a. Introitus
c. Clitoris
b. Urinary meatus
d. Vestibule
ANS: B

The ducts of the Skene glands (also called the lesser vestibular or paraurethral glands) are
related only to the urinary meatus.
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REF: Page 772

6. What is the function of the mucus secreted by the Bartholin glands?

a. Enhancement of the motility of sperm
b. Lubrication of the urinary meatus and vestibule
c. Maintenance of an acid-base balance to discourage proliferation of pathogenic

bacteria
d. Enhancement of the size of the penis during intercourse
ANS: A

In response to sexual stimulation, the Bartholin glands secrete mucus that serves only to
lubricate the inner labial surfaces, as well as to enhance the viability and motility of sperm.
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REF: Page 772

7. Which change is a result of puberty and defends the vagina from infection?
a. The pH stabilizes between 7 and 8.
b. A thin squamous epithelial lining develops.
c. Vaginal pH becomes more acidic.
d. Estrogen levels are low.
ANS: C

At puberty, the pH becomes more acidic (4 to 5) and the squamous epithelial lining thickens.
These changes are maintained until menopause (cessation of menstruation), at which time the
pH rises again to more alkaline levels and the epithelium thins out. Therefore protection from
infection is greatest during the years when a woman is most likely to be sexually active.
Estrogen does not play a role in infection protection.
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REF: Page 773

8. What happens to the vaginas lining at puberty?

a. It becomes thinner.
c. It assumes a neutral pH.
b. It becomes thicker.
d. It undergoes atrophy.
ANS: B

Before puberty, vaginal pH is approximately 7 (neutral) and the vaginal epithelium is thin. At
puberty, the pH becomes more acidic (4 to 5) and the squamous epithelial lining thickens. Cell
atrophy is not associated with puberty.
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REF: Page 773

9. Which structure is lined with columnar epithelial cells?

a. Perimetrium
c. Myometrium
b. Endocervical canal
d. Vagina
ANS: B

Of the available options, only the endocervical canal does not have an endometrial layer;
rather, the layer is lined with columnar epithelial cells.
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REF: Page 775

10. Where is the usual site of fertilization of an ovum?

a. Trumpet end of the fallopian tubes
c. Ampulla of the fallopian tubes
b. Fimbriae of the fallopian tubes
d. Os of the fallopian tubes
ANS: C

The ampulla, or distal third, of the fallopian tube is the usual site of fertilization (see Figure
23-7).
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REF: Page 775

11. Where is the usual site of cervical dysplasia or cancer in situ?

a. Squamous epithelium of the cervix meets the cuboidal epithelium of the vagina.
b. Columnar epithelium of the cervix meets the squamous epithelium of the uterus.
c. Squamous epithelium of the cervix meets the columnar epithelium of the uterus.
d. Columnar epithelium of the cervix meets the squamous epithelium of the vagina.
ANS: D

The point at which the columnar epithelium of the cervix meets the squamous epithelium of
the vagina is called the transformation zone or the squamous-columnar junction. The
transformation zone is especially susceptible to the oncogenic human papillomavirus (HPV),
which leads to cervical dysplasia and, ultimately, cervical cancer; these are the cells sampled
during a Papanicolaou (Pap) test.
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REF: Page 775

12. Having ejected a mature ovum, the ovarian follicle develops into a(n):
a. Atretic follicle
c. Corpus luteum
b. Thecal follicle
d. Functional scar
ANS: C

Having ejected a mature ovum, the only resulting structure is the corpus luteum.
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13. The mucosal secretions of the cervix secrete which immunoglobulin?

a. IgA
c. IgG

b. IgE

d. IgM

ANS: A

Mucosal secretions from the cervix contain enzymes and antibodiespredominantly IgA.
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REF: Page 775

14. The equivalent to the female gonad is the male:

a. Epididymis
c. Vas deferens
b. Spermatic cord
d. Testes
ANS: D

Between 6 to 7 weeks gestation, the male embryo will differentiate under the influence of
TDF. TDF stimulates the male gonads to develop into the two testes. The ovaries, the female
gonads, are the primary female reproductive organs.
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REF: Page 769

15. A surge of which hormone causes the corpus luteum to produce progesterone?
a. Follicle stimulating hormone
c. Gonadotropin-releasing hormone
b. Luteinizing hormone
d. Estrogen
ANS: B

Luteinizing hormone from the anterior pituitary stimulates the corpus luteum to secrete
progesterone, the second major female sex hormone.
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REF: Page 778

16. What directly causes ovulation during the menstrual cycle?

a. Gradual decrease in estrogen levels
c. Sharp rise in progesterone levels
b. Sudden increase of LH
d. Gradual increase in estrogen levels
ANS: B

Menstrual cyclicity and regular ovulation are dependent on (1) the activity of the gonadostat
(GnRH pulse generator); (2) the pituitary secretion of gonadotropins; and (3) estrogen
(estradiol)positive feedback for the preovulatory LH and FSH surges, oocyte maturation, and
corpus luteum formation.
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REF: Pages 778-780

17. Which anatomic structure secretes follicle stimulating hormone (FSH) and luteinizing

hormone (LH)?
a. Hypothalamus
b. Ovaries

c. Anterior pituitary
d. Adrenal cortex

ANS: C

The anterior pituitary is the gland that secretes FSH and LH.
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REF: Pages 780-781

18. During the time that ovulation occurs, which statement concerning basal body temperature

(BBT) is true?
a. BBT increases.

b. BBT decreases.
c. BBT fluctuates around 37 C (98 F).
d. BBT rises consistently above 37.8 C (100 F).
ANS: C

During the follicular phase of ovulation, the BBT fluctuates around 37 C (98 F).
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REF: Page 782

19. What structure in the male lies posterior to the urinary bladder?
a. Seminal vesicles
c. Cowper glands
b. Prostate glands
d. Parabladder glands
ANS: A

The seminal vesicles are a pair of glands, each measuring approximately 4 to 6 cm long,
which lie behind the urinary bladder and in front of the rectum. None of the other structures
lie in this location.
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REF: Page 788

20. When do penile erections begin?

a. Before birth
b. Shortly after birth

c. Shortly before puberty

d. After puberty

ANS: A

Erections begin in utero and continue throughout life, but ejaculation does not occur until
sperm production begins at puberty.
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REF: Page 787

21. Which statement is true regarding the major difference between male and female sex hormone

production?
Luteinizing hormone has no apparent action in a man.
In a man, sex hormone production is relatively constant.
Estradiol is not produced in a man.
In a man, gonadotropin-releasing hormone does not cause the release of follicle
stimulating hormone.

a.
b.
c.
d.

ANS: B

In men, sex hormone production is relatively constant with some diurnal variation. The other
options are not true statements.
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REF: Page 789

22. Where in the male body does spermatogenesis occur?

a. Epididymis
c. Seminiferous tubules
b. Rete testes
d. Vas deferens
ANS: C

Spermatogenesis takes place only in the seminiferous tubules of the testes (see Figure 23-14).
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REF: Pages 784-785

23. Which immunoglobulin is contained in breast milk?

a. IgA
c. IgG
b. IgE
d. IgM
ANS: A

Not only does breast milk composition change over time to meet the changing digestive
capabilities and nutritional requirements of the infant, but it also contains immune cells,
specific immunoglobulins, especially IgA, and nonspecific antimicrobial factors, such as
lysozymes and lactoferrin, that protect the infant against infection, allergies, and asthma.
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REF: Page 784

24. Which hormone promotes the development of the lobular ducts in the breasts?
a. Progesterone
c. Oxytocin
b. Prolactin
d. Estrogen
ANS: D

Only estrogen promotes the increase in the size of the breasts by the formation of a mass of
tissue under the areola, which increases the size and pigmentation of the areola and
contributes to the development of the lobular ducts.
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REF: Page 783

25. What causes the vasomotor flushes (hot flashes) that are associated with declining ovarian

function with age?

a. Decreased estrogen levels
b. Absence of estrogen

c. Increased estrogen levels

d. Rapid changes in estrogen levels

ANS: D

A rapid change in estrogen levels (withdrawal or increase), rather than low estrogen levels,
induces hot flashes.
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REF: Pages 794-795

26. When does the male body begin to produce sperm?

a. Before birth
c. At puberty
b. Shortly after birth
d. When erection is possible
ANS: C

Erections begin in utero and continue throughout life, but ejaculation does not occur until
sperm production begins at puberty.
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REF: Page 787

27. The human zygote has a total of how many chromosomes?

a. 23
c. 46
b. 25
d. 50
ANS: C

A 23-chromosome female gamete, the ovum, and a 23-chromosome male gamete, the
spermatozoon (sperm cell), unite to form a 46-chromosome zygote that is capable of
developing into a new individual.

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REF: Page 768

28. Which hormone promotes the development of testosterone in both males and females?
a. Progesterone
c. Oxytocin
b. Prolactin
d. Estrogen
ANS: B

Prolactin, a polypeptide synthesized and secreted from the pituitary, helps maintain
biosynthesis of testosterone.
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REF: Page 791

29. Which hormone stimulates gonads to produce both male and female hormones?
a. Gonadotropin-releasing hormone (GnRH)
b. Follicle-stimulating hormone (FSH)
c. Luteinizing hormone (LH)
d. Estrogen
ANS: C

Extrahypothalamic factors cause the hypothalamus to secrete GnRH, which stimulates the
anterior pituitary to secrete gonadotropinsFSH and LH. These hormones, in turn, stimulate
the gonads (ovaries or testes) to secrete female or male sex hormones.
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REF: Pages 769-771

30. Which hormone relaxes the myometrium and prevents lactation until the fetus is born?
a. Gonadotropin-releasing hormone (GnRH)
b. Follicle-stimulating hormone (FSH)
c. Progesterone
d. Estrogen
ANS: C

Progesterone is sometimes called the hormone of pregnancy. Its effects in pregnancy include
(1) maintenance of the thickened endometrium; (2) relaxation of smooth muscle in the
myometrium, which prevents premature contractions and helps the uterus expand; (3)
thickening of the myometrium, which prepares it for the muscular work of labor; (4)
prevention of lactation until the fetus is born; and (5) prevention of additional maturation of
ova by way of suppressing FSH and LH, thereby stopping the menstrual cycle.
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31. A Sims-Huhner test is of particular interest to a patient experiencing which condition?

a. Infertility
c. Venereal disease
b. Possible HIV infection
d. Perimenopause
ANS: A

A Sims-Huhner test evaluates the ability of sperm to penetrate and maintain motility in
cervical mucus 2 to 4 hours after coitus approximately 1 day before ovulation. The enzymelinked immunosorbent assay (ELISA) detects the presence of antibodies to human
immunodeficiency virus (HIV). Venereal Disease Research Laboratory (VDRL) is a test for
nonspecific venereal diseases. Estradiol levels are associated with erratic or intermittent
menstruation.

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REF: Page 792 | Table 23-3

MULTIPLE RESPONSE
32. Estrogen has many biological effects on the female body including: (Select all that apply.)
a. Maturation of reproductive organs
b. Differentiating female physical characteristics
c. Postpuberty closure of short bones
d. Regulation of the menstrual cycle
e. Endometrial regeneration after menstruation
ANS: A, B, D, E

Estrogen has numerous biologic effects, many of which involve interactions with other
hormones. Estrogen is needed for the maturation of the reproductive organs, development of
secondary sex characteristics (differentiating male and female physical characteristics that are
not directly related to reproduction), closure of long bones after the pubertal growth spurt,
regulation of the menstrual cycle, and endometrial regeneration after menstruation.
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REF: Page 776

33. Which statements about the human papillolmavirus (HPV) and vaccine are true? (Select all

that apply.)
a. Currently, two HPV vaccines have been approved for use in the United States.
b. HPV is believed to be responsible for the majority of the diagnosed cases of

cervical cancer.
c. A form of the vaccine has been approved for use in males to prevent genital warts.
d. The administration of the vaccine is a one-dose intramuscular injection.
e. The recommended age for vaccination of girls is between 11 and 12 years of age.
ANS: A, B, C, E

Two HPV vaccines are currently approved in the United States: (1) quadrivalent HPV
recombinant vaccine and (2) bivalent HPV recombinant vaccine. HPV is responsible for
99.7% of cervical cancer cases, 40% of penile cancers, and an estimated 5% of all cancers
worldwide. The vaccine is administered by intramuscular injection, and the recommended
schedule is a three-dose series with the second and third doses administered 2 and 6 months
after the first dose. The recommended age for vaccination of girls is 11 to 12 years. The
vaccine can be administered to girls as young as 9 years of age. The quadrivalent vaccine has
been approved for males 9 to 26 years of age to prevent genital warts.
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34. Which statements are true regarding the female menstrual cycle? (Select all that apply.)
a. Initial cycles may dramatically vary in length.
b. By adulthood, the commonly accepted cycle average is 28 (27 to 30) days.
c. The length of a cycle varies among women.
d. Up to 8 years before menopause, the intervals of the menstrual cycle begin to

lengthen.
e. Menopause is achieved when a woman is without a period for 2 years.
ANS: A, B, C, D

At first, cycles are anovulatory and may vary in length from 10 to 60 days or longer. As
adolescence proceeds into adulthood, regular patterns of menstruation and ovulation are
established at intervals ranging from 25 to 35 days. The length of the menstrual cycle varies
considerably among women. The commonly accepted cycle average is 28 (27 to 30) days,
with rhythmic intervals of 21 to 35 days considered normal. Approximately 2 to 8 years
before menopause, cycles begin to lengthen again. Menopause is defined as the cessation of
menstrual flow for 1 year.
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REF: Page 778

35. Testosterone is believed to have a role in: (Select all that apply.)
a. Male-patterned baldness
b. Libido levels
c. Acne development
d. Altered cholesterol metabolism
e. Thinning of the larynx
ANS: A, B, C, D

Testosterone is associated with all the options except thinning of the larynx; it actually
stimulates the growth of the larynxs cartilage.
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REF: Page 789

36. What are normal characteristics of aging of the male reproductive system? (Select all that

apply.)
Reduced sperm count
Slower, less forceful ejaculations
Testicular atrophy and softening
Longer time to achieve full erection
Decreased levels of testosterone

a.
b.
c.
d.
e.

ANS: B, C, D, E

The described effects on ejaculation, testes, erection, and testosterone are normal
characteristics of male aging. Sperm count remains normal with age, although the semen tends
to contain more defective and nonmotile sperm.
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REF: Pages 795-796