201 L10 Flashcards
Reproduction
The uterus and ovaries are suspended in the —— cavity by a series of ——–. These ——– correctly position the organs which is important because the ——– —— are connected to the uterus, but not the ——-.
The uterus and ovaries are suspended in the pelvic cavity by a series of ligaments. These ligaments correctly position the organs which is important because the Fallopian tubes are connected to the uterus, but not the ovaries.
Name the major ligaments that hold the uterus and ovaries in place?
Broad ligament
Suspensory ligament
Ovarian ligament
What ligament stops the lateral movement of the uterus?
Broad ligament
What is the name of the ligament described below?
A double layer of membrane that encloses the ovaries, uterine tubes and uterus and stops lateral movement of the uterus.
Broad ligament
What is the name of the ligament described below?
Connects the ovaries to the pelvic wall and contains the ovarian arteries/veins
Suspensory ligament
What is the name of the ligament described below?
Connects the ovaries to the uterus
Ovarian ligament
What is the purpose of the ovarian cycle?
Allows the production of an oocyte for fertilisation
When are oocytes produced?
During gestation
When a female human is born she has her entire complement of oocytes.
How many oocytes does she have?
About 1 million
When does the brain start controlling the female reproductive tract?
At puberty
What hormones are secreted during the ovarian cycle?
Follicle stimulating hormone (FSH)
Lutenising hormone (LH)
Progesterone
Inhibin
What activates the growth of the resting follicle?
FSH
What is the follicular weigh?
Cluster of oocytes that are developing together in the activated resting follicle.
What are the phases of the ovarian cycle?
Follicular phase
Luteal phase
What occurs during the ovarian cycle that separates the two phases.
Ovulation
What phase of the ovarian cycle show the highest level of estrogen, LH and FSH.
Follicular phase
What structure does the oocyte develop in?
A follicle
What helps the oocyte to develop that is in contact with it?
Granulosa cells
What do the follicles produce when they start growing?
Estrogen
When do ovarian follicles first activate?
After puberty
How many days does it take from the time of activation of a follicle to when it starts forming an antrum (capable of ovulation?)
85 days
What is the follicular wave?
This is when with each menstrual cycle groups of developing follicles are stimulated to grow very rapidly.
During the ———- phase of the cycle one ——– will dominate over the others in terms of ———-.
The other ——— in the ———- wave are going to die by a process called ———- (follicles stop developing).
By the time you reach ——– there is only a single ——– left to ovulate
During the follicular phase of the cycle one follicle will dominate over the others in terms of growth.
The other follicles in the follicular wave are going to die by a process called atresia (follicles stop developing).
By the time you reach ovulation there is only a single follicle left to ovulate
Usually, how many dominant follicles which go onto be ovulated are there in women?
1
Usually, how many dominant follicles which go onto be ovulated are there in women?
1
Pathway of follicle in female reproductive tract;
The ——— sweep around the ——— cavity and pick up the ———, which enters in the ——– ——– where if a pregnancy is going to occur there will be ——- present in the ——— ——- to fertilise the egg
The fimbrae sweep around the abdominal cavity and pick up the follicle, which enters in the fallopian tube where if a pregnancy is going to occur there will be sperm present in the fallopian tube to fertilise the egg
What is the top and bottom of the uterus called?
Top = fundus Bottom = cervix
What part of the uterus protrudes into the vagina?
Cervix
The non-pregnant uterus has a luminal volume of about 10ml.
The pregnant uterus contains about 5 litres of baby, amniotic fluid and placenta
Therefore major changes in the ———– of the uterus are required during ————
Therefore major changes in the physiology of the uterus are required during pregnancy.
The uterus is normally ——–. This is when the top of the uterus faces ———. As a result the fetus has to turn 90 degrees to be born.
————- uterus occur in 20-25% of women and is ———.
The uterus is normally anteverted. This is when the top of the uterus faces forwards. As a result the fetus has to turn 90 degrees to be born.
Retroverted uterus occur in 20-25% of women and is ———.
What are the 3 main layers of the uterus?
Serosa
Muscular myometrium
Inner endometrium
What part of a uterine layer is shed during menstruation?
Functional layer of the endometrium
What is the decidua?
The part of the uterus that comes away with the delivered placenta (endometrium of pregnant women)
What layer makes up the bulk of the uterine tissue?
Myometrium
What is the main function of the myometrium?
The forceful expulsion of the fetus at birth
Does the myometrium thickness change significantly during the menstrual cycle?
No
When does the myometrium contract?
At birth and during the menstrual cycle
What are the phases of the uterine endometrial cycle?
Menses
Proliferation
Secretory
During the ———– phase of the endometrial cycle the contractions of the ——— are generally ———- which may aid ——- transport
During the ——– phase of the endometrial cycle the contractions of the ——– are generally ———— which may aid ——– transport
During the proliferative phase of the endometrial cycle the contractions of the myometrium are generally upwards which may aid sperm transport
During the secretory phase of the endometrial cycle the contractions of the myometrium are generally downwards which may aid embryo transport.
What happens during the menses phase of the endometrial cycle?
There is the degradation of the functional layer of the endometrium.
What happens during the proliferative phase of the endometrial cycle?
Repair and regeneration of the functional layer
Tissue contains glands
prominent luminal epithelium
What happens during the secretory phase of the endometrial cycle?
Proliferation of tissue at a high rate
Mass change in glands
The endometrium is preparing to receive an embryo
Which endometrial cycle phase is the end of the menstrual cycle?
Secretory phase
When does the menstrual cycle begin?
On the first day of the menstrual bleed
Why is it important for the endometrium to be synchronised to the ovarian cycle?
Because the ovary is producing follicles that are going to be ovulated and may implant in the uterus endometrium
Where does the embryo implant?
Entirely inside the uterus wall
What is the decidual reaction?
The stroma of the endometrium becomes edematous, stromal fibroblasts expand and fill with glycogen (energy source for the embryo)
When does the decidual reaction occur?
Occurs spontaneously each menstrual cycle
Is the decidual reaction and the decidua required for implantation?
No
What proves that the decidual reaction and the decidua required are not required for implantation?
Ectopic implantation
Ectopic implantation can occur anywhere in the abdominal cavity.
Where does ectopic implantation mostly occur?
Inside the fallopian tube
The endometrium is ——– vascularised
During menstruation —– of the endometrium is shed and it has to ——— back to full thickness to allow implantation in —- days.
The endometrium is highly vascularised
During menstruation 2/3 of the endometrium is shed and it has to regenerate back to full thickness to allow implantation in 14 days.
Name the arteries that supply the uterus with blood.
Radial arteries
Terminal arteries
Arcuate arteries
Spiral arteries
What uterine artery is described below?
Runs in towards the centre of the uterus
Radial arteries
What uterine artery is described below?
Runs around the circumference of the uterus
Arcuate arteries
What uterine artery is described below?
Takes the blood up into the endometrium
Spiral arteries
What are the key vessels that supply blood to the endometrium and, during pregnancy, the placenta?
Spiral arteries
During what phase of the endometrium cycle do the spiral artery terminal segments get lost?
During menses the spiral artery terminal segments are lost along with the rest of the functionalis layer of the endometrium
What do the spiral arteries do during mensuration to prevent severe blood loss?
They spasm
Why do the spiral arteries develop into their shape?
In the proliferative phase of the cycle the spiral arteries (and endometrial glands) grow very rapidly
Since they grow faster than the surrounding stromal the arteries develop into spring-like coils.
What phase of the endometrial cycle do the spiral arteries grow rapidly?
Proliferative phase
What are the 2 layers of the cervix?
Ectocervix
Endocervix
The outermost layer of the —— is a single ———- epithelium which is continuous with the ——– ——.
The outermost layer of the endocervix is a single columnar epithelium which is continuous with the uterine lining.
What is epithelium lines the ectocervix?
Stratified squamous epithelium
At puberty the ——— everts during each ——- cycle and exposure to ——– and the —— environment induces a ——– zone between the —– and —— cervix
At puberty the cervix everts during each menstrual cycle and exposure to hormones and the vaginal environment induces a transitional zone between the ecto and endo cervix
Where do most cervical cancers arise from?
In the transitional zone
What tests are used to screen pr-cancerous change in the cervix?
Cervical smears
What causes cervical cancer?
HPV infection
What types of cervical cancer have vaccines?
Serotype 16 and 18
Regular cervical smear tests every three years are recommended for women, if they have ever been sexually active, from the age of — until they turn —–.
20
70
Having regular cervical smears can reduce a woman’s risk of developing cervical cancer by — percent
90%
What does LH do?
Triggers ovulation
What does FSH Do?
Stimulates follicular growth
In what phase of the cycle does estrogen peak?
Folliculat phase
What triggers LH secretion?
The estrogen produced by the developing follicles
In what phase of the cycle does progesterone peak?
Luteal phase
