Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GIGU - Week 5/6 (STILL QUARANTINE) > 38- Menarche/Puberty/Menstrual Disorders > Flashcards

38- Menarche/Puberty/Menstrual Disorders Flashcards

1
Q

Menstrual cycle occurs with the maturation of what axis?

A

Hypothalamic – Pituitary – Ovarian Axis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

________ from the hypothalamus stimulate ________ and ________ from the anterior pituitary, which stimulates ________ and ________ from the ovarian follicle.

A 
GnRH
FSH
LH
Estrogen
Progesterone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

FSH and LH are synthesized and stored in cells called _________.

A

Gonadotrophs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

The normal ovulatory cycle can be divided into what phases?

A

Follicular Phase

Luteal Phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

This ovulatory cycle phase begins with the onset of menstruation and culminates in the preovulatory surge of LH.

A

Follicular Phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

This ovulatory cycle phase begins with the onset of the preovulatory LH surge and ends with the first day of menses.

A

Luteal Phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Decreasing levels of ________ and ________ from the regressing corpus luteum of the preceding cycle initiate an increase in ________ by a negative feedback mechanism, which stimulates follicular growth and estradiol secretion for the next cycle.

A

Estradiol
Progesterone
FSH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Separate cellular functions occur in the ovarian follicle. LH stimulates the _______ cells to produce androgens (androstenedione and testosterone). FSH stimulates the ________ cells to convert these androgens into estrogens (E1 and E2).

A

Theca

Granulosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Both the LH and FSH are significantly suppressed through the negative feedback effect of the elevated circulating ________ and _________. If conception does not occur, these levels will decline near the end of the luteal phase as a result of corpus luteal regression. ________ with then rise which initiates new follicular growth for the next cycle.

A

Estradiol
Progesterone
FSH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the 5 peptides or biogenic amines from the hypothalamus that affect the reproductive cycle?

A

– Gonadotropin-releasing Hormone (GnRH)

– Thyrotropin-releasing Hormone (TRH)

– Somatotropin Release Inhibiting Factor (SRIF) or Somatostatin

– Corticotropin-releasing Factor (CRF)

– Prolactin Release-Inhibiting Factor (PIF)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

_________ appears to enhance the hypothalamic release of GnRH and induce the midcycle LH surge.

A

Estradiol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Gonadotropins have an (INHIBITORY/STIMULATORY) effect on GnRH release.

A

Inhibitory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

During early follicular development estradiol levels are low. About 1 week before ovulation, estradiol (E2) levels begin to increase. They generally reach a maximum 1 day before the midcycle _______ peak. After this there is a marked and precipitous fall.

A

LH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

During the luteal phase, _________ reaches a maximum 5-7 days after ovulation and returns to baseline before menstruation.

A

Estradiol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

During follicular development, the ovary secretes only a very small amount of _________. The bulk of it comes from the peripheral conversion of the adrenal pregnenolone and pregnenolone sulfate.

A

Progesterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Prior to ovulation, the unruptured luteinizing graafian follicle begins to produce increasing amounts of progesterone. Secretion of progesterone by the ________ ________ reaches a maximum 5-7 days after ovulation and returns to baseline before menstruation.

A

Corpus Luteum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

The number of oocytes is approx. 7 million at 20 weeks gestation. Significant atresia of oogonia occurs so at birth only 1-2 million remain. At puberty with continued atresia only _________ oocytes are available for ovulation with only ________ actually ovulating.

A

400,000

400

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

After puberty, primordial follicles undergo sequential development, differentiation, and maturation until a mature graafian follicle is produced. The follicle then ruptures, releasing an ________. Subsequent luteinization of the ruptured follicle produces the ________ ________.

A

Ovum

Corpus Luteum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

At about 8-10 weeks of fetal development, oocytes become surrounded by precursor granulosa cells. This oocyte-granulose cell complex is called a…

A

Primordial Follicle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

In the adult ovary, a graafian follicle forms. The innermost 3-4 layers of multiplying granulosa cells become cuboidal and adherent to the ovum, this is known as the ________ ________.

A

Cumulus Oophorus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

A fluid filled ________ forms among the granulosa cells. This enlarges and the centrally located primary oocyte migrates to the wall of the follicle. The innermost layer of the granulosa cells of the Cumulus Oophorus become elongated and form the ________ ________. This is released with the oocyte at ovulation.

A

Antrum

Corona Radiata

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Preovulatory ______ surge initiates a sequence of biochemical and structural changes that result in ovulation.

A

LH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Cells on the follicular wall surface degenerate and a _______ forms. The follicular basement membrane bulges through this and when it ruptures, the oocyte is expelled into the peritoneal cavity and ovulation has occurred.

A

Stigma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

After ovulation the granulosa cells of the ruptured follicle undergo luteinization. The luteinized granulosa cells, theca cells, capillaries, and CT form the ________ ________ which produces copious amounts of __________ and some __________.

A

Corpus Luteum
Progesterone
Estradiol

***Normal functional lifespan of Corpus Luteum is 9-10 days!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

If pregnancy does not occur, menses ensues and the Corpus Luteum is gradually replaced by an avascular scar called _______ _______.

A

Corpus Albicans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Put the following steps of the ovarian cycle in order –

A. The corpus luteum progressively becomes less sensitive to basal LH and dies if levels of LH-like activity (i.e., hCG) do not increase.

B. LH surge induces meiotic maturation, ovulation, and luteinization. The corpus luteum produces high P, along with E and inhibin.

C. FSH recruits a cohort of large antral follicles to enter rapid growth phase. Follicles secrete low amounts of E and inhibin.

D. Pituitary responds to falling E and P by increasing FSH secretion.

E. High P, E, and inhibin negatively feedback on LH and FSH, returning them to basal levels.

F. Declining FSH levels progressively cause atresia of all but 1 follicle, leading to selection of dominant follicle which produces high levels of E.

G. Corpus luteum dies, E and P levels fall.

H. High E has positive feedback on gonadotropes, LH (and some FSH) surges.

I. E and inhibin negatively feedback on FSH.

A

1) G.
2) D.
3) C.
4) I.
5) F.
6) H.
7) B.
8) E.
9) A.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

The endometrium is responsive to circulating progestins, androgens, and estrogens. It is divided into 2 zones, which are…

A
    • Functionalis (Outer Portion)

- - Basalis (Inner Portion)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

This layer of the endometrium undergoes cyclic changes in morphology during the menstrual cycle and is sloughed off at menstruation. Contains spiral arteries.

A

Functionalis (Outer Portion)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

This layer of the endometrium remains relatively unchanged during each cycle and after menstruation provides stem cells for the renewal of the other layer. Contains basal arteries.

A

Basalis (Inner Portion)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

The cyclic changes in histophysiology of the endometrium can be divided into 3 stages, which are…

A
  1. Menstrual Phase
  2. Proliferative or Estrogenic Phase
  3. Secretory or Progestational Phase
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What endometrial phase is being described below?

– Only portion of the cycle that is visualized externally.

– Disruption and disintegration of the endometrial glands and stroma, leukocyte infiltration, and RBC extravasation.

– Sloughing of the functionalis layer and compression of the basalis layer.

A

Menstrual Phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is considered cycle day 1?

A

First day of menstruation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

This endometrial phase is characterized by endometrial growth and proliferation secondary to estrogenic stimulation. There is an increase in length of the spiral arteries and numerous mitoses can be seen in these tissues.

A

Proliferative Phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

During this endometrial phase, following ovulation the secretion of progesterone by corpus luteum stimulates the glandular cells to secrete mucus, glycogen, and other substances. Glands become tortuous and lumens are dilated and filled with these substances. Stroma becomes edematous and mitosis are rare.

A

Secretory Phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

During the Secretory Phase, spiral arteries continue to extend into the superficial layer of the endometrium and become convoluted. At this point endometrial lining reaches its maximal _________.

A

Thickness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

If conception does not occur by day ______ (secretory phase) the Corpus Luteum begins to regress, secretion of progesterone and estradiol declines, and the endometrium undergoes involution.

A

23

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

1 day prior to the onset of menstruation, marked constriction of the _________ arteries occurs resulting in ischemia of the endometrium, leukocytes infiltration, and RBC extravasation. The resulting necrosis causes sloughing of the endometrium resulting in menstruation.

A

Spiral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

The _________ cycle is a terminal event of a physiologic process that enables the uterus to be prepared to receive another conceptus.

A

Menstrual

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Intact coagulation pathway is important in regulating menstruation. Menstruation disrupts blood vessels, but with normal homeostasis the injured vessels are rapidly repaired. Restoration of blood vessels requires successful interaction of ________ and ________ ________.

A

Platelets

Clotting Factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Medications such as Warfarin, Aspirin, and Clopidogrel can impair the coagulation system and be associated with…

A

Heavy bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Initial reproductive health visit should occur between ages ________ years. Provides an opportunity to start patient-physician relationship, build trust, and counsel pt’s and parents regarding healthy behavior. Primary goal of this visit is to provide preventative health care services, including educational information and guidelines, rather than problem-focused care. A general exam, breast exam, and external exam may be indicated.

A

13-15

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

An internal exam is not routinely performed unless indicated. Recommended first Pap test is at the age of _______.

A

21

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

This vaccine is one series for those who are not previously immunized between the ages of 9-26. It offers protection against cervical cancer, cervical dysplasia, vulvar or vaginal dysplasia, and genital warts.

A

Human Papillomavirus Vaccine – called Gardasil

***Specifically Gardasil 9!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Median age of menarche is ________ years, with 10% of females menstruating at 11.11 years and 90% menstruating by 13.75 years.

A

12.43

45
Q

Menarche occurs within 2-3 years after _________ (breast budding) at Tanner stage IV, rare before Tanner stage III.

A

Thelarche

46
Q

By the age of _______ years old 98% of females will have had menarche.

A

15

47
Q

_______ _______ is defined as absence of menarche by age 13 without secondary sexual development OR by age 15 with secondary sexual development.

A

Primary Amenorrhea

48
Q

What is the menstrual cycle interval for young females? Adults?

A

Young females = 21-45 Days

Adult females = 21-35 Days

49
Q

What is the menstrual flow length of young females?

A

7 days or less

***Use 3-6 tampons per day!

50
Q

________ ________ is defined as the absence of menstruation for 6 months. It is rare for girls and adolescents to remain amenorrheic for more than 3 months, need to check urine or serum B-hcG for pregnancy.

A

Secondary Amenorrhea

***A LOT of things can make a period irregular!

51
Q

The first menses is usually reported as medium flow, and mean blood loss per menstrual period is 30cc. Greater than 80cc has been associated with ________.

A

Anemia

***Changing a pad every 1-2 hrs is excessive, especially if bleeding more than 7 days!

52
Q

This is defined as abnormal uterine bleeding that cannot be attributed to medications, blood dyscrasias, systemic disease, trauma, or organic conditions. It’s usually caused by aberrations in the H-P-O axis resulting in anovulation.

A

Dysfunctional Uterine Bleeding (DUB)

***Most occurs around years of menarche (11-14 yo) or perimenopause (45-50 yo)!

53
Q

This is the term for abnormally frequent menses at intervals < 21 days.

A

Polymenorrhea

54
Q

This is the term for excessive and/or prolonged menses (> 80 mL and > 7 days) occurring at regular intervals.

A

Menorrhagia (Hypermenorrhea)

55
Q

This is the term for irregular episodes of uterine bleeding.

A

Metrorrhagia

56
Q

This is the term for heavy and irregular uterine bleeding.

A

Menometrorrhagia

57
Q

This is the term for scant bleeding at ovulation for 1 or 2 days.

A

Intermenstrual Bleeding

58
Q

This is the term for menstrual cycles at > 35 day cycles.

A

Oligomenorrhea

59
Q

For the PALM-COEIN classification system for abnormal bleeding in reproductive-aged women, list the PALM (structural causes).

A

P = Polyp (AUB-P)

A = Adenomyosis (AUB-A)

L = Leiomyoma (AUB-L) — Submucosal myoma (AUB-L sm) or Other myoma (AUB-L o)

M = Malignancy and hyperplasia (AUB-M)

60
Q

For the PALM-COEIN classification system for abnormal bleeding in reproductive-aged women, list the COEIN (nonstructural causes).

A 
C = Coagulopathy (AUB-C)
O = Ovulatory Dysfunction (AUB-O)
E = Endometrial (AUB-E)
I = Iatrogenic (AUB-I)
N = Not yet classified (AUB-N)
61
Q

Endometrial ________ form from the endometrium to create soft friable protrusion into the endometrial cavity. Can cause menorrhagia, spontaneous or post-menopausal bleeding.

A

Polyps

***AUB-P

62
Q

For endometrial polyps, ultrasound findings may reveal focal thickening of the endometrial stripe. _________ _________ and _________ allow for better detection.

A

Saline Hysterosonography

Hysteroscopy

63
Q

Most polyps are benign, need to remove with _________ since endometrial hyperplasia and carcinoma may also present as polyps.

A

Hysteroscopy

64
Q

This is defined as the extension of endometrial glands and stroma into the uterine musculature ( > 2.5mm beneath the basalis layer). 15% of patients with this have endometriosis. These islands do not participate in the proliferative and secretory cycles.

A

Adenomyosis (AUB-A)

65
Q

Adenomyosis (AUB-A) may be asymptomatic, cause severe secondary dysmenorrhea and menorrhagia, and can be associated with _________ with deep penetration.

A

Dyspareunia

***Pain with intercourse

66
Q

These are benign tumors derived from smooth muscle cells of the myometrium. Most common neoplasm of the uterus. Over 45% of women will have them by 5th decade. They are rarely malignant and mostly asymptomatic.

A

Uterine Leiomyomas (Fibroids)

***AUB-L

67
Q

Symptomatic fibroids can cause excessive uterine bleeding, pelvic pressure, pelvic pain, and infertility. Most common indication for _________ is symptomatic fibroids.

A

Hysterectomy

68
Q

Risk factors for developing ________ include:

    • Increasing age during reproductive years
    • African American women have a 2-3 fold increase risk
    • Nulliparity
    • Family history
A

Fibroids

69
Q

Factors that initiate leiomyomas are unknown. They rarely form before menarche or enlarge after menopause. Estrogen stimulates the proliferation of smooth mm cells, so they can dramatically enlarge during _________.

A

Pregnancy

70
Q

Leiomyomas (fibroids) are usually spherical, well circumscribed, white firm lesions with a whorled appearance on cut sections. May degenerate and cause pain, and can _________ especially in postmenopausal patients.

A

Calcify

71
Q

This represents an overabundance growth of the endometrial lining usually as a result of persistent unopposed estrogen. It is a precursor to endometrial cancer.

A

Endometrial Hyperplasia (AUB-M)

72
Q

What can be caused by the following things –

– PCOS

– Granulosa theca cell tumors - estrogen producing tumors

– Obesity - secondary to peripheral conversion of androgens to estrogens in adipose cells

– Exogenous estrogens - without progestins

– Tamoxifen

A

Endometrial Hyperplasia (AUB-M)

73
Q

What are the classifications of endometrial hyperplasia, and which are more likely to develop cancer?

A

Simple without atypia
Complex without atypia
Simple with atypia
Complex with atypia

***Simple and complex WITH atypia are most likely to develop into cancer!

74
Q

This type of endometrial cancer is endometrial adenocarcinoma and is most common.

A

Type 1

75
Q

This type of endometrial cancer is clear cell and papillary serous.

A

Type 2

76
Q

The most common presentation of endometrial hyperplasia is _________ bleeding.

A

Postmenopause

***Irregular uterine bleeding called perimenopause!

77
Q

This nonstructural cause for abnormal bleeding is associated with heavy flow (i.e., Von Willebrand disease).

A

Coagulopathies (AUB-C)

78
Q

This nonstructural cause for abnormal bleeding is associated with unpredictable menses with variable flow (i.e., polycystic ovarian syndrome).

A

Ovulatory Dysfunction (AUB-O)

79
Q

This nonstructural cause for abnormal bleeding can be due to infection.

A

Endometrial Causes (AUB-E)

80
Q

This nonstructural cause for abnormal bleeding can be due to IUD, IUS, or exogenous hormones.

A

Iatrogenic (AUB-I)

81
Q

This nonstructural cause for abnormal bleeding is reserved for entities that are poorly defined and/or not well examined (i.e., arteriovenous malformation).

A

Not Yet Classified (AUB-N)

82
Q

What are the available tissue sampling methods for diagnostic evaluation of abnormal uterine bleeding?

A
    • Office endometrial biopsy

- - Hysteroscopy directed endometrial sampling

83
Q

This type of tissue sampling method is a blind biopsy but adequate sample is obtained in 90% of patients. Better when pathology is global (hyperplasia) rather than focal (polyp). Side effects include cramping and uterine perforation (more serious).

A

In office EMBX

84
Q

What is absolute and relative contraindication for in office EMBX?

A 
Absolute = pregnancy
Relative = bleeding diathesis
85
Q

What are the treatments for AUB with medication?

A

– Normalize prostaglandins (NSAIDS prior to and during menses)

– Antifibrinolytic Therapy (Tranexamic Acid)

– Coordinate Endometrial Sloughing (MPA or OCP’s)

– Endometrial suppression (Progesterone daily, continuous OCP’s, IUS)

86
Q

What are the surgical treatments for AUB?

A 
Polypectomy 
Myomectomy
Dilation and Curettage (D &amp; C)
Uterine endometrial ablation
Hysterectomy
87
Q

What are the instruments for a D & C?

A

Dilators

Curettes

88
Q

This type of D & C is performed for irregular menstrual bleeding or postmenopausal bleeding to rule out endometrial hyperplasia or cancer.

A

Diagnostic D & C

89
Q

This type of D & C is performed for endometrial structural abnormalities (polyps, small pedunculate submucosal fibroids).

A

Therapeutic D & C

90
Q

This is the name for the treatment for endometrial ablation. It uses radio frequency to a bipolar mesh electrode with at the same time applying suction. Perforation safety mechanism. Ablation time is 90 seconds.

A

NovaSure

91
Q

This type of hysterectomy is done by an incision on the abdomen.

A

Total Abdominal Hysterectomy (TAH)

92
Q

This type of hysterectomy is done by a vaginal incision.

A

Vaginal Hysterectomy (TVH)

93
Q

This type of hysterectomy is done by small abdominal incisions and vaginal incisions.

A

Laparoscopic Assisted Vaginal Hysterectomy (LAVH)

Da Vinci Assisted Hysterectomy (TLH)

94
Q

This encompasses the development of secondary sexual characteristics and the acquisition of reproductive capability. Average duration is 4-5 years, occurring between 10-16 yo.

A

Puberty

95
Q

Onset of puberty is determined primarily by…

A
    • Genetic factors including race
    • Geographic location
    • Nutritional status
96
Q

Low levels of gonadotropins and sex steroids during this prepubertal period are a function of 2 mechanisms, which are…

A

1) Gonadostat sensitivity to the negative feedback of low circulating estradiol.
2) Intrinsic CNS inhibition of hypothalamic GnRH secretion.

***During 11 yo, these 2 mechanisms are lost!

97
Q

Between the ages of 8-11 there is an increase in serum concentrations of ________, ________, and ________.

A

DHEA
DHEA-S
Androstenedione

98
Q

In general, adrenal androgen production and differentiation by the Zona Reticularis of the adrenal cortex are the initial endocrine changes associated with puberty. Rise in adrenal androgens causes growth of ________ and _______ hair.

A

Axillary (Adrenarche)

Pubic (Pubarche)

99
Q

At the onset of puberty, ________-associated increases in GnRH secretion occur and gradually shift into adult type secretory patterns.

A

Sleep

100
Q

Increase in ________ promotes ovarian follicular maturation and sex steroid production, which leads to the development of secondary sexual characteristics.

A

GnRH

101
Q

By mid to late puberty, the positive-feedback mechanism of _________ on LH release from the anterior pituitary gland is complete and ovulatory cycles are established.

A

Estradiol

102
Q

What are the 4 stages of normal pubertal development?

A

1) Thelarche (Breast development)
2) Pubarche/Adrenarche (Pubic hair/Axillary hair development)
3) Maximal growth or peak height velocity
4) Menarche (Onset of menses)

103
Q

This stage of pubertal development is the first physical sign of puberty. Unilateral development and slight tenderness in first 6 months is not uncommon. Requires estrogen.

A

Thelarche (Breast development)

104
Q

This stage of pubertal development requires androgens.

A

Pubarche/Adrenarche (Pubic hair/Axillary hair development)

105
Q

This stage of pubertal development occurs 2 years earlier in girls and about 1 year before onset of menses.

A

Maximal growth or peak height velocity

106
Q

This stage of pubertal development requires pulsatile GnRH from the hypothalamus, FSH and LH from the pituitary, estrogen and progesterone from the ovaries, normal outflow tract.

A

Menarche (Onset of menses)

107
Q

Put the following Tanner stages of breast development in order from 1 to 5:

A. Projection of areola and papilla to form a secondary mound above the level of the breast.

B. Breast bud stage; elevation of breast and papilla as a small mound with enlargement of the areolar region.

C. Preadolescent; elevation of papilla only.

D. Mature stage; projection of papilla only, resulting from recession of the areola to the general contour of the breast.

E. Further enlargement of breast and areola without separation of their contours.

A

1) C.
2) B.
3) E.
4) A.
5) D.

108
Q

Put the following Tanner stages of pubic hair development in order from 1 to 5:

A. Hair spreads sparsely over the junction of the pubes; hair is darker and coarser.

B. Adult-type hair; there is no spread to the medial surface of the thighs.

C. Preadolescent; absence of pubic hair.

D. Adult-type hair with spread to the medial thighs assuming an inverted triangle pattern.

E. Sparse hair along the labia; hair downy with slight pigment.

A

1) C.
2) E.
3) A.
4) B.
5) D.

GIGU - Week 5/6 (STILL QUARANTINE) (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions