assessment and health promotion Flashcards
menstruation
periodic uterine bleeding that begins approximately 14 days after ovulation.
what is the menstrual cycle controlled by?
feedback system of three cycles:
1. endometrial
2. hypothalamic-pituitary
3. ovarian
what is the average length of a menstrual cycle
28 days
what is designated as day one of menstrual cycle?
first day of bleeding
what is the average duration of a menstrual flow?
5 days (with a range of 3-6 days)
what is the average blood loss during mentruation?
50 mL (with a range of 20-80mL)
how much of women does not appear to clot?
about 50%
where does the blood clot during menses?
in the uterus but liquifies before being discharged from the uterus
what does discharge during menses include?
mucus, epithelial cells, and blood
what does the menstrual cycle do?
prepares the uterus for pregnancy, when pregnancy does not occur, menstruation follows
what influence the menstruation cycle?
women’s age, physical and emotional status, and environment
four phases of mentrual cycle?
- menstrual phase
- the proliferative phase
- the secretory phase
- the ischemic phase
what happens during menstrual phase?
shedding of functional two thirds of endometrium (the compact and spongy layers) is initiated by the periodic vasoconstriction in the upper layers of the endometrium
basal layer is retained, regeneration begins near the end of the cycle from cells derived from the remaining glandular remnants or stromal cells in this layer.
what happens during proliferative phase?
a period of rapid growth lasting from fifth day to the time of ovulation.
endometrial surface is completely restored in approximately 4 days, or slightly before bleeding ceases.
eightfold to tenfold thickening occurs with a leveling off of the thickening of the endometrium at ovulation
proliferative phase depends on estrogen stimulation derived from ovarian follicles
what happens during secretory phase?
extends from day of ovulation to about 3 days before menstrual period.
after ovulation, large amount of progesterone are produced.
what does the hypothalamus and anterior pituitary gland in females regulate?
the production of FSH and LH
what is the target tissue of FSH and LH?
the hormones target the ovary, which produces ova and secrete estrogen and progesterone.
what is the mechanism between hormone secretion from the ovaries, the hypothalamus, and the anterior pituitary gland?
aids in the control of the production of sex cells and sex steroid hormone secretion
what happens to the hormones towards the end of the normal menstrual cycle?
blood levels of estrogen and progesterone decreases
what happens when the hormone of ovarian drops?
stimulate the hypothalamus to secrete gonadotropin-releasing hormone (GnRH).
what happens when GnRH is release?
GnRH stimulate the anterior pituitary secretion of follicle stimulating hormones (FSH)
decreased in estrogen caused GnRH to stimulate anterior pituitary
gland to release Luteinizing hormone (LH) –surges in LH and smaller peak of estrogen (around day 12)
this cause the expulsion of ovum from graafian follicles by about 24-36 hours.
what does FSH do?
stimulate development of ovarian graafian follicles and their production of estrogen.
at what day does LH peak on a 28-day cycle?
day 13 or 14
if fertilization does not occur, regression of corpus luteum follows
levels of progesterone and estrogen decline and menstruation occurs and the process begins again. this process is called hypothalamic-pituitary cycle.
primordial ova
immature oocytes
how many follicles begin to mature in each ovaries
1-20 follicles
what cause maturation of follicles?
FSH and estrogen
what does preovulatory surge of LH do
affects a selected follicles, the oocytes mature and ovulation occurs, and the empty follicle begins its transformation into the corpus luteum.
the follicle phase
begins its transformation into the corpus luteum.
aka pre-ovulatory phase - varies from woman to woman
what happens after ovulation
estrogen levels dropped.
90% of women, only a small amount of withdrawal bleeding occur, and it goes unnoticed.
In 10% of women, there is sufficient bleeding for it to be visible, resulting in what is termed midcycle ovulation.
ovarian cycle
- follicle phase
- ovulation - withdrawal bleeding (small) or midcycle bleeding (large) can occur
- luteal phase aka post-ovulation
- menstruation
how long does post-ovulation last?
requires 14 days (range from 13-15 days)
when does corpus luteum reach its peak of functional activity?
8 days after ovulation
secreting the steroids estrogen and progesterone
coincide with peak luteal functioning, fertilized ovum is implanted int eh endometrium, if no implantation, corpus luteum regress and steroid levels drop. two week after ovulation if implantation does not occur, the functional layer of uterine endometrium is shed through menstruation.
basal body temp before and after ovulation
before ovulation temperature is below 36 C (98.6 F) and after ovulation because of increase progesterone levels, body temp rises.
changes in cervical mucus
preovulatory and postovulatory mucus is viscous (thick) so sperm penetration is discouraged.
at time of ovulation, mucus is thin and clear. It looks like, feels, and stretches like egg white.
spinnbarkeit
stretchability of mucus
mittelschmerz
localized lower abdominal pain that coincide with ovulation.
prostaglandins (PGs)
oxygenated fatty acids classified as hormones
produced by most organs of body, including uterus.
metabolized quickly by most tissues
marked effect on metabolism, particularly glycolysis
affect smooth muscle contractility and modulation of hormonal
if PGs does not rise with LH, ovum remain trapped within graafian follicles.
influence production of estrogen and progesterone by the corpus luteum.
climacteric
transitional phase during which ovarian functions and hormone production decline.
spans the year form onset of premenopausal ovarian decline to the postmenopausal time when symptom stops
Menopause
from Latin mensis, month, and Greek pauses, to cease
refers to last menstrual period
can be dated 1 year after menstruation ceases
average age at natural menopause
51.4 years with an age range of 35 to 60 years
perimenopausal
a period proceeding menopause that last about 4 years.
during this time ovarian functions declines, ova slowly diminish, and menstrual cycles may be anovulatory, resulting in irregular bleeding. the ovary stops producing estrogen, and eventually menses no longer occur.
when do female and males reach physical maturity.
approximately at the age of 17, however individual development varies greatly.
