Ch. 19 The Menstrual Cycle Flashcards
The last menstrual cycle relates to the
onset of menses
The average menstrual cycle lasts ___ days with ovulation occurring on day ___.
28, 14
The first menstrual cycle is termed
menarche
Primary amenorrhea may be caused by congenital abnormalities or congenital obstructions, such as an ______
imperforate hymen
if an individual does not experience menarche before age 16, she is said to have _____
primary amenorrhea
_______may be associated with endocrinologic abnormalities or pregnancy
Secondary amenorrhea
Secondary amenorrhea that is not associated with pregnancy is characteristically diagnosed in the postmenarchal woman who has had ____ to ____months without a menstrual cycle.
3 to 6
The ________is the complex interactions that take place between the hypothalamus, pituitary gland, and ovaries as part of the female reproductive cycle.
hypothalamic–pituitary–gonadal axis
The _______is an area within the brain that is located just beneath the thalamus. The primary responsibility of the ______, as it relates to the menstrual cycle, is to regulate the release of hormones by the anterior pituitary gland.
hypothalamus
the hormone released by the hypothalamus that stimulates the pituitary gland to release the hormones that regulate the female menstrual cycle
gonadotropin-releasing hormone (GnRH)
The pituitary gland, often referred to as the “________,” is an endocrine gland located within the brain that consists of an anterior and a posterior lobe
master gland
The anterior lobe of the pituitary gland is responsible for the release of two chief hormones that influence the menstrual cycle: ____and____(*both act upon the ovaries)
follicle-stimulating hormone (FSH) and luteinizing hormone (LH)
FSH causes the development of multiple_______on the ovaries, whereas LH surges around day 14 of the menstrual cycle, resulting in ______.
follicles; ovulation
The ovaries produce two hormones called
estrogen & progesterone
Estrogen is initially produced by the __________of the secondary follicles during the first part of the menstrual cycle.
theca internal cells
cells of the follicle that produces estrogen
theca internal cells
______ has many other important functions, such as the regeneration of the endometrium after menses and the induction of salt and water retention. It also stimulates contractile motions within the uterine myometrium and the fallopian tubes.
Estrogen
progesterone is produced by the _______ of the ovary
corpus luteum
the temporary endocrine gland that results from the rupture of the Graafian follicle after ovulation
corpus luteum
______responsible for maintaining the thickness of the endometrium and inducing its secretory activity as the endometrium prepares for the possible implantation of a pregnancy.
progesterone
The ovary produces estrogen and progesterone, which influence the _______.
endometrium
The ovarian cycle consists of two phases: the _______ and ______
follicular phase and the luteal phase
The _____of the ovarian cycle is considered to begin on day 1 and lasts until day 14, thus, in effect, ending with ovulation.
follicular phase
During the follicular phase the anterior pituitary gland secretes ___, which initiates the follicular development of the ovary.
FSH
only one follicle will progress from primordial follicle to primary follicle and then to become a secondary follicle. This secondary follicle will eventually mature to become the _______ or dominant follicle before ovulation
Graafian follicle
the structure that contains the developing oocyte
cumulus oophorus
This Graafian follicle, which can grow as large as 2.7 cm, contains the developing oocyte (egg) within a region called the _____
cumulus oophorus
Around day 14, ____, produced by the anterior pituitary gland, stimulates ovulation, at which time the Graafian follicle, which has grown to a size of 15 to 27 mm, ruptures and expels a small amount of fluid and the ovum into the peritoneum. , produced by the anterior pituitary gland, stimulates ovulation, at which time the Graafian follicle, which has grown to a size of 15 to 27 mm, ruptures and expels a small amount of fluid and the ovum into the peritoneum.
LH
At the time of ovulation, the individual may feel a twinge of pain, and this is termed_______
mittelschmerz
the fingerlike extension of the fallopian tube located on the infundibulum
fimbria
The second phase of the ovarian cycle, days 15 to 28, is termed the _____
luteal phase
a temporary structure formed immediately following ovulation as the dominant follicle collapses and fills with blood; after the trauma heals, this becomes the corpus luteum
corpus hemorrhagicum
The corpus hemorrhagicum then rapidly converts into a temporarily endocrine gland in the form of the _____
corpus luteum
The _______, which is literally interpreted “yellow body,” while producing estrogen in small amounts, primarily produces progesterone to maintain the thickness of the endometrium and prepares the endometrium for the (conceivably) fertilized ovum.
corpus luteum
While the corpus luteum depends on LH to be maintained, ________negatively inhibits the production of LH by the anterior pituitary gland, resulting in the regression of the corpus luteum.
progesterone
The remaining structure of the corpus luteum is now termed the _______, which can often be seen sonographically as a small echogenic scar on the ovary.
corpus albicans
during the early follicular phase and late luteal phase, the ovarian artery will demonstrate a ____-resistive pattern, with ______impedance, and _____or low end-diastolic velocity.
high;increased;absent
During the late follicular and early luteal phases, the ovary will demonstrate a ____-resistive pattern, with____impedance and _____ levels of diastolic flow.
low;low;higher
Remember this chain of events: primordial follicle > ______ follicle > secondary follicle > Graafian (dominant) follicle > ______ > corpus hemorrhagicum > corpus luteum > _______
primary;ovulation;corpus albicans
The innermost layer of the endometrium that is stimulated by the hormones of the ovary to undergo changes throughout the menstrual cycle; provides an appropriate location for the implantation of the products of conception
functional layer (stratum funtionale)
The outermost portion of the endometrium consists of dense, cellular stroma slightly altered by the menstrual cycle
basal layer (stratum basale)
The endometrial cycle consists of two phases: the____ and ______
proliferative phase;secretory phase
The proliferative phase occurs ___menstruation and lasts until ovulation.
after
During the first half of the menstrual cycle, the endometrium undergoes thickening as a result of estrogen stimulation. Thus, proliferation of the endometrium, which is described as the multiplication of similar forms, occurs during the ______of the endometrial cycle because the functional layer increases in thickness.
proliferative phase
The proliferative phase may be divided into two phases, early and late, with the late proliferative phase often being referred to as the _______ phase.
periovulatory
The _______of the endometrial cycle occurs after ovulation and is stimulated by progesterone.
secretory phase
Should fertilization not take place, menses begin on day 1 of the cycle, resulting from a lack of _____and______.
estrogen and progesterone
If fertilization does occur, the endometrial thickness is maintained by the continual production of progesterone by the ________of pregnancy
corpus luteum of pregnancy
The ____ phase of the endometrial cycle occurs after menstruation and lasts until ovulation
proliferative (day 1-14)
The ___ phase of the endometrial cycle occurs after ovulation and it stimulated by progesterone
secretory (day 15-28)
the corpus luteum that is maintained during early pregnancy for the purpose of producing estrogen and primarily progesterone
corpus luteum of pregnancy
Mnemonic to recall correlation of the menstrual cycle phases “ovaries freely let every period start”
ovary, follicular, luteal, endometrium, proliferative, secretory
Sonographic appearance of endometrium during menses
thin & echogenic (up to 4mm)
Sonographic appearance of endometrium during early proliferative phase
thickening hypoechoic functional layer (4-8mm)
Sonographic appearance of endometrium during preovulatory (late proliferative phase) (days 5-14)
“three line sign” (6-10mm)
Sonographic appearance of endometrium during secretory phase
thick & echogenic (7-14mm)
Fertilization of conception typically occurs on what day of the menstrual cycle with the union of the egg & sperm in the fallopian tube?
day 15
The thickness measurement of the endometrium obtained with sonography should not include the adjacent hypoechoic ______ and is considered accurate when the double-layer thickness measurement is performed
myometrium
The ______ includes only the distance from basal layer to basal layer. If there is fluid within the endometrium, then the measurement of the two separate layers of the endometrium, excluding the fluid, should be obtained and then added together to obtain the true thickness
double-layer thickness
A difference in frequency, duration and amount of menstrual bleeding is referring to
abnormal uterine bleeding (AUB)
The production of ____ maintains the corpus luteum. Thus, ____ allows the corpus luteum to continue to produce estrogen and progesterone, which, in turn, maintains the thickness of the endometrium so that implantation can take place and the pregnancy can continue to progress normally
hCG
The cells that surround the blastocyst, the syncytiotrophoblastic cells (trophoblastic cells), then begin to produce __________
human chorionic gonadotropin (hCG)
the stage at which the conceptus implants within the decidualized endometrium
blastocyst
the trophoblastic cells surrounding the blastocyst that are responsible for producing human chorionic gonadotropin
syncytiotrophoblastic cells
the hormone produced by the trophoblastic cells of the early placenta; may also be used as a tumor marker in nongravid patients and males
human chorionic gonadotropin (hCG)
Measurement of the endometrium should be from ____ layer to ______ layer.
basal;basal
One of the more common suspicious pathologies that results in AUB is the presence of fibroid tumors or ______within or abutting the uterine cavity.
leiomyomas
Causes of AUB:
Uterine fibroids (leiomyoma)
Adenomyosis
Cervical polyps
Endometrial polyps
Endometrial hyperplasia
Endometrial cancer
Hypothyroidism
Anovulation
Iatrogenic
Ovulatory dysfunction
Coagulopathy
abnormal uterine bleeding
a condition that is the result of medical treatment; may be due to exposure to a pathogen, toxin, or injury following a treatment or procedure
Iatrogenic
blood clotting disorders
Coagulopathy
Absence of menstruation; can be classified as either primary amenorrhea or secondary amenorrhea
Amenorrhea
Monthly symptoms of menstruation without bleeding
Cryptomenorrhea
Painful or difficult menstruation
Dysmenorrhea
Abnormally heavy and prolonged menstruation
Menorrhagia (hypermenorrhea)
Irregular menstrual bleeding between periods
Metrorrhagia (intermenstrual bleeding)
Excessive or prolonged bleeding at irregular intervals
Menometrorrhagia
Irregular cycles >35 days apart
Oligomenorrhea
Frequent regular cycles but <21 days apart
Polymenorrhea
Regularly timed menses but light flow
Hypomenorrhea
What hormone stimulates the contractile motion within the uterine myometrium?
Estrogen
